Operation Manual PDF CT Scan Electromagneti 34

Suche
Operation Manual
Jetzt herunterladen !
Hochgeladen von Bayarkhuu Sukhbaatar
" 0 Bewertungen · 63 Ansichten · 492 Seiten

Dokumentinformationen #
Originaltitel
Operation Manual.pdf
Jetzt herunterladen !
Copyright
© © All Rights Reserved
Verfügbare Formate English
PDF, TXT oder online auf Scribd lesen
Dieses Dokument teilen
Facebook Twitter
$ Instr uctions for U se
E-Mail
Brilliance CT
Stufen Sie dieses
Volume 1 Dokument als nützlich ein?
4535 674 34601_C
Sind diese Inhalte unangemessen? Dieses Dokument melden

PHILIPS
Verbessern Sie Ihre Erfahrung &

Die Bewertung hilU uns, allen unseren
Lesern noch bessere Dokumente
anzubieten!
" Nützlich
% Nicht
nützlich
Contents
1 Introduction ..................................................................................... 1-1
1.1 About this guide ...................................................................................1-1

1.2 Intended use .........................................................................................1-4
1.3 Contraindications .................................................................................1-5
1.4 Compatibility .......................................................................................1-5
1.5 Compliance ..........................................................................................1-6
1.6 IEC-60601 classification .......................................................................1-8
1.7 Electromagnetic emissions ....................................................................1-9
1.8 Electromagnetic immunity..................................................................1-10
1.9 Electrical ratings .................................................................................1-12
1.10 Training..............................................................................................1-13
C
_
1
0
6
2 Safety................................................................................................2-1
4
3
4
7
2.1 Important safety directions ...................................................................2-1
6
5
3
2.2 Emergency procedures ..........................................................................2-4
5
4
s
2.3 Electrical safety and grounding .............................................................2-7
m
t
e
s
2.4 Mechanical safety..................................................................................2-7
y
S
l
a
2.5 Explosion safety ....................................................................................2-8
ic
d
e
2.6 Implosion hazard ..................................................................................2-8
M
s
p
2.7 Fire safety .............................................................................................2-8
lii
h
P
2.8 Electromagnetic compatibility ..............................................................2-9
2.9 Radiation safety ..................................................................................2-11
Brilliance CT- Volume 1 Contents i
2.10 Oil leaks .............................................................................................2-13

2.11 Laser safety .........................................................................................2-14
2.12 Protection measures ............................................................................ 2-15
3 Security of system and data............................................................. 3-1
3.1 Regulatory controls...............................................................................3-2

3.2 Security issues and guidelines................................................................ 3-3
4 Image performance quality assurance ............................................. 4-1
4.1 Overview ..............................................................................................4-1

4.2 Head & body system performance phantom......................................... 4-2
4.3 Schedule of quality assurance checks ..................................................... 4-8
4.4 Monthly checks ..................................................................................4-13
4.5 Advanced quality assurance checks......................................................4-16
4.6 Infant phantom testing (option) ......................................................... 4-25
5 System description........................................................................... 5-1
5.1 Operating station.................................................................................. 5-2

5.2 Gantry and patient table ....................................................................... 5-7
5.3 Gantry panels ....................................................................................... 5-8
5.4 Patient table........................................................................................5-12
5.5 Patient supports (positioning aids)...................................................... 5-17
5.6 X-Ray and detection systems............................................................... 5-21
5.7 Scanner connectivity options .............................................................. 5-22
5.8 Direct HIS-RIS connection ................................................................ 5-24
5.9 Bar code reader (optional) .................................................................. 5-25
5.10 Extended Brilliance Workspace (optional) ..........................................5-26
ii Contents Brilliance CT - Volume 1
5.11 NetForum ..........................................................................................5-26

5.12 Remote service....................................................................................5-26
6 Navigating the software ...................................................................6-1
6.1 Overview ..............................................................................................6-1

6.2 Workspace ............................................................................................6-2
6.3 Main area............................................................................................6-12
7 Scanner operation ............................................................................7-1
7.1 Overview ..............................................................................................7-1

7.2 Scanner start-up....................................................................................7-2
7.3 Tube conditioning ................................................................................7-4
7.4 Air calibration .......................................................................................7-5
7.5 System shutdown ..................................................................................7-7
7.6 Operating the gantry tilt and table ........................................................7-9
C
1
_ 7.7 Scan procedure....................................................................................7-16
0
6
4
3
7.8 Patient data options ............................................................................7-37
4
7
6
7.9 Change patient name ..........................................................................7-44
5
3
5
7.10 Surview scan (for plan on Surview) .....................................................7-46
4
s 7.11 Patient centering.................................................................................7-47
m
e
t 7.12 Plan on Surview ..................................................................................7-50
s
y
S
l 7.13 Dual Surview ......................................................................................7-54
a
ic
d
e 7.14 Multi Surview .....................................................................................7-55
M
s
p
lii
7.15 Organ ID ............................................................................................7-56
h
P 7.16 Voice manager ....................................................................................7-58
7.17 Continue current study.......................................................................7-61
7.18 Split study...........................................................................................7-62
Brilliance CT - Volume 1 Contents iii
7.19 Create Dose Summary Image ............................................................. 7-64

8 Scan protocols.................................................................................. 8-1
8.1 Overview ..............................................................................................8-1

8.2 Scan protocol parameter tabs ................................................................ 8-2
8.3 Cardiac options..................................................................................... 8-6
8.4 Pulmonary options ............................................................................... 8-8
8.5 CCT (Interventional) ........................................................................... 8-9
8.6 Surview............................................................................................... 8-10
8.7 Common protocol parameters ............................................................ 8-11
8.8 Axial scan parameters.......................................................................... 8-22
8.9 Helix scan parameters ......................................................................... 8-26
8.10 Injection .............................................................................................8-30
8.11 Filters ................................................................................................. 8-32
8.12 Generate protocol ............................................................................... 8-35
9 Optimized protocol selection .......................................................... 9-1
9.1 Classifying protocols ............................................................................. 9-2

9.2 Editing requested procedure & physician lists....................................... 9-9
9.3 Turning on optimized protocols .........................................................9-11
10 Step & Shoot Cardiac (option) ...................................................... 10-1
10.1 Introduction....................................................................................... 10-1

10.2 Overview of Step & Shoot Cardiac exam............................................ 10-5
10.3 Pre-scan preparation ........................................................................... 10-6
10.4 Begin the Step & Shoot Cardiac scan process ................................... 10-12
10.5 The Tracker line ....................................... ........................................ 10-21
iv Contents Brilliance CT - Volume 1
10.6 Start planning the Step & Shoot scan ...............................................10-23

10.7 Prepare for Step & Shoot scanning sequence.....................................10-34
10.8 The automatic Step & Shoot Cardiac scan........................................10-39
10.9 Evolving mode ..................................................................................10-40
10.10After reconstruction is complete........................................................10-42
10.11ECG editing .....................................................................................10-44
10.12Reconstruction using Re-recon and Offline recon.............................10-46
11 Bolus tracking................................................................................. 11-1
11.1 Overview ............................................................................................11-1

11.2 Bolus tracking scan series ....................................................................11-5
11.3 Executing Bolus tracking...................................................................11-11
11.4 Generate a bolus scan........................................................................11-16
12 Continuous CT (option) ................................................................. 12-1
C
1
_ 12.1 General...............................................................................................12-1
0
6
4
3
12.2 Principles of operation ........................................................................12-2
4
7
6
12.3 Safety instructions for CCT accessories ...............................................12-4
5
3
5
12.4 Preparations for biopsy........................................................................12-6
4
s 12.5 CCT scan parameters..........................................................................12-7
m
e
t 12.6 CCT reconstruction parameters........................................................12-10
s
y
S
l 12.7 Starting the biopsy procedure............................................................12-11
a
ic
d
e 12.8 Scattered radiation information.........................................................12-15
M
s
ilp 12.9 Generate a CCT protocol .................................................................12-16
i
h
P
13 DoseRight ....................................................................................... 13-1
13.1 Overview ............................................................................................13-1
Brilliance CT - Volume 1 Contents v
13.2 D-DOM (angular modulation)........................................................... 13-2

13.3 Z-DOM (longitudinal modulation).................................................... 13-4
13.4 DoseRight (automatic current selection).............................................13-5
13.5 Enable DoseRight ACS....................................................................... 13-6
13.6 Set DoseRight standards .....................................................................13-8
13.7 Overriding DoseRight ACS .............................................................. 13-10
13.8 General rules for DoseRight.............................................................. 13-11
14 Pulmonary gating (option) ............................................................. 14-1
14.1 Overview ............................................................................................14-1

14.2 Setting the sensor device preference .................................................... 14-3
14.3 Generating pulmonary protocols ........................................................ 14-4
14.4 Respiratory signal viewer (online) ....................................................... 14-6
14.5 Respiratory signal viewer (offline) .......................................................14-8
14.6 Respiratory Correlated Imaging ........................................................14-14
15 Jog (option) .................................................................................... 15-1
15.1 Axial jog .............................................................................................15-2

15.2 Helical mode ...................................................................................... 15-3
15.3 Scan procedure ................................................................................... 15-4
15.4 Generate a jog protocol.......................................................................15-5
16 Image reconstruction..................................................................... 16-1
16.1 Overview ............................................................................................16-1

16.2 Online recon.......................................................................................16-3
16.3 Offline reconstruction......................................................................... 16-4
16.4 Axial reconstruction parameters ..........................................................16-7
vi Contents Brilliance CT - Volume 1
16.5 Helical reconstruction parameters .......................................................16-8

17 Filming............................................................................................17-1
17.1 Overview ............................................................................................17-1

17.2 Filming window..................................................................................17-2
17.3 Toolbar...............................................................................................17-4
17.4 Film images.........................................................................................17-5
17.5 Print film (with and without delete)....................................................17-7
17.6 Modifying film parameters..................................................................17-9
17.7 Image manipulations.........................................................................17-10
18 Directory ........................................................................................ 18-1
18.1 Directory window ...............................................................................18-2

18.2 States (bookmarks)............................................................................18-13
18.3 Sub selection .....................................................................................18-15
C
1
_ 18.4 Preferences utility..............................................................................18-22
0
6
4
3
18.5 Image browser...................................................................................18-31
4
7
6
18.6 CD and DVD: Removable-media storage .........................................18-34
5
3
5
18.7 The CD-R device..............................................................................18-36
4
s 18.8 DVD-RAM device............................................................................18-41
m
e
t 18.9 Using storage devices ........................................................................18-47
s
y
S
l 18.10Queue manager.................................................................................18-49
a
ic
d
e 18.11Delete images....................................................................................18-51
M
s
p
lii 19 User information ............................................................................ 19-1
h
P
19.1 Technique factors-maximum deviations .............................................19-1
19.2 Gantry laser alignment lights...............................................................19-2
Brilliance CT - Volume 1 Contents vii
19.3 Preventive maintenance ...................................................................... 19-3

19.4 Cleaning the system............................................................................ 19-3
19.5 X-Ray system specifications ................................................................ 19-4
19.6 User’s dose and imaging information.................................................. 19-9
19.7 Head scan information .....................................................................19-15
19.8 Body scan information......................................................................19-21
19.9 IEC stray radiation dose map............................................................ 19-29
viii Contents Brilliance CT - Volume 1
Über 1 Million zufriedene Mitglieder
Probieren Sie Scribd KOSTENLOS für 30 Tage

aus, um ohne Werbung oder Unterbrechungen
auf über 125 Millionen Titel zuzugreifen!
Gratis-Testversion starten
Jederzeit kündigen.
1 Introduction
The Philips CT systems are advanced continuous-rotation computed

tomography systems suitable for a wide range of computed tomographic
(CT) applications.
1.1 About this guide

This manual is intended to assist users and operators in the safe and
effective operation of the equipment described. It covers the information
needed for your CT scanner.
• The “user” is considered to be the body with authority over the
equipment.
• The “operators” are those persons who actually handle the equipment.
C
_
Before attempting to operate the equipment, you must read, note, and
1
0
6
strictly observe all DANGER notices and safety markings on the CT
4
3 System.
4
7
6 Before attempting to operate the equipment, you must read this manual
5
3
5
4
thoroughly, paying particular attention to all Warnings, Cautions and
s Notes incorporated in it. You must pay special attention to all the
m
e information given and procedures described in the SAFETY section.
t
s
y
S
l
a
ic
d
e
M
s Warning Directions, which if not followed, could cause fatal or serious injury to an
p
lii
h operator, patient or any other person, or could lead to a misdiagnosis or
P
mistreatment.
Brilliance CT - Volume 1 Introduction 1-1
1.1 About this guide
Caution Directions, which if not followed, could cause damage to the equipment
described in this Instructions for Use and/or any other equipment or goods,
and/or cause environmental pollution.
Note Highlight unusual points as an aid to an operator.
Within this Instructions for Use, the most extensive configuration of the
system is described, with the maximum number of options and accessories.
Not every function described may be available on your system.
The documentation for the Brilliance CT system is supplied in these
volumes:
Volume 1 - Instructions for Use
This volume explains how to use the CT scanning system. It also contains
information about safety, data security, system start-up, software
navigation, scanning protocols, networking, and calibration.
Volume 2 - Review
This volume explains how to use the various image viewers supplied with
the system. Also included in this volume are instructions on how to use the
reporting option, and how to use graphic tools for annotating studies and
making basic measurements.
Volume 3 - Analysis
This volume explains how to use the non-cardiac analysis applications, such
as, liver and brain perfusion, angiography, dental planning, lung studies,
and virtual colonoscopy.
Volume 4 - Cardiac
This volume explains how to use the cardiac applications, including the
cardiac and pulmonary viewers.
1-2 Introduction Brilliance CT - Volume 1
About this guide 1.1
This Instructions for Use was originally drafted, approved, and supplied by
Philips Medical Systems (Cleveland), in the English language under the
product part code 4535 674 36701.
C
_
1
0
6
4
3
4
7
6
5
3
5
4
s
m
e
t
s
y
S
l
a
ic
d
e
M
s
p
lii
h
P
1.2 Intended use
1.2 Intended use

The Philips CT system is intended to be used and operated only in
accordance with the safety procedures and operating instructions given in
this Instructions for Use for the purpose for which it was designed. The
purpose for which the equipment is intended is given below. However,
nothing stated in this Instructions for Use reduces user’s and operator’s
responsibilities for sound clinical judgement and best clinical procedure.
The CT system is intended for use as a diagnostic patient imaging device
that produces images that correspond to tissue density. The quality of the
images depends on the level and amount of X-ray energy delivered to the
tissue. CT imaging displays both high-density tissue, such as bone, and soft
tissue. When interpreted by a trained physician, CT images yield useful
diagnostic information. They system is intended for use in the head and
whole body.
Use and operation of this equipment is subject to the law in the
jurisdiction(s) in which the equipment is being used. Both users and
operators must only use and operate the equipment in such ways as do not
conflict with applicable laws, or regulations which have the force of law.
Caution In the United States, Federal law restricts this device to sale, distribution,
and use by or on the order of a physician.
Note Equipment described in this manual is designed to be compatible with PMS

products. It is designed to operate according to recognized and accepted
compatibility standards. The equipment produces images which may be
transferred by the user to other non-PMS workstations by a network or
other means. When doing so, the user or manufacturer of that workstation
has the responsibility to validate that images are correctly transferred and
displayed under all conditions of use. Use of incompatible equipment may
result in the incorrect transfer, display, or other processing of the data.
C ontraindications 1.3
1.3 Contraindications
The Philips systems should not be used if any of the following
contraindications exist or are thought to exist.
• The image performance quality assurance checks listed under the
heading, Maintenance, have not been satisfactorily completed.
• The preventative maintenance program is not up-to-date.
• If any part of the equipment or system is known
(or suspected to be) operating improperly.
1.4 Compatibility
Equipment described in this manual should not be used in combination
with other equipment or components unless such other equipment or
components are recognized as compatible.
C
Changes and/or additions to the equipment should only be carried out by
_
1
0
Philips Medical Systems or by third parties expressly authorized by Philips
6
4
3
Medical Systems to do so. Such changes and/or additions must comply
4
7 with all applicable laws and regulations that have the force of law within the
6
5 jurisdiction(s) concerned, and with best engineering practice.
3
5
4
s
Changes and/or additions to the equipment that are carried out by persons
m
t
e without the appropriate training and/or using unapproved spare parts may
s
S
y lead to the PMS warranty being voided. As with all complex technical
l
ic
a equipment, maintenance by persons not appropriately qualified and/or
d
e using unapproved spare parts carries serious risks of damage to the
M
s equipment and of personal injury.
ilp
i
h
P
1.5 Compliance
1.5 Compliance
The Philips Brilliance CT system complies with relevant international and
national standards and laws. Information on compliance will be supplied
on request by your local PMS representative, or by:
Philips Medical Systems
PO Box 10 000
5680 DA BEST
The Netherlands
Facsimile: +31 40 276 2205
The Philips systems comply with relevant international and national laws
and standards on EMC (electro-magnetic compatibility) for this type of
equipment when used as intended. Such laws and standards define both the
permissible electromagnetic emission levels from equipment and its
required immunity to electromagnetic interference from external sources.
The Maintenance schedule identifies the procedures and frequency of their

performance, which is necessary to ensure (continued) compliance with the
Federal Performance Standards for Diagnostics X-Ray Equipment, 21
CFR Subchapter J, Radiological Health Section 1020.30 and 1020.33.
This symbol appears on components on your CT scanner system. It

indicates separate collection for electrical and electronic equipment in
compliance with the Waste Electrical and Electronic Equipment (WEEE)
Directive. Please dispose of the system in accordance with your local
regulations.
California
In compliance with California’s Best Management Practices for Perchlorate
Materials (California Code of Regulations, title 22, division 4.5, chapter
33, article 1), the following warning applies to all Philips Medical Systems
Compliance 1.5
Brilliance CT scanners and workstations due to Panasonic CR (button)

batteries that are mounted on printed circuit boards in various parts of the
system:
Warning Perchlorate Material – special handling may apply. For more information,
see www.dtsc.ca.gov/hazardouswaste/perchlorate/index.cfm.
Vermont
In compliance with the labeling requirements of the Vermont labeling law
V.S.A. 10, Chapter 159, §6621(d) and Section 6-803 of the Vermont Solid
Waste Management Rules, this product consists of devices that may contain
mercury, which must be recycled or disposed of in accordance with local,
state, or federal laws. (Within this system, the backlight lamps in the
monitor contain mercury.)
C
_
1
0
6
4
3
4
7
6
5
3
5
4
s
m
e
t
s
y
S
l
a
ic
d
e
M
s
p
lii
h
P
1.6 IEC-60601 classification
1.6 IEC-60601 classification

Type of protection against electric shock Class I equipment
Degree o f protection against electric shock Type B equipment
Degree of protection against harmful Ordinary equipment

ingress of water
Possible inter ference with ot her equipment IEC 60601-1-2 Group 1 Class A
Device for Radiated Emission
Mode of operation Continuous mode with short

time loading
Electromagnetic emissions 1.7
1.7 Electromagnetic emissions

The Brilliance CT scanner is equipped for use in the electromagnetic
environment specified below. Your facility should ensure that the system is
placed in an environment that meets these conditions.
Emissions test Compliance Electromagnetic environment - guidance
RF emissions, CISPR 11 Group1 Class A Brilliance CT uses RF energy only for internal
function. Ther efore, its RF emissions are ver y low
and not likely to cause any interference in nearby
electronic equipment.
Harmonic Emissions
No t Applicable The Brilliance CT is suitable fro use in all
IEC 61000-3-2 establishments ot her than domestic and those
Voltage fluctuations/flicker directly connected to the public low-voltage power
emissions supply network that supplies buildings used for

No t Applicable
domestic purposes.
IEC 61000-3-3
C
_
1
0
6
4
3
4
7
6
5
3
5
4
s
m
e
t
s
y
S
l
a
ic
d
e
M
s
ilp
i
h
P
1.8 Electromagnetic immunity
1.8 Electromagnetic immunity

The Brilliance CT scanner is equipped for use in the electromagnetic
environment specified below. Your facility should ensure that the system is
placed in an environment that meets these conditions.
Electromagnetic
Immunity Test IEC 60601 test level Compliance level
environment-guidance
Conducted RF 3 Vrms 3 Vrms O nly tho se cables supplied

IEC 61000-4-6 150 kHz to 80 MHz on a.c. power and with the Brilliance CT
signal ports system should be used.
150 kHz to 80 MHz
Radiated RF 3 V/m 3 V/m See Note 2 below

IEC 61000-4-3 80 MHz to 2.5 GHz 80 MHz to 2.5 GHz Interference may occur in
the vicinity of equipment
marked with the following
symbol:
Note 1 These guidelines may not apply in all situations. Electromagnetic propagation is affected
by absorpt ion and re flection fro m str uctures, objects and peo ple.
Note 2 the Brilliance CT has not been tested for radiated RF immunity over the entire frequency
range of 80 MHz to 2.5 GHz. It was step tested at the selected frequencies 40.66 to 40.7, 50.26,
76.25, 133.15, 144.47, 433.05 to 434.78, 439.30, 524, 534, 546, 548, 661, 751, 806, 833.5, 881,
902 to 928, 1279.23, 1800 and 2400 to 2500 MHz respectively, at a minimum of 3V/m field
strength. Test signal was 80% modulated AM, at 2Hz and 1000 Hz modulation frequencies.
Note 3 Only the equipment specified in the Brilliance CT Installation Manual may be used inside
the gantry and patient t able ro om.

anzubieten!
" Nützlich
% Nicht
nützlich
Electromagnetic immunity 1.8
Immunity IEC 60601 Compliance Electromagnetic environment-

Test test level level guidance
Electrostatic ±6 kV contact ±6 kV contact Floors should be wood, concrete or

discharge (ESD) ±8 kV air ±8 kV air ceramic tile. If the floors are covered
IEC 61000-4-2 with synthetic mater ial, the r elative
humidity should be at least 35% non-
conde nsing per the Brilliance C T
planning reference data (PRD).
Electr ical fast ±2 kV for power ±2 kV for power Main’s power quality must comply with
transient/burst supply lines mains input the Brilliance CT planning reference
IEC 61000-4-4 ±1 kV for ±1 kV for signal data (PRD).
input/output lines por ts
Surge ±1 kV differential ±1 kV differential Main’s power quality must comply with

IEC 61000-4-5 ±2 kV common ±2 kV common the Brilliance CT planning reference
mode mode data (PRD).
Voltage dips, No t Applicable Main’s power quality must comply with

short the Brilliance CT planning reference
C
_
1 interruptions data (PRD).
0
6
4 and voltage
3
4 variations on If the user of the Brilliance CT requires
7
6
5 power supply continued o peration during power
3
5 input lines mains interruptions, it is recommended
4
s IEC 61000-4-11 that the Brilliance CT be powered from
m
e
t an uninterruptible power supply.
s
y
S
l
a Power 3 A/m 3 A/m, Power frequency magnetic fields should
ic
d frequency 50/60 Hz be at levels character istic of a typical
e
M
s (50/60 Hz) location in a t ypical commercial or
ilp
i magnetic field hospital environment.
h
P
IEC 61000-4-8
1.9 Electrical ratings
1.9 Electrical ratings
Voltage Phase Frequency Power consumption (KVA)

(VAC) (Hz)
Continuous Short time
200 3 50/60 8 80
208 3 50/60 8 80
240 3 50/60 8 80
380 3 50/60 8 80
400 3 50/60 8 80
415 3 50/60 8 80
440 3 50/60 8 80
480 3 50/60 8 80
500 3 50/60 8 80
Training 1.10
1.10 Training
Operators of the Philips Brilliance CT system must have received adequate
training on its safe and effective use before attempting to operate the equipment
described in this Instructions for Use. Users must also ensure that operators
receive adequate training in accordance with local laws or regulations which
have the force of law.
If you require further information about training in the use of this equipment,
please contact your local Philips Medical Systems representative. Alternatively,
contact:
Philips Medical Systems
PO Box 10 000
5680 DA BEST
The Netherlands
Facsimile: +31 40 276 2205
C
_
1
0
6
4
3
4
7
6
5
3
5
4
s
m
e
t
s
y
S
l
a
ic
d
e
M
s
p
lii
h
P
2 Safety
2.1 Important safety directions

Philips Medical Systems products are all designed to meet stringent safety
standards. However, all medical electrical equipment requires proper
operation and maintenance, particularly with regard to human safety.
It is vital that you read, note, and where applicable, strictly observe all
DANGER notices and safety markings on the Brilliance CT system.
It is vital that you follow strictly all safety directions under the heading
Safety and all Warnings and Cautions throughout thisInstructions for Use
to help ensure the safety of both patients and operators.
In particular, you must read, understand and know the Emergency
Procedures described in this Safety section before attempting to use the
equipment for any patient examination.
C
_
1 You should also note the following information given in the Introduction
0
6
4 section of this Instructions for Use:
3
4
7 • intended use of the Philips Brilliance CT system
6
5
3
5 • contra-indications
4
s • training for operators of the Philips Brilliance CT system
m
e
t
s
y
S
l
a
ic
d
e Warning The X-ray unit may be dangerous to patient and operator unless safe
M
s exposure factors, operating instructions, and maintenance schedules are
p
lii
h observed.
P
Brilliance CT - Volume 1 Safety 2-1
2.1 Important safety directions
Warning Do not use the Brilliance CT system for any application until you are sure
that the Image Performance Quality Assurance has been satisfactorily
completed, and that the Preventative Maintenance Program is up to date. If
any part of the equipment or system is known (or suspected) to be
operating improperly or wrongly-adjusted, DO NOT USE the system until a
repair has been made.
Warning Operation of the equipment or system with improperly-operating or

wrongly-adjusted components could expose the operator or the patient
safety hazards. This could lead to fatal or other serious personal injury.
You can find information about the Image Performance Quality Assurance
and the Preventative Maintenance Program in the Maintenance section of
this Instructions for Use.
Warning Do not use the Brilliance CT system for any application until you have read,
understood and know all the safety information, safety procedures and
emergency procedures contained in this SAFET Y section. Operation of the
Brilliance CT system without a proper awareness of how to use it safely
could lead to fatal or other serious personal injury.
Warning Do not use the Brilliance CT system for any application until you have
received adequate and proper training in its safe and effective operation. If
you are unsure of your ability to operate this equipment safely and
effectively DO NOT USE IT. Operation of this equipment without proper
and adequate training could lead to fatal or other serious personal injury. It
could also lead to clinical misdiagnosis.
2-2 Safety Brilliance CT - Volume 1
Important safety directions 2.1
For information about training, please refer to Training in the

Introduction section of this Instructions for Use.
Warning Never attempt to remove, modify, over-ride or forcibly move any safety
device on the equipment. Interfering with safety devices could lead to fatal
or other serious personal injury.
Warning Do not use the Brilliance CT system for any purpose other than those for
which it is intended. Operation of the Brilliance CT system for unintended
purposes, or with incompatible equipment, could lead to fatal or other
serious injury. It could also lead to clinical misdiagnosis.
Intended use of the Brilliance CT system is described under the heading

Intended Use in the Introduction section of this Instructions for Use.
Compatibility is discussed under the heading Compatibility in the
Introduction section of this Instructions for Use.
C
_
1
0
6
4
3
4
7
6
5
3
5
4
s
m
e
t
s
y
S
l
a
ic
d
e
M
s
p
lii
h
P
2.2 Emergency procedures
2.2.1 Emergency stop

To bring scanner and Patient table movements and X-ray production to an
immediate halt, press one of the red Stop buttons. One button is located on
the Scan control box, and one on each gantry control panel.
2.2.2 Reset from emergency stop

Use this procedure to reset from emergency stop:
1 Locate the button that was pressed to initiate the stop.
2 Turn the button until it disengages from the stop position and returns
to its original position.
3 Turn the key on the scan control box.
Warning After the Stop button is pressed, the table is locked in place for two
seconds. Then it will be free floating with no up/down capabilities. Make
sure that you maintain control of the table so that it does not move.
Warning During all movements of the gantry (automatic and manual) and the
patient table, keep the patient under continuous observation to avoid
pressing the patient against the gantry or between table parts, as well as to
avoid disconnecting any infusion or resuscitation apparatus.
Emergency procedures 2.2
Warning Make sure that the motion of the table is in the direction that will ensure
that the patient can be easily released and will not get pressed against the
gantry covers.
2.2.3 Emergency patient release

If the patient’s head is lying on one side of the gantry opening and the
trunk and legs are lying on the other side of the opening, the patient should
be released in the direction of the legs.
If the head is likely to touch the roof of the gantry opening, lower the head
by removing the head support or the pillow, and turn the head to the side
before moving the patient table.
To release the patient in the event of a power failure or in an emergency
stop situation, use one of the following procedures:
C
_
Pulling the patient out
1
0
6
4
1 Grasp the handle at the end of the patient table.
3
4
7
6
2 If the patient can safely be pulled out, pull the patient table out.
5
3
5 3 Help the patient dismount.
4
s
m
e
t
s
y Pushing patient in
S
l
a
ic 1 Grasp the handle at the end of the patient table.
d
e
M
s
2 If the patient can be safely pushed in, push the patient table towards the
ilp back of the gantry.
i
h
P
3 Help the patient dismount.
Note In the event of a power failure or an emergency stop, it is impossible to

move the elevator of the patient table down. Therefore, it would be
advisable to keep a stool or stepladder on hand.

Electrical safety and grounding 2.3
2.3 Electrical safety and grounding
Warning Do not remove covers or cables from this equipment. High electrical
voltages are present within this equipment. Removing covers or cables
could lead to serious or fatal personal injury.
Covers or cables should only be removed by qualified and authorized

service personnel.
Only use this equipment in rooms or areas that comply with all applicable
laws (or regulations have the force of law) concerning electrical safety for
this type of equipment.
The equipment must be grounded to an earth ground by a separate
conductor. The neutral side of the line is not to be considered the earth
ground. On equipment provided with a line cord, the equipment must be
connected to a properly grounded, three-pin receptacle. Do not use a three-
to-two pin adapter.
C
_
1
0
6
4
2.4 Mechanical safety
3
4
7
6
5
3
5
4
s Warning Do not remove covers from this equipment. Removing covers could lead to
m
e
t serious or fatal personal injury.
s
y
S
l
ic
a Covers should only be removed by qualified and authorized service
d
e personnel.
M
s
p
lii
h
P
2.5 Explosion safety
2.5 Explosion safety

This equipment must not be used in the presence of explosive gases or
vapors, such as certain anaesthetic gases. Use of electrical equipment in an
environment for which it was not designed can lead to fire or explosion.
Warning Flammable or potentially explosive disinfecting sprays must not be used,

since the resultant vapor could ignite, causing fatal or other serious
personal injury and/or damage to equipment.
2.6 Implosion hazard
Warning Do not subject the system to serious mechanical shock, as the cathode ray
tube (CRT) can fracture if struck or jarred. This may result in flying pieces
of glass and phosphor coating that can cause serious injury.
2.7 Fire safety

Use of electrical equipment in an environment for which it was not
designed can lead to fire or explosion.
Conductive fluids that seep into the active circuit components of the
operator’s console may cause short circuits that can result in electrical fires.
Therefore, do not place any liquid or food on any part of the consoles or
other modules of the system.
Electromagnetic compatibility 2.8
Fire regulations for the type of medical area being used should be fully
applied, observed and enforced. Fire extinguishers should be provided for
both electrical and non-electrical fires.
All operators of this medical electrical equipment should be fully aware of
and trained in the use of fire extinguishers and other fire-fighting
equipment, and in local fire procedures.
Warning Only use extinguishers on electrical or chemical fires which are specifically
labelled for those purposes. Using water or other liquids on an electrical fire
can lead to fatal or other serious personal injury.
If it is safe to do so, attempt to isolate the equipment from electrical and

other supplies before attempting to fight a fire. This will reduce the risk of
electric shocks.
2.8 Electromagnetic compatibility
C
_
1
0
The Philips Brilliance CT system complies with the requirements of
6
4
3
applicable EMC standards (Refer to chapter 1 in this volume, sections 1.7
4 and 1.8).
7
6
5
3
5
4
s
m
e
t
2.8.1 Mobile telephones & similar products
s
y
S
l
Other electronic equipment exceeding the limits defined in such EMC
a
ic
d
standards, such as certain mobile telephones, could affect the operation of
e
M the Brilliance CT system.
s
ilp
i
h
P
2.8 Electromagnetic compatibility
Warning You should not allow portable radio transmitting devices (such as mobile
telephones) into the examination room - whether switched on or off. Such
devices could exceed EMC radiation standards could interfere with the
proper functioning of the Brilliance CT system. This could, in extreme
cases, lead to fatal or other serious personal injury or to clinical
misdiagnosis.
2.8.2 Electronic and Implanted Stimulators

Emissions from the CT system may affect other electronic equipment that
does not meet the EMC immunity limits
Caution Interference with electronic and implanted neural stimulators has been
observed during CT scanning, causing patient discomfort. Consider turning
off or disabling these devices while the patient is scanned.
Radiation safety 2.9
2.9 Radiation safety

X-ray and gamma rays are dangerous to both operator and others in the
vicinity unless established safe exposure procedures are strictly observed.
The useful and scattered beams can produce serious or fatal bodily injuries
to patients and persons in the surrounding area if used by an unskilled
operator. Adequate precautions must always be taken to avoid exposure to
the useful beam, as well as to leakage radiation from within the source
housing or to scattered radiation resulting from passage of radiation
through matter.
Those authorized to operate, participate in or supervise the operation of the
equipment must be thoroughly familiar and comply completely with the
current established safe exposure factors and procedures described in
publications, such as the “Diagnostic X-ray systems and their major
components,” section of subchapter J of Title 21 of the Code of Federal
Regulations, and the National Council on Radiation Protection (NCRP)
No. 102, “Medical X-ray and gamma ray protection for energies up to 10
MEV equipment design and use,” as revised or replaced in the future.
C Operators are strongly urged to comply with the current recommendations
_
1
0 of the International Commission on Radiological Protection, or in Japan,
6
4
3 the Medical Law and its enhanced regulations, or in the United States, with
4 those of the US National Council for Radiological Protection.
7
6
5 • ICRP, Pergamon Press, Oxford, New York, Beijing, Frankfurt, Sao
3
5
4 Paulo, Sydney, Tokyo, Toronto
s
m • NCRP, Suite 800, 7910 Woodmont Avenue, Bethesda, Maryland
e
t
s
S
y 20814, USA
l
a
ic Individuals responsible for the planning of X-ray and gamma ray
d
e
M equipment installations must be thoroughly familiar and comply
s
p
lii completely with NCRP No. 49, “Structural shielding design and evaluation
h
P for Medical of X-rays and gamma rays of energies up to 10 MEV,” as
revised and replaced in the future.
2.9 Radiation safety
In Japan, users should refer to Medical Law and its enhanced regulations,
Laws Concerning the Prevention from Radiation Hazards due to
Radioisotopes and Others and its enhancement regulations, Industrial
safety and Health Law, Laws Concerning the Prevention from Electrical
Dissociation Radiation Hazards, Ordinance by Local Government on Fire
Prevention and Dangerous Article.
Failure to observe these warnings may cause serious or fatal bodily injuries
to the operator or those in the area.
2.9.1 Radiation warning lamps

The radiation warning lamps on the gantry panels, on the scan control
panel, as well as site radiation warning lamps, must light up if scanning has
been triggered.
If a radiation warning lamp does not light up:
• Shut down the system immediately and contact Customer Service.
• Press the Emergency Stop button if there is danger to you or the
patient.
2.9.2 Installation and environment

Except for installations requiring certification by the manufacturer per
United States Federal Performance Standard, see that a radiation protection
survey is made by a qualified expert in accordance with NCRP 012, Section
7, as revised or replaced in the future.
Perform a survey after every change in equipment, workload or operating
conditions which might significantly increase the probability of persons
receiving more than the maximum permissible dose equivalent. In Japan,
report the installation to the Competent Authority.
Oil leaks 2.10
2.10 Oil leaks

The x-ray tube and high-voltage generator are cooled by oil. This is a
closed-circuit system that is sealed.
Caution If oil leaks are detected, shut down the scanner and immediately contact
the nearest Philips field service office.
C
_
1
0
6
4
3
4
7
6
5
3
5
4
s
m
e
t
s
y
S
l
a
ic
d
e
M
s
ilp
i
h
P
2.11 Laser safety
Warning
• Do not stare into the laser beam and instruct the patient not to stare
into the beam.
• The use of optical instruments, such as eyeglasses with large diopter
or mirrors, with this product will increase eye hazard.
• Ensure that, for head examinations, the patient wears protective
glasses when the laser beams are on.
Protection measures 2.12
2.12 Protection measures

Take the following protection measures to protect both yourself and the patient.
Anyone who has to be near the patient during scanning must wear protective
clothing (lead apron), wear a PEN dosimeter and/or film badge, and stay in the
zone shielded by the system (to the side of the gantry or behind a mobile
protective wall).
The physician is responsible for protecting the patient from unnecessary
radiation.
• Always use a gonadal shield, if possible.
• Use the pediatric mode for children.
C
_
1
0
6
4
3
4
7
6
5
3
5
4
s
m
e
t
s
y
S
l
a
ic
d
e
M
s
p
lii
h
P

anzubieten!
" Nützlich
% Nicht
nützlich
3 Security of system and data
Philips Medical Systems is dedicated to helping you maintain the

confidentiality, integrity, and availability of electronic protected health
information and the hardware and software products that create and
manage these data.
Maintaining security of Philips Medical Systems’ products should be an
important part of your facility's security-in-depth strategy. You should
implement a comprehensive, multi-layered strategy (including policies,
processes, and technologies) to protect information and systems from external
and internal threats. Your security strategy should follow industry-standard
practices, addressing physical security, personnel security, procedural security,
risk management, security policies, and contingency planning.
The practical implementation of technical security elements varies by site
and may employ a number of technologies, including firewalls, virus
scanning software, authentication technologies, etc. As with any computer-
C
_
based system, protection must be provided such that firewalls and/or other
1
0
6
security devices are in place between the medical system and any externally
4
3 accessible systems. These perimeter and network defences are essential to
4
7
6 good security practice.
5
3
5
4
This chapter provides guidelines to help the operator and owner
s
m
understand the possible ways security can be compromised, and then insure
e
t
s that safeguards are in place to prevent this from happening. For specific
y
S
l
information about security within their institutions, operators and owners
a
ic can consult with the following offices at their location:
d
e
M • Information Systems Security Officer
s
p
lii • Chief Information Officer
h
P
• HIPAA Officer (in the U.S.A.)
• Safety Officer
Brilliance CT - Volume 1 Security of system and data 3-1
3.1 Regulatory controls
3.1 Regulatory controls
Protect patient’s health information

One of the most important assets to protect with security measures is the
patient’s health related information.
Many governments require maintaining the confidentiality of this
information. Therefore, strict security measures must be taken to guard this
protected information.
(Users in the U.S.A. may find guidelines at
http://www.hhs.gov/ocr/hipaa/.)
Prevent unauthorized device modification

Philips Medical Systems sells highly complex medical devices and systems.
We are required to follow government-regulated quality assurance
procedures to verify and validate modifications to the operation of our
medical devices.
Operators and owners of this medical equipment must permit only Philips-
authorized changes to be made to these systems, either by Philips’ personnel
or under Philips’ explicit published direction.
Caution Although the Philips Brilliance CT operates on a personal computer (PC)

platform, the installation of PC software not specified in the Philips system
documentation may adversely affect the operation and security of the
system, as well as the networks to which the system is connected. T hese
adverse effects may not be immediately apparent to the user. Users should
therefore not install unauthorized software onto their system.
3-2 Security of system and data Brilliance CT - Volume 1
Security issues and guidelines 3.2
3.2 Security issues and guidelines

In addition to the patient information and device integrity needs discussed
in the preceding section on regulatory requirements, the following topics,
issues, and guidelines should be understood and addressed by operators and
owners.
Network security
The Brilliance CT must be placed on a secure local computer network that
has protections against viruses and other harmful computer system
intruders. Make sure the equipment is connected to a local network that
uses appropriate protection, such as a firewall and virus scanners.
Remote Service
Philips Medical Systems has a global, web-based network for connecting
many of your Philips systems to our advanced service resources. This secure
tunnel approach provides your equipment with a single point of network
access to on-site Philips equipment using Virtual Private Network
C
_ technologies. The remote service function is a secure connection through
1
0
6 explicit authorization and authentication control with encryption of all
4
3
4
data.
7
6
5
3
5
4 Antivirus Updates
s
m
e Virus definition files and updated virus scanning engines are included with
t
s
S
y the equipment. Updates of virus definition files and/or corrective software
l
a versions are regularly made available by Philips to address known
ic
d
e vulnerabilities (virus and otherwise).
M
s
ilp The system’s antivirus scanner is scheduled to activate during off hours,
i
h
P while system is typically not in use. (Refer to the section “Antivirus
Software” in the System Description chapter of this volume for details.)
Brilliance CT - Volume 1 Security of system and data 3-3
3.2 Security issues and guidelines
Caution Under no circumstances should updated virus definition files (or any type of
software) be installed on the Brilliance CT by anyone other than a Philips
Field Service Engineer or an authorized Philips agent.
Room access control

Procedures must be put in place to limit physical access to the medical
equipment, to prevent accidental, casual, or deliberate contact by
unauthorized individuals.
Access to the room containing the Brilliance CT should be controlled by
policy and procedures that identify who is authorized to occupy specific
areas. Check with your Safety and Security Office for more information on
what measures are in place or how to implement room access controls.
Positioning of display monitors

Unauthorized visual access to protected information can be minimized by
positioning the system’s display monitor so it faces a wall, to prevent
viewing from doorways, hallways and other traffic areas.
To help in limiting unauthorized visual access, an unattended Brilliance CT
display automatically goes blank after a set period of time.
3-4 Security of system and data Brilliance CT - Volume 1
User login and logout protections

A consistent user login process (user names and passwords) provides good
security of protected information. Minimum login standards include:
• Implementing strong passwords. This is the easiest and most effective
method to increase security. Strong passwords consist of at least eight
alphanumeric, mixed case characters, digits and special characters like
‘@’ or ‘*’. Never use words that can be found in the dictionary
• Never post or share user names and passwords
• Change passwords periodically
Removable / portable media

When using removable media (floppy disks, CD-ROMs, DVD-ROMs,
and EODs) be aware of these security issues:
• Inserting removable media can introduce a virus to the medical device.
• Removing media containing patient data can allow access to the data by
unauthorized individuals.
• If the media is to be discarded it must be destroyed or disabled so that
the data can no longer be accessed.
Caution Whenever media is inserted into the Brilliance CT, be sure that the media
has not been exposed to potential viruses, worms and trojans that infect
desktop PCs.
Caution Removable media that contains images and/or other medical information
must be stored in a secure area that is not accessible by unauthorized
individuals.
4 Image performance quality assurance
4.1 Overview
Imaging performance of the scanner is checked by scanning head and body
system phantoms.
When testing image quality, the system should be properly calibrated.
This chapter covers information on these areas:
• Head and body phantom.
• Quality assurance checks-daily and monthly.
Read this section carefully and follow all instructions regarding scheduling
and performance of quality assurance checks.
Note These instructions represent the manufacturer’srequired QA performance
checks. If additional testing is required by your national or local authorities,
C
_ please contact your Philips Service representative.
1
0
6
4
3
4
7
6
5
3
5
4
s
m
e
t
s
y
S
l
a
ic
d
e
M
s
ilp
i
h
P
Brilliance CT - Volume 1 Image performance quality assurance 4-1
4.2 Head & body system performance phantom

The phantom consists of two portions which cover the aspects of head and
body scans. This section covers the specifications of both the head and
body portions of the phantom. Familiarize yourself with this information
before you scan either portion. The illustration below shows the entire
phantom.
1 Head phantom
2 Body phantom
3 Physics layer
4 Water layer
5 Multi-pin layer
6 Copper wire
7 45 degree angle wedge
4-2 Image performance quality assurance Brilliance CT - Volume 1
Head & body system performance phantom 4.2
4.2.1 Head phantom

The head phantom is a PVC shell filled with water. It is 200 mm in
diameter and consists of three layers:
• physics layer for impulse response and tomographic section thickness
(slice width) measurements
• water layer for measuring noise
• multi-pin layer for checking contrast scale
The standard deviations for image noise on the 64 channel versions of the
scanner is as follows:
• Head Noise - 3.6-4.4 to 3.6-4.6
4.2.2 Body phantom

The body phantom is a nylon cylinder 300 mm in diameter. It has an
absorption of 100 ± 10 CT and includes these features:
• Teflon pin-absorption 890 ± 50 CT
C
• water hole-absorption 0 ± 10 CT
_
1
0
6 The standard deviations for image noise on the 64 channel versions of the
4
3
4
scanner is as follows:
7
6
5
• Body Noise - 10.2-12.8
3
5
4
s
m
e
t
s
y
S
l
a
ic
d
e
M
s
p
lii
h
P
4.2.3 Phantom composition

Item Description
1 Physics Layer
2 Aluminum strips embedded at 45 degrees
3 0.18 mm copper wire for impulse response measurement
4 Water Layer
5 Multi-pin layer
6 Nylon (Aculon) body with six smaller Lexan pins of 3 mm,

4 mm, 5 mm, 6mm, 7mm and 8mm respectively
7 Lexan pin
8 Acr ylic pin
9 Acr ylic with seven rows of holes of different diameters. each
Row 1 1.00 mm holes, 2.00 mm apart

C
_
1 Row 4 1.75 mm holes, 3.50 mm apart
0
6
4
4
7
6
3
5
s
m
e 10 Teflon pin
t
s
y
S
l 11 Polyethylene pin
a
ic
d
e 12 Body layer
M
s
p 13 Water hole
lii
h
P 14 Teflon pin
4.2.4 Representative quality assurance images

Quality assurance images acquired during the daily and monthly checks can
be stored, if desired, on EOD cartridges. The digital data of the following
images are stored on the “Reference QA Images CD.”
Multi-pin layer using head Std-QA Water layer using head Std-QA
protocol protocol
Body layer using Body Std-QA protocol
Physics layer Impulse response

(6mm slice width, Head std-QA (modified-100 FOV, Head std-QA
Protocol) Protocol)
C
_
1
0
6
4
3
4
7
6
5
3
5
4
s
m
e
t
s
y
S
l
a
ic
d
e
M
s
ilp
i
h
P
4.3 Schedule of quality assurance checks
Daily checks
Daily checks should be done to ensure the best possible image quality from
your scanner. The procedures for daily checks cover these areas:
• Noise - on head phantom, water layer.
• Noise and artifacts - on body phantom.
Monthly checks
Use your facility’s recommended schedule for monthly checks. These
procedures must be conducted at least once each month.
• Contrast scale and artifacts - on head phantom, multi-pin layer.
Advanced checks
Advanced checks are intended for use as advanced applications for
Physicists and your Philips Service Specialist.
• Impulse Response - on head phantom, physics layer.
• Slice thickness - on head phantom, physics layer for all slice
thicknesses.
Schedule of quality assurance checks 4.3
4.3.1 Daily checks

Use the water layer of the phantom for the daily checks.
Head scan
1 Position the water layer of the head phantom in the center of the scan
circle.
2 Perform a scan using the Head STD-QA protocol with parameter
values as shown below:
Common scan parameters
FOV 250
Storage Local
No of Scans 1
Filter EB
SP Filter No
C
_ 64 slice
1
0
6
4
3 Collimation 16 x 2.5
4
7
6
5
Thickness 5
3
5
4 Increment 0
s
m
e Rot Time 0.75
t
s
y
S
l Voltage 120
a
ic
d
e
M mAs/slice 250
s
p
lii
h 3 Check the four resulting images to ensure they are free of artifacts.
P
Note • If the images display with artifacts, check that the water phantom is the
only item contained within the scan field, and repeat the procedure.
• If there is still a problem, contact your Philips Service Specialist.
4 From these images, select one.

5 Place around the center of the phantom image, a ROI with an area of
7000 ± 2000 mm2.
6 Check these items:
AV (average) SD (Standard Deviation)
All scanners 64 slice
0 ± 4 CT 4 ± 0.4 CT
7 If the SD does not display, use this procedure to change the setting:
• Click Options.
• Select Display Utilities.
• Select ROI Values.
Schedule of quality assurance checks 4.3
Body scans
1 Position the body phantom in the center of the scan circle.
2 Perform a scan using the Body STD-QA protocol (under Abdomen)
with the parameter values as shown below:
FOV (mm) 350
Storage Local
No of Scans 1
Filter B
SP Filter No
Adaptive Filter No
64 slice
Collimation 16 x 2.5
C
Thickness (mm) 5
_
1
0 Increment (mm)
6 0
4
3
4 Rot Time (sec) 0.75
7
6
5
3 Voltage 120
5
4
s
m mAs/slice 250
e
t
s
y Resolution Std
S
l
a
ic Scan Angle 360°
d
e
M
s
ilp
3 Check the four resulting images to ensure they are free of artifacts.
i
h
P 4 From these images, select one to conduct the remainder of the checks.
5 Check the absorption reading for the Teflon pin. It should be as

follows:
Teflon pin 890 ± 50 CT
Note All measurements should be made by positioning a small RO I well within

each of the checked pins and regions.
6 Place around the center of the phantom, an ROI with an area of 14000
±1000 mm2. The ROI should not touch the Teflon pin or water hole.
7 Check these items:
64 slice
AV (average) 100 ± 10 CT (or

the CT value on
the phantom label)
SD (Standard Deviation) 11.9 ± 1.2 CT
8 If the SD does not display, use this procedure to change the setting:
• Click Options.
• Select Display Utilities.
• Select ROI Values.
Monthly checks 4.4
4.4 Monthly checks

Use the multi-pin layer of your phantom for month checks.
Note • If the imagesdisplay with artifacts, check that the phantom is the only
item contained within the scan field, and repeat the procedure.
• If there is still a problem, contact your Philips Service Specialist.
Head scan
1 Position the multi-pin layer of the head phantom in the center of the
scan circle.
2 Perform a scan using the Head STD-QA protocol with parameter
values as shown in the tables:
FOV 250
Storage Local
C No of Scans 1
_
1
0
6
4 Filter EB
3
4
7
6 SP Filter No
5
3
5 Adaptive Filter No
4
s
m
e
t
s
y
S
l
a
ic
d
e
M
s
p
lii
h
P
4.4 Monthly checks
64 slice
Collimation 16 x 2.5
Thickness 5
Increment 0
Rot Time 0.75
Voltage 120
mAs/slice 250
Resolution Std
Scan Angle 360°
Image quality
Check the quality of one image according to the following criteria:
• Check with the LINE tool that the diameter of the large Acrylic pin is
50 ±1 mm.
• All resolution holes (seven rows) in the Acrylic pin should be visible.
• Five of the six low contrast pins in the Aculon body should be
detectable.
Note As the phantom ages, the low contrast pin is more difficult to visualize.

anzubieten!
" Nützlich
% Nicht
nützlich
Monthly checks 4.4
Absorption readings
The readings for the absorption of the different pins must be as follows
(values in CT numbers):
Region Value
Water 0±4
Nylon (Aculon) +100 ± 15 (+10% relative t o wat er)
Polyethylene -75 ± 15 (-8% relative to water)
Teflon +1016 ± 50 (+99% relative to water )
Acr ylic +140 ± 15 (+14% r elat ive to wat er )
Lexan +116 ± 15 (+12% relative to water )
Note All measurements should be made by positioning a small ROI well within
each of the checked pins and regions.
C
_
1
0
6
4
3
4
7
6
5
3
5
4
s
m
e
t
s
y
S
l
a
ic
d
e
M
s
p
lii
h
P
4.5 Advanced quality assurance checks

These procedures can be useful for resolving problems revealed by the daily
checks. They are intended for use as advanced applications for Physicists
and your Philips Service Specialist.
4.5.1 Impulse response measurements

1 Position the physics layer of the head phantom in the center of the scan
circle.
2 Perform a scan using the Head STD-QA protocol, with the parameter
values listed in the Daily Checks section, except FOV (in mm) = 100.
3 Activate the MISC, Impulse Response.
4 The Full Width at Half Max of the Impulse Response profile should be
1.45 mm ± 0.10 mm.
4.5.2 Tomographic section thickness measurements

This function is used to check the slice thickness (slice width) of the
scanner during monthly tests. Available protocols depend on your scanner
type.
Setup
Before activating the Slice Thickness function, be sure perform the
preliminary procedures in steps 1-4 below.
1 Perform Short Tube Conditioning.
2 Perform Detailed Air Calibration at 120 kV, STD, for all Collimations.
This procedure also warms up the tube.
3 Install the system phantom used for slice width measurements.
Advanced quality assurance checks 4.5
4 Perform a lateral Surview scan. The plan varies depending on your

system configuration:
• for 64 slice scanner, go to Checking the 64 slice protocols, on
page 4-17.
Checking the 64 slice protocols

This section contains information for conducting advanced quality
assurance procedures for the 64 slice configurations.
1 Plan an axial scan on the Surview as shown in the example below:
C
_
1
0
6
4
3
4
7
6
5
3
5
4
s
m
e
t
s
1 Head phantom 2 First slice
y
S
l
a 3 Out direction 4 In direction
ic
d
e
M
s
ilp
i
h
P
Checking the 16 x 2.5 protocol

1 Adjust the table so that the phantom centerline aligns with the laser
lights.
2 Set up a standard patient scan using the workflow bar (see Scan
procedure, on page 7-16).
Note The gantry should be set at zero degrees (perpendicular).
3 Perform the first Axial scan with the following parameters:
Parameters for First Slice Width Scan (16 x 2.5, Axial)
Position head first / supine Voltage [kV] 120
FOV [mm] 250 mAs 250
Tilt 0 Resolution standard
Length [mm] 40 Recon. standard
No. of Slices 4 Cent er X [mm] 0
Increment [mm] 0 Center Y [mm] 0
Collimation 16 x 2.5 Window Center 60
Thickness (mm) 2.5 Window Width 300
Rot. Time [sec] 0.75 Filter EB
Scan Angle 360 Matrix 512
Cycle Time 1
4 Using the same parameters as above, perform an axial scan on either

side of the center (first scan):
C
_
1
0
• Move the phantom 20 mm from the center in the OUT direction to
6
4
3
capture the second scan.
4 • Move the phantom 20 mm from the center in the IN direction to
7
6
5
3
capture the third scan.
5
4
s 5 Access the Directory window.
m
e
t
s
y
6 Select the first scan series.
S
l
a 7 Click the Slice Width icon under Application.
ic
d
e
M 8 Select the middle image of the first scan.
s
p
lii
h 9 Click Ok.
P
10 Click the Vertical ROI icon on the left tool bar.
11 Move, rotate and resize the ROI to symmetrically position it on the

aluminum strip and parallel to the plastic rectangles.
Physics layer Impulse response

6 mm slice width/Head std-QA Protocol modified-100 FOV, Head std-QA Protocol
12 To view the sensitivity profile and results of the measurements, click the
Plot icon on the left toolbar.
13 Measure both vertical aluminum strips, and average the results.
14 Repeat steps 4-13 using the second scan.
• At step 6, select the first slice for measurement.
15 Repeat steps 4-13 using the third scan.
• At step 6, select the last slice for measurement.
16 Average the results of the three scans.
17 For the 6,10,16, and 16P slice configurations, multiply the result by 2
to calculate the full width half maximum.
18 Verify the result is within the allowed tolerance:
Collimation Tolerance
16 x 2.5 2.5 mm +/- 0.50 mm
32 x 1.25 1.5 mm +/- 0.40 mm
40 x 0.625 1.1 mm +/- 0.30 mm
19 Exit the Slice Width program.
Note The smallest slice width value appears thicker than its marked (nominal)
value. This is due to the measurement method used. To achieve a more
precise measurement, a different phantom should be used.
C
_
1
0
6
4
3
4
7
6
5
3
5
4
s
m
e
t
s
y
S
l
a
ic
d
e
M
s
ilp
i
h
P

Now that you have completed the measurements on the first protocol, you
can check the second protocol.
1 Repeat steps 1– 19 for the second protocol with a slice width
measurement of 1.25mm. Note that mAs, Resolution, and Filter are
different than the first Slice Width scan. The table below shows
parameters for the scanner.
Parameters for second slice width scans (32 x 1.25, Axial)
Tilt 0 Resolution high res
Length [mm] 40 Recon. O n line
No. o f Slices 4 Cent er X [mm] 0
Collimation 32 x 1.25 Window Center 60
Thickness 1.25 Window Width 300
Rot. Time [sec] 0.75 Filter E
Cycle Time 1
Note The smallest slice width value appears thicker than its marked (nominal)

Use this procedure to check the 40 x 0.625 protocol.
1 Repeat steps 1– 19 (see page 18) for this protocol. Use a slice width
measurement of 0.625 mm. Note that mAs, Resolution, and Filter are
Parameters for third slice width scans (40 x 0.625, Axial)
Length [mm] * Recon. O n line
No. of Slices 4 Cent er X [mm] 0
Collimation 40 x 0.625 W indow Center 60
Thickness 0.625 W indow W idth 300
C Rot. Time [sec] 0.75 Filter E

_
1
0
6 Scan Angle 360 Matrix 512
4
3
4
7 Cycle Time 1
6
5
3
5
4 Note • The smallest slice width value appears thicker than its marked (nominal)
s
m
e
t
s precise measurement, a more sophisticated method should be used.
y
S
l • The Philips System Phantom is not designed for precise measurements of
a
ic
d
e
thin slices. The measurements of 40 x 0.625 slice width are performed
M
s only for consistency purpose.
p
lii
h 2 Verify the result is within the allowed tolerance:
P
• 1.5 mm +/- 0.30 mm

Now that you have completed the measurements on the first protocol, you
can check the second protocol.
1 Repeat steps 1– 19 for the second protocol with a slice width
measurement of 0.625 mm. Note that mAs, Resolution, and Filter are
Parameters for third slice width scans (64 x 0.625, Axial)
Length [mm] * Recon. O n line
No. o f Slices 4 Cent er X [mm] 0
Collimation 64 x 0.625 W indow Center 60
Thickness 0.625 W indow Width 300
Rot. Time [sec] 0.75 Filter E
Cycle Time 1
Note • The smallest slice width value appears thicker than its marked (nominal)
• The Philips System Phantom is not designed for precise measurements of
thin slices. The measurements of 64 x 0.625 slice width are performed
only for consistency purpose.
2 Verify the result is within the allowed tolerance:

• 1.1 mm +/- 0.30 mm

Infant phantom testing (option) 4.6
4.6 Infant phantom testing (option)

The infant scanning mode is recommended for scanning infants under
eighteen months of age. This section provides instructions for using your
infant phantom to check the performance in the infant scanning mode.
The Infant Phantom is intended to radiographically simulate the infant or
baby imaging condition.
C
_
1
0
6
4
3
4
7
6
5 1 Head phantom 2 Body phantom
3
5
4
s 3 Head phantom centerline 4 Body phantom centerline
m
e
t
s
S
y This phantom consists of a head section and a body section. The head
l
ic
a section is made with a 4.5 inch (11.4 cm) outside diameter, 1.5 mm thick,
d
e PVC, cylindrical shell. The body section consists of an approximately 15cm
M
s diameter cylindrical acrylic shell.
ilp
i
h
P Before use, fill the cylindrical volumes of the phantom with distilled water.
Take care to allow all air bubbles to escape the water chamber through the
top fill box.
4.6 Infant phantom testing (option)
4.6.1 Attaching and scanning the phantom

Before you can use the infant phantom for quality assurance testing, you
must attach it to the patient table. Use this procedure to install the
phantom.
1 Move the patient table away from the gantry (OUT).
2 If present, remove the standard phantom.
3 Check the mounting bracket to ensure it is tightly attached.
4 Insert the infant phantom by sliding it into the notch on the bracket.
5 Tighten the screw on the system phantom and make sure it is
positioned securely in place.
6 Move the patient table up to position the phantom in isocenter.
7 Turn on the laser markers.
8 Move the patient table back towards the gantry (IN).
9 Position the table so that the laser markers line up with the Body
centerline on the phantom.
10 Zero the table.
11 On the console, set up a patient study:
• Select Infant under Age Group.
• Select an infant protocol from the protocols.
The Axial B ra in ≤ 18 mo nt hs pediatric protocol with an ROI which covers
the central 80% of the water image should yield these results:
• The CT number of the distilled water should measure 0 ± 4 CT
numbers.
• Body Protocols should yield 0 ± 6 for the body water section.
Note Your service engineer can adjust the CT number level if it is out of
specification.
Infant phantom testing (option) 4.6
You can also use the phantom immediately before imaging infant heads to
accurately correct the CT number of infant brains for quantitative results.
For example, if the phantom image produces a CT number of -2.0 before
the brain exam and then the infant brain image measures + 26.0, then the
infant brain result can be corrected to give + 28.0 CT numbers. This
procedure permits a more quantitative infant head examination for those
who can benefit from greater CT number accuracy.
C
_
1
0
6
4
3
4
7
6
5
3
5
4
s
m
e
t
s
y
S
l
a
ic
d
e
M
s
p
lii
h
P
5 System description
While the slice configurations vary, all Brilliance CT systems are advanced
continuous-rotation tomographic systems that consist of these
components:
• Operating station
• Scan control box
• Gantry
• Patient table
C
_
1
0
6
4
3
4
7
6
5
3
5
4
s
m
e
t
s
y
S
l
a
ic
d
e
M
s
ilp
i
h
P
Brilliance CT - Volume 1 System description 5-1
5.1 O perating station
5.1 Operating station

The operating station is used to operate and monitor the scans being
performed. It consists of the following components:
• Computing system
• Scan control box
• Monitor
• Keyboard and mouse
• Patient intercom
• Data storage devices
• Automatic filming control device
5.1.1 Computing system

The computing system consists of these elements:
• Dell computer with Windows operating system (Host)
• Common image reconstruction system (CIRS)
Caution Never interrupt the electric current to the computer when it is on. Doing
so could cause damage to the computing system or to the software.
5.1.2 Monitor
A 21-inch, high resolution monitor with 1280 x 1024 pixel resolution is
used to display images and operate the system.
An optional flat panel monitor is also available.
The power switch for the monitor is located on the front. The power
indicator LED lights when you turn on the monitor.
5-2 System description Brilliance CT - Volume 1
O perating station 5.1
Caution To maintain optimal adjustment and correlation with the filmed images, do
not change the settings of the monitor.
5.1.3 Dual monitor

Dual monitors are standard for the 16 power, 40-slice, and 64-slice
Brilliance CT configurations. With dual monitors, the system displays
information this way:
• Scanning operation is conducted on the left monitor. Some Physics
applications and Service and Diagnostic applications also open on the
left.
• The Directory and post-processing applications open on the right
monitor.
With this feature, you have the option to drag an application along with its
dialog boxes, to the second monitor. The pop-up menu will also display on
the second monitor.
C
_
1
0
6
4
3
4
7
6
5
3
5
4
s
m
e
t
s
y
S
l
a
ic
d
e
M
s
p
lii
h
P
5.1.4 Scan control box

Once the scanning process has been initialized via the on-screen scan
toolbox, you can control the remainder of the process using the Scan
control box.
The box consists of a variety of buttons and LEDs for controlling and
displaying gantry tilt angle and patient table movements:
1 Emergency Stop button stops gantry motions and x-ray generation in
the event of an emergency.
2 Tilt button tilts the Gantry in the direction indicated by the arrows (in
relation to the diagram on the button).
3 Manual scan button for performing individual scans.
4 Auto scan button for performing multiple scans in a series.
5 Pause button interrupts the scanning series and enables changes. This
button may also be used to stop scans under certain conditions.
6 Enable button enacts machine controlled patient table and gantry
movements.
7 Microphone / Microphone on button allow you to speak to the patient.
8 Volume controls set volume for the console and gantry speakers.
9 Table in/out and up/down buttons move the Patient table in the
respective directions.
10 Control screen indicates position of gantry and table. The first line is
tilt, the second is vertical and third is horizontal.
11 Key starts and stops gantry rotation (turn towards you for the on
position).
O perating station 5.1
5.1.5 Patient intercom

The patient intercom is a system which allows you to communicate with
the patient during a scan procedure. The patient portion of this system
consists of a speaker and microphone located in the opening of the gantry.
The user portion of the system consists of a speaker and a microphone on
scan control box.
Recorder microphone
A recorder microphone is located in the scan control box. This microphone
is used to record messages that can be used during the scan process.
5.1.6 Data storage

The Philips Brilliance CT scanner allows these options for storing data:
• internal hard disk
• erasable (rewritable) optical disk-EOD
• internal rewritable DVD-RAM
C • internal CD writer
_
1
0
6
4
3
4
7
Internal hard disk
6
5
3
5
The internal hard disk is used to store images, the operating system, raw
4
s
files and calibration data. To allow for flexibility, this disk space can be
t
m
e expanded to suit your needs. Contact your Philips Service Representative
s
S
y for information on expansion of internal drive space.
l
a
ic
d
e
M Erasable optical disk (EOD)
s
ilp
i
h
P
The EOD provides storage of patient images and raw files on removable,
re-usable cartridges.
Internal CD writer
The internal CD writer is a CDR drive that stores DICOM images along
with the necessary viewing software on a CD. It provides an alternative for
archiving images or transferring patient images to referring physicians.
Note • Always use a blank CD for recording.
• Upon completion of the writing process, verify that all required
information hasbeen written to the CD.
Internal DVD-RAM device

The internal DVD-RAM is a functional equivalent to the EOD device,
allowing you to store patient images and raw files on removable, re-usable
DVD-RAM disks.
5.1.7 AMC - automatic filming control device (optional)

This is an interface to laser imagers and non-DICOM printers. In
conjunction with the Filming function, it enables film rearranging and
automatic printing.

anzubieten!
" Nützlich
% Nicht
nützlich
G antr y and patient table 5.2
5.2 Gantry and patient table

The gantry provides the support and means for rotating the X-ray tube,
Beam Elements, Detectors, and Front End Electronics (FEE). The gantry
panels (front and rear) are used to activate the laser marker, tilt the gantry,
and control patient table movements.
C
_
1
0
6
4
3
4
7
6
5
3
5
4
s
m
e
See Volume 1, Chapter 2: Safety for description of emergency procedures.
t
s
y
S
l
a
ic
d
e
M
s
ilp
i
h
P
5.3 Gantry panels
5.3 Gantry panels

The front gantry panels (see 1 in example below) control and display the
gantry tilt angle, patient table movements, alignment markers and safety
system release. The LEDs for the buttons light when their function is
enabled. The system also includes rear gantry control panels which control
the gantry tilt angle, patient table movements, alignment markers and
safety system release. The rear panels do not display tilt or table position.
5.3.1 X-ray indicator

The light inside the gantry (see 2 in example above) flashes to indicate that
x-rays are in progress.
Gantry panels 5.3
5.3.2 Gantry control panel
1 Indicator screen 2 Tilt
3 Laser light on/off 4 Emergency Stop button
5 Out to external marker 6 In to internal marker
C
_
7 Table up 8 Table in
1
0
6
4
3
9 Table out 10 Patient release
4
7
6 11 Table down 12 Zero screen
5
3
5
4
s
m
e
t
s
y
S
l
a
ic
d
e
M
s
p
lii
h
P
5.3 Gantry panels
5.3.3 Rear gantry control panel (option)
1 Tilt 2 Laser light on/off
3 Emergency Stop button 4 In to internal marker
5 Patient release 6 Out to external marker
7 Table in, out, up, down 8 Zero screen
Note This panel is optional on some models.
Gantry panels 5.3
• Tilt button tilts the gantry in the direction indicated by the arrows (in
relation to the diagram on the button).
• Table in, out, up and down buttons move the patient table in the
respective directions. A high patient table value
(255 maximum) represents a low position; whereas a low value (95
minimum) represents a high position.
• In/out buttons allow you to move the table in and out to position the
patient between the internal and external laser markers.
• Laser on/off button turns on and off both the internal and external
laser markers which are used for positioning the patient in the slice
plane.
• Patient release moves the patient table (out and down) and gantry (to
zero tilt) to positions for easiest patient release at the end of the
scanning procedure. The patient table moves to its maximum distance
from the gantry and lowers to its minimal height. When the button is
released before completing the process, all motion stops.
• Zero screen resets the In/out indicator to zero.
• X-ray on indication light.
C
_
• Stop button to bring the scanner and patient table movements and X-
1
0
6
ray generation to an immediate halt. The Stop buttons are located on
4
3 the gantry control panels.
4
7
6
5
3
5
4
s
m
e
t
s
y
S
l
a
ic
d
e
M
s
ilp
i
h
P
5.4 Patient table
5.4 Patient table

The patient table has four main components:
• Main patient table and base - can move up or down, and in or out.
• Table top - can move independently in or out from the main patient
table unit.
• Release devices - consisting of two tape switches, one on each side of
the patient table handle; one foot switch on the floor between the base
of the table and the gantry, and an optional foot switch (12 NC
453567058051) at the rear of the gantry as shown below.
Note The rear foot switch should only be used to provide quick patient removal
from the rear of the gantry. It is not designed for CCT use. Pressand hold
the foot switch to release the table.
The patient table moves the patient to the scan position through the use of
the gantry control panel. The operator then makes fine adjustments in
preparation for the actual scan, still with the gantry control panel (lightly
press the in/out button to move the table by 0.5 mm increments).
Movement of the patient table during the scan procedure is then controlled
either from the gantry control panel or from the Scan control box.
Patient table 5.4
Normal unloading of a patient, after completing the scanning procedure, is

controlled from the gantry control panel.
Rapid or Emergency release of the patient table can be achieved by
grabbing the tape switches along either side of the table, or by pressing the
foot switch located on the floor between the patient table and the gantry, or
by pressing the rear foot switch. This unlocks the table from its driving
mechanism and allows it to be manually extended or retracted.
Note For Safety purposes, the Tape and Foot Switches act as an Emergency
Clutch of the main patient table unit, preventing dangerous outward
movement.
Warning The table supports a maximum weight patient of 204 kg (450 lbs), in the
lying position, with a center of gravity at 860 mm from the top of the head.
Warning Make sure all ancillary equipment is moved away from the table when
moving table in/out and up /down.
C
_
1
0
6
4
3
4
5.4.1 Foot pedals (optional)
7
6
5
3
Use the foot pedals to load and unload a patient while your free hands
5
4 guide the patient’s IV lines, tubing, ECG wires, and etc. into position.
s
m There are three foot pedals that can be operated from either side of the
e
t
s
y
patient table. They are located on the floor between the base of the patient
S
l
a
ic
d
e
M
s
p
lii
h
P
5.4 Patient table
table and the gantry. Starting at the base of the table, they include the
unload pedal, the load pedal, and the free-float pedal.
Note There may also be an optional foot switch (12 NC 453567058051) at the
rear of the gantry for a quick or emergency patient-table release, for
patient removal from the rear of the gantry. It is not designed for CCT use.
Press and hold the switch down to release the table.
Load pedal
The load pedal (between the unload and free-float pedals) moves the
patient table to a preset table height position of 85mm. This height can be
configured to your specific needs by your local field service engineer.
Procedure
1 Press and hold the Load pedal with your foot.
2 Hold the load pedal down until the patient table completes the move to
the preset table height and desired table position.
Note The patient table stops moving when you release the load pedal or the
preset table height position is reached.
Patient table 5.4
Unload pedal
The unload pedal returns the tilt position to zero. Then the patient table
moves out of the gantry and down to the unload position.
Procedure
1 Press and hold the unload pedal with your foot.
2 Hold the unload pedal down until the patient table completes the move
and stops in the unload position.
Note The patient table stops moving when you release the unload pedal or the
unload position is reached.
Free-float pedal
The free-float pedal (closest to gantry) unlocks the table from its driving
mechanism and allows it to be manually extended or retracted – a quick or
emergency table release. You can manually move the table in and out of the
gantry only, not up or down.
C
_
1
0
6
4 Procedure
3
4
7
6
1 Press the free-float pedal with your foot.
5
3
5
4
2 Hold the free-float pedal down and manually move the tabletop with
s your hands.
m
e
t
s
y Notes • The patient table re-engages when you release the Free-float pedal.
S
l
a • Rapid or Emergency release of the patient table can also be achieved by
ic
d
e grabbing the tape switches along either side of the table, or by pressing
M
s the optional foot switch at the rear of the gantry.
ilp
i
h
P
5.4 Patient table
5.4.2 Bariatric patient table

• The bariatric patient table has a patient load capacity of 650 pounds.
• The bariatric patient table is compatible with the current oncology
therapy tabletop and specifically for absolute marking up to 450 lbs
(+/- 2 mm).
• The bariatric tabletop increases the width of the couch top by 4 inches
(total width is 21 inches).
• The bariatric tabletop sits 2 inches above the couch. Be aware that
positioning in the head holder may need to be adjusted accordingly.
• When the foot extension is attached to the couch, it will be slightly
below the tabletop. A positioning device may be necessary for patient
comfort.
Warning Do not use the bariatric table top as an oncology therapy top. It is not
compliant for oncology use.

Patient supports (positioning aids) 5.5
5.5 Patient supports (positioning aids)

This section gives an overview of the standard and optional patient
supports (positioning aids). Use the patient supports to position the patient
safely and comfortably to prevent motion artifacts.
Note Patient supports are prone to wear and tear. They must be replaced with
original parts if they are dirty or damaged.
Warning • Do not use any positioning aids not mentioned in this chapter.
• For all couch types, take care when using attachments (such ashead and
foot holders) to avoid collision with the gantry.
• Non-original patient supports may cause danger for the patient through
collisions with the gantry. Image quality may also decrease.
• If a head holder or support is not engaged securely, it can come loose
causing injury to the patient.
• Positioning aids must be used exclusively for their intended purpose: head
holder only for positioning the head, table top extension only for
C positioning the feet.
_
1
0
6
4
3
4
7
6
5
3
5
4
s
m
e
t
s
y
S
l
a
ic
d
e
M
s
ilp
i
h
P
Foot extension (standard item)

The table top extension is used for feet-first positioning of the patient.
Examination up to the region of the thoracic spine is possible.
Caution Only the patient’s feet should be placed in this holder, as it does not support
body weight.
Warning Do not use the foot holder when scanning head/brain as artifacts may be
produced.
Pads, cushions and straps (standard item)

This complement of accessories includes head cushions, patient straps for
immobilization, and pads for patient comfort.
Patient restraint kit (standard item)

The components of this restraint system have an integrated rod interlock
that securely connects them to grooved panels on either side of the patient
table. A combination of straps can be used concurrently.
Patient supports (positioning aids) 5.5
Elevated head holder

The head holders can be used for most routine child or adult CT head
exams. The angle of the elevated holder positions the head naturally for a
routine brain scan and minimizes the required gantry angle to achieve
optimal results.
Coronal head holder, supine Elevated Head holder
The coronal head holder is used for coronal head scans of patients lying on
their backs. The slope of the holder positions the patient with the neck
extended and the head dropped back.
C
_
1
0
6 Therapy table top (optional)
4
3
4
7
6
This is a comprehensive patient positioning system. The unit features
5
3
indexed immobilization to ensure easily reproducible positioning for
5
4 subsequent scans and treatment in radiation oncology.
s
m
e
t
s
y
S
l
a
ic
d
e
M
s
p
lii
h
P
Infant or pediatric cradle (optional)

The pediatric cradle is used to support infants and children during scans.
Warning Make sure that the infant cradle cannot collide with the gantry during table
top movement.
Armrests
The polycarbonate armrests provide temporary support to allow you to
begin an intravenous line for contrast while the patient is on the table. After
you have completed the line, remove the armrests to begin your scan.
Caution Make sure that the armrests are removed before beginning a scan. Failure
to do so can result in damage to the armrests.
X-Ray and detection systems 5.6
5.6 X-Ray and detection systems
5.6.1 X-Ray tube

The Brilliance CT system’s X-ray tube is mounted on the gantry. Two tubes
are available, depending on the system: a 5 MHU tube and an 8 MHU
tube.
Both tubes have a rotating anode with a variable focal spot size. The focal
spot sizes are 0.5 x 1.0 mm2, and 1.0 x 1.0 mm2. Refer to chapter 18 of this
volume of the user manual for more infromation about the X-ray tube.
5.6.2 X-Ray power supply

The X-ray Power Supply consists of the rotor-mounted DC-to-high-
frequency inverters and the high voltage transformers. It is powered from
the power cabinet through low-voltage slip-rings and controlled by the
computerized high voltage control unit.
C
_
1
0
6
4
3
4
7
6
5
3
5
4
s
m
e
t
s
y
S
l
a
ic
d
e
M
s
ilp
i
h
P
5.7 Scanner connectivity options
5.7 Scanner connectivity options

The Brilliance CT system is fully capable of communicating with PACS.
Once you have your Philips Representative set up the connectivity options,
you will have these options:
• Auto-send ES lines
• Block transfer of specific images
• HIS/RIS connectivity
5.7.1 Auto Send ES lines

The Auto send ES lines as secondary capture allows the ES to be
automatically created as a secondary capture at the end of the study and
send it to all the devices that were defined in the protocol.
• Not all the PACS are capable of receiving ES lines. The ES image
(surview with referenced lines) can now be automatically saved as a
secondary capture image, the overlays are burned-in before exporting to
that system, and any PACS viewer can view the lines.
• If the feature is active, a secondary capture is created for each original
ES Surview and for all studies.
• The destination devices for secondary capture image will be the same as
for original ES images defined in the protocol.
Note Normally, on the scanner, images are sent as they are created with the ES
Surview sent last (at the end of the study). If the images are sent from the
Directory then the ES and other Surview images are sent together (before
the clinical scan).
Scanner connectivity options 5.7
5.7.2 Block transfer of certain image types

The purpose of this feature is to block images of certain types from being
sent to devices where they are not supported or not needed on. When this
option is selected, the following images are not sent to the PACS:
• PS CT (Surview with plan)
• ES CT (Surview with lines representing the slices)
• ES SC (Surview as a secondary capture)
• Tissues (derived images)
• ECG Wave (ECG viewer files)
• Pulmo Wave (Pulmo viewer file)
• Color RGB images (images saved with Save or Save As with the
secondary image capture option)
Caution Make sure you backup images before deleting them from the scanner.
Blocked images will be lost when deleted form the scanner.
C
_
1
0
6
4
3
4
7
6
5
3
5
4
s
m
e
t
s
y
S
l
a
ic
d
e
M
s
p
lii
h
P
5.8 Direct HIS-RIS connection
5.8 Direct HIS-RIS connection

This feature enables a button in the Home window to open a direct
connection from the scanner to the HIS/RIS. Only a service engineer may
configure the HIS/RIS connection. This will ensure a reliable connection
with the HIS/RIS.
HIS/RIS connectivity allows these options (see the Scanner operation

chapter for more information):
• Continue last study (see Repeating or continuing a series, on
page 7-36)
• Split study (see Split study, on page 7-62)
• Split series (see Series list, on page 18-10)
• Merge series (see Auto Options, on page 8-16)
Bar code reader (optional) 5.9
5.9 Bar code reader (optional)

The Brilliance scanner software supports use of a bar code reader to enter
patient data into the patient data form. This option can be used if HIS/RIS
is implemented in your facility.
Warning Avoid pointing the bar code reader at the eyes. The laser light can cause eye
C damage.
_
1 Avoid access to the bar code reader by untrained personnel.
0
6
4
3
4
7
6
5
3
5
4
s
m
e
t
s
y
S
l
a
ic
d
e
M
s
ilp
i
h
P
5.10 Extended Brilliance Workspace (optional)
5.10 Extended Brilliance Workspace (optional)

The Extended Brilliance Workspace is an independent diagnostic
workstation that enables the physician to review and process clinical images
without interfering with scanner operation.
The Extended Brilliance Workspace is connected to the CT system through
an Extended Brilliance Workspace high-speed data communication link.
5.11 NetForum
NetForum provides a venue for you to share vital information regarding the
effective clinical use of Philips MR & CT Imaging systems with other users
and experts worldwide.
Net Forum is located at: http://netforum.medical.philips.com/
5.12 Remote service

Philips Medical Systems provides service through a variety of methods. The
Philips Remote Service Network (RSN) provides a method for receiving
assistance from off-site service technicians. When remote service is
activated, the technician can use the remote service feature to navigate
through your system while speaking with you on the phone. This way, both
you and the off-site technician can see what’s happening in real-time.
Before a remote service session can begin, you will be instructed to
authorize the connection with your system, to ensure consistent compliance
with all required security and patient confidentiality standards. Contact
your Philips Service Representative for more information.

anzubieten!
" Nützlich
% Nicht
nützlich
6 Navigating the software
6.1 Overview
There are several elements that are common to the Brilliance applications.
The software features two main windows—scanning and processing, the
combination of which provide options for conducting a complete scan and
processing the resulting images to suit your needs. This chapter introduces
you to the basic functionality available in the scanning window. For
information regarding the processing window, see the Directory chapter.
C
_
1
0
6
4
3
4
7
6
5
3
5
4
s
m
e
t
s
y
S
l
a
ic
d
e
M
s
p
lii
h
P
Brilliance CT - Volume 1 Navigating the software 6-1
6.2 Workspace
6.2 Workspace
The image below shows the Workspace which displays when the system
starts up or after the Start Study workflow button is clicked. In the dual
monitor configuration, it displays on the left monitor.
The workspace consists of these areas:

1 Workflow bar
2 Control panel
3 Main area
6-2 Navigating the software Brilliance CT - Volume 1
Workspace 6.2
6.2.1 Workflow bar

Your scanning process is guided by a simple graphical user interface, called
the Workflow bar, that appears across the top of the window. In the images
below, the top image is the workflow bar from the scanner side of a dual
monitor system and the bottom image is the bar from the directory side of
the dual monitor system. In a single monitor system, a Processing button is
used to access the Directory workflow bar.
The Workflow bar consists of several buttons that become highlighted to

guide you as you work your way through an exam.
The buttons are color-coded to indicate their status at your current point in
the flow:
Selected (bright yellow, as in the Start Study button above): you are in this
stage of the workflow.
C
_ Note At any time, only one of the workflow buttons is in the “Selected” state.
1
0
6
4
3 Active (light yellow, as in the Home button above): this stage of the
4
7
6 workflow is accessible, if you want to move to it.
5
3
5
4 Inactive (grayed-out, as in the Protocols button above): this function
s
m
cannot be accessed at this stage in the workflow.
e
t
s
S
y On the scanning side of the system, the Workflow bar consists of these
l
a buttons:
ic
d
e
M • Start Study—to start a new study or to continue the previous one. The
s
p
lii
patient details are defined manually or from HIS/RIS.
h
P
This step is active automatically after you log in. This button is always
enabled, except during image acquisition or between acquisitions in
6.2 Workspace
timed scans and Bolus tracking. It is also enabled automatically after

clicking End Study.
When enabled, its behavior depends on the state of the examination
flow:
• If you click this button before selecting a procedure, you can change
patient details for this study.
• If you click this button after planning scans but before performing
them, the system gives and option to stop the current study and start
a new one.
Note Once a procedure is selected, the patient details cannot be changed.
• Protocols—used to select the exam protocol. After clicking Protocols,
the Exam Protocols Selection displays. There are two sub-steps—
Protocol Groups and Exam Procedures.
This button is disabled from the start of the new study until all the
mandatory fields are filled in. If you click Protocols when there are
remaining scans, you are prompted to confirm the deletion of the scans
not performed.
• If you click this button during PlanScan, the newly selected protocol
replaces the previously selected protocol.
• If you click this button during ready mode, the system exits ready
mode.
• PlanScan—used to plan the exam protocols. This button is disabled
from the start of the new study until an exam protocol is selected.
The button is Active until Go in ScanProtocol is clicked. After this the
ScanProtocol disappears and the ViewScan step becomes automatically
active.
Workspace 6.2
• If you click this button during scan preparation, this cancels going to
Ready mode.
• If you click this button during Ready mode, it exits from Ready.
Note The Start study, Protocols and Plan Scan are disabled during image
acquisition or between acquisitions in timed scans and Bolus tracking.
• ViewScan—active during scans and online reconstructions. The

application area contains Scan tool panel, Scan Viewer, Time Ruler and
may contain ECG Viewer.
This button is Disabled from the start of the new study until the first
scan is performed.
If the Manual/Auto button on the scan control box is pressed during
Ready, the ViewScan becomes active automatically. Exit from ViewScan
ends the study.
• Filming—to display and select the images for filming. It is always
Enabled.
• End Study—stop all functions of the current study (including evolving
plan, post). If there are outstanding reconstructions, archiving, and
C
_
1
filming they continue in background. This button is disabled until
0
6
4
something is entered in patient data and during image acquisition or
3
4
between the acquisitions in timed scans and Bolus tracking.
7
6
5
3 Note Ending the study prior to the completion of reconstructions will not
5
4
properly update the executed surview.
s
m
e
t After ending the study, a new study is automatically opened and
s
y
S
l
a
StartStudy becomes Active.
ic
d
e • Processing—(single monitor only) to toggle to the Directory window.
M
s
ilp
i
h
P
6.2 Workspace
6.2.2 Tool panel

The tool panel contains scanning workflow tools and information which
change with the different workflow phases:
• Home/Utility menus
• Start Study/Plan Study
• View Scan (during and after scanning)
• Main Functions
Workspace 6.2
1 After patient data has been entered, the top

region of the tool panel contains this data
including name, ID and patient position.
2 This region of the tool panel contains buttons
which allow you to alter the scan series: (such
as Insert Scan, Insert Recon, Duplicate and
Next series as shown here). For more
information see Edit the preset scans series,
on page 7-25.
3 This area is the scan series list. Each line
represents a step (such as, main, recon,
additional recon, or MPR) and provides
information about the series type, and the
current status For more information, see Scan
series features, on page 6-8.
4 The protocol parameters are organized into
tabs (such as Main Parameters tab, Injection
tab, Voice tab, Automatic Options tab and
C Advanced tab as shown here). For additional
_
1 information, see Chapter 8: Scan protocols.
0
6
4
3
4
5 This area displays information for parameters
7
6 that are automatically calculated (such as
5
3
5
CTDI, scan time and DLP).
4
s 6 The status area display messages during every
m
t
e
s
step of operation (such as Edit Patient data,
y
S
l
Protocol Selection, Plan scan, Scanning
a
ic Acquisition completed, and Recon completed).
d
e Additionally, the available devices, remaining
M
s space on the devices and the Queue manager
p
lii
h
P
display in this area.
6.2 Workspace
Scan series features

The scan series features are a part of the Tool panel. Familiarity with the
buttons, icons and functionality of the scan series features will help ensure a
more efficient scan procedure.
Series list (from left to right):

Each line represents a scan series. Each line contains a series number, status
icon, series name, and a series characteristic icon.
• Series Number (1, 2, 3). Additional recons and MPRs are numbered as
well.
• Series Status: The series status appears to the left of the scan series. The
icon updates with the scan progress.
Scan is Planned
Scan complete
Scanning (X ray on)
Recon Preview
Recon in progress
• Series name includes the following parameters (taken automatically
from the protocol):
• Scan Type (CTA Renal, Abdomen)
• Label (if exists)
• Surview/Axial/Helical
• For surview only – AP / Lateral / Dual / Multi
• For MPR only - Sagittal / Coronal
Workspace 6.2
• Series characteristic icons, on the right side of the series name:

Contrast injection
Timed
Bolus Tracking
Cardiac
CCT
Pulmo
Axial Jog
Helical Jog
C
_
1
0
6
4
3
4
7
6
5
3
6.2.3 Home menu
5
4
s
The Home menu displays when Home is clicked.
m
e
t
s
y
S
l
a
ic
d
e
M
s
ilp
i
h
P
6.2 Workspace
Menu buttons
Click a button to access the corresponding feature.
• Air Calibration - a part of normal system maintenance that ensures
proper operation of the scanner (see Air Calibration
Recommendations, on page 7-5).
• Generate Protocols - to create new customized protocols. For a full
procedure see Generate protocol, on page 8-35.
• Direct HIS-RIS connection-when enabled, a button displays in the
Home menu. Click to open a direct connection from the scanner to the
HIS/RIS.
Note Only a service engineer may configure the HIS/RIS connection. This will
ensure a reliable connection with the HIS/RIS.
• Logout - to exit out of the Brilliance CT system.
Utilities
These utilities are available from the Home menu.
• Tube Conditioning - allows you to bring the tube to normal operating
temperature after a pause in system operation of more than ten hours
(see Tube conditioning, on page 7-4).
• Classify Protocols - enables mapping protocols with specific
parameters: for example: requested procedure (from HIS/RIS), patient
size, and referring physician (see Chapter 9: Optimized protocol
selection).
• Voice Manager -use to add new custom auto voice phrases, or edit and
delete existing auto voice phrases that may be used during the scan
process (see Voice manager, on page 7-58).

Workspace 6.2
Service tools
Bug Report -to save all of the relevant information about a specific problem
for postmortem/remote analysis. When using the bug report click Help to
open the bug report procedure and export the reports to the Brilliance CT
EOD as well as the Philips Service FTP site.
LogBook-for the recording of every service event that occurs during the
entire lifetime of the system.
When using the log book, click Help to view the log book procedure.
Process Monitor-for monitoring some of the main processes and provides
an indication about a failure of any of a process.
Open utilities list-to display the open Home utilities. Clicking on any one
of the open utilities bring the utility window to the front.
C
_
1
0
6
4
3
4
7
6
5
3
5
4
s
m
e
t
s
y
S
l
a
ic
d
e
M
s
p
lii
h
P
6.3 Main area
6.3 Main area

The contents of the main area vary depending on the part of the scan
process you are in:
• Patient Data form
• Plan Scan Window
• Plan Surview Window
• Scan Viewer Window
6.3.1 Patient data form
The sample above shows the patient data form which is used to enter
patient data for a new study.
Main area 6.3
These options are available:

• New opens a blank patient form.
• Current brings the details of the current patient (that was last entered)
to the parameter fields.
• Anonymous fills a preset subset of generalized patient details for
unidentified patients.
After the scan has finished, you may operate a utility for correcting
Anonymous patient data retroactively in the Patient Catalog and in
archives.
• Catalog opens the local Patient Catalog. If other catalogs are connected,
they can also be accessed from the Patient Catalog.
• Scheduled activates the Patient Catalog with the Scheduled list open.
• HIS/RIS allows retrieval of patient data from Hospital or clinic
HIS/RIS. When selected, this option displays a window from which
you can select and send patient data to the patient data form.
Note HIS/RIS functions are enabled only if the Brilliance system is connected to
the Hospital’s (clinic’s) LAN.
C
_
1
0
6
Patient data fields
4
3
4
7
While the sample does not show all fields, you can customize the window
6
5 to display those fields relevant for your site. You must use the mandatory
3
5
4 fields for all studies. These are the options from which you can select:
s
m • Patient I.D. (mandatory field)
e
t
s • Last Name (mandatory field)
y
S
l
ic
a • First Name (mandatory field)
d
M
e • Middle Name
s
ilp • Gender (mandatory field)
i
h
P • Date of Birth
• Age
6.3 Main area
• Age Group (mandatory field; automatically selected if age or date of

birth is entered)
• Patient’s weight (select from a range)
• Patient’s height
• Voice Language
• Accession number
• Other Patient ID
• Patient Comments
• Ethnic Group
• Referring Physician (doctor sending the patient to be scanned)
• Requesting Physician (radiologist reviewing final images)
• Operator Name
• Requesting Department
Note • Age Group - You must select the appropriate setting for the age of the
patient. If the patient is a child up to 18 months, the appropriate setting is
Infant.
• Gender - The Other option refers to Anonymous patients whose gender
is anatomically unidentifiable. It may also refer to anything other than a
living creature (for example, minerals and phantoms).
Note Mandatory fields must be completed in order to conduct a scan procedure.

All mandatory fields have a red asterisk.
Note You have the option to configure your system so that, during a manual
patient entry, the first field to be completed when you start a study is either
the Patient ID or Accession number.
Main area 6.3
6.3.2 Plan Scan window

After selecting a protocol, the Plan scan mode is activated. The Protocols
window closes and the Plan Scan window appears. The different steps of
the protocol (scans and recons) appear on the series list.
C
_
1
0
6
4
3
4
7
6
5 The scan protocol allows you to select and review the scan and
3
5 reconstruction parameters. Only after approving the parameters in the scan
4
s protocol can the scan or the reconstruction be executed. The protocol also
m
e
t
s
y
defines processing, archiving and filming parameters of the scan.
S
l
a
ic Note You are required to understand technical and physics parameters and their
d
e effect on each other in order to modify and approve scan procedure.
M
s
p
lii The first step in the scan series list, usually the surview scan, is highlighted.
h
P
The surview protocol parameters appear in the tool panel.
Note The toolbar is not used in the Plan Scan window.
6.3 Main area
6.3.3 Plan Surview window

The surview scan is a non-rotational scan that is used for planning the
clinical scans. This scan can be performed either AP (from above—180°) or
Lateral (from the side—90°). The option of dual surview may be used. The
Dual surview performs both scans one after the other allowing plan using
both scans.
The blue box overlay is the planned scan coverage area. Should you
manipulate the planned area, the system will automatically update the
corresponding protocol (see Plan on Surview for more information).
Note You must plan each scan separately:
• Each scan has its own plan box.
• The selected scan is the only active box (all others are grayed out).
Main area 6.3
6.3.4 Scan viewer window

The scan viewer window allows you to see the final results of your scan (all
images) before any post-processing is done. You can use this window to
ensure the quality of the images, as well as send specific images to print.
C
_
1
0
6
4
3
4
7
6
5
3
5
4
s
m 1 The Workflow bar contains the workflow buttons.
e
t
s
y 2 The Menu bar consists of several menu options which, when selected,
S
l
a display a list of operation that can be performed.
ic
d
e
3 The Toolbar contains icons for activating the frequently used
M functions. The icons on the Toolbar vary depending on the
s
ilp application you are using. Each is described in detail in the applicable
i
h
P chapter.
4 The Tool panel provides the tools and information necessary to
6.3 Main area
conduct a study (see Tool panel, on page 6-6).

5 The Message line displays help and system messages.
6 The Scroll bar is for scrolling through the images.
7 The Main area displays the reference images and resulting cuts.
8 The Graphics tools, located at the upper-right side of the Viewer
window, contains the graphical aids for annotating and measuring
features on the images.
The following sections illustrate and describe standard features for these
options:
• Toolbar
• Graphics tools
Keep in mind that the icons on the toolbar vary depending on the
application you are using and are, therefore, described in detail in the
applicable chapter.
Main area 6.3
Toolbar
Save image for saving the window contents.
Film image for sending the window contents to the Filming

application.
Select an option to display images: Single Image, Four Images, 4x4

Images (16), or Set Desired Number of Images.
Select image to select one or several frames.

Select one series to select one series from the multiple series currently
displayed (such as one of the two groups in Dual mode).
Select all to select all the images in the viewer.
Inverse image window to reverse the gray levels of the image, thereby
displaying a negative of the image.
Leaf & select Images for Fast Leafing and also for deselecting the
C
1
_ graphics, zoom, and pan buttons, thus enabling selection of images.
0
6
4
3
4
7
Enhance image allows you to drag mouse up or down to sharpen or
6
5
3
smooth the image(s).
5
4
s
m
e
Pan image for moving the selected images within the window.
t
s
y
S
l
a Zoom image for magnifying and reducing the selected images.
ic
d
e
M
s
p
Start Re-Recon for reconstruction of part or all of the images with
lii
h
P
different parameters such as Filter, Zoom, Pan and Window. The image
must have the zoom, pan and windowing optimized prior to pressing
Start Re-Recon.
6.3 Main area
Auto scroll down stops the automatic display of currently

reconstructing images so that the you can manually view images.
Graphics tools
The Graphics tools display in the upper right corner of the main window
after a scan has been executed. These tools provide the graphical aids for
annotating and measuring features on the images. (For detailed instructions
on using the graphical tools, see Legacy Viewer volume 2).
Line (straight, curved and freehand) for length measurement
ROI (elliptical, rectangular, curved and freehand) Regions of interest for

measuring area, mean and standard deviation of the pixel values
Text for annotation on the images
Cursor for measuring pinpoint pixel values
Angle for measuring angles between features on the image
Arrow for pointing to feature elements
Move graphic element
Rotate graphic element
Change the shape of the graphic element

anzubieten!
" Nützlich
% Nicht
nützlich
7 Scanner operation
7.1 Overview
In order to keep your scanner running efficiently, we recommend you
adhere to these tips:
• Each day, make sure that all archive transfers are complete in the
Archive Manager.
• Routinely transfer image sets to avoid large data transfers to PACS,
EBW, EOD, CD and DVD.
• Maintain the local disk at or below 75% capacity (approximately 400
studies)
• After using applications that are no longer needed, close or exit the
application.
• Perform a host computer restart daily, this will refresh the host
computer.
C
_
1
0
• When copying data to an EOD, limit the selection to four studies at
6
4
3
one time.
4
7
6
5 The remainder of this chapter covers these scan operation procedures:
3
5
4 • login and daily checks
s
m
e • operation of patient table
t
s
S
y • scanning process
l
a
ic • ancillary functions
d
e
M
s
Review this information carefully before using the scanner.
ilp
i
h
P
Brilliance CT - Volume 1 Scanner operation 7-1
7.4 Air calibration
5 Follow the steps detailed in the Follow Instructions dialog box.

6 Click Scan. The Air Calibration dialog box appears (the image below
displays the dialog box from the 64-slice configuration).
7 Select a set of calibration modes, or click All scans to perform all

calibration modes.
8 Click Start Scanning. The scanner runs the necessary scans and displays
the results. Upon completion, the system displays this message: Air
Calibrations Finished Successfully.
9 Click Close to return to the desktop.
Warning Do not perform air calibration with anyone in the scan room.
7-6 Scanner operation Brilliance CT - Volume 1
System shutdown 7.5
7.5 System shutdown

A complete system power-down is comprised of three procedures:
• Shutdown the gantry and Host computer
• Shutdown the CIRS server(s)
• Shutdown wall power
Note While it is not necessary that you shut the system down daily, you must do
so at least once a week, or as your site deems necessary. Do not shut down
wall power during weekly shutdown.
7.5.1 Shutdown the gantry and host

Use this procedure to shut down the gantry and the Host computer.
1 Turn OFF the key on the scan control box. The gantry will turn off in
approximately 1 minute. If you wish to abort the Shutdown, turn the
key back to the ON position.
2 Click Home. The system displays the Home menu.
C
_
1
0 3 Click Logout. The system displays the Welcome to Windows dialog
6
4
3 box.
4
7
6 4 Press Ctrl+Alt+Delete on the keyboard. The system displays the Log on
5
3
5
4
to Windows dialog box.
s
m
e
5 Click Shutdown. The system displays the Shutdown Windows dialog
t
s
y box.
S
l
a
ic 6 Select Shutdown from the dropdown menu.
d
e
M
s
7 Click OK. The system will turn off.
p
lii
h
P The gantry and host are now shutdown. If necessary, continue to
Shutdown CIRS computers, on page 7-8.
7.5 System shutdown
7.5.2 Shutdown CIRS computers

1 Locate the CIRS server(s) inside the cabinet. The number of servers will
vary depending on the your system’s slice configuration.
2 Press and hold the Power button on each server (about 5 seconds) until
the green light is off (order is not important here).
7.5.3 Shutdown wall power

1 Locate the Start/Stop buttons (wall power).
2 Remove power from the system by pressing the Stop button. The UPS
(if present) will beep, indicating power is off.
3 Wait at least 30 seconds before pressing Start.
Note Failure to wait at least 30 seconds may cause improper reboot, and require
you to repeat the entire process.
Note For long term shutdown, turn off UPS.

Operating the gantry tilt and table 7.6
7.6 Operating the gantry tilt and table

Press the appropriate buttons on the gantry panel to move the patient table,
switch the laser marker on or off and tilt the gantry.
Patients weighing up to 450 lb (204 kg) can be positioned on the table and
examined.
• Be especially careful when positioning heavy patients on the table.
• Before you start the examination ensure that the patient is not
endangered either by the movement of the table or by the inclination of
the Gantry.
The stability of the Patient table is not at risk when scanning very heavy
patients, but the correct functioning of the table (lift, positioning precision)
cannot be guaranteed 100%.
When the patient is lying on the stretcher, with legs towards the Gantry, use
the stretcher extension to support the patient’s legs.
Use the Axial Head-Holder for axial head scans and the Coronal Head
Holder for supine coronal head scans.
C
_
1
0
6 Caution • Blood and contrast medium are health risks. Take safety precautions
4
3
4 when removing blood or residual contrast medium.
7
6
5
• Use a commercial biocide, approved by your governing authority to clean
3
5
4
the surface of the system including the table, headholders and accessories
s (see Chapter 18: Cleaning the system for more information).
m
e
t
s
y
S
l
a
ic
d
e
M
s
p
lii
h
P
7.6.1 Patient positioning in gantry
Table Up/Down
To vertically position the region to be scanned from the lowered position
(where the patient can sit and then lay down on the Patient table in the
Gantry opening), use the Up button on the Gantry panel. Use the Up and
Down buttons to properly adjust the table position.
Table In/Out
To bring the patient’s region of interest into the Gantry opening, use the In
or Out buttons.
• “Tapping” an In or Out button will move the table 0.5 mm each time it
is tapped.
• When an In or Out button is continuously held down, movement
accelerates after about five seconds. For fine adjustments, press and
release the button accordingly.
To zero the indicators for the Patient table position at the beginning of the
study, press the Zero button. Zeroing is recommended only after the
patient has been positioned, prior to the first scan. After the first scan of the
study is performed, zeroing is disabled.
Note Wait at least 5 seconds after the zero button has been pressed before
beginning the first scan.
Warning When bringing an unrestrained child into the Gantry opening, be prepared
to prevent the child from reaching out to grab the Gantry Panel (especially
the Gantry Panel buttons).
Note • The Patient table cannot be moved IN when it is below a certain height.
Raise the Patient table UP to enable moving it IN.
• The Patient table motion stops within 10 mm upon actuation of an
emergency stop control.
• If the couch is pushed in manually by using the tapeswitch or foot pedal,
be sure couch is high enough (above 210) to avoid colliding with the
gantry.
7.6.2 Table and gantry movements
Manual motions
1 To move the Patient table and tilt the Gantry, use the motion controls:
• on one of the Gantry control panels
• on the Scan control box
Note Movement of the patient table is executed at two speeds. After pressing the
appropriate button, the table moves at a slow speed and after several
seconds, if the button remains pressed, it proceeds to a higher speed.
C
_
1
0
2 To stop movement, release the pressed button.
6
4
3
4
7
6
5
3
5
4
Caution • While movingthe table and Gantry, take care not to insert your feet
s under the table side covers or between the Gantry and Patient table.
m
e
t
s
• Avoid inserting your fingers between the stretcher and the table carriage.
y
S • Avoid placement of ancillary equipment (such as wheelchairs, IV pumps
l
a
ic or beds) under the table. The table could collide with these items during
d
e
M movement.
s
ilp
i
h
P
Automatic motions
In automatic mode, when a motion requires the use of the Enable button,
the following occurs:
• A message displays on the monitor, prompting the use of the button.
• The Enable LED lights up.
To allow automatically controlled horizontal positioning of the patient and
automatically controlled changes of the tilt angle when planning a study on
Surview, or between sequences, use the Enable button.
1 Press and hold the Enable button.
While the Patient table is moving, the Enable LED turns on until
motion stops—the horizontal table motion lights blink during motion.
When motion stops, the Patient table and tilt are positioned in the
desired location.
2 If necessary, correct the table position manually.
3 To stop movement immediately, release the button.
4 If the Enable button was released before arriving at the desired position,
press Enable again until the planned position is reached.
Gantry tilt
Note • In certain Patient table heights, the normal tilt range is limited. Raise or
lower the Patient table to enable tilting.
• The gantry tilt motion stops within an angle of 0.5degrees upon actuation
of an emergency stop control.
To tilt the Gantry forward (+) or backward (-), press the respective buttons
on the Gantry Panel. The tilt range is from -30 to +30 degrees. Zero (0)
indicates that the Gantry is in the vertical position. When adjusting tilt, the
table makes a full stop at zero tilt until the button is released and pressed
again.

Tilt safety envelope
For the patient’s safety, there is a “Safety Envelope” which limits the range
of the Tilt Angle as a function of the Patient table height. (The illustration
below displays this envelope.)
The system checks the scan’s Tilt Angle against the table’s Vertical position.
C
If the either of the values are outside the envelope, table motion into gantry
_
1
0
aperture is prohibited.
6
4
3
4 Tilt Angle Permissible Vertical Heights
7
6
5 +30 From -86 to - 15
3
5
4
s +15 From -168 to -15
m
e
t
s 0 From -208* to -15
y
S
l
a
ic -20 From -145 to -15
d
e
M -30 From -27 to -15
s
p
lii
h * when the couch is all the way out, this value is -400
P
7.6.3 Laser marking

The Laser On/Off button toggles on and off the marking laser. For precise
positioning of the patient in the slice plane, press the Laser On/Off button.
The slice plane is marked by a long, thin light-beam. The center of the
Gantry opening is marked by shorter and thicker perpendicular beams on
the top and sides of the body.
Note The laser beam utilization is best when using the external marker option
(all three planes are visible).
To turn off the marker, press the Laser On/Off button again. If not
switched off in this manner, the marker lights automatically turn off after
about one minute.
Warning • Do not stare into the laser beam.

• Instruct the patient not to stare into the laser beam.
• The use of optical instruments (such aseyeglasses with large diopter or
mirrors) with this product will increase eye hazard.
7.6.4 Patient release

To unload the patient, use the Patient release button on the Gantry control
panel. This first causes the gantry tilt to return to zero and the table to
move horizontally out to its limit. After both these have occurred, the table
moves down.
Note All motion stops when the Patient Release button is released.
Alternatively, bring the gantry to vertical using the Tilt button, then move
the table fully Out and then Down.
7.6.5 Emergency patient release

If the patient’s head is lying on one side of the Gantry opening and the
trunk and legs are lying on the other side of the opening, the patient should
be released in the direction of the legs.
If the head is likely to touch the roof of the Gantry opening, lower the head
by removing the head support or the pillow, and turn the head to the side
before moving the stretcher.
Warning After the Stop button is pressed, the table is locked in place for two
seconds. Then it will be free floating with no up/down capabilities. Make
sure that you maintain control of the table so that it does not move.
To release the patient in the event of a power failure, use one of the
following procedures:
Pulling the patient out

1 If the patient can safely be pulled out, pull the stretcher out.
C
_
1 2 Help the patient dismount.
0
6
4
3
4
7
6
5
Pushing patient in
3
5
4 1 If the patient can be safely pushed in, push the Patient table towards the
s
m back of the Gantry.
e
t
s
y
S 2 Help the patient dismount.
l
a
ic
d Note In the event of a power failure or when the Stop indication is lighted, it is
e
M
s impossible to move the elevator of the Patient table down. Therefore, it is
ilp
i advisable to keep a stool or stepladder on hand.
h
P
7.7 Scan procedure
7.7 Scan procedure

A typical scan procedure consists of these steps:
• enter patient information
• select patient position
• select an exam protocol
• perform scan
You may also choose to add any of these options to your exam procedure:
• Plan on Surview—Exam protocols usually include a Surview scan and
automatically launch Plan on Surview upon reconstruction of the
Surview image. See Plan on Surview, on page 7-50, for more
information.
• Dual Surview (optional procedure)
• Multi-protocol series of CT scans in Axial as well as Helical mode
• Multi-reconstruction
• MPR
The scanning process is set-up and initialized from the Scan control panel
on the screen. Table movement is controlled from the Scan control box
outside of the scan room or the gantry control panels inside of the scan
room. This section provides detailed steps to complete a typical exam
procedure, as well as descriptions of the available options.
Note In addition to the scanning options you also have the option to film and
conduct post-processing analysis.
Scan procedure 7.7
Enter patient information

1 Click Start Study. The Patient data form displays:
C
_
1
0
6
4
3
4 2 Enter the patient data (mandatory fields are highlighted). You have
7
6
5
several options for entering patient data:
3
5
4
• For a new patient, click New. See Entering a new patient, on
s page 7-37 for instructions on filling in patient data.
m
e
t
s • For a current patient, click Current. The system fills the fields with
y
S the information from the last patient entered.
l
a
ic • For an anonymous patient, click Anonymous, the system fills in all
d
e
M required information except age group.
s
p
lii • To select a patient from the catalog, click either Catalog or
h
P Scheduled. See Using the patient catalog, on page 7-38 for
instructions on using the patient catalog.
7.7 Scan procedure
• When connected to a HIS/RIS system, the software supports patient

data entry using a bar code reader (see Using the bar code reader, on
page 7-41).
• With a HIS/RIS connection you can also enter a patient ID or
accession number and click the HIS/RIS icon to access that patient’s
information.
Select a patient position and procedure

The next step in the scan procedure is selecting the patient position. Use
this procedure to select a position:
1 Locate the Position field in the upper right corner of the window.
2 Click the arrow to display a list of options. Highlight Decubitus to view
the additional decubitus positions:
3 Select a patient position by clicking it.

anzubieten!
" Nützlich
% Nicht
nützlich
Scan procedure 7.7
After the position is defined, you also have the option to select a requested
procedure:
1 Click arrow to the right of the Requested Procedure field. The system
displays a list of procedures.
2 Scroll through the list to select an option.
Now that you have completed the mandatory fields, continue to Select a
protocol.
Caution Before proceeding to protocol selection, verify that the patient information
loaded into the patient data fields (from any source) is correct. Failure to do
so could result in scanning a patient with the wrong information thus
requiring another scan on the patient.
Select a protocol
The scan procedure requires you to select an exam protocol. In order to
acquire optimal images, it is recommended that you use factory-set exam
protocols.
C
_
1
0 Note If in the previous step, you used a Requested Procedure with a linked
6
4
3 protocol and the classify protocols is on, you will not see the Exam Protocol
4
7
6 Groups in the lower right corner. The system will automatically load the
5
3 protocol that is linked to the Requested Procedure and display the
5
4
s accompanying protocol parameters (see Optimized Protocol Selection for
m
t
e more information).
s
y
S
l
a
ic
d
e
M
s
p
lii
h
P
7.7 Scan procedure
1 Click Exam protocol groups in lower right corner of the window, or

click the Protocols workflow button. The system displays the Exam
protocol groups:
Note The image above shows the Adult Exam Protocol Groups. When the
Classify protocols feature is active, an infant displays if the infant or Child
Age Group is selected.
2 Click an exam protocol group to select it.
Scan procedure 7.7
The system displays the exam protocols for that group.
C
_
1
0
6
4
3 • Tabs along the left side of the window allow you to select additional
4
7
6 single exam protocols (Surview, Axial or Helix).
5
3
5
• Exam protocols have mini-icons describing the specific automatic
4
s
options included. In the example above, the first four protocols
m
t
e feature Voice, injection and timing.
s
y
S
l Note Protocol names can vary based on facility. Check with the Chief
a
ic
d
e
Technologist to ensure you have the correct Protocol name.
M
s
ilp 3 Click an Exam protocol to select it. The system displays the viewer and
i
h
P
7.7 Scan procedure
the Protocol parameters for the first sequence.
4 If needed, edit the protocol parameters.
Note A reconstruction memory limitation may sometimes occur when you are
acquiring images using 2 second rotation time. This limitation causes the
images not to be reconstructed. If this occurs, perform the reconstruction
off-line, using the same parameters. (If this does not work, increase the slice
thickness and perform the off-line reconstruction again.)
Note You can click the Use previous surview image button (as seen above) to
load the previous surview to the plan viewer. The new surview step will be
deleted. This option is also accessible from the shortcut (right click) menu.
5 Click Go. The system displays a message when it is ready to scan.
Scan procedure 7.7
Note If the table has to move more than 100 mm, the enable button box displays.
Press and hold the Enable button until the Manual or Auto Scan prompt
box displays.
6 Press Manual or Auto to begin scanning the patient. Upon completion,

the system displays the images in the viewer window.
Note Except in the case of Surviews, if evolving was selected in the protocol, the
images display before the final reconstruction. Zoom, pan and windowing
can be changed after the clinical scan and before the main reconstruction is
performed.
7 If your Exam protocol includes a Surview or Dual Surview, you may

now plan on your Surview scan/s. If you used the current patient
option, the system displays a Use Previous option.
• Continue to Plan on Surview, on page 7-50 for instructions on
planning the Surview.
8 If you are finished with the study, you can end it and begin another.
• Click End study.
• If prompted, click yes to close the viewer.
C
_
1
0
6
4
3
7.7.1 Functionality of Series List during planning
4
7
6 • Clicking on a scan series opens the corresponding scan parameters and
5
3
5
plan viewer. The step becomes highlighted.
4
s • After the protocol is selected, planning is done step-by step, only the
m
e
t previous steps, the current step and the next step are enabled.
s
y
S
l
ic
a • After all the steps are planned, it is possible to select any one of them.
d
e
M • Proceeding to the next step can be done in three ways:
s
p
lii • Click the Next button.
h
P • Select the next step by clicking on it on the series list.
• Right-click Next on the graphical plan.
7.7 Scan procedure
• You can drag and drop steps in order to change the order of the scans.
You cannot drag Added reconstructions and MPRs to other scans.
Note Status icons update continuously.
Series list right click options

This section describes right click options on the series list.
During planning
The right click shortcut menu for the planning stage includes these options:
• Paste opens scan protocols and plan viewer for the new step.
• Copy and Paste to a scan with add recon or MPR applies to the add
recons and MPR as well.
• Delete when used on a scan eliminates the scan and corresponding
added reconstructions and MPRs.
• Delete when used on an added reconstruction deletes the
corresponding MPRs as well.
During scanning
• During X-ray On and during Timed Sequence, all steps are disabled
(grayed out). The current scan is highlighted in blue.
• During Get-ready and Ready-for-scan, all steps are enabled.
• During Get-ready and Ready-for-Surview, all steps except the Surview
step are disabled (because they haven’t been planned yet).
• If Pause is pressed during a Surview scan, all steps except the Surview
step are disabled (because they haven’t been planned yet).
• You cannot click or right click during X-ray On or Timed Sequence.
Scan procedure 7.7
• You can click and right-click in these cases:

• x-ray off (get-ready of the next scan)
• ready to scan (press manual/enable window)
• after pause was pressed
• at the end of all scans
Series list click on a step

This section describes the results of clicking on a step in the series list.
• If the step hasn’t been scanned yet , clicking it opens Plan on Surview
with the scan parameters from the last plan (re-plan). The step becomes
highlighted. If you clicked on the step during Get-ready or Ready-for-
scan, the system exits ready state and opened the scan protocols.
• If the scan was completed but the preview images are still in evolving
viewer (no final recon), clicking the step brings the evolving viewer to
front and opens the corresponding images (by scrolling on the evolving
viewer).
• If the final recon has started, clicking the step opens the corresponding
C
_
images. If the step is an MPR step, the images display in the CT viewer.
1
0
6
4
3
4
7
6 7.7.2 Edit the preset scans series
5
3
5
4 In either plan window, you have the option of editing the scan series.
s
m
e Note While planning a preset procedure before the final series has been planned
t
s
y
S (viewed), the GO button is grayed out and cannot be clicked.
l
a
ic
d Use the buttons in the Tool panel to edit the series.
e
M
s
ilp 1 Click the Edit icon to insert scans on the series list.
i
h
P
Note Only the clinical steps are added to the list. The Surview step is
automatically deleted.
7.7 Scan procedure
2 The Exam Protocol Groups dialog box opens.

3 Select a protocol to add to the Series list. The new scan is added after
current highlighted scan and all of its added recon and MPRs.
4 The Scan Protocol and plan viewer display the new scan’s plan viewer
and protocol.
5 Select an option:
• Click to duplicate the highlighted Series with the same parameters
and associated steps. The duplicated step is added after selected Series
and its recons and MPRs.
• Click to add a new recon. It is generated after the highlighted scan.
When Offline, the new add recon is generated as last Series.
• Click to add a new MPR step to the Series List after the highlighted
scan or recon. The scan protocol and plan viewer display the new
MPR step.
• Click Next Series to move to next step in Series list (including add
recons and MPRs).
Insert a scan
1 To change protocols after scanning the surview, click Protocol on the
Workflow bar. The system prompts you to end the current procedure.
2 Click Yes. The Exam protocol window appears.
3 Select the new Exam group.
4 Select the Exam protocol. The Plan scan window appears with the new
scan series. The previous surview scanned is the first scan series in the
scan series list. The check next to the Surview indicates the scan was
already performed.
Note If any other scan series was performed they also appear with a check mark.
Any scan that was not performed does not appear in the list.
Scan procedure 7.7
5 To plan the new scan on the surview previously scanned, right click the
new scan.
6 Select Use previous surview (or click the Use previous surview button
at the bottom of the protocol dialog box). The new scan can now be
planned on the surview previously scanned. If the new protocol
contains a surview, the second (new) surview will be deleted from the
scan series list.
7 If you have already clicked End Study and want to add a new protocol
for the current patient, click Current. The current patient’s data
automatically completes.
8 Select the patient position.
9 Click Protocols.
10 Select a new protocol. The Plan scan window appears with the scan
protocol.
11 Right click the clinical scan series.
12 Select Use Previous Surview (or click the Use Previous Surview button
at the bottom of the protocol dialog box). The previous surview
C
1
_ replaces, or is inserted into the new series list.
0
6
4
3
4
You may now plan the new scan on the surview image you previously
7
6 scanned.
5
3
5
4
s
m
e
t
s
y
S
l
a
ic
d
e
M
s
p
lii
h
P
7.7 Scan procedure
Copy, paste, and delete scan series

1 Right click a Scan series to display the shortcut menu.
2 In the shortcut menu select the desired option:
• Copy to copy the series to the clipboard.
• Paste to paste the series in the clipboard to the series list (multi-series
scans only). The pasted series is inserted below the selected series.
• Delete to delete the series (multi-series scans only).
Plan MPR
MPRs are generated from the scan data and may be useful to quickly
visualize the area of interest. MPR can be planned during the plan scan
stage. After the reconstruction is complete, the CT Viewer launches and the
MPR images display. Use this procedure to add a MPR to your study.
1 Click on a scan in Series list during Plan Scan stage.
2 Click Insert MPR. The MPR is inserted after the selected series.
Setting MPR parameters

1 Click on the MPR in Series list to view the parameters.
• Change the length graphically or by typing in the desired value.
• Change the FOV using the graphical interface.
MPR orientation
You can change the orientation of the MPR using one of these methods:
• Use the orientation buttons (Sagittal/Coronal/Axial) to set the MPR
direction (use maximum scan volume).
• Use the Sagittal angle and Coronal angle. Range is –90 to +90.
• Use the graphic interface to rotate the MPR.

Scan procedure 7.7
Note When generating an MPR the user can only set the Tilt angle. The angle
depends on the Surview used. In the Surview plan viewer, only the
graphically viewed angle may be set.
• When using a Surview 180, Sagittal angle can be rotated.
• When usingSurview 90, Coronal angle can be rotated.
• When using both angles, the plan box (blue filled rectangle) is used to
manipulate MPR (such as; move, change FOV).
After all images are reconstructed, MPR images are automatically loaded
into the CT Viewer. You can Edit the MPR this way:
1 In the CT Viewer, select the Series selection tab; the whole volume and
MPR series are listed.
2 Select the MPR series.
3 Edit a batch using the Delete and Insert keyboard keys:
• Press Delete to delete a slice.
• Press Insert to insert a slice.
Note These changes are done on the closest MPR plan box edge.
4 Using the mouse, drag the box edge to graphically rotate the MPR box.
C
_
1 5 Right click the series in the Series selection tab.
0
6
4
3
4 6 You can choose to Save as well as to Film the images.
7
6
5
3
5
Note To save the MPR images, select the MPR series and click Save. Images are
4
not automatically saved. The series is saved in the Storage device that was
s
m defined in the Auto options of the protocol.
e
t
s
y
S
l
a
ic
d
e
M
s
ilp
i
h
P
7.7 Scan procedure
7.7.3 Fast get-ready

Note The Fast Get-Ready feature is enabled/disabled in the Preferences function,
which is described in the Directory of the user guide.
When the Fast Get-Ready feature is enabled, the examination flow box does
not display between the series. Reconstruction is halted until the current
series is complete.
When the Fast Get-Ready feature is disabled, the examination flow box
displays between the series. Reconstruction runs during the current series.
7.7.4 Scanning workflow

This section provides some basic information regarding the workflow
during a scan procedure. Keep in mind that the main steps of the procedure
are accessed using the workflow buttons at the top of the Home window
(see Chapter 6: Navigating the software for more information).
Using the Enable button

After clicking Ok at the end of Plan on Surview, you may be prompted to
press the Enable button to move the patient table and gantry to the
position of the first planned series.
• Press and hold the Enable button on the Scan control box to begin
patient table and gantry motions, while watching the patient.
• Releasing the button stops the motion.
• Pressing the button again resumes motion.
Scan procedure 7.7
Warning • During all movements of the gantry (automatic and manual) and the
patient table, keep the patient under continuous observation to avoid
pressing the patient against the gantry or between table parts, aswell as
to avoid disconnecting any infusion or resuscitation apparatus.
• During studies, the patient table or gantry movements are automatic.
Make sure that there is enough clearance between the patient and the
gantry. Before initiating the scan, perform manual movements to check
the clearance.
• Make sure that the patient is strapped securely to avoid dangling of the
hands. Ensure that the patient is placed securely on the patient table and
is not in danger of falling.
• Auto scan means that automatic motions are expected without using the
enable button.
Note • If patient table position and gantry tilt change, the system displays an
error message. Click OK to resubmit the plan.
• If you want to change the procedure preset flow, press the Stop/Pause
button.
• If the patient’s position (orientation) requires changing, Click Pause and
C
_ change the Patient Position (at the bottom of the window) to correspond
1
0
6 to the actual patient orientation on the table.
4
3
4
7
6
5
3
5
4
Warning Once the table has moved to the planned position, DO NOT reposition the
s table. If a different start position is desired, pressStop/Pause and replan the
m
e scan.
t
s
y
S
l
a • The LEDs for Manual Scan and/or Auto Scan on the Scan control box
ic
d light up when the scanner is ready to scan. Press Manual to perform the
e
M
s
p
series one-by-one (for multiple Axial scans, you also have the option to
lii press Auto to perform all scans).
h
P
• During X-ray production the following lights turn on:
7.7 Scan procedure
• the X-Ray Indicator Lamp on the Scan control box

• the X-Ray indication on the gantry control panel
• When the scanner is busy, the Manual Scan and Auto scan buttons are
not lit.
• When working with Axial or Helix/Concurrent mode, the images are
reconstructed during the scan.
• Adjust the window Center and Width for optimal viewing of the
image.
• Zoom and pan the image to enlarge and center the image or the region
of interest. Also, you may set the image to optimal size and move it with
the mouse.
• All subsequent images of the study will be zoomed to the same size
when the A (All) button appears clicked.
• To switch image scrolling through the viewer On/Off, click the
Automatic Scrolling button.
• When On, each image scrolls through the viewer (according to the
number of displayed images) as quickly as it is reconstructed.
• The process repeats until switched Off, or until the reconstruction is
complete.
• When Off, the scrolling process stops, without affecting the
reconstruction process.
Note If you perform a graphic operation during the image display (positioning of
any graphical element like ROI or cursor), the Automatic Scrolling function
is automatically switched off.
• For detailed operation instructions on image manipulations and

graphics refer to Volume 2: Review Modes.
• Perform the rest of the scans in the series, using the Manual and Auto
Scan buttons on the Scan control box.
Scan procedure 7.7
• To interrupt scanning, press the Stop/Pause button on the Scan control

box or select the Stop/Pause button in the Scan toolbox at the left side
of the screen.
• When the series is completed, the patient table and gantry tilt are set for
the next series. The gantry tilt will change only when you press Enable.
• The steps are repeated until the whole plan procedure is completed.
C
_
1
0
6
4
3
4
7
6
5
3
5
4
s
m
e
t
s
y
S
l
a
ic
d
e
M
s
ilp
i
h
P
7.7 Scan procedure
7.7.5 Examination flow

The Examination flow dialog box allows you to make changes during a
study. Access the dialog box by clicking the Stop/Pause button located in
the tool box or pressing the button on the scan control box. The dialog box
also displays when the scan series is complete.
The Examination flow box also displays at the end of each series in a study.
There are several conditions under which you may choose to use this
option:
• pause in the middle of a study
• change the exam protocol
• select a new protocol
• extend the length of the scan
• repeat the same scan
• continue to the next series
• re-plan on Surview
• stop an exam
Scan procedure 7.7
Note When you have multiple series planned with a trigger, all series are scanned
using the trigger mode, and the Examination flow box doesnot display until
all series are complete.
These options are available:

• Repeat last series - repeat (without change) the previous scan of any
type (Surview, Axial or Helix). For more information, see Patient data
options, on page 7-37.
• Next series - go to the next series as planned in the Plan on Surview
stage. Next series blinks when Stop/Pause displays between series. If the
present series is the last one, it is grayed out.
• Continue current series - continue scanning in the current series. The
system automatically provides default values for the Table start position
as well as the length to be added (in mm). You have the option to enter
your own Start and Add values.
When starting a new study with Current patient, there is an option to
Continue Previous Study in order to add new scans to the last study,
thus having a single entry in the Archive.
If Current is selected, the Continue Last Procedure button brings the
C
1
_ previous procedure of the last study including the plan and any
0
6
4
changes.
3
4
7 Note The Examination Flow dialog box also displays automatically between series
6
5
3 to allow you to continue to the next series and at the end of the study to
5
4
allow you to stop the exam.
s
m
e
t
s
y
S
l
a
ic
d
e
M
s
p
lii
h
P
7.7 Scan procedure
Repeating or continuing a series

Use the Repeat Last Series option to scan according to your last scan.
• Click Repeat Last Series. The system prepares to run a scan identical to
the most recent scan conducted. It automatically provides default values
for the table start position, slice number and Number of Slices.
Use the Extend series option to alter the scan position or scan length. You
can change position and length using slices or table position:
Slices
1 Enter a value in the Start at slice # field to change the default start
location of the additional images. If contiguous additional images are
desired do not change the default start slice.
2 Enter a value in the Add Slices field. The default number is the
minimum number of images the scanner can add. Additional images
can also be added.
3 Click Continue Current Series.
Position
1 Enter a value in the Start position box field to change the default start
location of the additional images. If contiguous additional images are
desired do not change the default start position.
2 Enter a value in the Add mm field. The default number is the
minimum length the scanner can add. Additional length can also be
added.
3 Click Continue Current Series.
Patient data options 7.8
7.8 Patient data options

This section describes the options available for entering patient data in the
patient data window.
Warning The Change patient name option in the directory shortcut menu, allows
you to fix patient data that has been manually entered in the patient data
form. T his feature should not be used with patient data entered from the
HIS/RIS system.
7.8.1 Entering a new patient

When entering a new patient, you must enter the mandatory fields which
are highlighted. Use this procedure to enter a new patient:
1 Click Start Study.
2 In the Patient ID field, type the Patient ID for the patient to be
C
_
scanned.
1
0
6
4
3 In the Last Name field, type the last name of the patient and press Tab.
3
4
7
6
4 In the First Name field, type the first name of the patient and press
5
3 Tab.
5
4
s 5 Click appropriate Age group option for the patient:
m
e
t
s • Infant
y
S
l
a
• Child/Youth
ic • Adult
d
e
M
s
ilp
i
h
P
6 Click the appropriate Gender for the patient:

• Male
• Female
• Other
7 Select a scan position.
8 Enter the rest of the patient’s details, if desired (they are optional).
Note • To reach a field from anywhere on the screen, click inside the text box.
After typing the data, press Enter. The cursor jumps to the next field.
<Tab>also jumps between consecutive fields.
• Enter the date in the international format: yyyy mm dd (1969 1002).
• The value of the Age field can be typed directly. Once the Date Of Birth is
entered, the patient’s age and Age range are automatically entered.
Upon completing the patient data entry, continue with the scanning
procedure on page 16.
7.8.2 Using the patient catalog

The Patient catalog window is used for handling and managing the Patient
catalog database and for easy selection of a scanned patient. The default
screen uses the Patient Name column to set priority of the list (according to
the alphabetical order of the patients’ family names), although the order in
which the lines display can be arranged according to preference. At the head

anzubieten!
" Nützlich
% Nicht
nützlich
of each column is a button that, when clicked, rearranges the order of all
the lines, according to that parameter.
C
_
1
0
6 • The Patient catalog list displays only those patients who have already
4
3
4
been scanned.
7
6
5
• Scheduled list displays only those patients who are scheduled to be
3
5
4
scanned.
s
m
• HIS/RIS opens the list of patients in the Hospital or Radiology systems
e
t
s database for extracting patient data to the Patient data form (displays
y
S only when Brilliance is connected to Hospital LAN).
l
a
ic
d
e Note When HIS/RIS is enabled you also have the option of displaying the medical
M
s alerts stored in the database. Usually the Scheduled list is updated by the
ilp
i HIS/RIS pushing patients into it.
h
P
Menu bar
The Menu bar of the Patient Catalog consists of several options:
File includes these options:
• Add a New Patient to the scheduled list.
• Delete a selected line from the catalog.
• Save Catalog in a file and clear the catalog.
• Logout of the Brilliance system.
• Close the Patient Catalog.
View contains a list of the Patient data fields. A selected item (marked by a
yellow rectangle) displays in the Patients list.
• Layout displays a dialog box with the Patient Data Column Head
parameters. From the dialog box, columns can be included or excluded
from the Patient Catalog by selecting or deselecting those parameters.
• Filter displays the in Filter dialog box.
• No Filter clears all filters.
• Days Filter opens a dialog box which contains additional options:
• No. of days before
• Today
• No. of days after
• All orders display all order.
• Scheduled displays scheduled patient studies list.
• Catalog displays all the catalog patient list.
• Cancel stops the filter operation (after defining filters in dialog box).
• Refresh reorders the list according to the filter parameters.
• HIS/RIS displays the HIS/RIS patient list (if connected).
7.8.3 Using the bar code reader

The Brilliance CT software supports use of a bar code reader to enter
patient data into the patient data form. This option can be used if HIS/RIS
is implemented in your facility.
1 To use the bar code reader, scan the patient’s bar code with the bar code
reader.
The HIS/RIS catalog displays all the patient’s studies/accessions that
have been ordered.
C
_ 2 Select the desired accession/study.
1
0
6
4
3
3 Click OK to populate the patient information into the patient data
4
7 window.
6
5
3
5 Note Depending on the HIS/RIS that is accessed, this behavior may vary slightly.
4
s
m
e
t
s
y
S Warning Avoid pointing the bar code reader at the eyes. The laser light may cause
l
a
ic eye damage.
d
e Avoid access to the bar code reader by untrained personnel.
M
s
p
lii
h
P
Warning Make sure you confirm patient details after using the bar code reader.
7.8.4 PreFetch
The PreFetch feature allows you to access previous studies of a patient
before conducting a follow-up exam, regardless of scan type (CT, MR, CR,
RF) or storage location. You can send these images to a pre-selected archive
location in order to access them for viewing. The default Prefetch filter can
be set from the Preferences function (see Preferences utility, on
page 18-22).
PreFetch is accessed from the Patient data window. Use this procedure to
access the Prefetch option.
1 Type the appropriate information in the Patient ID field.
2 Click the PreFetch button to the right of the Patient ID field.
The system displays previous studies of the specific patient in the

Archive manager.
3 Select a study or studies to review.
4 Click Ok. The system provides a list of destinations where you can send
the images.
5 Select a destination.
6 Click Ok to load the images.
Note The selected device and destinations are retained until the next time
Prefetch mode is used.
Warning Before continuing to Exam Protocol Groups, verify that the patient
information loaded into the patient data fields is correct. Failure to do so
could result in scanning a patient using the wrong protocol or patient
information.
C
_
1
0
6
4
3
4
7
6
5
3
5
4
s
m
e
t
s
y
S
l
a
ic
d
e
M
s
ilp
i
h
P
7.9 C hange patient name
7.9 Change patient name

Patient data can be changed using the Change Patient Name feature. You
may choose to use this feature in cases such as these:
• If a patient study was created using the Anonymous feature, the patient
details may be changed after completing the study
• If a patient study was created using the wrong patient data, the patient
data may be corrected after the study is completed.
• If a patient study is used for publication, the patient details may be
changed to anonymous patient data.
Warning The Change patient name option should not be used with patients entered
from the HIS/RIS system.
7.9.1 Procedure
The Change patient name feature is accessible from the local Directory. Use
this procedure to change patient data.
1 Select the patient study or individual series to change.
Note: If a study is selected only the series selected in the series list are included in
changing the patient name.
2 Right click the series or patient study.

3 From the menu, select Change Patient name. The Change Patient
Name dialog box appears.
C hange patient name 7.9
4 Change any of the patient information. There are two methods to

insert new patient data:
• The new patient details can be imported from the HIS/RIS. Click
HIS/RIS and select the patient. Click OK. The dialog box fields are
updated with the HIS/RIS patient details. The new patient study has
the unique ID of the selected patient in the HIS/RIS.
Note The HIS/RIS button displays only if the HIS/RIS connection is configured.
• Manually type in the new patient details. A new study entry with a
unique ID is created in the local directory with the new patient
details.
Warning Manually typing new patient details will change only the details of the
available fields. All other available patient data will be cleared from the
patient study.
5 Click OK to save the changes. A new study is created in the local

directory with the new patient details.
C
_ When importing the new patient details from the HIS/RIS, if the system
1 Caution
0
6 preference is configured to take the study unique ID from the HIS/RIS, the
4
3
4
7
original study and the new study with the changed patient details will have
6
5 the same unique ID.
3
5
4
s
A new unique ID is created when the HIS/RIS is not used.
m
e
t The original study entry is not changed and remains in the original storage
s
y
S
l
a
device/folder. It is up to the user to retain or delete the series duplicates.
ic
d
e
M
s
p
lii
h
P
7.10 Surview scan (for plan on Surview)
7.10 Surview scan (for plan on Surview)

1 After entering patient data, select an Exam protocol which includes a
Surview scan. The Surview protocol displays in the tool panel. It is the
first series in the study. If you have selected the current patient option,
the system also displays a Use Previous Surview button:
• To create a new Surview, continue to step 2.
• To use the previous Surview, click the button and continue to Plan on
Surview, on page 7-50.
Note You can ensure the protocol includes a surview by holding the pointer over
the mini-image until the description box displays.
2 If necessary, edit the Surview scan parameters.

• The parameters are divided into tabs. Click the protocol tabs to view
and edit the parameters.
• To review a scan for the first time, each scan series must be reviewed
in the order of the scan series list. After first reviewing all the series
you may return and re-edit the series in any order.
• To continue to the next scan series, click NEXT.
• When the scan protocols are correct, click GO.
Note Parameters that are grayed out cannot be changed.
3 When the initialization of the scanner is complete, it is ready to scan.

The system displays a message and the Manual scan button lights up on
the Scan control box.
4 Press the Manual scan button to perform Surview. The Surview image
displays.
Patient centering 7.11
7.11 Patient centering

Patient centering is a feature to assist the user to properly center anatomy. A
green center line appears on the lateral surview (90 degree) as a graphical
representation of the ISO-center of the gantry.
You can adjust the bed height by using the up/down arrows on the CT box
to assure that the anatomy being scanned is at the ISO-center of the gantry.
As you adjusts the bed height, the green center line moves across the lateral
surview image.
Image quality is affected by the distance of the reconstructed image from
the ISO-center. The further the image is from the ISO-center the lower the
image quality. When the patient is positioned on the couch, the anatomy
to be scanned should be placed within the ISO-center for optimal image
quality.
Procedure
1 Do a lateral surview scan:
C
_
1
• Position the patient on the bed.
0
6
4 • Scan surview.
3
4
7
• A green line representing the ISO-center appears on the lateral (90
6
5 degree) surview.
3
5
4
s Note If the center line is not desired, right mouse click over the surview and
m
e select Hide center line. The next time a lateral surview is scanned the
t
s
y
S center line will appear.
l
a
ic
d
e
M
s
ilp
i
h
P
7.11 Patient centering
2 Verify the ISO-center position on the lateral surview.

• If the patient anatomy is not in the desired position (off of ISO-
center) then raise or lower the table by pressing the up/down arrow on
the CT box.
Warning Adjusting the table height after planning on the surview may result in
undesired outomes.
• If the patient anatomy is in the desired position (ISO-center) then

proceed with planning and/or scan.
3 Complete scan.
Warning Watch the patient at all times during all bed movements (either vertical or
horizontal), to ensure safety while the patient is inside the scanner opening.
Additional information
• When a vertical motion starts, the system switches to the main recon of
the currently planned scan.
• When you change the bed’s vertical position, the system automatically:
• Re-calculates the reconstruction y-shift according to the new position
of the ISO-center.
• Changes the Y-shift in the reconstruction parameters.
• Changes the Y-shift in the Plan viewer accordingly for the current
recon (active recon being planned).
• If a scan, other than the current scan, requires a change in parameters to
enable the Y-shift (for example, pitch), that scan becomes un-planned

Patient centering 7.11
and the following message appears: "As a result of the change in bed
height, the following steps need to be re-planned:...” It includes a list of
the relevant step numbers in the form of: Step #1, Step #2, and so on.
• For the current scan, the pitch is changed automatically, and no
message appears.
• If a scan is planned in the IN direction, but is not preceded by an OUT
scan over the same anatomical region, you are prompted to move the
couch (using Enable) to the innermost scan position, at which point
you are ready to proceed with the scan.
Warning During all movements of the bed, the operator should be looking at the
patient on the bed in order to prevent any collisions between the patient
and the gantry covers.
C
_
1
0
6
4
3
4
7
6
5
3
5
4
s
m
e
t
s
y
S
l
a
ic
d
e
M
s
ilp
i
h
P
7.12 Plan on Sur view
7.12 Plan on Surview

When the surview scan is complete, the surview image displays with a plan
scan series box:
Three surview images are saved for a study:

• the surview
• the surview with the planned scan box
• the surview with the ES (executed scan) lines
Note After scanning a clinical series, the surview image is saved with the ES
(executed scan) lines.
Plan on Surview 7.12
The scan control panel displays the parameters for the next scan .
General rules for multiple scan series

If the patient moved on the table, click the Stop/Pause button.
If the patient’s position requires changing, restart the procedure.
Warning To ensure accurate planning and execution, do not move the table Up or
Down after the AP Surview scan.
7.12.1 Defining the position of a scan series

In order to define the position of a scan series, you must first familiarize
yourself with the tools provided in the scan window.
Plan window toolbar

C
1
_ The Toolbar, located at the top of the window, contains these buttons:
0
6
4
3
• Save to save the image either as a DICOM image or as a secondary
4
7
capture.
6
5
3
5
• Film to film the image with the plan box.
4
s
m
• Inverse to view the image in inverse color.
e
t
s
S
y • Leaf & select for Fast Leafing and also for deselecting the graphics,
l
ic
a zoom, and pan buttons, thus enabling selection of images.
d
e
M • Enhance to enhance the view (click the button and drag the mouse over
s
p
lii
the image).
h
P
• Pan to pan the image.
• Zoom to zoom the image.
7.12 Plan on Sur view
To define the position, coverage and angle of the series on the Surview
image use this procedure:
1 Place the pointer over the plan box.
2 Right click to display the shortcut menu:
• Show line - to view the ES lines
• Hide inactive steps - to hide the plans of other scan series.
• Hide transparent filling - to hide the light blue hue filling the active
scan step.
• Next step - to go to the Surview plan of the next series step.
• Delete step - to delete the active series step.
3 Click the middle mouse button to window the image.
4 Drag with the left mouse button pressed:
• If the mouse is in the middle of the plan box the box is dragged with
the mouse.
• If the mouse is over one of the box boundaries the boundary will drag
with the mouse.
Plan on Surview 7.12
Plan cursors
When the cursor is over the plan area, it changes shape:
Move the Scan - move mouse Cursor to the middle of scan plan box (not
on top one of the scan's borders), click and drag the scan plan box to its
desired position.
Change Start/End - move mouse Cursor to beginning or end of scan, click
and drag the line up or down.
Change Field of View - move mouse Cursor to the scans side borders, click
and drag the line left or right.
Rotate the scan (Axial and MPRs only) - move mouse Cursor on the Rotate
icon above the scan rectangle, click and drag the mouse left or right.
When the mouse is over the corners of the contour click and drag the
corner to change the corner position. This changes the start or end, length,
FOV, X/Y shift. When dragging the corner, the FOV does not change
symmetrically
C
_
1
0
6
4
3
4
7
6
5
3
5
4
s
m
e
t
s
y
S
l
a
ic
d
e
M
s
ilp
i
h
P
7.13 Dual Surview
7.13 Dual Surview

The Dual Surview is an option which allows you to perform two
consecutive Surview scans:
• Lateral (90°) while the table moves out.
• AP (180°) while the table moves out.
You can plan the study on both Surview images. Use this procedure to
conduct a Dual Surview:
1 During normal Patient set-up, select an exam protocol which includes
Dual Surview.
Note You can change a single Surview to Dual under the View Angle field:
Form the View angle menu, select dual.
2 If necessary, edit the protocol parameters.

3 Click Ok on the Surview scan protocol panel.
4 Click Automatic to initiate automated dual Surview scan sequence.
• A lateral Surview is performed. When the first scan is complete, the
lateral Surview displays in the Viewer.
• When the second scan is complete, the AP Surview displays in the
Viewer with the plan lines for the first series.
5 Adjust the location of the first series on the AP Surview image.
6 Click the toggle button to view the Lateral Surview.
7 Adjust the location (and tilt if necessary) of the first Series on the
Lateral Surview. The plan changes are also updated on the AP Surview.
8 Use the toggle button to switch between the Surview images and
optimize the plan according to your needs.
9 Click Next to repeat planning for any additional sequences in the Exam
protocol.
10 Click Ok to begin scanning.
Multi Surview 7.14
7.14 Multi Surview

Multi Surview is an option which allows you to perform as many
consecutive Surview scans as you desire. You have the choice of these scan
types:
• AP Surview while the table moves out.
• Lateral while the table moves out.
You can plan the study on the Surview images. Use this procedure to
conduct a Multi Surview:
1 During normal Patient set-up, select an exam protocol which includes
Multi Surview.
Note You can change a Surview to Multi under the View Angle field:
From the View angle menu, select Multi.
2 If necessary, edit the protocol parameters.

3 Click Go on the Surview scan protocol panel.
C
_ 4 Press Manual to initiate the scan. An AP Surview is performed as the
1
0
6 table moves in the out direction. When the first scan is complete, the
4
3
4
AP Surview displays in the Viewer.
7
6
5 5 Repeat last series as many times as necessary to get desired accuracy.
3
5
4 • Extend series allows you to add more length to scan. Click Repeat
s
m Last Series to scan.
e
t
s
y 6 Click Next Series to go to 90° lateral.
S
l
a
ic
d Note Press the Pause button at any time to continue to the Helical scan
e
M
s
p
lii 7 When desired Surview results are obtained, click Next Series to move to
h
P the Plan on Surview stage.
7.15 Organ ID
7.15 Organ ID
The Organ ID feature automatically isolates the lung images for better
viewing. Depending on your settings, the system automates these tasks:
• detection of lung limits
• setting zoom and pan (per picture or per series)
• lung windowing
• filming of selected images
When you access the Organ ID menu, these options are available:
• Per Image-set each window and zoom as desired.
• All selected-system automatically sets window and zoom for all images.
• Undo after film-resets all images to original settings after filming is
complete.
• Perform with window-automatically enables optimized windowing.
Warning After activating the Organ ID feature, make sure that the ROIs created on
the images are included in the current view and that all images have been
produced.
Organ ID 7.15
Use this procedure to access Organ ID.

1 At the end of a study, click Organ ID. The Organ ID menu displays.
2 Click Lungs. The system automatically performs these procedures:

• detection of Lungs limits
• selection of images with Lungs in viewer
• zoom and pan (per picture or per selection of images)
• lung windowing.
3 If you wish to film the resulting images, click the Film Icon.
4 To return the original images after filming, select Reset All from the
Edit menu.
C
_
1
0
6
Note If Undo after filming is selected, the images automatically return to their
4
3 original state.
4
7
6
5
3
5
4
s
m
e
t
s
y
S
l
a
ic
d
e
M
s
ilp
i
h
P
7.16 Voice manager
7.16 Voice manager

Use Voice manager to add new custom auto voice phrases, or edit and
delete existing auto voice phrases that may be used during the scan process.
When using the voice manager to record autovoice, make sure to turn
down the volume control setting from the Gantry as doing so will reduce
background noise in the recording and improve the sound quality.
Recording does not require the you to press the microphone button.
1 From the Home menu, click Utilities.
2 Select Voice Manager from the Home utilities. The system displays this
dialog box:
• The left side of this box displays the stored languages.

• The right side displays the sets of instructions available in each
language.

anzubieten!
" Nützlich
% Nicht
nützlich
Voice manager 7.16
3 Click an option on the menu bar to access its features:

File-exit the voice recorder.
Language-add a new language, delete an existing language, set the
selected language as the default.
Set-create a new set of instructions, delete the selected language set
from all languages, clear the selected set from a specific language, save a
set of instructions.
Tools-configure volume of the voice.
Note File names followed by the letter (L) are Locked, and cannot be deleted or
edited.
Note • To activate a selected option, click Ok.

• Clicking on the Cancel button will cause the application to exit. Any
changes which have been saved, will be kept.
• After selecting a set of messages, it is possible to listen to the pre-scan
and post-scan messages by pressing the PRE > or POST >button
respectively.
• While listening, click the Stop button to stop the message.
C
_
1
0
6
4
3
4
7
6
7.16.1 Create a new voice command
5
3
5 Use this procedure to record a message for use during a scan.
4
s
m 1 Click Home to access the menu options.
e
t
s
y 2 Select Voice Manager from the Utilities list.
S
l
a
ic 3 On the scan control box, reduce the volume for listening and speaking
d
e
M
s
using the controls on the side of the box.
ilp
i 4 Select Create New from the Set menu options.
h
P
5 Name the new set. The system displays the new name in the voice list.
7.16 Voice manager
6 Click on the new name.

7 Name the Pre (start) message.
8 Press and hold the Mic button on the scan control box.
9 Click the Record button on the Pre side of the Voice manager window.
Note If you release the Mic button before you end the recording, feedback noise
will be created.
10 Speak in low to normal tones, taking care to position yourself away

from the microphone.
11 Name the Post (end) message.
12 Repeat steps 7 through 10 using the commands on the End (Post) side
of the Voice manager window.
Note When both messages are complete, you can check them using the
corresponding play button.
13 Click File.
14 From the Set option, select Save to save the new voice command.
Note You must log out of the system and then log in to use the new voice
command.
Continue current study 7.17
7.17 Continue current study

The Continue current study feature can be used to add series to last patient
study after clicking End Study.
• To continue the study, click the Continue Last Study check box on the
patient data form.
• The option is enabled if the patient was selected by pressing “Current”
on the Workflow bar.
• To repeat the last scan with the same protocol click Select Last Exam
Protocol.
C
_
1
0
6
4
3
4
7
6
5
3
5
4
s
m
e
t
s
y
S
l
a
ic
d
e
M
s
p
lii
h
P
7.18 Split study
7.18 Split study

If the requested procedures for the imported HIS/RIS studies were preset in
the generated protocol, the Create New Study for the Required Procedure
parameter in the Auto Option tab is automatically set.
If the procedure description was not set in the generated protocol, the
required procedure must be selected manually.
If the requested procedure was set in the generated protocol, it
automatically displays in the Start Study window and is used as the series
description in the Directory.
Note The Create New Study for Required Procedure lists only the imported
HIS/RIS procedure descriptions for the current study.
Use this procedure to set the requirements for each scheduled study:
1 Enter the patient ID number, accession number or patient name and
click HIS/RIS.
2 Select the scheduled patient scans to perform. Click OK.
3 Click Exam protocols and select the scan Group and scan series for the
first scan to perform.
4 Review all scan parameters before scanning the surview.
5 Create a plan on Surview for the entire area to be scanned (for example,
Chest Abdomen, and Pelvis in one series).
6 Insert additional reconstructions to match the number of requested
procedures selected from the HIS/RIS.
7 Click the first additional recon.
8 Click the Automatic Options tab.
9 Select the first requested procedure.
10 Plan the additional reconstructions to cover the area of interest
Split study 7.18
11 Repeat steps 8 through 10, for each additional reconstruction and

requested procedure.
12 When you have completed the plan, click GO to acquire the scan. The
entire study is acquired and reconstructed as one series. Additional
reconstructions are also completed and shown as individual series in the
Archive.
Each scan appears in the Directory:
• A separate study is created.
• Each study has a surview series: the regular surview and the ES
Surview image.
Note The PS Surview image is saved with the first series.
C
_
1
0
6
4
3
4
7
6
5
3
5
4
s
m
e
t
s
y
S
l
a
ic
d
e
M
s
ilp
i
h
P
7.19 Create Dose Summary Image
7.19.1 Overview
When you end a study an image is added to the surview series in the patient
directory. This image contains a dose summary of all scanned series.
7.19.2 Set parameters

Click the Preferences button to open Preferences.
In Preferences under category you must select options under the directories
Image Viewing and Scanner Options in order to set the parameters for the
dose summary image.
Create Dose Summary Image 7.19
Display Dose Information

1 Under the Preferences Category click on Utilities under the Image
Viewing directory.
2 Under Image Parameters click on Display Dose Information.
C
_
1
0
6
4
3
4
7
6
5
3
5
4
s
m
e
t
s
y
S
l
a
ic
d
e
M
s
p
lii
h
P
Enable Dose Image Generation

1 Under the Preferences Category click on Scanner under the Scanner
Options directory.
2 Click on Enable Dose Image Generation.
Create Dose Summary Image 7.19
7.19.3 Dose summary table

After you have completed the study the following Dose summary table is
available for your reference.
C
_
1
0
6
4
3
4
7
6
5
3
5
4
s
m
e
t
s
y
S
l
a
ic
d
e
M
s
ilp
i
h
P

8 Scan protocols
8.1 Overview
This chapter covers the protocols used during the scan procedure as well as
the parameters available in each protocol
Review this information carefully before using the scanner.
8.1.1 Protocol selection

There are several scan modes:
• Surview scans are radiographic-like scans upon which the study is
planned.
• Axial scans are the CT mode of slice-by-slice scanning while the Patient
C
Table is motionless. The result is: n slice images (n is the product of the
_
1
0
number of scans, and the number of slices/scan in the specific scanner,
6
4
3
one to forty depending on the scanner model and the selected
4 collimation).
7
6
5
3
5 • Helical (spiral) scans are multi-rotational scans while the Patient Table
4
s is incrementing continuously. The result is a series of slice images,
m
t
e reconstructed with flexible increment.
s
y
S
l
a
ic
d
e
M
s
p
lii
h
P
Brilliance CT - Volume 1 Scan protocols 8-1
8.2 Scan protocol parameter tabs

The scan series protocol parameters are organized into tabs. Click a tab to
access its corresponding parameters:
Main parameters tab shows slice thickness, increment, start and end
locations and the dose information of all the scans performed in the
protocol in addition to the standard displayed dose information.
Injection tab (appears on helix and axial steps)
Voice tab (appears on Surview, helix and axial step, including Locator)
Automatic Options tab (appears on all modes - surview, axial, helix,

offline, additional, re-recon, MPR)
Cardiac tab (appears on cardiac protocols only) It appears on helix,

axial, add recon, re-recon and offline steps—including Locator).
CCT (interventional) tab (appears on axial mode, on CCT protocols

only)
Jog mode tab (varies depending on scan type) shows the dose
information of all the scans performed in the protocol in addition to
Axial Helical
the standard displayed dose information.
Pulmonary tab (gating appears in the clinical menu).
Advanced tab (appears on Surview, Helix and Axial steps)
8-2 Scan protocols Brilliance CT - Volume 1
Scan protocol parameter tabs 8.2
8.2.1 Scan Series name

The Exam protocol series name includes the following:
• Scan Type (Organ)
• Label (if exists)
• Surview/Axial/Helical
• For surview only - AP / Lateral / Dual
• For MPR only - Axial / Sagittal / Coronal
Step type Name format Example
Surview Scan Planned, Surview, AP / Lateral / Dual Planned, Surview, Lateral
Axial Scan Scan Type, Label, Axial Cardiac, Calcium scoring, Axial
Helical Scan Scan Type, Label, Helical Thorax, Chest HR +, Helical
Add recon Add recon, Label Add recon, 3 mm smooth
MPR MPR, Label, Axial / Sagit tal / Co ro nal MPR, 7.5mm, Co ro nal
Locator Locator, Locator
C
_
1
0
6
4
3
8.2.2 Modifying protocols
4
7
6 If the values of the Protocol Parameters do not suit the case requirements,
5
3
5
modify them as follows:
4
s
m
• Select the desired parameter for modification by either pressing the Tab
e
t
s
key until its ComboBox is reached, or by directly clicking in its
y
S
l
ComboBox with the left mouse button.
a
ic
d
e • Where an arrow appears to the right of a ComboBox, clicking that
M
s arrow opens a drop down menu of selections. Appropriate values may
ilp
i
h
also be typed in a ComboBox, although not every box allows a full
P
range of values. In that case, only those values displayed in the drop
down menu will be accepted.
• Select or type a value in any of the boxes where the value should be
changed. The cursor is by default inside the ComboBox, so that typing
is enabled immediately.
• Click the arrow of the ComboBox whose value is to be changed and
select another value from the displayed list. Alternatively, and where
possible, click inside the box and type the desired value.
• To modify the current protocol during the scanning procedure, click on
the Pause/Stop button, then click and change the parameters.
When all the parameters are set as desired, click Go.
The LED for Manual button will light up and system will ready for scan.
Depending on the scan, the Auto LED may also light.
Note If the preset parameter values are changed frequently, replace them
permanently with frequently used values. The parameter values can be
changed in the Generate Protocols function.
Caution Make sure that the correct scan parameters are entered to ensure correct
left/right orientations.
8.6 Surview
8.6 Surview
FOV [mm] (Field of View)
The FOV parameter denotes the diameter of the reconstructed image.
The FOV value is usually copied from Plan on Surview, where it is
interactively set by the FOV function. The FOV value can be selected
from a list or typed directly in its text box in the range of:
• 50 to 500 mm for all resolutions except Ultra High resolution
• 25 to 250 mm for Ultra High Resolution
The 250 mm FOV is normally used for head, spine and infant scans.
The 350 mm and 500 mm FOV are normally used for body scans.
View Angle [degrees]
This parameter is used to set the angle from which the X-ray tube
irradiates the patient during Surview, analogous to conventional
radiography. The available viewing angles are 90 ° (lateral), 180° (AP)
dual and multi.
Thickness [mm]
This parameter indicates that the collimation is set to 4 x 0.625 mm
during the Surview scan. The effective spatial resolution in the direction
of the Axial Surview scan is 0.625 mm. It is set to this value and cannot
be changed.
Current [mA]
This parameter is used to set the X-ray current. Type the desired current
in the range of 30 mA to 150 mA in adult protocol and 30 mA in
infant protocol. You can also select from a predefined list with
frequently used values. Low mA values are generally recommended for
the surview scans.

anzubieten!
" Nützlich
% Nicht
nützlich
Common protocol parameters 8.7
8.7 Common protocol parameters
8.7.1 Main
Click the Main parameters tab to access the clinical options.
Label
This parameter is used to insert a label that will appear on all the images
of the series. Any string up to 16 characters long may be typed in this
field. The content of this field can also be ignored (it may remain blank,
thus suppressing a label from appearing on the images). Alternatively, it
may be selected from a predetermined list of labels.
Start [mm]
The Start value denotes the Patient Table position for the first image in
the scan series. The value in this box is copied from the Plan on
Surview. If there is no plan, and a number is typed in the Start Position
ComboBox, the Patient Table will be moved to this planned position
during the scan process (while pressing and holding the Enable button).
C
1
_ The Start position can be changed with a resolution of 0.5 mm. When
0
6
4
an asterisk (*) appears, the scan will start from the current Patient Table
3 position, which is taken from the Patient Table in/out settings when the
4
7
6 scanner is in the Ready for Scan state.
5
3
5
4 End
s
m
t
e
s
The End value denotes the Patient table position for the last image in
y
S
l
the scan series. The value in this box is copied from the Plan on
a
ic Surview. If there is no plan, and a number is typed in the End Position
d
M
e field, this represents the end couch location for the active scan. The
s End position can be changed with a resolution of 0.5 mm. When an
p
lii
h
P
asterisk (*) appears, the scan ends at based on the length entered into
the Length field.
Length [mm]
The Length parameter gives the region covered by the Helix. Usually,
the value in this box is copied from Plan on Surview but you can type
any desired value in the correct resolution and range. If the entered
value is out of range (for example, the time that is needed to execute is
less than the scanner limitation), a message displays.
Increment [mm]
The Increment parameter is used to set the distance between two
consecutive scans in millimeters.
The default value of the Increment is equal to the selected collimation.
For example, if a thickness of 16 x 2.5 is selected and Auto is entered,
the patient table moves 40 mm between adjacent scans.
Entering a minus sign (-) before the Increment value sets the Patient
Table increment towards the Gantry (in). When working with a plan,
changing the sign before the increment will change the location of the
start and the last slice position, without changing the area covered by
the series. Any desired increment is allowed between the collimation
aperture (the sum thickness achieved in the scan) and 100 mm, with a
resolution of half a millimeter.
Caution Increment of zero is allowed for axial scans, however the scanned area will
receive an increased amount of radiation. This mode will be used for
biopsies, the Functional CT application and for Bolus tests. It is suggested
that the dose used in these cases should be as low as allowed by the specific
application.
When the Thickness value is changed, the increment is set

automatically to the sum of the Slice Thickness achieved by one scan,
unless it was zero. In that case, the Increment value remains set at zero.
Voltage [kV]
The Voltage parameter is used to set the voltage according to the
absorption characteristics of the scanned body part.
All Infant scans are only performable with Medium (120 kV) or Low
(90 kV) voltage. Low or Medium voltages improve contrast resolution
in small and medium objects or bodies, and therefore are preferred for
scanning infants and normal size patients respectively. On the other
hand, a High voltage (140 kV) scan provides greater penetration in
large objects and reduces the noise of the images.
mAs
The mAs [mAs] parameter sets the exposure value during the scan. It is
determined by the Tube Current and by the Scan Time. The Scan Time
is determined by the Rotation time and by the Scan Angle.
A larger mAs factor decreases the image noise and enhances the contrast
resolution but increases the radiation dose the patient receives and the
X-ray tube loading.
When the scan time is changed, the software changes the current to
C
_
keep the mAs constant (up to the tube and generator power
1
0
6
limitations).
4
3
4 Note The mAs posted is always per slice, not per rotation.
7
6
5
3
5
4
DLP [mGy x cm]
s
m
e
DLP is a calculation of the CTDI vol times the total radiated length, and
t
s
y represents the total dose given to the patient in the current scan.
S
l
a
ic CTDIVol [mGy]
d
e
M
s The CTDIw [mGy] parameter gives the average dose over the volume
ilp
i
h
scanned with the scan parameters defined within the protocol. The dose
P
index depends on the Voltage, mAs, Slice Thickness, Slice Increment
and the Scan Length. It displays for information only and cannot be
modified.
No. of Images
The Number of Images value is derived from the user-defined Sequence
Length and Scan Increment.
Scan Time [sec]
The Scan Time [sec] parameter gives the total time of the scan.
The Scan Time value depends on the Scan Length, total Collimation,
Rotation Time and Pitch available in the protocol. The displayed value
is for reference only and cannot be changed in this field.
Injection tab
To set the contrast injection to a timed sequence, select Contrast in the
Injection tab, and select Timed. A time bar appears along the bottom of
the window. These injection parameters are available:
• Trigger: non timed, timed (with or without SAS), and bolus tracking
• Post injection delay: The delay from injection to start of the scan.
• Agent: Contrast agent such as Iodine
• Route IV (intravenous) GI (swallowed) or both
• Concentration (mg/mL): of contrast material in solution
• Volume (mL): of material used
• Flow rate (mL/sec) of the contrast injection
Voice
Auto voice phrase
The Auto voice phrase parameter is used to select a pre-recorded
message set: before the scan (for example, “hold your breath”) and after
it (for example, “breathe”).
Note Access language selection from the Patient details dialog box.
If the Preset protocol message is not relevant, (for example, a non-

cooperative patient) select None from the list box to cancel the message.
• If you select None from the Scan protocol dialog box, the voice
message is disabled for the current scan only.
• If you select None from the Patient data dialog box, the voice
messages will be disabled for the entire study.
C
_
1
0
6
4
3
4
7
6
5
3
5
4
s
m
e
t
s
y
S
l
a
ic
d
e
M
s
p
lii
h
P
Auto Options
Stor.
The Image Storage parameter is used to select the archive devices for
storing the reconstructed image.
1 To change the archiving media (add/remove), click Storage Devices.
Default is selected.
2 To change the storage device selection, disable the default by clicking it.
3 Select the new devices.
4 Click OK to close and save your storage options.
Note This changes that storage device for only this series. To modify the Default
Storage devices, click on the Preferences menu and select Default Storage
device.
The Local device cannot be deselected. Any of the listed devices can be
optionally selected (see Chapter 18: Directory for more details).
Film
Reconstructed images can be sent immediately after display to the
Filming application.
To set the Film parameters click Auto Filming under the Automatic
Options tab. The Film Protocol dialog box appears:
Auto Send: Select an Auto Send option from the drop down list:
• Immediate-send to the Filming application after reconstruction.
• Series End-send to the Filming application at the end of the series.
• Study End-send to the Filming application at the end of the study.
• No-cancel automatic filming.
Auto processing
Auto processing includes these options:
• Review sets the appropriate viewer for viewing reconstructed images.
• Analysis sets the appropriate application for analyzing reconstructed
images.
Create New Study
Allows you to reconstruct a single series scan into several distinct series
with their own requested procedure name and accession number. See
Split study, on page 7-62 for more details.
Merge series
You have the option of merging two series which will display as a single
series in the Directory.
• From the Plan on Surview window, plan all series.
• Select specific series you want to merge.
• Click the Automatic Options tab.
• Select Merge with Previous Series box.
C
_
1 • Click GO to initiate scan or repeat steps for additional series you wish
0
6
4 to merge.
3
4
7
6 The merge series option provides these results:
5
3
5
4 • In the Directory under the IRS device, raw data files are listed by
s
m
e
series number. The raw data files are not merged, and will equal the
t
s
y number of series planned prior to merging.
S
l
a
ic • When multiple planned series are merged during reconstruction, they
d
e display in the Directory as a single series.
M
s
ilp • Merge is not available retrospectively.
i
h
P
Note See Directory for more information on viewinga series.
8.7.2 Advanced
Click the advanced tab to access the advanced options.
Collimation [mm]
Tailored to different applications, several collimation apertures are
available:
• 40 x 0.625 mm (for sharp and/or thin images, Spine and Head
images, Head CTA)
• 32 x 1.25 mm (for body, aorta CTA), and 8 x 3 mm (for large patient
Body, shoulders).
The minimum available thickness is always larger than the basic
collimation. For example, in order to obtain 0.67 mm slice thickness,
the 40 x 0.625 or 20 x 0.625 collimation must be selected. The tables
show Resolution, Collimation and Thickness.
Resolution Collimation Thicknesses Coverage

[mm]
High, Standard, Detailed 64 x 0.625 0.67, 0.8, 0.9, 1.375, 1.4, 2, 2.5, 3, 4, 5 40
High, Standard, Detailed 40 x 0.625 0.67, 0.8, 0.9, 1, 1.5, 1.4, 2, 2.5, 3, 4, 4.5, 5 25
High, Standard, Detailed 32x0.625 0.67, 0.8, 0.9, 1.375, 1.4, 2, 2.5, 3, 4, 5 20
High, Standard, Detailed 32 x 1.25 1.4, 1.5, 2, 2.5, 3, 3.5, 4, 4.5, 5 40
Standard, Detailed 16 x 2.5 3, 3.5, 4, 4.5, 5, 5.5, 6.5, 7.5 40
Standard, Detailed 16x1.25 3, 3.5, 4, 4.5, 5, 5.5, 6.5, 7.5 20
Resolution
These Resolution modes are available:
• Detailed with resolution up to 12 lp/cm for all scan angles with FOV
< 250 mm.
• Standard with resolution up to 12 line pairs/cm.
• High with resolution up to 15 lp/cm (such as, for orthopedic studies);
360° or 420° scan angle.
• Ultra-High resolution with up to 24 lp/cm (such as, for ear, dental,
and some orthopedic studies); 360° or 420° scan angle.
• Standard and High resolution scan modes are available within an
FOV of up to 500 mm. Ultra-High and Detailed modes are available
within an FOV of up to 250 mm.
Note When using UFD the FOV is limited to 250 mm. It is recommended that
you limit the x and y shift to a maximum of +/- 85.
C
_
1
0
6
4
3
4
7
6
5
3
5
4
s
m
e
t
s
y
S
l
a
ic
d
e
M
s
p
lii
h
P
Rot Time [sec]

The Rotation Time [sec] parameter defines the duration of one rotation
of the gantry. The table below shows the relationship between the
rotation time and Resolution.
Resolution
Rotation Time Standard High Ultra-high Detailed
(seconds) Resolution
0.42 X X X X
0.5 X X X X
0.75 X X X
1.00 X X X
1.5 X X X
2.0 X X X
FOV [mm] (Field of View)

The FOV parameter denotes the diameter of the reconstructed image.
The FOV value is usually copied from Plan on Surview, where it is
interactively set by the FOV function. The FOV value can be selected
from a list or typed directly in its text box in the range of:
• 50 to 500 mm for all resolutions except Ultra High resolution
• 25 to 250 mm for Ultra High Resolution
The 250 mm FOV is normally used for head, spine and infant scans.
The 350 mm and 500 mm FOV are normally used for body scans.
Filter
This parameter is used to set the mathematical algorithm which
determines the sharpness (or smoothness) of the image. The noise (and
sometimes the streak artifacts) in the image increase as the sharpness of

the image increases, and vice versa. In general, the low contrast
resolution decreases as the spatial resolution (and the image noise)
increases.
Center X [mm], Center Y [mm]
Center X and Center Y set the Horizontal (X) and Vertical (Y)
displacements, in millimeters (with resolution of 1.0 mm) of the
reconstructed image relative to the center of the Gantry opening. They
are used to center the region-of-interest in the image frame.
Usually, the Center X and Center Y values are copied from Plan on
Surview where it is interactively set by the Move function. Values
within the range of ± FOV/2 may also be typed.
Matrix
The Image Matrix parameter sets the number of pixels that the
reconstructed image will contain. The matrix sizes are 512 2, 7682,
10242. Understanding the relationship between FOV, resolution mode
and reconstruction will help you make a matrix choice that produces
the best image quality:
C
_
• Standard/Detailed resolution, matrix =1.6 x FOV
1
0
6
(except filter D)
4
3
4
7
• Standard/Detailed resolution, filter D, matrix = 2.5 x FOV
6
5
3
5
• HR: matrix = 3.2 x FOV
4
s
m
• UHR: matrix =5.0 x FOV
e
t
s
S
y For example, if the scan mode is HR and the FOV is 300 mm, then the
l
a matrix is 3.2 x 300 = 960. The closest available matrix selection is 1024.
ic
d
e
M Automatrix is an additional feature that can be set through the system
s
p
lii
reconstruction preferences. When enabled, the matrix is automatically
h
P calculated and is not available in the Advanced tab.
8.8 A xial scan parameters
8.8 Axial scan parameters

Thickness [mm] (in Main tab)
Use the Thickness parameter to set the tomographic thickness, which
determines the spatial resolution in the axial direction (perpendicular to
the plane of the slice).
Select the desired combination of collimation and reconstruction from
a string in the ComboBox.
Increment [mm] (in Main tab)

consecutive scans in millimeters.
The default value of the Increment is equal to the selected collimation.
For example, if a thickness of 16 x 2.5 is selected and Auto is entered,
the patient table moves 40 mm between adjacent scans.
Entering a minus sign (-) before the Increment value sets the Patient
Table increment towards the Gantry (in). When working with a plan,
changing the sign before the increment will change the location of the
start and the last slice position, without changing the area covered by
the series. Any desired increment is allowed between the collimation
aperture (the sum thickness achieved in the scan) and 100 mm, with a
resolution of half a millimeter.
Caution Increment of zero is allowed for axial scans, however the scanned area will
receive an increased amount of radiation. This mode will be used for
biopsies, the Functional CT application and for Bolus tests. It is suggested
that the dose used in these cases should be as low as allowed by the specific
application.
A xial scan parameters 8.8
When the Thickness value is changed, the increment is set

automatically to the sum of the Slice Thickness achieved by one scan,
unless it was zero. In that case, the Increment value remains set at zero.
Cycle Time [sec] (in Main tab)

The time duration between the start of adjacent scans.
Note Rotation Time, Scan Angle, and Slice Increment affect the minimal Cycle
Time.
Cycles (in Main Parameters tab)

In Automatic Scan mode, the scanner stops after the set number of
scans has finished.
Note The number of images is determined by the number of slices per scan. For
example, for collimation 16 x 2.5 and thicknessof 5 mm, five scans will
produce 40 slices.
Collimation [mm] (in Advanced tab)

C
_ Tailored to different applications, several collimation apertures are
1
0
6 available.
4
3
4
7
6 The minimum available thickness in the Axial mode is always equal to or
5
3
5
greater than the basic collimation.
4
s
m
e
t
s
y
S
l
a
ic
d
e
M
s
ilp
i
h
P
8.8 A xial scan parameters
The tables below show Resolution, Collimation and Thickness for axial
scans:
Axial scan protocols

[mm]
Standard, Detailed, High 64 x 0.625 0.625, 1.25, 2.5, 5, 6.25, 12.5, 25 40
Standard, Detailed, High 40 x 0.625 0.625, 1.25, 2.5, 5, 12.5, 25 25
Standard, Detailed, High 32 x 0.625 0.625, 1.25, 2.5, 5, 10 20
Standard, Detailed, High 32 x 1.25 1.25, 2.5, 5, 10, 20 40
Standard, Detailed 16 x 2.5 2.5, 5, 10 40
Standard, Detailed 12 x 0.625 7.5 7.5
Standard, Detailed 12 x 1.25 3.75, 7.5, 15 15
Standard, Detailed 18 x 1.25 5.625, 11.25, 22.5 22.5
Ultra High 20 x 0.625 0.625, 1.25 12.5
Ultra High 2 x 0.5 0.5 1
High 2 x 0.625 0.625, 1.25 1.25
Note Fused Thicknesses are recommended to minimize partial volume artifacts.
Slice Thickness Dose Efficiency - If any protocol results in less than

70% Z axis geometrical dose efficiency, the system displays the
following message:
A xial scan parameters 8.8
Tilt [deg] (in Advanced tab)

The Tilt value (in degrees) denotes the Gantry Tilt angle for the
planned scan on lateral (90 degree) Surview scan. The value in this box
is copied from Plan on Surview, where it is interactively set by the
Rotate function. The Gantry will tilt to the desired tilt angle before the
scan starts (while the Enable button is pressed and held). When an
asterisk appears, the scan will be executed with the current Gantry Tilt
Angle. The range for Axial scans is from -30° to +30° depending on the
couch height (see Operating the gantry tilt and table, on page 7-9).
Note When the Surview scan angle is 180°, the Rotate button is grayed out.
C
_
1
0
6
4
3
4
7
6
5
3
5
4
s
m
e
t
s
y
S
l
a
ic
d
e
M
s
p
lii
h
P
8.9 H elix scan parameters
8.9 Helix scan parameters

Thickness [mm] (in Main tab)
The tomographic Thickness is the spatial resolution in the Z direction
(the FWHM of the sensitivity profile, measured along the axis
perpendicular to the image plane of the slice). This is a discrete
parameter that can be selected from the drop down list. The values in
the list are based on the basic collimations. The basic values are then
multiplied by factors that are available for this collimation.
Increment [mm] (in Main tab)

consecutive reconstructed slices. The value can be entered by typing or
selecting an option from the ComboBox. If the Contiguous option is
selected, the Increment will be set as equal to the Slice Thickness. If the
Overlap option is selected, the Increment will be set equal to half the
Slice Thickness.
When working with Plan, entering minus (-) before the increment, sets
the Patient Table increment towards the Gantry (in position). This is
possible only if the scan was planned on Surview. Changing the sign
before the increment will change the location of the start and the last
slice position, without changing the area covered by the series. Any
desired increment is allowed between -10.0 times the slice thickness and
one tenth of the slice thickness, with a resolution of one-tenth of one
millimeter (0.1), provided the number of reconstructed slices does not
exceed 2048 per series.
Collimation [mm] (in Advanced tab)

Tailored to different applications, several collimation apertures are
available.
H elix scan parameters 8.9
The minimum available thickness in the Helical mode is always greater

than the basic collimation.
The tables below show Resolution, Collimation and Thickness for axial
scans:
Helical scan protocols

[mm]
High, Standard, Detailed 40 x 0.625 0.67, 0.8, 0.9, 1, 1.5, 1.4, 2, 2.5, 3, 4, 4.5, 5 25
High, Standard, Detailed 32x0.625 0.67, 0.8, 0.9, 1.375, 1.4, 2, 2.5, 3, 4, 5 20
High, Standard, Detailed 32 x 1.25 1.4, 1.5, 2, 2.5, 3, 3.5, 4, 4.5, 5 40
Standard, Detailed 16 x 2.5 3, 3.5, 4, 4.5, 5, 5.5, 6.5, 7.5 40
Standard, Detailed 16x1.25 3, 3.5, 4, 4.5, 5, 5.5, 6.5, 7.5 20
C
_
1
0
6
4
3
4
7
6
5
3
5
4
s
m
e
t
s
y
S
l
a
ic
d
e
M
s
ilp
i
h
P
8.9 H elix scan parameters
8.9.1 Adaptive filter

The Adaptive filter enables reduction of the pattern noise (streaks) in non-
homogeneous bodies.
In asymmentrical objects, readings of lower signal contribute higher noise,
while readings with higher signals make only minor contributions to the
total noise. The Adaptive filter processes a small number of the readings—
only those that contribute the highest noise. The result is a reduction of the
image pattern noise, with only a minor degradation in the resolution. In
other words, the appearance of image noise is improved in areas such as the
shoulders and the hip/pelvic area.
If the Automatic Special Filters option is selected in preferences, the system
determines whether the Adaptive filter is required, based on the type of scan
being done. If the Automatic filter preference is OFF then the Adaptive
filter may be disabled in the Advanced tab of all scan protocols.
H elix scan parameters 8.9
8.9.2 Advanced
Pitch (CT pitch factor)
The Pitch parameter represents the value of the Patient table speed (this
is a normalized speed: the motion of the table relative to the total
collimation for one rotation of the Gantry 1, 10 12.5, 25 mm or
40 mm).
CT pitch factor =Δd/T
Where Δd is the patient table travel in horizontal direction.

T is the collimation (nominal tomographic section thickness)
A larger Pitch enables a longer total coverage for a given scan time but
can sometimes produce a lower quality image, in terms of image noise.
The Pitch values in the ComboBox are recommended from an image
quality perspective. If the High or Ultra High resolution mode is
selected, then a Pitch value greater than one is not available.
The maximum available pitch is limited by FOV.
Evolving mode
C
_
1
0
When working with Evolving mode, the images are displayed in a
6
4
3
separate window, and are dynamically refreshed. You may adjust the
4
7
window Center and Width for optimal viewing of the image, to
6
5 monitor the proper execution of the scanning process.
3
5
4 • Zoom in/out to enlarge or reduce the series of images.
s
m
e
• Pan an image to center the series of images or the region of interest.
t
s • Adjust the window setting.
y
S
l
a • Click OK to complete the Reconstruction.
ic
d
e
M
s
p
lii
h
P
8.10 Injection
8.10 Injection
Injection
In scans that use contrast there are three scan triggering modes:
• Non-timed: In this mode the contrast is injected and when you are
ready and press Manual to start the scan.
• Timed: In this mode after starting the injection, when ready press the
Auto button on the CT box; the helical scan starts after a Post
Injection delay.
• Bolus Tracking: In this mode the clinical scan begins automatically
after the Tracker scan reaches the threshold. You can also set a post
threshold delay. For details on Bolus tracking see the Bolus Tracking
chapter.
Note SAS is an optional injection method for timed scans.
When the injector delay (on the injector console) is used, the scan is
initiated when the countdown reaches zero. For every timed scan, a
time ruler appears at the bottom of the window displaying the injection
delay time, injection time, and scan times. If the delay and injection
times are not acceptable a warning message appears above the ruler. The
scan will not start until the delay is within acceptable parameters.
The Trigger to start the scan can be started manually or automatically.
For Spiral scans the scan can be started with Auto Start or SAS.
• In manual mode operation, you must press the Auto scan button and
the Injection button at the same time.
• In automatic mode, press Go to initiate the scan. The scanner waits
for the start signal from the contrast injector before beginning the
scan. If a delay is set, scanning begins after the countdown is
complete.
For an explanation of Bolus Tracking see the Bolus Tracking chapter.

anzubieten!
" Nützlich
% Nicht
nützlich
Injection 8.10
Use this procedure to activate SAS with Trigger:

1 In the Injection tab in the scan protocol box.
2 Select the option Contrast. The injection options appear:
• Trigger: non timed, timed (with or without SAS), and bolus tracking
• Post injection delay: The delay from injection to start of the scan.
• Agent: Contrast agent such as Iodine, etc
• Route IV (intravenous) GI (swallowed) or both
• Concentration (mg/mL): of contrast material in solution
• Volume (mL): of material used
• Flow rate (mL/sec) of the contrast injection
3 Select the Timed injection option. The SAS option appears and the
time bar appears along the bottom of the window.
4 Select SAS.
5 Complete the rest of the injection options. Verify the scan delay is
within the acceptable parameters.
6 After reviewing all the parameters click Go and follow the on-screen
C
instructions to begin the scan.
_
1
0
6
4
Note • Images captured after the contrast is injected display the letter “C”.
3
4 • The contrast injection parameters are optional.
7
6
5
3
5
4
s
m
e
t
s
y
S
l
a
ic
d
e
M
s
p
lii
h
P
8.11 Filters
8.11 Filters
Standard Filters Head Body
A Ver y smoot hed, can be used t o significantly decrease noise. Recommended for X X
use when the patient is ver y large and the dose inadequate for the pat ient’s
size.
B Smoothed, but sharper and noisier than A. Recommended for CTA (for X X
example, COW), routine abdomen, and pelvis.
C Sharper, creates relatively low-noise images. Recommended for CTA (for X X

example, COW), routine abdomen, and pelvis to get slightly higher sharpness
than with Filter B.
D Sharp and edge-enhancing. Creat es relatively high-noise images and r aises the X X
bone density.
E Sharper, delivers relatively correct CT values, even for small details. X
L Sharper than E. Delivers relatively correct CT values even for small details. X
Recommended for reconstruction of low -noise lung images.
YA Sharper and noisier. Recommended for reconstruction of sinuses, facial bones, X

dental, etc. The thinner the axial slices the sharper the axial, 2D and 3D
images. This filter delivers smoother images than YC and YD.
YB Sharper and noisier than YA, recommende d for reco nstr uction o f sinuses, facial X X
bones, etc. The thinner the axial slices, the sharpe r the axial, 2D and 3D
images. This filter delivers smoother images than YC and YD.
UA Designed for head scans only. Minimizes the beam-hardening artifacts and X
significantly improves t he bo ne-soft t issue interface (in areas such as br ain or
or bits). Low noise, allows detection of small lesions with re latively low noise.
UB Designed to detect small lesions with improved bone/ soft tissue interface (in X
areas such as brain or or bits). Low contr ast, for moderate resolution.
UC Designed to detect small lesions with improved bone/ soft tissue interface (in X
areas such as brain or orbits). Increases noise in images.
Filters 8.11
High Resolution Filters Head Body
A Smoot hed, can be used to render the image o f the soft tissues as a moderate X X
standard filter (such as C) does.
B Smoothed, but sharper and noisier than A. X X
C Sharper, cre ates r elatively low-noise images and raises bo ne de nsity in head X X
scans.
D Sharp and edge-enhancing, creates relatively high-noise images and raises the X X
bone density.
E Used for internal physics and image quality tests. X X
F Slightly sharper than C , this filter delivers images with mo der ate shar pness and X
noise, appropriate to reconstr uction o f knees and shoulders.
L Sharper than E. Delivers relatively correct CT values even for small details. X
Recommended for reconstruction of low -noise lung images.
YC Sharp and no isy. Recommended for reco nstr uction of lungs, sinuses, facial X X
C bones, dental, and or tho pedics.
_
1
0
6 YD Extremely sharp and no isy. Recommended for reco nstr uction of IAC (when t he X X
4
3
4 scan is HR rather than UHR) and sinuses. Also for reconstruction of lungs and
7
6 orthopedics.
5
3
5
4 UA Designed for head scans only. Minimizes the beam-hardening artifacts and X
s
m significantly improves t he bo ne-soft t issue interface (in areas such as br ain o r
e
t
s or bits). Low noise, allows detection of small lesions with re latively low noise.
y
S
l
a
ic UB Designed to detect small lesions with improved bone/ soft tissue interface (in X
d
e areas such as brain or orbits). Allows good detectability of low contrast at
M
s moderate resolution.
ilp
i
h
P UC Designed to detect small lesions with improved bone/ soft tissue interface (in X
areas such as brain or orbits). Increases noise in images.
8.11 Filters
Ultra-High Resolution Filters Head Body
A Smoothed, can be used to rescue the image of the soft tissues from a UHR X X
scan, initially aimed to render only the bone (IAC or orthopedics). The images
created by this filter look almost like those created by the C standard filter.
B Slightly sharper than A, edge-enhancing. Creates relatively low-noise image. X X

Has the same role as A but allows slightly better bone rendering. Can be used
to rescue knee images from UHR scans that are normally not appropriate to
this anatomy.
C Sharpness and edge enhancement between B and D (non-enhancing for body X X

scans). Creates relatively low-noise images.
D Sharp and edge-enhancing. Creates low-noise images and raises the bone X X
density. REcommended for orthopedics.
E Used for internal physics and image quality tests. X X
YE Ver y sharp and noisy, recommended for extremities. X X
YF Extremely sharp, in fact the sharpest filter of the system. It is also the noisiest X X
filter. If the images reconstructed with this filter are too noisy due to use of
inadequate low do se, then use t he Recon Enhancement t o smoo th t hem (use -
0.25 or -0.5). Recommended for extra-sharp extremity images.
Note There are also special X filters for Cardiac. See Volume 4, Cardiac Guide for
more information.
G enerate protocol 8.12
8.12 Generate protocol

This function is used for changing, deleting or duplicating Scan Protocols.
If you have an open study, you must end it before you can use the generate
protocol function.
1 Click Home to display the Home options.
2 Click Generate Protocols. The Generate Main Form dialog box
displays and the exam protocol groups display.
3 Select the Exam Protocol Group, from which you want the generation
of the protocol to begin.
4 Select an existing protocol.
• This selection automatically fills in names in the two fields of the
dialog box. At the same time, the Protocol Parameters window
opens.
5 Manipulate the parameters as necessary. In Helical and Axial mode
modes, these parameters are available in Generate protocol mode.
• Clinical application - special clinical applications such as cardiac or
C
_
CCT.
1
0
6 • Offset beginning of reconstruction- set offset to the desired distance
4
3
4
(in mm) after the beginning of the scan.
7
6 • Scan type.
5
3
5
4 6 After all parameters settings in that window are complete, click Go.
s
m
t
e 7 In the Generate Main Form, select the age group for which you wish to
s
y use the protocol (this selection is mandatory).
S
l
a
ic 8 If desired, you can also set these options:
d
e
M • weight
s
p
lii • requesting physician
h
P
• requested procedure
9 When you have filled in all the required information select one of the
buttons at the bottom of the Generate Protocol dialog box:

• Save to permanently replace the parameters in a protocol with the
changes you have just made. Use this option to change an existing
protocol.
• Save As to keep the original protocol, but generate a new Protocol
with the changes you have just made. After selecting this, you are
prompted to select a protocol group and enter a new protocol name
(see creating a new protocol).
• Delete to delete the selected protocol from the set of protocols. The
system prompts you to confirm your selection.
• Undo to re-edit the protocol parameters. The system displays the
parameters box on the left.
• Cancel to exit the Generate Protocols application.
Note The factory protocols are the basic set of default protocols shipped with the
system. They can be used as is, and can be viewed and copied, but not
deleted. You can generate user protocols by editing copies of the factory
procedures, or by copying procedures from backups, or by editing existing
user procedures.
8.12.1 Creating a new protocol

After editing the parameters of an existing protocol, you have the option to
save this information as a new protocol. To do so, select Save As, in the
Generate Main form. This dialog box displays:
• The top field in the box, Exam Protocol Group, allows you to select the
type (group) of protocol. Click the arrow to display the protocol types.
• The bottom field, Exam Protocol Name is for typing the new protocol
name.
• The new protocol will be saved in the User set of protocols.
C
• If you wish to generate a protocol which is similar (or identical) to one
_
1
0
of the original Factory Procedures, click the Factory Default diamond
6
4
3
to view the Factory Procedures.
4
7
6
5
Note Protocol names can vary based on facility. Check with the Chief
3
5
4
Technologist to ensure you have the correct Protocol name.
s
m
e
t
s
y
S
l
a
ic
d
e
M
s
ilp
i
h
P
8.12.2 Creating a new exam protocol group

You can also use the Generate protocols window to create new exam
protocol groups. Use this procedure to create a new group.
1 In the Generate protocol window, locate the Exam protocol groups tab.
2 Right click on one of the blank boxes. The system displays an Add
group option.
3 Click Add group. A dialog box displays.
4 Type a new name for the group.

5 Click Ok to save the new protocol group. The new group is
now included with the rest of the Exam protocol groups.
6 You can use Generate protocols, on page 6-1 to add protocols

to the new group.
Note • You cannot change the default image at this time.
• Choose Group Image and Default Group image are not yet active.
C
_
1
0
6
4
3
4
7
6
5
3
5
4
s
m
e
t
s
y
S
l
a
ic
d
e
M
s
p
lii
h
P
8.12.3 Changing the exam protocol order

Within the Generate Protocol window, you also have the option of
changing the order of the exam protocols you generate.
Note You cannot change factory-set protocols.
Use this procedure to change the exam protocol order.

1 Click Home to display the home options.
2 Click Generate Protocols.
3 Click on the desired Exam protocol group. This screen displays.
4 Click the Change Protocol Order button at the bottom of the window.

5 Click and drag a protocol to change the order. A cursor line displays on
the screen to indicate the new position of the protocol.
• To undo your changes, click Undo Group Protocols Order.
8.12.4 Editing a protocol group

1 In order to edit protocols, you must first click the Select protocol
button at the bottom of the Exam protocols window.
The system returns you to the Generate protocol window.
2 Follow steps 3-9 in Generate protocols, on page 6-1.
3 At step 9, select Save to save your changes.
8.12.5 Deleting a protocol group

You can also use the Generate protocol window to delete protocol groups.
Use this procedure to delete a group.
1 In the Generate protocol window, locate the Exam protocol groups tab.
C
_
1
0 2 Right click on the protocol group you wish to delete. The system
6
4
3 displays the Delete group option.
4
7
6 The system will prompt you to confirm your selection.
5
3
5
4 3 Confirm your selection to delete the exam protocol group.
s
m
e
t Note You cannot delete a protocol group which contains exam protocols. To
s
y
S delete the protocols, see step 9in the Generate protocol procedure on page
l
a
ic 8-35.
d
e
M
s
ilp
i
h
P
9 Optimized protocol selection
Optimized protocol selection allows you to customize the list of protocols

which display after the patient data is entered in the patient window (via
HIS/RIS or type in). This customized list provides the most effective use of
the software, by streamlining the scanning process. It is recommended that
this process be done by a senior technologist with the assistance of a Philips
Applications specialist. Before using the Optimized protocols, you must
first set the user mode to Senior technologist. The procedures for setting
the mode as well as classifying the protocols are included in this section.
C
_
1
0
6
4
3
4
7
6
5
3
5
4
s
m
e
t
s
y
S
l
a
ic
d
e
M
s
p
lii
h
P
Brilliance CT - Volume 1 Optimized protocol selection 9-1
9.1 C lassifying protocols
9.1 Classifying protocols

Before using the Optimized protocol selection, you will have to ensure that
all system exam protocols have been classified. The classification will be
used to determine which protocols will display after the patient data is
entered in the patient window (via HIS/RIS or type in). Initially, all
protocols are factory-set to display when an adult scan is selected.
These parameters are used to classify protocols:
• requested procedure
• patient weight
• patient age
• requesting physician
The process requires a two-step procedure:
• selecting protocols
• setting the classification parameters
9-2 Optimized protocol selection Brilliance CT - Volume 1
C lassifying protocols 9.1
9.1.1 Selecting protocols

Use this procedure to select your system Exam protocols.
1 On the workflow toolbar, click Home. The system displays the Home
options:
C
_
1
0
6
4
3
4
7
6
5
3
5
4
s
m
e
t
s
y
S
l
a
ic
d
e
M
s
ilp
i
h
P
2 Click Classify Protocols in the Misc menu.

The system displays the exam protocol groups:
3 Click an Exam protocol group to select it.

The system displays a split window:

• The left shows the protocols included in the group you selected.
• The right shows a blank table with the parameter headings across the
top.
C
_
1
0
6
4
3
4
7
6
5
3
5
4 You will use the right side of the window to set classification
s
m information.
e
t
s
y 4 To enter a protocol in the table, click its corresponding icon in the list
S
l
a
ic
d
e
M
s
p
lii
h
P
on the left. The system displays the protocol name in the table.
5 Repeat step 4 until all the desired protocols from this group display in
the table.
Note Initially, all protocols are set to display for adult scans. When new protocols
are added to the table, the parameter columns display the default settings.
Continue to Setting classification parameters.
9.1.2 Setting classification parameters

Now that you have selected the desired protocols, you must set the
parameters which will be used to determine when the protocols will display.
Use this procedure to set the parameters.
1 In the table on the right side of the window, click inside of a parameter
box.
2 Click the arrow to display its options.
3 Select an option by clicking it.

• You can select multiple options for a single parameter (except age).
• You can deselect an option by clicking it again.
C
1
_ • You can clear the selected options in a specific parameter box by
0
6
4
selecting All.
3
4
7 4 Click outside the box to keep the selection.
6
5
3
5 Note You cannot select more than one age range for a protocol.
4
s
m
t
e 5 Repeat steps 1-3 for each protocol you want to classify.
s
y
S
l
a
6 When you finish, select an option:
ic
d
e
• Save to automatically save your changes.
M
s
• Cancel to return to the Home window. The system will ask you if you
ilp
i would like to save your changes, or exit without saving.
h
P
If you wish to classify protocols for another Exam protocols group, go to

Classifying protocols, on page 9-2 and repeat the process.
When you select a protocol group which has protocols that have already
been classified, those protocols will display in the table with their
classification parameter settings.

anzubieten!
" Nützlich
% Nicht
nützlich
Editing requested procedure & physician lists 9.2
9.2 Editing requested procedure & physician lists

Within the Protocol classification window, you also have the option to edit
the lists of requested procedures and requested physicians. Use this
procedure to make your changes.
1 Click Edit in the upper left corner of the window. A drop down list
displays.
2 Select an option from the list:
• Edit Physicians List
• Edit Requested Procedures List
The system displays this dialog box:
C
_
1
0
6
4
3
4
7
6
5
3
5
4
s
m
e
t
s
y
S
l
a
ic
d
e
M
s
ilp
i
h
P
3 Click the Name field to type in a new name.
9.2 Editing requested procedure & physician lists
4 After entering a name, select an option:

• Add a name to the list.
• Replace correct previously entered information.
• Remove a name from the list.
• Save changes without closing the dialog box.
• Close the dialog box-you will be prompted to save if you have not
done so.
9.2.1 Importing RIS procedures

Brilliance CT includes a utility which imports current procedures from the
RIS (based on the information in the schedule). Additional new procedures
can be added by requesting imports from RIS.
Turning on optimized protocols 9.3
9.3 Turning on optimized protocols

Once all protocols have been classified, you still need to activate the
optimized protocol feature. Use this procedure to activate the optimized
protocols.
2 Select Utilities.
3 From the Utilities menu, select Classify Protocols.
4 Click the Exam Protocols tab.
5 Click Use Classification to turn the feature on.
Caution The selected exam protocols are only the recommended protocols. It is the
responsibility of the technologist to approve the selection.
C
_
1
0
6
4
3
4
7
6
5
3
5
4
s
m
e
t
s
y
S
l
a
ic
d
e
M
s
p
lii
h
P
10 Step & Shoot Cardiac (option)
10.1 Introduction
Step & Shoot Cardiac is a scanning option for the 64-channel Brilliance
CT system. It provides high quality CT images of the coronary arteries and
heart anatomy at very low radiation dose levels (up to 80% reduction).
During Step & Shoot Cardiac, X-rays are generated only during the cardiac
phase of interest. This produces coronary CT angiography examinations
with reduced effective dose (the actual dose reduction depends on scan
technique, patient size and scan coverage).
ECG-gated axial scan

Step & Shoot Cardiac is an ECG-gated axial prospective acquisition, using
4 cm collimation in the Z direction. This protocol allows the 64-channel
C
_
1
Brilliance CT to achieve full heart coverage with sub-millimeter, isotropic
0
6
4
resolution within a short breath-hold.
3
4
7
6
5
3
Patient qualifications
5
4
s Not all patients qualify for the Step & Shoot Cardiac scan. To acquire
m
t
e images with satisfactory quality, it is recommend that the scanned patient:
s
y
S
l
• have a stable heart rate, with mean lower than 65BPM
a
ic
d
• have no severe known arrhythmias
e
M • not be extremely obese
s
ilp
i
h
P
Brilliance CT - Volume 1 Step & Shoot Cardiac (option) 10-1
10.1 Introduction
Compatibility with other Brilliance cardiac applications

Step & Shoot Cardiac is compatible with all currently available Brilliance
cardiac applications, including Comprehensive Cardiac Analysis (CCA).
Note No functional analysis is available for the Step & Shoot C ardiac scan.
Generating new protocols that include Step & Shoot Cardiac

When you want to generate new protocols using Step & Shoot Cardiac, be
aware that Step & Shoot is both a Scan type and an axial protocol.
Therefore, when you are working with a Scan Type: helical, the Step &
Shoot protocol will not appear as a selection.
To make your own Step & Shoot protocol, start with a Cardiac Axial
protocol as your base to build on, and make sure your Scan Type is set to
Step & Shoot.
Note • In case of sequential timed studies, the Step & Shoot study must be the
last in the sequence.
• For detailed information about generating protocols refer to the “Scan
Protocols,” chapter 8 in this volume.
10-2 Step & Shoot Cardiac (option) Brilliance CT - Volume 1
Introduction 10.1
10.1.1 Arrhythmia compensation

Step & Shoot Cardiac utilizes a single-cycle reconstruction algorithm. The
acquisition will automatically detect and compensate for arrhythmias
during the acquisition sequence.
How arrhythmia compensation works

A Step & Shoot scan is a sequence of axial data acquisition (usually 3 or 4,
depending on the size of the patient’s heart).
A heart cycle equals the R-to-R peak of the ECG wave. Each R-to-R peak
can be divided into heart anatomical phases from 0% to 99%. For
optimum results for a Step & Shoot scan, 75% is the recommended
acquisition phase (for a patient with a low heart rate).
Each axial acquisition is made during a specific portion (phase) of a heart
cycle. Each acquisition is followed by a patient table movement.
The Step & Shoot Cardiac protocol compensates for arrhythmia as follows:
• After you start the Step & Shoot Cardiac scan, the planned scanning
C
sequence proceeds normally until an arrhythmia (if any) is detected.
_
1 • If X-rays are being generated during the arrhythmia, the irradiation is
0
6
4 stopped.
3
4
7
6
• The patient table is held in position while the arrhythmia passes.
5
3
5
• Then a following heart cycle is scanned.
4
s
• The patient table then moves to its next planned position, and
m
t
e another acquisition is begun at the new position.
s
y
S
l
a
You can view the detection of arrhythmias on the ECG wave during the
ic scan. Below is an example wave. The blue X symbol indicates where the
d
e
M arrhythmia caused the termination of an acquisition.
s
p
lii
h
P
10.1 Introduction
Overview of Step & Shoot Cardiac exam 10.2
10.2 Overview of Step & Shoot Cardiac exam

1 Patient preparation
2 Equipment setup
• ECG monitor setup
• Patient electrode connections
• Injector setup
3 Verify patient’s ECG wave
4 Review patient’s heartbeat and any arrhythmia
5 Begin Step & Shoot scan process
6 Acquire surview
7 Set up Bolus locator and tracker scan
8 Start the scanning sequence of Step & Shoot
9 Plan on Surview
10 Set Bolus tracking threshold
C
_
1
0
11 Begin and complete Step & Shoot Cardiac acquisition
6
4
3 12 Observe Evolving mode images and edit ECG if needed
4
7
6
5 13 Reconstruct images
3
5
4
s
14 Re-recon images if needed (and edit ECG if needed)
m
e
t
s
y
S
l
a
ic
d
e
M
s
ilp
i
h
P
10.3 Pre-scan preparation

• Ask the patient to refrain from stimulants (i.e. coffee) prior to scan
• Do not give oral contrast.
• The 64 slice Step & Shoot Cardiac scan is usually a short scan time. Ask
the patient not to take in a deep breath. Ask the patient to simulate a 10
second breath-hold.
• Review voice commands prior to examination.
• The patient should have good IV access (18-21G, if possible). The IV is
usually placed in the antecubital vein.
10.3.1 Set up ECG monitor

Note • This procedure provides only an overview of ECG monitor setup
procedures. For detailed information about this procedure refer to
“Cardiac Gating and Tagging,” which is Chapter 4 of Volume 4 of this
User Manual set.
• Refer to the Philips ECG monitor user manuals for more instructions
about setup and use.
Philips M3 or MP5 model setup (overview)

1 Connect the leads to the Philips M3 or MP5 monitor.
2 Connect ECG signal cable’s input plug to the Philips M3 or MP5
monitor.
3 Connect ECG signal cable’s output plug to the rear of the gantry.
4 Connect the Main power cable to the Philips M3 or MP5 monitor.
5 Plug the main power cable into the AC wall outlet.

Pre-scan preparation 10.3
6 Make sure the M3 or MP5 monitor’s internal battery is fully charged.

When the battery is charged, disconnect the M3 or MP5 monitor from
the AC wall outlet.
Warning The power cable included with the M3 or MP5 monitor is only for charging
the battery. You must disconnect the ECG monitor from the AC power
outlet when using the monitor in conjunction with the CT scanner.
7 Position the ECG monitor so that the monitor and all cables do not
impede the free movement of personnel.
8 Mount the ECG monitor in an approved manner and secure it
properly.
Caution • The ECG monitor should be mounted and secured to avoid patient injury.
• Feet/Head first orientation options are available to allow for scanning
while keeping the ECG monitor, stand and cables away from the patient.
• Route all cables between the ECG monitor, the patient, the table and the
CT scanner so that they do not impede the free movement of personnel.
C
_
1
0 9 Continue at Step 1 of the next procedure “Testing the ECG monitor
6
4
3 (before first use).”
4
7
6
5
3
5
4
s
m
e
t
s
y
S
l
a
ic
d
e
M
s
ilp
i
h
P
10.3.2 Testing the ECG monitor (before first use)

Before using the ECG monitor for the first time, you should test it with a
simulator or a volunteer.
Note This procedure provides only an overview of ECG monitor testing
procedures. For detailed information about this procedure refer to
“Cardiac Gating and Tagging,” which is Chapter 4 of Volume 4 of this User
Manual set.
1 Hook up the monitor to an ECG simulator (or, as described in the

“Cardiac Gating and Tagging” chapter, use a volunteer seated outside
the scan room).
2 Verify the acquisition of the ECG wave.
3 If a clean ECG wave does not display on the monitor, make sure that
the electrodes are placed properly and the contacts are good. You may
need to reposition the electrodes closer to the heart. For additional
information regarding the ECG wave, see Verifying the ECG wave, on
page 10-10.
10.3.3 Making patient electrode connections

Note This procedure providesonly an overview of patient preparation. For
detailed information about this procedure refer to “Cardiac Gating and
Tagging,” which is Chapter 4 of Volume 4 of this User Manual set.
Warning You must disconnect the ECG monitor from the AC power outlet when
using the monitor in conjunction with the CT scanner.
1 Clean the contact sites thoroughly with soap and water to remove oils
or scaly outer layers of skin. Ideally, shave sites having hair to ensure
good electrode contact with the skin.
Electrode placement 2 Apply clean electrodes as shown in the Electrode Placement diagram.
• right pectoral
• left pectoral
• left mid-abdomen
3 Connect the three ECG leads to the electrodes
• RA lead to right pectoral
• LA lead to left pectoral
• LL lead to left mid-abdomen
ECG Lead Colors
RUA LUA LLL
US - AAMI White Black Red
Europe - IEC Red Yellow Green
4 Secure the leads to the body with adhesive tape to prevent any movement.
5 Observe sinus rhythm for 1 minute with arms raised.
C
_
1
0
6
4 Caution Route all cables between the EC G monitor, the patient, the patient table, and
3
4 the CT scanner so that they do not impede the free movement of personnel.
7
6
5
3
5
4
s
m
e
t
s
y
S
l
a
ic
d
e
M
s
p
lii
h
P
10.3.4 Verifying the ECG wave

Verify the ECG wave as described in the “Cardiac Gating and Tagging” chapter
in volume 4 of this manual set.
If a clean ECG wave does not display on the scanner and monitor, make sure
that the electrodes are placed properly, and the contacts are good. You may need
to reposition the electrodes closer to the heart.
10.3.5 Review patient’s heartbeat and any arrhythmias
When a clean ECG wave is obtained from the patient, visually inspect the ECG
wave on the monitor/ECG viewer to confirm that the conditions for Step &
Shoot scan are met:
• The patient’s heartbeat should be less than the recommended rate.
• Any arrhythmia is within acceptable limits.
Caution The ECG wave should not be used to diagnose patient health condition. Use it
only to help confirm patient suitability for the Step & Shoot Cardiac scan.
10.3.6 Prepare the patient for contrast injection
Determining contrast parameters

Contrast parameters for the Step & Shoot Cardiac axial scan should be similar
to the parameters your medical facility is using for cardiac helical scans.
For more information on contrast parameters, you may want to access to the
CT NetForum Community at:
http://netforum.medicalphilips.com
This is a community of healthcare professionals worldwide who share their
knowledge and experience using Philips CT products.
When you have registered at the site, navigate to the CT forum and search
through the area called “Exam Cards” for contributors’ information about
contrast parameters on helical cardiac CT.
C
_
1
0
6
4
3
4
7
6
5
3
5
4
s
m
e
t
s
y
S
l
a
ic
d
e
M
s
ilp
i
h
P
10.4 Begin the Step & Shoot Cardiac scan process

Note For detailed information about scanning, refer to the “Scanner Operation” and
“Scan Protocols” chapters in this volume of the User Manual.
1 Enter patient information.

2 Click Start Study.
3 Select patient position. Feet first is recommended.
4 Select exam group – Cardiac.
Begin the Step & Shoot Cardiac scan process 10.4
5 Select the exam protocol StepShoot.
Selecting a Step & Shoot scan automatically defines scans in the Series List.
This list, shown below, appears in the upper left corner of the Surview
opening window.
C
_
1
0
6
4
3
4
7
6
5
3
5
4
s
m
e
t
s
y
S
l
a
ic
d
e
M
s
p
lii
h
P
10.4.1 The Surview image

The Surview scan is a non-rotational scan that is used for planning the Step &
Shoot Cardiac scan. The Surview image will be used later, after you have started
the Step & Shoot scanning sequence, to plan the Step & Shoot Cardiac scan.
In the Surview image below, the blue rectangular planning overlay has been
sized and positioned to cover the heart area.
10.4.2 The Surview opening window

Note For detailed information about performing the Surview scan, refer to the
“Scanner Operation” chapter in this volume of the User Manual.
The Surview opening window is shown below, with the Main parameters tab
active.
C
_
1
0
6
4
3
4
7
6
5
3
5
4
s
m
e
t
s
y
S
l
a
ic
d
e
M
s
ilp
i
h
P
10.4.3 Surview main parameters tab

Label - A text entry is optional in this field.
View Angle - You can choose from three surview positions:
• The default view angle is 180. This provides a view from above the
patient.
• The 90 view angle provides a view from the patient’s side.
• Dual - The Dual surview creates both 180 and 90 scans.
Start - Displays a * symbol if no position has been established. The scan will
start from the current Patient Table position, which is taken from the Patient
Table in/out settings when the scanner is in the Ready for Scan state.
Note: Manually position the patient, using the gantry laser positioning lights, so
the Surview scan will begin just above the shoulders.
End - Displays a * symbol if no position has been established. The scan end is
based on the value in the Length field.
Length - The default length is 300 mm.
kV - The default voltage is 120 kV. Selections are 80, 120, and 140 kV.
Current [mA] - The default current is 30 mA. Selections are from 30 to
200 mA.

anzubieten!
" Nützlich
% Nicht
nützlich
Other Surview tabs

The other parameter tabs in the Surview scan are Inject, Voice, Automatic
Options, and Advanced. For details about these tabs, refer to the same tabs
described in the Step & Shoot Cardiac scan section later in this chapter.
C
_
1
0
6
4
3
4
7
6
5
3
5
4
s
m
e
t
s
y
S
l
a
ic
d
e
M
s
ilp
i
h
P
10.4.4 Perform Surview scan

1 When you have finished reviewing and/or setting Surview scan parameters,
click Go.
2 After you click Go you will be prompted to “Press the MANUAL Scan”
button on the scanner Control Panel.
3 Press and hold the Manual Scan button.
The voice message will instruct the patient to hold their breath, and the scan
will commence.
4 When the Surview scan is complete, the Surview image will appear on the
display, and the Step & Shoot scan will advance to the Locator stage.
Heart Rate analysis

An automatic Heart Rate analysis is performed after the Surview scan. The
patient’s heart rate for the previous 30 seconds is examined. If the rate exceeds
the maximum recommended rate, the following message is shown:
Note If you continue the scan on a patient having a heart rate greater than the
recommended rate, the resulting image quality may be deteriorated due to
motion artifacts, and the performance of the arrhythmia correction function
may be deteriorated.
10.4.5 The Locator line

After you finish the surview work stage, the Locator stage is automatically
started. The Locator line is used to identify where an ROI will be placed for
tracking contrast agent attenuation prior to triggering a Step & Shoot scan.
Move the Locator line to the desired anatomical location, as shown below,
which should be at the level of the Carina.
C
_
1
0
6
4
3
4
7
6
5
3
5
4 Label - The label defaults to locator.
s
m
t
e
s
Position - The position will have a location value (or a *symbol if no position
y
S
l
has been established).
a
ic
d
e
FOV - The field of view defaults to 400mm.
M
s mAs - The mAs defaults to 30; available values are 10 through 100.
p
lii
h
P kV - The voltage is fixed at 120 kV.
Thickness - The thickness is fixed at 10mm.
Suggest Locator Position - Click Suggest Locator Position to view a mini-image

of the suggested Locator position.
The Dose Indication box calculates the scan time and the irradiation profile
(the CTDI and DLP values).
T he Tracker line 10.5
10.5 The Tracker line

Click Tracker in the scan series list. The system displays the Tracker line in the
same location where you placed the Locator line (the lines are connected;
moving one causes the other to move).
C
_
1
0
6
4
3
4
7
6
5
3
5
4 Tracker main parameter tab
s
m
e Label - The label defaults to tracker.
t
s
y
S
l FOV - The field of view is 400mm by default; it will automatically be set later to
a
ic
d
e
250mm.
M
s
ilp
mAs - The mAs value is 30 by default. You can choose a different mAs.
i
h
P kV - The voltage is fixed at 120 kV.
Cycle time - The cycle time defaults to 2.1 seconds.
10.5 T he Tracker line
Cycles - This is the number of scanner rotations before scanning begins. Default
is 30. You can enter values between 2 to 50.
Thickness -The thickness for the tracker slice is fixed at 10 mm.
Post injection delay - This is the delay in seconds from injection to start of scan.
Default is 1.0. You can enter a value between 1 and 49.
Automatic minimum [post injection] delay - Activates the minimum post
injection delay, which is 1.0.
SAS - This is an available option that allows the Brilliance scanner to trigger the
injector automatically. If you have this option, you can activate this feature by
clicking the check box.
Voice tab - The default is no voice message.
Advanced tab - The Window Center and Width values are under this tab.
Proceed to planning the Step & Shoot scan

1 When you are finished with planning the Tracker, click the StepShoot, Axial
selection in the series list.
The Step & Shoot Cardiac scan becomes active and its opening window
displays.
2 Your first operation will be to plan the scan using the Surview. The
procedure starts on the next page.
Start planning the Step & Shoot scan 10.6
10.6 Start planning the Step & Shoot scan

After planning the Tracker scan, click the StepShoot, Axial selection in the
series list. The Step & Shoot opening window appears.
C
_
1
0
6
4
3
4
7
6
5
3
5
4
s
m The ECG wave has a series of blue oblique striped overlays that indicate the
e
t
s
y
approximate area of the planned acquisitions. This is the mid-diastole to end-
S
l
a
diastole portion of the heart cycle, where the heart cycle is most stable in terms
ic of movement. This area of the heart cycle will contain the default 75% cardiac
d
e
M
s
phase.
p
lii
h A time ruler appears at the bottom of the screen showing the scan length and
P
starting time.
10.6.1 Plan on Surview
Use the blue overlay box to define the position and length of the Step & Shoot
scan. The scan will be confined within the maximum effective FOV region. The
available FOV is identified by the vertical black background in the center of the
display. The scan length should cover the entire heart.
The scan length can be adjusted only in discrete portions, with each portion
being the length of a single acquisition. The total scan length equals the number
of patient table positions (cycles), times the length of each acquisition.
Mouse - The easy way to move and size the blue box is with the mouse. You can
drag the box into the desired position and change its height (scan length) by
dragging its upper and lower edges. You can also change its width (FOV) by
dragging its sides. The Surview overlay may also be adjusted using the Length
parameter in the Main parameters tab.
10.6.2 Timed scans

The scan ruler helps you evaluate the appropriate clinical parameters, such as
the amount of contrast, breath-hold time, etc.
During the scan, the ruler operation reflects the time progress (as it does in
standard helical timed scans).
Note There is a delay between the time Threshold is reached and the time the scan
starts, asseen in the ruler above. This is the 7 second Post Threshold Delay. (This
delay parameter appears in the Injection tab).
C In arrhythmia cases, since the exact time to complete the scan is not known, the
_
1
0 ruler displays the approximate maximum scan time.
6
4
3
4
7 Maximum scan time is determined using the median value of the R-to-Rs over
6
5
3
the previous 30 seconds, the number of patient table positions, and the number
5
4 of heart cycles that may be skipped due to detected arrhythmias.
s
m
t
e The scan timing will start at the start of injection, but the actual acquisition will
s
S
y not begin until contrast reaches its threshold value.
l
a
ic
d
e
M
s
ilp
i
h
P
10.6.3 Step & Shoot main parameters tab

Label - A text entry is optional in this field.
Start - Shows the table position at the start of the scan.
End - Shows the table position at the end of the scan.
Length - Shows the length of the scan.
Direction - Defaults to the patient orientation you selected when you started
the exam.
Thickness - This is the thickness of the slice that is actually represented on the
CT image, as opposed to the size selected by the collimator opening. The
default thickness is 0.9 mm. The minimum thickness is 0.8. You can select
values up to 5 mm.
Increment - This is distance between two slices. Select Overlap or Contiguous
to set the increment value.
kV - Defaults to 120 kV. You can also select 80 or 140 kV.
mAs - The default value is 150 mAs. The maximum value is 210 mAs (at 120
kV).
Cycle time - This parameter is grayed out. The cycle time value is determined
by the Step & Shoot protocol.
Cycles - This is an axial scan parameter. The minimum number of acquisition
cycles is 1. The maximum are 10. Usually, 3 or 4 acquisition cycles will cover the
heart.
Dose indication box - The extent of arrhythmia compensation cannot be
known before the scan. Because of this, the scan time and the irradiation profile
(the CTDI and DLP values) are presented in a “range” format. These values will
be updated after the scan is completed.
The possible values for CTDI, DLP, and Time are denoted by a range where the
minimal value represents a case without any arrhythmia, and the maximal value

represents a case with numerous arrhythmias, which, when skipped, cause delays
between scan acquisitions.
Note The time values are calculated based on heart rate on the surview ECG wave.
C
_
1
0
6
4
3
4
7
6
5
3
5
4
s
m
e
t
s
y
S
l
a
ic
d
e
M
s
p
lii
h
P
10.6.4 Step & Shoot injection tab

Proper injection timing is critical to achieve a quality Step & Shoot Cardiac
scan. When you set up the injection protocol for Step & Shoot for the patient,
you should take into consideration the maximum scan time. This time is
denoted both in the scan ruler and in the main parameters tab (Dose indication
box).
Contrast - Defaults to contrast “On” (the box is checked).
Non-timed - This selects a scan with a manually timed start, with no automatic
timing of intravenous contrast.
Note: It is possible to configure a Step & Shoot scan to start immediately by

setting the protocol to “non-timed” and the voice to “none.”
Timed - This selects a scan using a timing bolus.

Bolus Tracking - This selects a scan using Bolus Tracking software.
Threshold - The threshold setting determines the contrast agent level at which
the scan will be automatically triggered. The default setting is 110 Hounsfield
Units (HU), which is the recommended value.
Post Threshold delay - You can select either automatic minimum delay or user-
defined delay. The Post Threshold delay (minimum of 7 sec) allows enough
time for the heart wave to stabilize for arrhythmia compensation to function
accurately.
The time needed to achieve heart wave stabilization may be influenced by the
Valsalva manoeuvre, wherein the patient may bear down when hearing the
“hold your breath” command. This may cause a decrease of the venous blood
return to the right side of the heart, which causes a heart wave anomaly.
Automatic minimum [post threshold] delay - The minimum automatic delay is
7 seconds.
Fill in remaining fields as appropriate.
10.6.5 Step & Shoot voice tab

Note: Voice messages longer than 4 seconds are disabled for Step & Shoot.
The default voice message is “Breathe in, and hold your breath.” (Short
inspiration, Breathe.) This is the shortest breathing message provided by the
system.
The four second time limit on the voice message leaves enough time within the
remainder of the 7 second Post Threshold Delay for the heart rate to stabilize.
(See Valsalva manoeuvre on the previous page.)
C
_
1
0
6
4
3
4
7
6
5
3
5
4
s
m
e
t
s
y
S
l
a
ic
d
e
M
s
ilp
i
h
P
10.6.6 Step & Shoot automatic options tab

Auto Storing - Use this function to select the archive devices for storing the
reconstructed image. The Local device is the default device, and cannot be
deselected. To change the archiving media (add/remove), click Storage Devices.
The archive storage device you select will apply for only this series unless you
click Apply To All Series.
Auto Filming - You can send reconstructed images to the Filming application
immediately after they are displayed. Click Auto Filming to access the Film
Protocol dialog box, where you can make selections.
Auto processing - You can have the reconstructed images from Step & Shoot
Cardiac automatically launched into cardiac applications. These options are
available:
• Click Review to select a viewer for viewing reconstructed images. The
Cardiac Viewer is opened by default on the second monitor, and
reconstructed images automatically display there after reconstruction is
complete.
• The Analysis function allows you to select the desired application for
analyzing reconstructed images.
Note: Details about the Automatic Options are described in the Auto Options
section of the Scan Protocols chapter (chapter 8) in this manual.
10.6.7 Step & Shoot cardiac tab

Cardiac Phase - During a study only one cardiac phase can be acquired. The
default phase is 75%. It is the recommended phase. The cardiac phase can be
selected from the range of 45% - 85%. You can also type in a number within
that range.
C
_
1
0
6
4
3
4
7
6
5
3
5
4
s
m
e
t
s
y
S
l
a
ic
d
e
M
s
p
lii
h
P
10.6.8 Step & Shoot advanced tab

Resolution - Selections are Standard (default) or Detailed. Use Standard
resolution for Step & Shoot, except for cases of extremely obese patients.
Collimation - This value is fixed at 64x0.625 and cannot be changed.
Tilt - Gantry tilt angle defaults to 0.0 and cannot be changed.
Rotation time - The Rotation Time parameter defines the duration of one
rotation of the gantry. This value is fixed at 0.4 second and cannot be changed.
FOV - The field of view parameter denotes the diameter of the reconstructed
image. The maximum field of view available is 250mm.
Filters - The same filters are available for the Step & Shoot scan as for cardiac
helix scans.
• Cardiac Smooth (CA)
• Cardiac Standard (CB)
• Cardiac Sharp (CC)
• Cardiac Detailed Stent (CD)
• Xres Smooth (XCA)
• Xres Standard (XCB) - This is the default filter.
• Xres Sharp (XCC)
• Xres Detailed Stent (XCD)
Enhancement - The enhancement filter is used to smooth or sharpen images.
The 0.0 enhancement setting is recommended.
Window C and W - You may adjust the window Center and Width for optimal
viewing of the image.
• The window center (level) sets the location on a CT number scale where
the levels of gray are assigned. It is the center CT value of the window
width.
• The window width sets the number of gray levels or CT numbers assigned
to an image. It is the range of the Hounsfield Units that will be
represented on a particular image.
Center X and Center Y - Use these settings to adjust the horizontal and vertical
displacements of the reconstructed image relative to the center of the Gantry
opening. They are used to center the region-of-interest in the image frame.
Matrix - This parameter sets the number of pixels that the reconstructed image
will contain. The 512 matrix setting is recommended for best image quality.
DOM - This function is not part of the Step & Shoot Cardiac scan.
Adaptive filter - This filter normally applies to cardiac retrospective scans and is
not required in Step & Shoot, which accomplishes the same effect using 3D
axial reconstruction.
The Allow manual couch [patient table] movement setting is inactive because
all patient table movement is controlled by the Step & Shoot scan protocol.
C
_
Edge Correction - The default reconstruction is with Edge Correction.
1
0
6
Uncheck the Edge Correction checkbox to select reconstruction without Edge
4
3 Correction.
4
7
6
5
3
5
4
s
m
e
t
s
y
S
l
a
ic
d
e
M
s
ilp
i
h
P
10.7 Prepare for Step & Shoot scanning sequence

When you have finished reviewing the axial scan parameters for the Step &
Shoot Cardiac scan, click Go.
10.7.1 Initial steps

1 After clicking Go, a message about “More than one scan . . .” is shown.
2 Click OK to continue. The message “Hold ENABLE during patient

positioning” is shown.
3 Hold down the Enable button on the Scan Control Panel. The message
“Press MANUAL to scan.” is shown.
4 Press the Manual button on the Scan Control Panel.
Prepare for Step & Shoot scanning sequence 10.7
10.7.2 Set the Tracker threshold value

Note Refer to the Bolus Tracking chapter (chapter 10) in this volume of the manual for
details about using the Bolus tracking function.
C
_
1
0
6
4
3
4
7
6
5 The Bolus Tracking window, shown above, is where you set up the tracking
3
5
4 function.
s
m
e
t
s
The Tracker will track blood flow through the artery of your choice (placing the
y
S
l
ROI on the descending aorta is recommended) to detect when contrast is
a
ic
d
present. When the contrast reaches the specified threshold as it crosses the
e
M Tracker line, the Step & Shoot scan is started automatically.
s
p
lii The threshold default is 110 Hounsfield Units. (You can change the threshold
h
P
value in the Injector tab, described earlier.)
Note You can also visually monitor the threshold level on the display, and you can
trigger the injector manually if desired.
When the Tracker window opens, you are asked to “Set ROIs and Threshold or
Replan Procedure.” The threshold has been set by default to 110, but it can be
changed at this time, if desired.
Note • The “Replan procedure” function allows you to replan the threshold value.
Click REPLAN to return to threshold planning.
• You can also drag the threshold line on the displayed graph to change the
threshold value.“
Use this procedure to set up the Tracker.

1 Identify the Descending Aorta on the axial image. (You may need to first
adjust the width and center values for optimum viewing.)
2 Click on the desired artery (in this case the descending aorta). An ROI is
created. The Av (Average value) of image pixels enclosed by ROI is shown.
3 Click OK in the Bolus Tracking box to finish setting the threshold ROI.

anzubieten!
" Nützlich
% Nicht
nützlich
Prepare for Step & Shoot scanning sequence 10.7
4 After setting the threshold ROI, you will be prompted to “Press AUTO to
start the timed series.”
Press the Auto button on the Scan Control Panel.

5 You will be prompted to “Please Inject Contrast - Start scan when ready.”
6 Start the Injector.

C
_
1
0
7 You can monitor the progress of contrast flow by observing the Bolus
6
4
3
Tracking graph at the upper left in the main Tracker window.
4
7
6
5
3
5
4
s
m
e
t
s
y
S
l
a
ic
d
e
M
s
p
lii
h
P
The graph shows the HU value of the contrasted blood measured at the
ROI. Also shown is the time since injection, and the differential between the
current HU value and the threshold setting.
8 As you monitor the contrast flow, a message gives you the option “To stop
tracking and skip to the clinical scan.” This option allows you to override
the automatic scan triggering function and instead manually start the scan
by clicking the START CLINICAL SCAN button.
You would use this function if, while monitoring the graph, you notice that
the contrast threshold line value is not being crossed.
The automatic Step & Shoot Cardiac scan 10.8
10.8 The automatic Step & Shoot Cardiac scan

When either the threshold is reached, or when you manually start the scan, the
Step & Shoot scan will proceed.
Step & Shoot Cardiac scans are completely automatic – that is, changes in
patient table position, and the start of the scan are not under control of the
operator.
The voice message will prompt the patient to “Breathe in, and hold your
breath.”
The first data acquisition begins at first available phase point that appears after
the Post Threshold Delay.
The patient table will travel to its new position only after the acquired data has
been validated.
Each shot starts and ends according to the ECG wave.
When the Step & Shoot Cardiac scan is complete, the system displays the
Evolving mode window, described in the next section.
C
_
1
0
6
4
3
4
7
6
5
3
5
4
s
m
e
t
s
y
S
l
a
ic
d
e
M
s
ilp
i
h
P
10.9 Evolving mode
10.9 Evolving mode

The Evolving mode functions concurrently with the scan, reconstructing a
selection of the entire scan in the form of partial images in a separate window.
As the scan continues, the images are dynamically refreshed.
The Evolving mode enables you to see a quick overview of the scan and allows
you to set zoom and pan, and adjust window settings prior to final
reconstruction.
• Zoom in/out to enlarge or reduce the series of images.
• Pan an image to center the series of images or the region of interest.
• Adjust the window settings.
• Edit the ECG R-tags.
Click OK in the message window to start the final Reconstruction.
Evolving mode 10.9
Click OK in the message box after making your adjustments to zoom, pan, and
window, and after editing the ECG wave. (ECG editing is described in the
procedure following this one.)
The reconstruction process proceeds. Only the cardiac phase defined in the Step
& Shoot parameters (usually 75%) will be reconstructed.
C
_
1
0
6
4
3
4
7
6
5
3
5
4
s
m
e
t
s
y
S
l
a
ic
d
e
M
s
p
lii
h
P
10.10 After reconstruction is complete
10.10 After reconstruction is complete
When reconstruction is complete the Reconstruction window is shown. After

evaluating the reconstruction, and before you end the exam, you have several
options available from this window:
• You can select Repeat Last Series to repeat (without change) the previous
scan.
• You can select Continue Current Series to continue scanning one
additional acquisition cycle in the current series. The system automatically
provides (under the “Extend Series” parameters) the default values for
After reconstruction is complete 10.10
patient table start position as well as the length to be added (in mm). You
also have the option to enter your own Start and Add values.
Note • You can continue a scan only if the scan was normally terminated. If the scan
was abruptly terminated (by pressing Pause/E-stop, etc.) the scan cannot be
continued but must be repeated.
• There is more information about Continuing Current Series and Repeat Last
Series in the “Examination Flow” section of chapter 7 in this volume of the
manual.
• You can perform a Re-recon procedure, which allows you to modify some
of the reconstruction parameters and reconstruct the images again. (The
Re-recon procedure is described with more detail a little later in this
chapter.)
C
_
1
0
6
4
3
4
7
6
5
3
5
4
s
m
e
t
s
y
S
l
a
ic
d
e
M
s
ilp
i
h
P
10.11 EC G editing
10.11 ECG editing

Note • For detailed procedures about ECG editing, see “Using the correction
feature” in volume 4 of this user manual, chapter 4 “Cardiac tagging and
gating” chapter.
• See also the “ECG Viewer” section in that chapter.
The main function of ECG editing in Step & Shoot Cardiac is to allow moving
the position of one or more R-tags. Moving R-tags allows you to change (in a
small way) how images are reconstructed.
R-tag editing is available:
• before the initial reconstruction process (after Evolving)
• before a Re-recon
• before an Offline reconstruction
Other ECG editing options are:
• Measure
• Undo
• Reset
ECG editing
To access the ECG Editing function, click the ECG Tools button.
In the ECG editing function, only limited editing of R-tags can be performed.
You can move an R-tag up to 100msec in each direction from the original R-tag
point.
To move an R-tag - Click on the red dot on the R-wave and drag the dot left or
right. A message tells you when you have tried to move an R-tag more than
100msec.
EC G editing 10.11
A message on the ECG wave will identify an edited R-tag.
This allows you to fine tune the R-tag location, which sometimes can improve
the image quality. Since only a single heart phase is acquired in a Step & Shoot
Cardiac scan, there is only a limited amount of data that can be reconstructed.
You cannot add or remove an R-tag, and you cannot perform any arrhythmia
editing.
C
_
1
0
6
4
3
4
7
6
5
3
5
4
s
m
e
t
s
y
S
l
a
ic
d
e
M
s
p
lii
h
P
10.12 Reconstruction using Re-recon and Offline recon
10.12 Reconstruction using Re-recon and Offline

recon
After a scan is completed and the normal reconstrction has finished, you may
want to make changes to the way images are reconstructed, or you may want
additional, unplanned reconstructions of a specific area. You perform such
reconstructions on raw data.
Raw data - Raw data is data acquired during the scan from which image data is
created.
• After the study is ended, raw data is saved temporarily to local storage. It
remains in local storage until it is automatically erased.
• As new raw data is sent to local storage, if the storage area becomes full,
the oldest raw data will be erased automatically. Any erased raw data is not
recoverable. (You can, if desired, “lock” raw data to prevent it from being
erased.)
How long raw data stays in local storage before it is automatically erased
depends on how full the storage is, and on how much raw data is being sent to
local storage on a daily basis.
Re-recon - Re-recon is the reconstruction that can be accessed directly from the
initial reconstruction display, while the raw data is still immediately available for
use.
Offline reconstruction - Offline reconstruction allows you to perform
reconstruction after you have ended the study, but before the raw data has been
erased.
The Re-recon and Offline reconstruction functions are described on the
following pages.

Reconstruction using Re-recon and Offline recon 10.12
10.12.1 Re-recon function

Note Before starting the Re-Recon function, you must first specify the new
reconstruction parameters.
You can re-recon with different parameters such as:

• Filter
• Zoom
• Pan
• Window
• Edge Correction
• R-tag editing
Click the Start Re-Recon button to access the Re-recon window, shown below.
C
_
1
0
6
4
3
4
7
6
5
3
5
4
s
m
e
t
s
y
S
l
a
ic
d
e
M
s
p
lii
h
P
10.12 Reconstruction using Re-recon and Offline recon
The parameters in the Re-recon tab have the same options and functionality as
in main reconstruction process.
10.12.2 Offline reconstruction

Note The offline reconstruction function can be performed only on raw data files that
are stored in the CIRS directory. You will need to locate the raw data in the
directory. Refer to detailed instructions in the “Image reconstruction” chapter
(chapter 15) of this volume of the manual.
The Offline reconstruction function allows you to reconstruct part or all of the
patient images with different parameters, such as these:
• Start, End, and Length of the scanned series
• Thickness
• Filter Enhancement
• Window
• Matrix
Use this procedure to reconstruct raw data offline:
1 Under Selected Device in the Directory, click the IRS icon. A list of patients
displays.
2 Select a patient.
3 Select the series to be reconstructed.
4 Select an option:
• View Recon to view images as they are reconstructed.
• Background Recon to reconstruct images in the background.
If the ECG information was captured, it also displays on the screen.
The system displays the parameters that correspond with the scan.
5 Change the reconstruction parameters, if desired.
You cannot change the Main reconstruction parameters.
Reconstruction using Re-recon and Offline recon 10.12
6 To delete one of the additional reconstructions, right click on it and select

Delete.
7 When you have completed the reconstruction settings, select an option:
• Click Start Recon to accept the settings and begin reconstruction. If you
are using background reconstruction . . .
• Click Cancel to revise your settings.
C
_
1
0
6
4
3
4
7
6
5
3
5
4
s
m
e
t
s
y
S
l
a
ic
d
e
M
s
ilp
i
h
P
11 Bolus tracking
11.1 Overview
The Bolus tracking function maximizes the efficiency of CT scans that are
enhanced through the use of a contrast agent.
When a contrast agent is used to enhance the visualization of organs, the
enhancing effect varies over time as a function of the agent’s concentration
in the blood. Ideally, the Clinical scan is performed when the level of the
contrast agent is at its peak enhancement.
Bolus tracking is designed to help the user time the Clinical scan with
precision. This is done by preceding the Clinical scan with locator and
Tracker scans.
The Locator scan is a fused Axial scan that is used to locate an ROI and to
set a threshold of contrast agent attenuation at that ROI position. During a
C
1
_ Bolus tracking operation, the Tracker scan tracks the contrast agent level at
0
6
4
the selected ROI, and, when the threshold is exceeded, the Clinical scan is
3
4 automatically started.
7
6
5
3 The Bolus tracking function provides the following advantages and
5
4 features:
s
m
t
e
s
• Automatic vessel/organ tracking including initial single click vessel
y
S
l
segmentation, motion compensation, and artifacts and plaque removal.
a
ic
d
e
• Precise control over scan timing in relation to contrast agent level.
M
s • The ability to improve the differentiation between the blood cycle
ilp
i
h
P
phases (such as the Arterial phase, Portal and Venous phase, and organ
uptake).
• Automatic scan triggering based on threshold value.
Brilliance CT - Volume 1 Bolus tracking 11-1
11.1 Overview
• Scan start based on injector trigger (purchasable SAS option is then pre-
requisite).
• Protocol planning and modifications for the basic Bolus tracking scans:
Locator (fused Axial), Tracker (fused Axial) and Clinical (Helix).
• The contrast level threshold is operator-defined; the system default is
150 H.U.
• A programmable time delay is available between start of the injection
and the start of the Tracker scan.
• The start of the Clinical scan is automatically initiated when the
programmable threshold is reached.
• A manual override is permitted, thus terminating the Tracker scans and
initiating the Clinical (helical) scan sequence.
• A programmable time delay is available between termination of the
Tracker scan and the start of the Clinical study.
• Additional Clinical helix scans can be planned, if desired; they also are
automatically started.
• Up to four (two can be automatic) ROIs can be established for Tracker
scans.
• The densities of the ROIs are calculated and displayed at intervals equal
to the Cycle time. The consequent Hounsfield unit progress displays on
the same graph as the threshold level.
Note Only the threshold determined by the first ROI terminates the Tracker scan
and initiates the Clinical (helical) run. Information for other ROIs is
recorded but does not affect operation.
11-2 Bolus tracking Brilliance CT - Volume 1
Overview 11.1
11.1.1 Hardware requirements

A power injector, manually controlled by the operator, is the minimum
requirement.
Optionally, the injector may be equipped with scan trigger. Then the time
from injection start is counted down, and the scanner is automatically
initiated after a preset interval. This delay helps save patient irradiation at
the beginning of the injection, before the time when the contrast agent can
be viewed.
Note In order to use the injector scan trigger feature, you must have the Spiral
Auto Start (SAS) option on your Brilliance system. this feature is for use
with only Philips-approved injectors.
11.1.2 Automatic tracking

The automatic tracking feature allows you to define a complete ROI using
a single seed point. This feature can compensate for patient movements,
artifacts, and some stenosis. It creates better calculation of the contrast
C
enhanced vessel/organ resulting in a more accurate triggering of the Clinical
_
1
0
scan.
6
4
3 With the new automatic tracking feature, the ROI is defined by clicking a
4
7 seed point inside the vessel/organ. The system automatically tracks the
6
5
3
5
vessel/organ from this seed point.
4
s
m
The automatic ROI can compensate for patient movement, artifacts, and
e
t
s stenosis (to some extent). Use of the feature results in more accurate
y
S triggering of the clinical Angiography scan.
l
a
ic
d Initial vessel/organ segmentation finds the non-enhanced vessel. The
e
M
s resulting ROI is slightly reduced to avoid boundary problems. Edited ROIs
ilp
i
h
are also adjusted accordingly.
P
11.1 Overview
• Motion compensation uses registration of consecutive scans. The

compensation is limited since large movements result in motion
artifacts and the image are not suitable for tracking.
• Vessel Segmentation applies shrinking at each step of vessel/organ
definition to avoid vessel edge effects. This helps reduce the presence of
items such as fine movements and small plaques.
• Enhancement calculation removes small streaks, noise and artifacts.
• Failure Detection recognizes failure due to these inconsistencies:
• The outcome of the segmentation had a major increase or decrease of
area.
• The ROI center location has moved substantially when no major
movement was found by the registration.
Bolus tracking scan series 11.2
11.2 Bolus tracking scan series

The basic Bolus tracking operation consists of a set of three scans, Locator,
Tracker, and Clinical. These scans are preceded by a standard Surview scan
and optionally followed by additional Clinical scans.
Note The Locator and the Tracker scans are executed at the same position and
therefore they appear as a single line on the Surview.
The Locator scan is a single fused scan series, which can be replanned for
better patient positioning. It is performed before administration of the
contrast agent. It allows you to set the patient position, the ROI locations
and the contrast enhancement threshold for the Tracker scan.
The Tracker scan is a fused axial scan series with fixed intervals between
scans, determined by the Cycle Time. The Tracker and Clinical scan(s) are
performed after the administration of the contrast agent. The Tracker scan
monitors the concentration of contrast agent at the specified ROI, and
compares it to the set threshold. As soon as the threshold is exceeded, the
Tracker scan is terminated, the patient table moves to the Clinical scan start
location and the Clinical scan is performed automatically.
C
_
1 Note The Tracker scan may be terminated manually, by clicking the "Start
0
6
4 Clinical Scan" dialog box, before the threshold is reached. Manual
3
4
7
6
termination of the Tracker scan is followed by the same sequence of events
5 (table movement and Clinical scan) that occurs after automatic threshold
3
5
4 termination.
s
m
e
t
s
The Clinical scan is targeted to run when the level of the contrast agent is
y
S
l
at its peak enhancement.
a
ic
d
e The first Clinical scan may be expanded by the addition of consecutive
M
s Clinical scans. Optional Clinical scans are pre-planned together with the
p
lii first Clinical scan.
h
P
The following pages provide instructions for conducting a Bolus tracking
scan.
Use this procedure to conduct a scan:

1 Click the Start Study workflow button.
2 Enter the patient information in the patient data form.
3 Click the Protocols workflow button.
4 Click the desired exam protocol group. The list of specific Exam
Protocols displays.
5 Select the desired protocol. The system displays the protocol parameters
for the Surview.
Note The Locator and tracker scans may already be included in the protocol you
select, however they can also be added during the scan set-up.
6 If needed, edit the protocol parameters (see the Scan protocols chapter
in Volume 1 for more information).
7 Click Go to start the Surview scan. The system displays the Surview
image.
Now that the Surview is complete, you can continue to the Bolus tracking
scan.
• If the Locator and tracking scans are included in your protocol,
continue to planing the locator and tracker scans, step 4.
• If the Locator and tracking scans are not included in your protocol,
continue to Planning the locator and tracker scans, step 1.

anzubieten!
" Nützlich
% Nicht
nützlich
11.2.1 Planning the locator and tracker scans

If your protocol did not include the bolus tracking option, you must add it
before using this procedure.
1 Click the Injector tab in the Scan tool panel.
2 Select Bolus Tracker.
• The system displays Locator and Tracker scans in the series list and
automatically closes the injector tab.
3 Click Locator in the scan series list. The system displays a locator line
on the image.
4 Move the locator line to the desired anatomical location.
C
_
1
0
6
4
3
4
7
6
5
3
5
4
s
m
e
t
s
y
S
l
a
ic
d
e
M
s
p
lii
h
P
Note Click Suggest Locator Position to display a mini-image with a suggestion for
placing the locator.
5 Click Tracker in the scan series list. The system displays the tracker line
in the same location where you placed the locator line (the lines are
connected, moving one causes the other to move).
• Make sure placement defines the desired area of interest.
6 Click the Clinical scan in the series list. The Main scan parameters
display. A time ruler appears at the bottom of the screen showing the
scan length and the start point relative to the injection start.
7 To add a Clinical scan, click Insert/Dup and select an appropriate scan

protocol, as described in
Chapter 7: Scanner operation.
• Up to three additional scans can be programmed.
• To change the parameters, follow the same instructions as for the first
Clinical scan editing.
Note The PTD of the additional Clinical scan is, by default, the shortest available
for a given situation. Like the PTD of the first Clinical scan, It is measured
relative to the time that the Threshold has been reached, at the end of the
Tracker scan.
Warning Do not attempt to manually change the gantry Tilt or the patient table
Up/Down position during or between the Locator, Tracker, and Clinical
Scans.
8 Verify all scan parameters. For the cardiac scan, you can also set the
Multi phase option (see Offline reconstruction, on page 16-4).
9 Using the tools in the toolbar, define the desired ROIs and the
threshold for the tracker scan. you can draw up to two automatic and
up to four manual-ROIs. Only the first ROI drawn (displayed in

orange) is used to trigger the scan.
Click Suggest ROI to display a suggested ROI.
Click Set Manual ROI to draw the ROI manually.
Click Set Auto ROI to automatically display the RO
Note You must use the toolbar tools to mark the ROIs, however, you can use the
graphic tools to adjust the ROIs:
• The average CT value appears next to each ROI. T he value automatically
adjusts if the RO I is changed.
• The Change Shape Graphic tool and the bounding box allow you to
change the size and location of the ROI.
10 In the graph, the dotted line is the average of the orange ROI. If
desired, you can reset the threshold:
• Type in the threshold in the dialog box, or
• Use the Move graphic tool.
C
_
1 11 Verify there is no error message above the time ruler on the bottom of
0
6
4 the window. Messages may be due to one of these errors:
3
4
7
• long post threshold delay
6
5
3
• ROI is out of the image boundary
5
4 • scan parameter selection does not fit the PTD
s
m
e
t
s Note The Scan is planned to start with a programmable delay after the threshold
y
S completion. This delay is called Post Threshold Delay (PTD). If the scan
l
a
ic parameter selection does not fit the PTD, a warning displays. The PT D is
d
e
M automatically set to the minimum available value.
s
ilp
i
h
P
12 Click an option in the message box to continue:

• Ok to continue to the tracker scan. Go to step 13 below.
• Replan to exit the results and replan the locator and tracker scans. Go
to step 3 above.
13 Follow the on-screen instructions to complete the bolus scan. When
using manual voice, give breathing instruction to the patient when the
tracker crosses the threshold.
The system displays the resulting images.
14 Adjust the images as necessary.

15 Click Ok to reconstruct the images.
Executing Bolus tracking 11.3
11.3 Executing Bolus tracking
11.3.1 Execution sequence - tracker and clinical scans

These two scans together should be considered as one sequence. Before the
Tracker scan starts, an active viewer opens. The left side of the Viewer is
allocated to the Contrast enhancement vs. Time graph while the right side
displays the images on which the contrast enhancement is measured.
The protocols of the Clinical scan(s) which follow the Tracker scan can be
partially edited at this stage.
Note • The Auto Start mode: When the system prompts, press the Injector start
button. The Tracker scan starts with the delay defined in the Tracker scan
protocol after the injection start.
• The Manual Start mode: Simultaneously press the Manual button (to
start the Tracker scan) andthe Injector start button. The scan starts after
a lapse of time equal to that defined asDelay in the Tracker scan protocol.
Note Since the Delay is counted down from the moment the Manual button is
C pressed, it is important to press both the Manual and the Injector buttons
_
1
0 simultaneously.
6
4
3
4 As the Tracker scan begins, the images containing the ROI measurements
7
6
5
3
appear at a rate equal to the previously defined cycle time. The computed
5
4 averaged densities also appear on the graph, which is updated at the same
s
m rate.
e
t
s
y The measured density within the ROI should reach the threshold value and
S
l
a then the Clinical scan should start.
ic
d
e
M
s Note Periodic checks of CT number correctness is essential for the accuracy of
p
lii the Contrast vs. Time plot and consequently for the precision of the Clinical
h
P
start timing.
In case you wish to start the Clinical scan before the threshold is reached,
click Start Clinical Scan.
The Clinical scan starts after a lapse of time equal to that defined in the
Tracker scan protocol and after the table reaches the pre-defined position.
A time ruler displays the countdown time to the end of the scan and to the
start of the next Clinical scan, if any.
Warning Watch the monitor screen during the Tracker scan. If an anomaly appears
during the Tracker scan execution, for example:
• the graph doesnot appear
• the plot is not updated
• the images do not appear
• the contrast intake does not reach the threshold after a reasonable lapse
of time.
Then proceed as follows:
• If visual examination of the CT images shows that the contrast intake is
reasonable, then click on Start Clinical Scan and proceed quickly to the
start of the Clinical scan.
• If the anomaly does not allow you to see if the contrast intake is
reasonable, or if it is clear that the contrast intake is not sufficient, then
immediately stop the scanning procedure (by either clicking on
STOP/PAUSE or by pressingthe STOP button on the Scan control panel)
and then stop the injection.
11.3.2 Execution sequence - additional clinical scan

The additional Clinical scan(s) normally start following the corresponding
PTD (Post Threshold Delay) as defined during the plan.
• If you decide to start them before the scheduled time, immediately click
Stop/Pause after the completion of the first Clinical scan.
• Click Next Series. The scanner enters the Ready status.
• Start the scan by pressing the Manual Scan button on the scan control
box.
Note The PTD length is at least 2.5–4 seconds (depending on scanner model). If
the Scan start position is different between the Tracker and the Clinical
scans, then the PTD are longer.
If Bolus tracking can not be performed at the default location, minimize

bed movement by setting a Tracker location as close as possible to the start
position of the first Clinical scan.
Voice Message - Another parameter impinging on the PTD value is the
message. The Clinical scans are preferably programmed without any
message or with the shortest available messages. The patient is preferably
C
_
instructed by intercom close to the Tracker scan stop, when the ROI value
1
0
6
almost reaches the threshold level.
4
3
4
7
In order to optimize the contrast agent administration, the injection time
6 for arterial phase examinations should be roughly equal to the Clinical Scan
5
3
5
4
time.
s
m
e
Higher injection rates result in better contrast enhancement. High injection
t
s rates (if the physician assesses that the patient can tolerate them) are
y
S
l desirable mainly for shorter injection times.
a
ic
d
e
M Alternatively, a short Scan time may allow moderate injection rate with
s
ilp acceptable contrast level and relatively low Contrast agent administration.
i
h
P
Thus, for arterial examinations, the Scan time should be as short as
possible.
In the case of a first-phase Aortic scan, it is recommended to set the

Threshold Level at 150 HU in order to enable the system to start the first
Clinical Scan at the optimal contrast level.
Locator Default Parameters - In order to avoid miscalculation of contrast
agent attenuation within the ROI, the software restricts the use of certain
parameters to default values as follows:
• Reconstruction mode (On Line)
• Scan Increment (0)
• Fused mode
• Image Matrix (5122)
• Resolution (STD or Detailed)
• Number of slices (1)
Tracker Parameters - The following parameters are set by the software to be
identical with their Locator values:
• Scan diameter
• Slice thickness
• Filter
• Center X,Y
• Field of View
• Tilt
• Location
• kVp
• mAs
Fixed Parameters - The following parameters are predefined, and can not
be changed:
• Matrix (5122)
• Reconstruction Filter B
• Fused
Only the last image of the Tracker Scan is saved on the local disk. This
image contains the following information:
• active ROIs Hounsfield Unit (HU) level
• the elapsed time from injection
Note If desired, all Tracker Scans can be reconstructed in Off-line Recon.
The Injector display panel is supposed to provide the Bolus administration

data. This is the ultimate device for observing items such as Injection time,
proper bolus flow, and flow rate.
Note Pay particular attention to the Injector display during the bolus
administration. Use the display information as the basis for your procedure
control decisions.
C
_
1
0
6
4
3
4
7
6
5
3
5
4
s
m
e
t
s
y
S
l
a
ic
d
e
M
s
p
lii
h
P
11.4 Generate a bolus scan
11.4 Generate a bolus scan

The Bolus scan protocol is defined as having Locator and Tracker scans.
2 Click Generate Protocols. The Generate Main Form dialog box
displays and the Exam Protocol Groups display.
4 Select an existing protocol which contains a surview and helix scan.
Note A bolus procedure must have a Surview.
5 Select the helix protocol clinical tab and set the desired parameters.
6 Select helix protocol injection tab.
7 Select bolus tracking. Locator and tracker scans are automatically
created and appear before the clinical scan.
8 Select the locator scan.
9 Set the parameters: Voice and FOV.
Note The minimum necessary dose is preferred during the Locator and Tracker
scans in order to reduce patient irradiation. If the accumulated dose is
greater than or equal to 250mGy, a warning message displays.
10 Select the tracker scan and set the post injection delay, if desired. This is
the delay between the start of contrast injection and the beginning of
the tracking scan. Activate SAS if desired.
11 Select the helix scan and set the injection threshold (the CT value
threshold that triggers the helix scan). The value set is the protocol
default but this can be changed during the study.

Generate a bolus scan 11.4
12 Set the post threshold delay. This is the delay between achieving
threshold and the start of the clinical scan.
13 If desired add more clinical scans or MPRs.
Note After changing the clinical scan (collimation, resolution, rotation time) the
operator must click on locator and tracker for the parameter changes to
update.
14 After all parameters are set correctly, click Go.

15 In the Generate Main Form, select the age group for which you wish to
use the protocol (this selection is mandatory).
16 If desired, you can also set these options:
• Weight
• Requesting physician
• Requested procedure
17 When you have filled in all the required information select the Save or
Save As button at the bottom of the Generate Protocol dialog box.
• Selecting Save adds Bolus Tracking and permanently changes that
C
existing protocol.
_
1
0
• Selecting Save As, keeps the original protocol, and generates a new
6
4
3
protocol with the changes you have just made. After selecting this,
4 you are prompted to select a protocol group and enter a new protocol
7
6
5
3
name.
5
4
s
m
e
t
s
y
S
l
a
ic
d
e
M
s
ilp
i
h
P
General 12.1
12 Continuous CT (option)
12.1 General
Continuous CT (CCT) is a scanning mode that allows the physician to
perform extended, low-dose scans while performing a biopsy. You can
control the scan by pressing the foot-pedal switch in the gantry room.
The Continuous CT options include Fluro CT which allows for high-speed
extended scans during biopsy. This option does not include the low dose
feature offered by the standard CCT, but instead displays images at a much
faster rate.
For either option, the resulting images display on a remote monitor in the
scan room, providing near-real-time visual feedback during the biopsy. The
remote monitor may be attached to a cart ( CART option) or it may be
mounted on a ceiling arm (Ceiling-Mount option).
C
_
1
0
6
4
3 12.1.1 CCT components
4
7
6
5
These are the components required to use the Continuous CT application:
3
5
4 • A Foot-pedal, used by the physician to activate the CCT scan from
s
m
e
within the scan-room.
t
s
y
S
l
• CCT System with monitor (on a cart or mounted on a ceiling arm).
a
ic
d
e
M
s
p
lii
h
P
Brilliance CT - Volume 1 Continuous CT (option) 12-1
12.2 Principles of operation
12.2 Principles of operation
Warning The displayed images can be shown either as Right on Left, view from Bed,
or View from Feet. This view may conflict with the normal default image
orientations as set in the default setting of the scanner.
This function requires two persons for best performance:

• a Technologist seated in the operator-room
• an interventional doctor who conducts the biopsy procedure in the
scanner-room
To shorten the biopsy procedure, the doctor should activate the foot-pedal
during the biopsy procedure.
The biopsy procedure starts by positioning the patient on the table
according to the planned area of the biopsy. In general, a surview and a
sequence of scans (axial or spiral) are performed to help locate the lesion
(the target) and plan the insertion path (trajectory) of the needle. A typical
slice is then selected, and using the graphics tool-box (distance and angle
measurements), the biopsy planning is performed.
The insertion point is marked on the patient skin and the biopsy procedure
is initiated. The biopsy-needle is inserted and its location can be viewed at
almost real-time on the monitor. The interventional doctor activates the
pedal and a burst of scans (Continuous or Fluoro mode) or a single image
scan (Single mode) are executed with low-dose axial scanning. As the pedal
is released the scans and the radiation stop at once.
During scans, the images display on the remote monitor in 1, 2, or 4
format as selected previously in the protocol.
The doctor follows the needle-tip as he/she proceeds with the insertion
toward the target.
12-2 Continuous CT (option) Brilliance CT - Volume 1
Principles of operation 12.2
The displayed images can be shown either as Right on Left, View from Bed,
View from Feet, or Anterior on left. This view may conflict with the normal
default image orientations as set in the default setting of the scanner.
When displaying more than one image per frame (two or four images), the
images are displayed simultaneously with each image representing a
different slice location. The needle may be seen in more than one slice
location and, by identifying the needle-tip, the next table translation can be
planned.
Table and gantry movements are supported during the CCT procedure to
reposition the patient for the next scan session.
As the pedal is released at the end of the burst-session, the last image
remains ‘frozen’ on the screen. These images are also registered in the
normal study-viewer and can be used for archiving and filming. The last
image can be windowed, panned and zoomed, and those settings are kept
for the next scan-burst.
Stop, pause, and table movement

The CCT operation can be paused or stopped at the end of the procedure
C
_ by the Technologist.
1
0
6
4
3 Between scans, the Technologist can move the table. If the table position is
4
7
6 changed, the scan can continue without cancelling the whole scan.
5
3
5 • In the axial scan, the system does not scan while the patient table is
4
s moving.
m
e • In the fluro mode, the scan is continuous and so is the reconstruction.
t
s
y
S
l
The system compensates to improve images that are produced while the
a
ic patient table is moving and the scan may continue without any
d
e operator intervention.
M
s
ilp
i Note The system can remain in ready mode for 30 minutes.
h
P
12.3 Safety instructions for CC T accessories
12.3 Safety instructions for CCT accessories
Foot pedal
CCT has a special foot pedal to activate scans from the gantry room. Make
sure the foot pedal is free of foreign objects to ensure easy and safe access
during operation.
Caution Take care not to collide with or step on the pedal housing.
Additional monitor cart (optional)

The additional monitor cart inside the scanner room should not be used to
hold anything but the original monitor. The 21-inch monitor-base should
always be on top of the stand and secured properly. When not in use, the
cart and its cables should be moved to a corner of the room so they do not
interfere with routine activities in the scanner room. Care must be taken
not to collide with the monitor stand or trip on the monitor cables.
Additional monitor ceiling support (optional)

The additional monitor ceiling support is a heavy device, which is attached
to the gantry-room ceiling and carries the 20-inch flat monitor. Do not
hang any other items on this support such as aprons or other accessories.
When not in use, the additional monitor support should be folded and out
of the way of the patients and the technologists on site.
Safety instructions for CCT accessories 12.3
Hand-protection accessories (not supplied)

When operating the system in the Continuous CT scanning mode, needle-
holding handles should be used to avoid direct irradiation to the doctor’s
hands.
Also, radiation-reducing gloves are recommended for this procedure, if
needle-holding handles are not used.
C
_
1
0
6
4
3
4
7
6
5
3
5
4
s
m
e
t
s
y
S
l
a
ic
d
e
M
s
p
lii
h
P
12.4 Preparations for biopsy
12.4 Preparations for biopsy

The following preliminary preparations must be done before beginning the
procedure.
• Position the monitor in the gantry room at a convenient location,
taking into account the expected direction of approach to the patient.
• Check that the foot pedal is free from interfering objects and is easily
accessible to the Interventional operator.
• Make sure that the Gantry indicator lights are functioning properly by
performing a continuous CT scan without a patient.
• Prepare sterile materials, if necessary. For example, a clear sterile sheet
with an adhesive strip may be attached over the Gantry panel for
operating the table motions from the Gantry room.
• Check the intercom for clear bi-directional communication between
the Interventionist and the console operator.
• Prepare the appropriate radiation shielding equipment and materials.
• Prepare the intervention kit, including the extended handle and
accessories.
Note If the monitor is located on a cart, make sure that the cables connected to
the device are not in the way of the patient or the personnel in the scan
room.
Warning • This procedure should be done with two staff members. The individual at
the console should proceed only as instructed by the individual
conducting the biopsy procedure to avoid injury to both the patient and
staff.
• The laser remains ON until the end of the clinical series. If the patient's
eyes are in the path of the laser, turn off laser to avoid injury.
C C T scan parameters 12.5
12.5 CCT scan parameters
12.5.1 Gating protocol

In order to activate the CCT mode select a protocol that includes the
appropriate Interventional scan.
There are three CCT modes.
• Single mode activates a 240 deg scan each time the pedal is pressed. All
images created in this mode are saves in the directory.
• Continuous mode activates sequential scans as long as the pedal is
being pressed. One 240 deg scan is executed for each cycle time. The
system saves only the last image displayed each time the pedal is
released.
• Fluoro mode operates with the X- ray sequentially on, completing 360
degree scans as long as the pedal is being pressed. Images are
reconstructed in a rate of 8 images per second. The system saves only
the last image displayed each time the pedal is released.
C
_
Set one of these options in the CCT Mode field.
1
0
6
4
3
Rotation Time
4
7
6 For single mode, all rotation times are optional.
5
3
5
4 For continuous and fluoro mode, only 0.42 or 0.5 rotation times are
s
m available.
e
t
s
y
S CCT convention mode
l
a
ic
d
e
A list of possible conventions includes: left on right, view from feet and
M
s
view from bed.
ilp
i
h
P
12.5 CCT scan parameters
CCT decubitus convention mode

A list of possible conventions for decubitus modes includes: Anterior on
left, view from feet, view from bed.
Image display order
Set the display order of the images according to patient position: head to
feet, feet to head, view from bed.
Parameter Description Options Default
Image display (Convention) Image Right on Left Right on left

orientation Left on Left
Anterior on left
Anterior o n right
Image display order Image display order on Superior/Inferior Superior /Inferior

the screen. Inferior /Superior
Thickness
The following tables show thickness as it relates to collimation.
Brilliance 64
Collimation Thickness Thickness Thickness

1 image mode 2 image mode 4 image mode
12x0.625 7.5 3.75 ---
16x0.625 10 5 2.5
12x1.25 15 7.5 3.75
40x0.625 12.5 6.25
32x1.25 10

anzubieten!
" Nützlich
% Nicht
nützlich
C C T scan parameters 12.5
The thickness parameter plays an important role in CCT. The selected

thickness determines both the tomographic thickness of the CCT images
and the layout screen of the CCT Viewer.
• In Single mode, any of these combinations are allowed to be selected.
• In Continuous and Fluoro mode, only fused (F) images are permitted
and only a single image layout is available.
Images are reconstructed in a dedicated 256 x 256 matrix in continuous

mode, and 512 x 512 in fluoro single mode. Images acquired using
continuous mode display in the fastest cycle time of 1–2 images per second.
Images acquired using Fluoro mode display at a rate of 8 images per second.
C
_
1
0
6
4
3
4
7
6
5
3
5
4
s
m
e
t
s
y
S
l
a
ic
d
e
M
s
ilp
i
h
P
12.6 CC T reconstruction parameters
12.6 CCT reconstruction parameters

These parameters are typical to CCT reconstruction:
• On line - full or partial quality reconstruction after each scan, before
the next scan is enabled.
• Matrix - 5122 is available for CCT reconstruction.
• Film - In continuous and fluoro mode, only the last image per scan
session is available for filming. In single mode, you can film all images.
• Image storage - In continuous and fluoro mode, only the last image per
scan session can be stored. Those images are temporarily kept in the
Study-Viewer. In single mode, all images are saved.
Note To view all images not saved in the Viewer, the study must be reconstructed
after the completion of the exam.
Starting the biopsy procedure 12.7
12.7 Starting the biopsy procedure

After you have made the biopsy protocol selection, control of scanning is
passed to the foot pedal. When the scanner is ready, the following message
appears in the bottom of the CCT screen.
The Accumulated time and Accumulated CTDI are displayed during the
entire biopsy procedure. Total dose to patient is calculated by the following
formula:
(Total Number of Images) x (CTDI Value per Slice) = Total Dose
Depending on the mode of Pedal Activation, with the pedal already set in
the protocol, either single X-ray shots or a continuous burst of scans are
C
generated.
_
1
0
6 Note • You can switch between the Single, Fluoro and Continuous modes by
4
3
4 Pausing the session and resetting the Pedal Mode parameter in the biopsy
7
6
5
protocol monitor.
3
5 • You can move the table in or out between successive pedal activations for
4
s more convenient patient handling, or for adjusting the patient scanning
m
e
t
s
area for better lesion localization. Moving the table during scanning may
y
S cause motion artifacts.
l
a
ic
d
e
M
s
p Warning This procedure should be done with two staff members. The individual at
lii
h
P
the console should proceed only as instructed by the individual conducting
the biopsy procedure to avoid injury to both the patient and staff.
Warning If radiation does not stop when pedal is released, these conditions could
exist:
• The pedal is stuck.
• There is a short due to cable damage.
Press the Emergency STOP button to stop the radiation.
Starting the biopsy procedure 12.7
12.7.1 Lesion localization process

The different screen layouts offer an easy process for lesion localization.
• In a four image layout the upper-left image in the display represents the
slice farthest away from the gantry (regardless of the position of the
patient). If you enter an asterisk as the start and end position the laser
marker is located exactly between slice II and Slice III.
C
_ Note The first image is always away from the gantry.
1
0
6
4
3 Note If the patient is laying head first the upper left image is the most inferior
4
7
6 image.
5
3
5 • If the patient is laying feet first the upper left image is the most superior
4
s image.
m
e
t • In the dual format, two images are shown. The laser marker is located
s
y
S
l
a
exactly between slice I and Slice II.
ic
d
e • In the single format, Continuous and Fluoro mode may be selected.
M
s The displayed image is a Fused image. The laser marker is located
ilp
i
h exactly at the Table location of the Fused image.
P
Warning If the needle tip is not visible in any of the displayed images, it implies that
the needle tip is not present in the beam path indicated by the slice
thickness in the corresponding table location. The table location must be
changed so the needle tip is clearly visible in an appropriate slice.
12.7.2 Radiation information

The CCT mode is intentionally designed to activate the x-rays and CT
scanning while a member of the medical staff is present in the gantry room.
Scanning is initiated by pressing a foot pedal, which energizes the x-ray
generator. In general, the gantry room is equipped with warning lights and
a buzzer to give an alarm when x-rays are on. The shielding of the scanner
room does not provide any protection to the medical staff present in the
gantry room. The staff should be aware of the hazard imposed by direct and
scattered radiation.
During CCT mode, the Technologist and other personnel should be aware
that control of the activation of x-rays originates in the gantry room and
not from the main console.
The dose to the patient (per cycle) displays to the Technologist upon
selecting the protocol. If the table increment is 0, the number of the
repeated scans multiplies the dose to the patient.
Warning If there is any indication that x-rays are not turned off after releasing the
foot pedal switch, press one of the STOP buttons on the gantry control
panels or the Pause button on the scan control box. This stops the
generation of x-rays, scanner rotation, and patient table motion.
To recover from the STOP condition, refer to the Emergency Procedures

section in chapter 2 of this volume of the User Manual.
Scattered radiation information 12.8
12.8 Scattered radiation information

In the single and continuous CCT mode, scans with a rotation angle of
240° are used, which are centered beneath the patient. As a result, the
scattered dose above the patient is only about one third of the dose beneath
the patient and at his or her sides.
At 0.5 m from the slice plane, the dose/slice over the patient is 0.9
mGy/scan. Below the patient and at the sides the dose/slice is 2.9
mGy/scan.
Accumulated dose at 0.5 m distance = (Accumulated session time) x 2.7 mGy
The scan conditions are:

• 120 kV, 50 mAs
• Fused 6 mm (4 x 1.5) slice thickness
• 240° scan angle
• 0.33 sec scan time
For a slice thickness of 4x3 mm the doses are 1.7 times greater.
The radiation dose changes linearly with the mAs and Slice Thickness.
C
_
1
0
6
The dose at 140 kV is 1.5 times higher than at 120 kV.
4
3
4
7
The dose at 80 kV is 0.31 times higher than at 120 kV.
6
5
3
5
4
s
m
e
t
s
y
S
l
a
ic
d
e
M
s
p
lii
h
P
12.9 Generate a CCT protocol
12.9 Generate a CCT protocol

To generate a CCT protocol:
From the clinical application dropdown menu
2 Click Generate Protocols.
• The Generate Main Form dialog box displays and the Exam Protocol
Groups display.
4 Select an existing Axial protocol from the Axial Scan type tab on the left
side of the Exam Protocols page.
5 Select the Body Scan Type from the Scan Type dropdown menu.
6 In the Clinical Application dropdown, select CCT.
7 The CCT tab appears with the CCT parameters.
8 Select the CCT mode.
Generate a CCT protocol 12.9
Display mode or number of displayed images, and the Slice Thickness
C
9 When all parameters have been modified as desired, click GO.
_
1
0
6 10 Use the Save or Save As functions on the Generate Main Form page in
4
3
4
order to save the CCT protocol.
7
6
5
3
5
4
s
m
e
t
s
y
S
l
a
ic
d
e
M
s
ilp
i
h
P

13 DoseRight
13.1 Overview
The DoseRight - Automatic Current Selection (ACS) function
automatically suggests the mAs for each patient based on an automated
learning method in order to achieve a constant image noise level. The result
is an overall dose savings. Since the image quality required for various
protocols is different, each protocol has its own DoseRight setting:
• Auto for Automatic Patient Size Averaging. The system measures, using
the Surview image, the body size of each patient scanned. An average
body size, of all patients scanned with the specific protocol, is
calculated. This accumulating or running average is used as the
“standard” size for the specific protocol. The mAs value that appears in
the protocol is a recommended setting. The mAs setting can be changed
manually by typing a new value in the mAs field.
C
1
_ • Yes for User Determined Image Noise Reference. In this mode the
0
6
4
system will not automatically use scans to calculate the average. Instead,
3
4
you decide to use the current scan as the reference for the protocol mAs
7
6 setting.
5
3
5
4
• No to turn off the DoseRight feature.
s
m
t
e Note If it becomes evident that DoseRight doesnot provide optimal results for
s
y certain protocols, DoseRight may be set to NO for those protocols in
S
l
a Generate Protocols.
ic
d
e
M
s
p
lii
h
P
Brilliance CT - Volume 1 DoseRight 13-1
13.2 D-DOM (angular modulation)
13.2 D-DOM (angular modulation)

DoseRight-D is a scanner function, which modulates the tube current
during each rotation based on patient body symmetry change using
specially-developed hardware and software algorithms. D-DOM is used to
achieve maximum dose saving in areas of greatest asymmetry without
compromising the image quality.
In rotationally asymmetrical objects, readings from lower signals contribute
higher noise, while readings from higher signals make only minor
contributions to the total noise. Without D-DOM the highest mAs
amounts are used to ensure reasonable image quality.
D-DOM is used to reduce the mA in the rotational direction of the high
signal. This results in major dose saving for rotationally asymmetrical
objects.
The sample below shows a schematic presentation of the modulation used
for three different cylindrical objects.
The modulation calculation is carried out on line during the scan. It uses
the data of the previous rotation to calculate the next rotation modulation.
• For rotationally symmetrical body parts, no dose saving is obtained.
• For a less symmetrical body part, the dose saving achieved is higher.
13-2 DoseRight Brilliance CT - Volume 1
D-DOM (angular modulation) 13.2
The mAs displayed on the image is the actual mAs used in part of the scan
which was used for that particular slice. The image parameters, in cases
where D-DOM was used, include both the planned protocol mAs and the
actual mAs used to create that slice.
D-DOM is not used in these cases:
• head scans
• a single axial scan
• axial range with a scan angle of 240 degrees
D-DOM is used only when the mAs chosen in the protocol is at least 10%
lower than the maximum mAs.
You can select D-DOM from a dropdown menu on the advanced tab of the
protocol parameters screen.
Before you can use D-DOM, activate it in the system preferences. Use this
procedure to activate D-DOM.
1 From the Processing window, click the Preferences button.
2 From the dialog box, select Scanner.
C
3 Click the D-DOM checkbox.
_
1
0
6 4 Click Ok to accept the selection and close the Preferences dialog box.
4
3
4
7
6
5
3
5
4
s
m
e
t
s
y
S
l
a
ic
d
e
M
s
p
lii
h
P
13.3 Z-DOM (longitudinal modulation)
13.3 Z-DOM (longitudinal modulation)

The same mAs is used during a scan along the longitudinal direction (Z-
axis). Dose saving can be achieved by adjusting the mAs along the
longitudinal direction, to achieve the same image quality for the various
slices.
Z-DOM consists of the following steps:
• A protocol is chosen and a surview scan is acquired.
Note AC S must be activated during the surview scan.
• The surview data is processed. As a result, a mAs profile along the z-axis
is calculated, so that the same noise is maintained in all of the slices
along the Z-axis of the plan. The protocol mAs chosen by the operator
is the maximum mAs that will be used for the region of the body with
the highest attenuation.
Z-DOM can be operated simultaneously with DoseRight ACS.

When ACS is used with Z-DOM, the system suggests a mAs based on the
patient’s size. You have the option to use this value or modify it without
disabling the E-DOM feature.
Before you can use Z-DOM, activate it in the system preferences. Use this
procedure to activate Z-DOM.
1 From the Processing window, click the Preferences button.
2 From the dialog box, select Scanner.
3 Click the Z-DOM checkbox.
4 Click Ok to accept the selection and close the Preferences dialog box.
DoseRight (automatic current selection) 13.4
13.4 DoseRight (automatic current selection)

Two variations of DoseRight ACS are available. They consist of a Manual
(user defined reference set) and an Automated version (factory pre-stored
reference set).
Note DoseRight is only a recommendation and the scan will be used only after
user approval.
DoseRight and Dose Modulation can be used independently.
C
_
1
0
6
4
3
4
7
6
5
3
5
4
s
m
e
t
s
y
S
l
a
ic
d
e
M
s
ilp
i
h
P
13.5 Enable DoseRight ACS
13.5 Enable DoseRight ACS

The DoseRight feature must be activated in your preferences before you
can use it for scanning. You have the option of enabling it so that it is
available for all applicable scans, or limiting the feature to specific
protocols.
13.5.1 System
Use this procedure to enable the feature on your system.
1 In the Processing window, click the Preferences button.
2 Click Scanner.
3 Select DoseRight.
4 Select the desired DoseRight ACS setting: Yes or Auto.
5 Click OK to accept the settings and close the dialog box.
Enable DoseRight ACS 13.5
13.5.2 Specific protocol

You can also enable DoseRight ACS for a specific protocol.
6 Click Home on the Workflow bar.
7 Click Generate Protocols
8 Select the protocol you wish to use with DoseRight ACS.
9 Select the Helix scan step Advanced Tab.
10 Select DoseRight ACS.
11 Click OK.
12 Select a save option:
• Click Save to save the settings to the selected protocol.
• Click Save As to rename the protocol before saving.
C
_
1
0
6
4
3
4
7
6
5
3
5
4
s
m
e
t
s
y
S
l
a
ic
d
e
M
s
p
lii
h
P
13.6 Set DoseRight standards
13.6 Set DoseRight standards

When DoseRight is set to Yes, you have several options for setting and
altering the protocol standards.
13.6.1 Select a reference image

If the ACS is set to Yes, use this procedure to create the standard for a
protocol.
1 Select the protocol you wish to use with DoseRight ACS.
2 Acquire the Surview and plan your scan through the area of interest.
3 Verify that the images have the desired quality for the selected protocol.
4 Select the image with the desired quality for a certain protocol.
5 Select Operations from the menu bar.
6 Click Save DoseRight. A dialog box appears.
7 Click Save. This mAs setting for the image becomes the standard mAs
setting from this point forward for the current protocol. Every patient
scanned with this protocol is compared to the saved standard and the
mAs is reduced or increased, in order to keep the image quality
consistent from patient to patient.
Note It is important to save an image scanned with the lowest dose required as a
reference to achieve the desired noise level. T his enables you to achieve the
maximum dose saving for all upcoming scans. This is usually achieved for a
particular protocol by saving a reference image of a typical or large patient.
Set DoseRight standards 13.6
13.6.2 Replacing the reference image

If you need to change the reference image to use as the protocol standard:
1 Select the protocol you want to change.
2 Select the DoseRight ACS option on the Advanced tab.
3 Perform the necessary scans with that protocol.
4 Select the image with the desired settings.
5 On the Menu bar, select Operations.
6 Click Save DoseRight. This setting is the new standard mAs. The
system displays a confirmation message:
C
_
1
0
6
4
3
4
7
6 The message varies depending on how the new settings change the
5
3
5
4
protocol dose:
s
m
• If saving the new settings decrease the protocol dose, this message
e
t
s
appears: “the protocol dose will be decreased.”
y
S
l
a
• If saving the new settings increase the protocol dose, this message
ic appears: “the protocol dose will be increased.”
d
e
M
s
• If saving the new settings does not change the protocol dose, the
ilp following message appears: “the protocol dose will not be changed”
i
h
P (usually appears when you try to save a reference from a scan that was
scanned with DoseRight ACS already ON).
13.7 Overriding DoseRight ACS
13.7 Overriding DoseRight ACS
Caution Always check that the DoseRight ACS recommended mAs correspond to
the actual patient size. If it appears that there is a mismatch (too large a
current for a thin patient or too low for a large one), alter the setting
appropriately.
The method for overriding the DoseRight ACS varies depending on the
system settings:
• If the system is set to YES, clear the DoseRight ACS selection to disable
the feature.
• If the system is set to AUTO, and you are planning on Surview using an
ACS enabled protocol, the system will automatically compare the
patient’s Surview to the standard patient size on the system and
recommend an appropriate mAs value.
Change the desired mAs value and the DoseRight ACS will be
automatically reset to NO.
Note The system will take into account the user-set mAs and adjust the average
reference body size for following scans.
Note • DoseRight may only be used for Abdomen, Pelvis, Thorax and Spine
studies.
• DoseRight ACS should not be used for Head, Pediatric, Calibration and
QA protocols.

anzubieten!
" Nützlich
% Nicht
nützlich
General rules for DoseRight 13.8
13.8 General rules for DoseRight

1 DoseRight ACS is not available in the following cases:
• Surview was not done
• Scan was executed with a tilt
• If a protocol was inserted into a multi-protocol
• If a protocol was duplicated in a multi-protocol
2 Clinical scans using DoseRight ACS in the User-Selected Image Noise
Level method can only be performed if a reference scan was saved for
the specific protocol in the past. There is no such constraint on the
Automatic Patient Size Averaging method.
3 If the maximum kV and mAs are reached during the scan using
DoseRight ACS, a warning message is shown stating that the maximum
kV and mAs have been reached and prompts you to stop using
DoseRight ACS. Selecting NO will set the mAs to the default value and
other affected parameters to be set with their original protocol values.
4 A limited set of scan parameters can be changed compared to the image
reference protocol when using DoseRight ACS. The parameters that
C
_
1
can be changed are those that have only minor influence on the noise
0
6
4
level. If you change other parameters, the DoseRight ACS will be
3 turned off.
4
7
6
5
3
5 When allowed parameters are changed during a clinical scan using
5
4 DoseRight ACS, the mAs is automatically recalculated. When
s
m forbidden parameters are changed, the DoseRight ACS feature
e
t
s
y
automatically changes to 'NO' and is not available until the changes are
S
l
a
undone. A warning message appears.
ic
d
e 6 When the mAs is changed manually, the DoseRight ACS feature
M
s automatically changes to No, and can be changed back to Yes.
ilp
i
h
P
14 Pulmonary gating (option)
14.1 Overview
The pulmonary gating application helps ensure high-quality imaging of
respiratory motion. Scans can be conducted using one of two devices:
• Bellows - This system is a deformable rubber belt that when placed
across the patient’s chest/waist measures the changes in lung volume. It
generates a breathing signal corresponding to the lung volume.
• Varian - This system uses an infrared camera that follows a positional
reflective marker placed on the patient’s waist (made especially by
Varian for Oncology purposes). The sensor type used for respiratory
monitoring and gating is the RPMTM Respiratory Gating System.
The following three modes are supported (option):
• Prospective Axial enables you to trigger an axial scan at a particular
C
_
breath level (threshold). The clinical usefulness in diagnostic radiology
1
0
6
is that it minimizes artifacts due to respiratory motion for those patients
4
3 who are not able to hold their breath during the scan. In radiation
4
7
6
oncology, the prospective axial dataset may be used for planning gated
5 treatments. By matching the scan phase with the treatment phase you
3
5
4 can be assured of providing the CT simulation plan that delivers the
s
m
e
highest tumorcidal dose while maximizing the amount of healthy tissue
t
s that is spared.
y
S
l
ic
a • Prospective Spiral enables you to visualize the breathing waveform and
d
e begin a spiral scan at a desired breath level. This mode is used in
M
s conjunction with breath-hold imaging (typically followed by breath-
ilp
i
h
hold gated treatments).
P
Brilliance CT - Volume 1 Pulmonary gating (option) 14-1
14.1 Overview
• Retrospective Spiral (4D CT) results in the ability to generate multiple

phases allowing for visualization of motion during the respiratory cycle.
This mode entails acquiring an over-sampled ultra low pitch spiral scan
of the thorax or desired area, and correlating it in reconstruction with
the patient's breathing. The resulting images can be used to assess
motion of the tumor and critical organs, make decisions about gating
the radiotherapy delivery, and delineate a target volume that
encompasses the entire range of tumor motion.
The phases are marked as a percent of respiration and indicate the temporal
steps from one maximal peak to the other. A continuous cine display of a
multi-phase study is called 4D-CT.
14-2 Pulmonary gating (option) Brilliance CT - Volume 1
Setting the sensor device preference 14.2
14.2 Setting the sensor device preference

Before conducting a pulmonary scan, you must define the sensor device in
the scanner preferences. These preferences are accessible through the
Brilliance CT Directory. Use this procedure to define the sensor device.
1 Click Preferences in the Directory tool panel. The Preferences dialog
box opens.
2 Under Scanner options, select the Scanner menu.
3 In the Pulmo Sensor Device list, select the sensor to be used (Varian or
Bellows).
4 Click OK to accept the selection.
C
_
1
0
6
4
3
4
7
6
5
3
5
4
s
m
e
t
s
y
S
l
a
ic
d
e
M
s
ilp
i
h
P
14.3 Generating pulmonary protocols
14.3 Generating pulmonary protocols

Before you can conduct a pulmonary scan, you must ensure that the
appropriate protocols are available. This section contains information for
generating axial and helical pulmonary protocols.
The Generate Protocol feature is part of the Home menu options:
1 Click Home. The Home menu opens.
2 Select Generate Protocols.
3 Select the Thorax protocol group.
4 Select the appropriate Scan Type; Pulmo 4D, Pulmo Gating Spiral or
Pulmo Gating Axial.
• The Pulmo protocol tab opens.
5 Click the Pulmonary parameters tab.
• Information in the tab varies depending on the scan type:
6 If you are conducting a prospective axial scan, select the a respiratory
level for gating of where you want to image:
• Max Inhale
• Max Exhale
• User Defined (you must enter a value for this). 1 is average peak, 0 is
valley.
7 If you are conducting a restrospective scan, select the pulmo phase
desired for reconstruction.
8 Complete the rest of the parameter selections.
Note Do not enable voice commands.
9 Click OK to save the protocol parameters.

10 Complete the Generate Main Form dialog box.
11 Click Save As.
Generating pulmonary protocols 14.3
12 Name the protocol appropriately.

13 Click Exit to complete the generate protocol procedure.
Note For axial protocols using the bellows, user defined level requires a “LEARN”
phase on the Respiratory Signal Viewer. You must click the learn button
once to begin learning and again to complete learning. Allow several
respirations between clicks to acquire data.
C
_
1
0
6
4
3
4
7
6
5
3
5
4
s
m
e
t
s
y
S
l
a
ic
d
e
M
s
p
lii
h
P
14.4 Respiratory signal viewer (online)
14.4 Respiratory signal viewer (online)

When in a pulmonary protocol, the online respiratory viewer is displayed.
Several options for manipulating the settings on the monitor are provided:
Freeze - stops the real-time viewer and enables you to scroll within the
recorded wave using the scroll bar on the right side of the screen.
Record - enables you to start recording the real-time signal at any time
during the study.
Measure - enables you to measure the time between two points on the
wave.
Learn - causes the system to “analyze” the wave to find the average
height of the highest and lowest peaks on the graph. In this mode, the
system displays lines indicating the averages of highest and lowest
points of the wave.
1 Press once and the system goes into learning mode where it is.
2 When pressed again the system analyzes the breathes just learnt and the
the system calculates.
Note This feature can be used only in Axial Prospective scans using the Bellows
Respiratory signal viewer (online) 14.4
The first image below shows the viewer when a bellows system is used. The
second image shows the viewer when the Varian system is used. The
waveforms and pulses displayed are on-line screens which display at the
time of the scan only.
Warning The respiratory wave should not be used to diagnose patient condition. Use
it to help plan and select optimal phase(s) for reconstruction and to analyze
the reconstructed images.
C
_
1
0
6
4
3
4
7
6
5
3
5
4
s
m
e
t
s
y
S
l
a
ic
d
e
M
s
ilp
i
h
P
14.5 Respiratory signal viewer (offline)

The pulmonary tab functions both as the viewer and the editor. Can only
be used after the completion of the scan to view the acquired pulmonary
waveform.
14.5.1 Pulmonary waveform viewing

The viewer provides several options for manipulating the settings:
Buttons
Measure enables you to measure the time between two points on the
waveform.
Edit R-Tags Vector enables you to toggle the editing mode on/off.
Right click menu

The viewer menu is available by right clicking over the viewer:

Respiratory signal viewer (offline) 14.5
Rescale X-axis
This function enables you to change the time scale by choosing between
these time options:
• 1 second
• 2 seconds
• 5 seconds
• 10 seconds
• 30 seconds
Show phases & dose right

The waveform viewer is designed to display the location of the selected
pulmonary phases. This feature can assist with identifying an optimal
pulmonary phase for reconstruction in accordance with the desired
application. Use this procedure to view a phase.
1 Right click over the waveform viewer to access the menu.
2 Click Show Phases for reconstruct.
3 Select a phase for reconstruction in the scan protocol by comparing the
C
desired phase location to the actual location.
_
1
0
6 4 Once the desired phase is defined, you can check to see if the dose
4
3 modulates during scan according to the defined phase.
4
7
6
5
3
• To check, select Show Phases for reconstruct from the menu. A real-
5
4 time graph showing the intensity of the x-rays during the scan
s
m displays under the waveform curve.
e
t
s
y
S
l
a
ic Warning The waveform should not be used to diagnose patient condition. Use it to
d
e
M help plan and select optimal phase(s) for reconstruction and to analyze the
s
p
lii
reconstructed images.
h
P
Show Grid displays a grid over the waveform viewer.
Edit Tags Vector takes you into editing mode.
Auto scale amplitude on scrolling If checked the display is scaled to what is

currently shown on the screen. If not checked the display is scaled to the
range of the entire waveform.
14.5.2 Pulmonary waveform editing

You can add, remove or modify current tags. You can only edit tags found
on the X-ray portion of the waveform. Pulmo waveform editor allows you
to manually edit these tags.
Note • Depending on the application the R-tags may need to be relocated.
• Do not attempt to drag a tagoff of the X-ray on portion of the waveform.
These tools and icons are available when editing the waveform:
Buttons
Edit R-Tags Vector enables you to toggle the editing mode on/off.
Note The Undo and Reset buttons are only visible when R-Tags editing is enabled.
Undo removes the last change.
Reset returns the waveform to its original state, save with the scan. The
system displays a warning with a message asking you to confirm your
selection.
Cursors
This cursor appears when clicking a R-tag.
This cursor appears when pointing to a R-tag.
This cursor appears when pointing to a phase.
Right click menu

The viewer menu is available by right clicking over the viewer:
Move R point (left click) repositions an R-tag.

Remove R point (double click) deletes an R-Tag. Active only when you
right mouse click on an R-Tag.
New R point (double click) add a new R-Tag. Active only when you click
anywhere on the waveform that is not an R-Tag.
14.5.3 Breathing Statistics

Breathing statistics display on the Info tab of the waveform viewer. Access
breathing statistics from the Info tab, where the respiratory waveform is
viewed:
C
• Online (immediately after scan finishes)
_
1 • Offline (View Recon)
0
6
4
3 • Pulmonary Viewer (under Tools)
4
7
6
5
3
5
4
s
m
e
t
s
y
S
l
a
ic
d
e Note Do not use breathing statistics alone to make treatment decisions. Consult
M
s the waveform and image information as well.
ilp
i
h
P To access breathing statistics:
1 Click the info tab of the respiratory signal viewer.

• Breathing statistics display.
Statistic Descriptions
Scan length
Amount of time data was collected. Statistics only account for time
when Xrays were on.
# of breath cycles captured
Number of breaths completed during the scan. Statistics only take into
account breaths that occurred while Xrays were on.
Mean BR
Average rate the patient breathed during the scan.
Breath rate range
Slowest breath rate to fastest breath rate. Make sure that the rate is
consistent and that a minimum rate is maintained throughout duration
of the scan for the selected pitch. If not, some slices may not have
enough data to reconstruct the entire respiratory cycle.
Average full exhalation phase

On average across all breaths, this phase represents the location within
the breathing cycle at which full exhalation occurs. It should be
somewhere near 50%, but could vary widely depending on degree of
asymmetry of breathing pattern.
Average full inhalation phase
On average across all breaths, this phase represents the location within
the breathing cycle at which full inhalation occurs. Expect the value to
be near 0%, but it may deviate from 0% for Varian RPM TM due to the
Varian predictive algorithm's handling of irregular breathing.
Amplitude range (relative)
This statistic reports the smallest and largest breaths relative to the
amplitude of the average breath. The first value represents the smallest
breath, the second represents the largest. Ideally, both values should be
close to 1. The closer to 1, the more consistently the patient breathed.
Amplitude standard deviation (relative)
C
This statistic reports the standard deviation of the amplitude values.
_
1
0
Consistency of breath size (amplitude), is important for 4D CT image
6
4
3
quality and may factor into deciding whether or not patient is a
4
7 candidate for gated radiotherapy. The smaller the standard deviation,
6
5 the more consistently the patient breathed.
3
5
4
s Note If you are going to contour IT V or create MIP, the phases average full
m
e exhalation and average full inhalation may be chosen for reconstruction
t
s
y
S as a possible alternative to reconstructing 10 phases.
l
a
ic
d
e
M
s
p
lii
h Caution If hysteresis is significant do not limit to just 2 phases. Make sure to double-
P
check that the choice of phases make sense.
14.6 Respiratory Correlated Imaging

This section explains how to use both the Bellows System and the Varian
RPMTM for Respiratory Correlated Imaging.
14.6.1 Bellows
Bellows is designed for use with the Philips Bellows System for Prospective
Axial Triggering, Prospective Spiral Triggering and Retrospective Spiral
Gating.
Warning Do not allow the bellows to come in direct contact with the patient's skin.
The bellows material can cause skin irritation and allergic reaction.
Prospective Axial Triggering
Note This is only one of many ways to use this system.
Connect bellows sensor device

1 Connect the bellows sensor device to the port on back of the Gantry
marked Pulmonary.
2 Click Preference in the Directory tool panel.
3 Click Scanner options, select Scanner menu.
4 In the Pulmo Sensor Device list, select Bellows.
5 Click OK to accept.
6 Attach the Bellows sensor to the patient at the site of Diaphragm or as
desired by the physician.
Note This must be done prior to selecting Start Study.
Respiratory Correlated Imaging 14.6
7 Explain the scan to the patient.

• Emphasize the importance of maintaining a steady, consistent breathing
pattern and rate.
Start study
1 Click Start Study to begin a new study.
2 Enter patient information to complete the data form.
3 Click Exam Protocols.
4 Select Thorax protocol group.
5 Select a Prospective Axial Pulmonary Gating protocol.
• The Surview scan parameters open.
6 Verify scan parameters.
7 Click GO to start the Surview.
Note Auto Voice should not be turned “On” in the Surview or Scan Series.
8 Plan the Pulmonary scan on the Surview.

C
_
1
0 9 Click the Pulmo tab.
6
4
3 • The pulmonary parameters open.
4
7
6
5 10 Choose a scan angle.
3
5 • The desired scan angle is 240.
4
s
m
e
t
s
y
S
l
a
ic
d
e
M
s
ilp
i
h
P
11 Select a Respiratory level for gating:

• Max Inhale - the scan begins (is triggered) 280 milliseconds (at a
rotation time of 0.4 sec) after the maximum inhale (the red dot on
the viewer).
• Max Exhale - the scan begins (is triggered) 280 milliseconds (at a
rotation time of 0.4 sec) after the maximum exhale (the blue dot on
the viewer).
• User Define - the operator decides when to begin the scan (is
triggered) and whether to scan during the inhalation (UP) or
exhalation (DOWN) phase of the respiratory cycle.
12 Verify the respiratory waveform in the viewer.
13 If the Maximum Inhale/Maximum Exhale option was used, click GO
to perform the scan.
14 If the User Defined option is used, click Learn two times on the viewer.
• You must click the learn button once to begin learning and again to
complete learning. Allow several respirations between clicks to acquire
data.
Note The system does not allow a scan to begin without clickingthe Learn button
two times.
15 Type in the Trigger level.

• A pulse based on the trigger level tells the scanner to start the scan
during every respiratory cycle at the defined point.
• 0.1 downward is recommended if exhalation phase is desired.
16 Select “Upward or Downward” of the user defined level.
Note The range for user define is 0 - 2.00. 0.1 downward is recommended if
exhalation phase is desired. 0 is the average full expiration and 1.00 is the
average full inspiration.
17 Click GO to start the scan.
18 End Study.
Prospective spiral

marked Pulmonary.
6 Attach the Bellows sensor to the patient at the site of Diaphragm or as
Note This must be done prior to selecting Start Study.
C
_
1
0
6
4
Start study
3
4
7
6
5
3
2 Enter patient information to complete the data form.
5
4
s 3 Click Exam Protocols.
m
e
t
s
y
S
l
a 5 Select Pulmo gating spiral protocol.
ic
d
e • The Surview scan parameters open.
M
s
p
lii 6 Verify scan parameters.
h
P

9 Instruct the patient to hold their breath.
10 Verify the respiratory waveform in the viewer.
11 Click GO to start the scan.
12 End Study.

anzubieten!
" Nützlich
% Nicht
nützlich
Caution • The prospective spiral waveform should only be used to evaluate breath
hold. Disregard all tags used to evaluate breathing statistics or any other
information related to the waveform.
• Do not evaluate the waveform using tags, breathing statistics or green
lines in the Pulmo viewer.
Retrospective spiral correlated imaging

marked Pulmonary.
C
1
_ 6 Attach the Bellows sensor to the patient at the site of Diaphragm or as
0
6
4
3
4
7
6 Note This must be done prior to selecting Start Study.
5
3
5
4 7 Explain the scan to the patient.
s
m
e
• Emphasize the importance of maintaining a steady, consistent
t
s
y breathing pattern and rate.
S
l
a
ic
d
e Start study
M
s
p
lii 1 Click Start Study to begin a new study
h
P
2 Type in Patient Information to complete the data form.
3 Click Exam Protocols

4 Select Thorax protocol group
5 Select a Pulmonary 4D protocol.
6 The Surview scan parameters open.
• Verify scan parameters.
7 Click GO to start the surview.

8 Plan the pulmonary scan on the surview.
9 Select rotation speed and pitch based on patient’s breath rate.
Breath Rate For 0.5 sec Rotation For 0.44 sec Rotation
(in breaths per minute) Time, use a pitch no Time, use a pitch no
higher than: higher than:
20 0.15 0.12
15 0.11 0.1
14 0.105 0.09
13 0.09 0.085
12 0.09 0.08
11 0.08 0.07
10 0.075 0.065
Note The concept is that the couch can move no more than 1 detector length
(24mm if collimation is 16x1.5) in the time it takes to complete one full
breath cycle. The formula is Rot Time (seconds) * Breath Rate
(breaths/min.) / 60 (seconds/min.) = max allowed Pitch Factor. Then
decrease slightly to allow for variability of breathing rate during the
acquisition.
Note Depending on Rotation Time and Pitch scan length may vary. Scan time is
limited to 120 seconds.
Pulmonary parameters
1 Click the Pulmo tab. The pulmonary parameters display.
2 Next to Pulmo Phase, select desired phase for initial reconstruction.
Note If additional reconstructions are desired select “untagged” under the drop
down menu.
C
_
3 Select Add Phases, enter desired phases.
1
0
6
• Selecting “Equally Spaced 10” for example, generates 10
4
3 reconstructions from the same breathing cycle spaced at 10%
4
7 intervals, where 0% is full inspiration. Phase binning is based on
6
5
3
5
time.
4
s
• 0%-100% represents a complete respiration.
m
e
t
s
y
4 Click OK.
S
l
ic
a 5 Observe the Pulmonary waveform until a steady Respiratory pattern
d
e has been observed.
M
s
ilp 6 Click GO to start clinical scan.
i
h
P
7 Press Manual.
• Scan usually takes 60-90 seconds.

8 When scan is completed the reconstruction viewer opens.
9 You can edit the Pulmonary Tags at this step if desired.
• For more information on how to edit tags see Edit Pulmonary Tags.
10 Click OK to begin reconstruction of the data.

11 Once all desired phases have reconstructed, load all phases into Pulmo
viewer to view. The pulmonary waveform automatically loads.
12 Send desired phases to Tumor Loc or the Radiation Treatment Planning
system of choice.
Note Time to first image can be up to 90 seconds.
14.6.2 Varian RPMTM

This section explains how to perform prospective respiratory gating on the
Brilliance CT using the RPMTM respiratory gating system from Varian. Also
explained is how to perform retrospective respiratory correlated imaging
(4D CT) on the Brilliance CT using the RPMTM respiratory gating system
from Varian. For more detailed information, refer to the RPM TM reference
guide from Varian.
Note Prospective spiral scanning in conjunction with the RPMTM should be
accomplished by using a standard thorax scan.
Prospective Axial Triggering
Note These are applicable to the Brilliance Big Bore CT Scanner Version 2.2 and
Varian RPMTM system Version 1.64 or 1.65.
1 Connect the Varian RPMTM sensor device to the Gantry.

2 Ensure that the Varian RPM TM is turned on, connected to the hospital
network and fully booted before logging on to the CT host.
C
1
_ 3 Log in to the CT Host.
0
6
4
3
• Wait at least 5 seconds before logging in to the CT Host.
4
7
6 Note The CT HOST should be restarted once per day.
5
3
5
4 4 Click Preference in the Directory tool panel.
s
m
e
t
s
y
S
l 6 In the Pulmo Sensor Device list, select Varian.
a
ic
d
e
M 7 Click OK to accept.
s
p
lii 8 Place the marker block on the patient chest or abdomen as described in
h
P
the Varian operator’s manual or as desired by the physician.

breathing pattern and rate.
Start Study
2 Type in Patient information to complete the data form.
3 Click Exam Protocol group.
5 Select a Pulmo Gating Axial protocol.
Launch Varian RPMTM

1 Login to Varian RPMTM workstation.
2 Double click the RPMTM Respiratory Gating system icon to launch the
gating application.
Access options menu

1 To access options menu, you must first close the patient list.
2 Click View.
3 Click Options.
Prospective gating tab options

4 Verify that the settings on the Gating tab are set to the following:
• Simulation Type: CT Sim
• Gate on Amplitude or Phase: Amplitude
• Threshold: 20
• Verify that Auto start of session recording is not checked.
5 Once all of the above settings are verified, click OK.
CT Interface tab options

6 Verify that the settings on the CT Interface tab are set to the following:
• CT Triggering: Trigger based on gate must be selected
• CT X-Ray on Indicator: Estimated from scanner settings must be
selected
• CT Scan Length: 0.44 sec
• CT Delay: 0.28 sec. (This assumes the optional 0.4 sec rotation speed
is used on the CT scanner).
• Verify that Prompt to export a respiration data file after recording is
C
finished is not checked.
_
1
0 7 Once all of the above settings are verified, click OK.
6
4
3
4
7
6
5 Patient list
3
5
4
s
8 Return to the Patient List:
m
t
e • Select File
s
y
S
l
• Choose Select Patient
a
ic
d
• The Patient List opens.
e
M
s 9 Click New Patient button.
ilp
i
h
P
10 Enter the Patient Data (exactly as it is entered on the CT scanner).
11 Click OK.
12 Highlight patient Last Name under the “Last Name” column in the list
and click Select.
• New Treatment Field window opens.
13 Click the drop down arrow for a list of predefined Treatment Fields or
type in a customized label.
14 Choose the appropriate Treatment Field.
15 Click OK.
• A message opens “Create reference session 1 for N field?”
N=Treatment Field selected.
16 Click Yes.
17 RPMTM screen opens with Track enabled.
Learning phase
At this point, the RPMTM system goes through its learning phase where it
tracks the patient’s respiratory motion. Once the system has learned the
respiratory motion the number of blue bars on the top left of the screen
should decrease to only 1 or 2 after a few breath cycles if the patient is
breathing regularly. If it doesn’t, dim the room lights and try again. If the
number of bars still won’t go down and the patient is breathing periodically,
then verify the settings of the camera. Refer to the Varian manual for more
information.
Acquire surview
18 On the CT scanner, acquire the Surview and any other preliminary
scans desired.
Note Some customers choose to perform a routine chest exam before the
pulmonary acquisition. These should be completed before pressing the
Record button on the Varian RPMTM.
19 The Surview scan parameters open. Verify scan parameters.

22 Press Record on the Varian RPMTM computer.
Graph of the gating application

On the graph of the Gating application, the patient’s breath cycle loads.
23 Set the desired trigger levels on the RPM TM workstation. (Refer to the
Varian manual for instructions.)
• Curves are drawn in black and green. Green indicates where along the
curve X-rays would be on. Adjust as the Physician desires.
24 Click the Enable Gating button.
Note A square pulse appears on the scanner corresponding to each peak. A

waveform does not appear on the scanner until after the scan is complete.
C
_
1 25 On the CT scanner, once the pulmonary series of the protocol is
0
6
4
3
selected, a waveform viewer opens. Once Enable Gating is pressed on
4
7
the RPMTM workstation, pulses (rectangles) begin to appear on the CT
6
5 Scanner.
3
5
4
s
26 Click GO on the CT Scanner to start the clinical scan.
m
e
t
s 27 End Study on CT Scanner.
y
S
l
a
ic
d
e
M
s
p
lii
h
P
Retrospective Spiral Gating
Note Below are procedures for the Brilliance CT Big Bore Scanner Version 2.2
and Varian RPMTM system Version 1.64 or 1.65.
1 Connect the Varian RPM TM sensor device to the Gantry.

2 Ensure that the Varian RPM TM is turned on, connected to the hospital
network and fully booted before logging on to the CT host.
3 Log in to the CT Host.
• Wait at least 5 seconds before logging in to the CT Host.
Note The CT HOST should be restarted once per day.

6 In the Pulmo Sensor Device list, select Varian.
8 Place the marker block on the patient chest or abdomen as described in
the Varian operator’s manual or as desired by the physician.
breathing pattern and rate.
Start Study
2 Type in Patient information to complete the data form.
3 Click Exam Protocol group.
5 Select a Pulmo Gating Axial protocol.

Launch Varian RPMTM

1 Login to Varian RPMTM workstation.
2 Double click the RPMTM Respiratory Gating system icon to launch the
gating application.
Access options menu

1 To access options menu, you must first close the patient list.
2 Click View.
3 Click Options.
Pulmonary 4D tab options

4 Verify that the settings on the Pulmonary 4D tab are set to the
following:
• Simulation Type: CT Sim
• Gate on Amplitude or Phase: can be either Amplitude or Phase.
• Threshold: 20
C
_
• Verify that Auto start of session recording is not checked.
1
0
6 5 Once all of the above settings are verified, click OK.
4
3
4
7
6
5
3
5
4
s
m
e
t
s
y
S
l
a
ic
d
e
M
s
p
lii
h
P
CT Interface tab options

6 Verify that the settings on the CT Interface tab are set to the following:
• CT Triggering: Trigger base on phase value. Set Phase value to 0.
• Sensed via Digital I/O: must be selected.
• Set Binary value indicating X-Ray on: 1.
• Prompt to export a respiration data file after recording is finished: is
checked (otherwise you must export manually).
• Recalculate phase before respiration data export: is not checked. It is
recommended not check box.
• Export filename format: set to PatientID_ExamNumber
_SeriesNumber.vxp (but can be set to anything). This field is
determined upon installation by your field engineer.
• Verify Export file location is set to C:\Documents and
Settings\VARIAN\Desktop\Gating\Breath (unless instructed
otherwise by service or hospital personnel). This field is determined
upon installation by your field engineer.
7 Once all of the above settings are verified, click OK.
Patient list
8 Return to the Patient List:
• Select File
• Choose Select Patient
• The Patient List opens.
9 Click New Patient button.
10 Enter the Patient Data (exactly as it is entered on the CT scanner).
11 Click OK.
12 Highlight patient Last Name under the “Last Name” column in the list
and click Select.
• New Treatment Field window opens.
13 Click the drop down arrow for a list of predefined Treatment Fields or
type in a customized label.
14 Choose the appropriate Treatment Field.
15 Click OK.
• A message opens “Create reference session 1 for N field?”
N=Treatment Field selected.
16 Click Yes.
17 RPMTM screen opens with Track enabled.
Learning phase
At this point, the RPMTM system goes through its learning phase where it
tracks the patient’s respiratory motion. Once the system has learned the
respiratory motion the number of blue bars on the top left of the screen
should decrease to one or two after a few breath cycles if the patient is
breathing regularly. If it doesn’t, dim the room lights and try again. If the
number of bars still won’t go down and the patient is breathing very
periodically, then verify the settings of the camera. Refer to the Varian
C
_
1
manual for more information.
0
6
4
3
4
7
6
Acquire surview
5
3 18 On the CT scanner, acquire the Surview and any other preliminary
5
4
s scans desired.
m
e
t
s
y Note Some customers choose to perform a routine chest exam before the
S
l
a pulmonary acquisition. T hese should be completed before pressing the
ic
d Record button on the Varian RPMTM.
e
M
s
ilp 19 The Surview scan parameters open. Verify scan parameters.
i
h
P

22 Press Record on the Varian RPMTM computer.
Graph of the gating application

On the graph of the Gating application, the patient’s breath cycle loads.
The curves being drawn are be black and red. Red indicates the patient is
breathing irregularly. It is most desirable to have the wave appear entirely in
black.
23 Click the Enable Gating button.
Note A waveform does not appear on the scanner until Enable Gating has been
selected. This may take several seconds.
• On the CT scanner, once the pulmonary series of the protocol is
selected, a waveform viewer appears. Once Enable Gating is pressed
on the RPMTM workstation, pulses (rectangles) begin to appear on the
waveform.
24 Based on the patient’s breathing rate, determine which pitch and
rotation speed to use by choosing them from this table:
Breath Rate For 0.5 sec Rotation For 0.44 sec Rotation
(in breaths per minute) Time, use a pitch no Time, use a pitch no
higher than: higher than:
20 0.15 0.12
15 0.11 0.1
14 0.105 0.09
13 0.09 0.085
12 0.09 0.08
11 0.08 0.07
10 0.075 0.065
Note The concept is that the couch can move no more than 1 detector length
(24mm if collimation is 16x1.5) in the time it takes to complete one full
breath cycle.
Note The formula is Rot Time (seconds) * Breath Rate (breaths/min) / 60

(seconds/min) = max allowed Pitch Factor. Then decrease slightly to allow
for variability of breathing rate during the acquisition.
Note Depending on Rotation Time and Pitch scan length may vary. Scan time is
limited to 120 seconds.
25 Once satisfied with parameters, click GO to start the clinical scan.

26 When scan is completed do not click OK.
27 The “Varian respiration sample file” must first be imported to the
scanner. To save the file on the Varian computer: Click the Stop button
on the Varian RPMTM.
28 Type in the exam number 1, and 1 in the series number field. Press OK.
• Varian RPMTM displays: Click Yes to replace previous file.
29 Verify the Exported successfully message appears. Click OK.
C
_
1
0
30 Click OK on the CT scanner to import the file.
6
4
3 31 Perform edit tags if desired at this step.
4
7
6 • For information on how to edit tags see Edit Pulmonary Tags.
5
3
5
4 Note Tags represent where the reconstruction defines the beginning of the
s
m
e
breath cycle (0%). Please be aware that there is no opportunity to edit tags
t
s sent from RPMTM during gated treatment.
y
S
l
a
ic
d
e
M
s
p
lii
h
P
Begin reconstruction
32 Press OK to begin reconstruction. The 0% phase is reconstructed.
Note Time to first image can be up to 90 seconds
33 May end study after the first image displays.
Note If additional phasesare desired continue with steps below.
34 From the Directory select patient.

35 Click the IRS from selected devices.
36 Click View Recon.
37 Perform edit tags if desired at this step.
• For information on how to edit tags see Edit Pulmonary Tags.
38 Select Add Phases and enter desired phases.
• Selecting “Equally Spaced 10” for example, generates 10
reconstructions from the same breathing cycle spaced at 10%
intervals, where 0% is full inspiration. Phase binning is based on
time. 0%-100% represents a complete respiration.
39 Click OK.
40 Click Start Recon.
41 Once all desired phases have reconstructed, load all phases into Pulmo
viewer or Tumor Loc to view. The pulmonary waveform automatically
loads.
42 Send desired phases to Tumor Loc or Radiation Treatment Planning of
choice.
15 Jog (option)
Jog is a scan sequence that “jogs” back and forth to cover the same anatomy
multiple times with a short delay between scans at the same locations. This
mode is customized for CT perfusion scans where images of the same
anatomy are obtained after the injection of contrast material in order to
track the contrast enhancement on a voxel basis. Time-density analysis of
this type allows the measurement of such functional parameters as blood
flow, blood volume and transit times.
There are two Jog modes:
• Axial jog mode - recommended for Brain perfusion studies.
• Helical jog mode - recommended for studies requiring more than two
times the collimation coverage.
C
_
1
0
6
4
3
4
7
6
5
3
5
4
s
m
e
t
s
y
S
l
a
ic
d
e
M
s
p
lii
h
P
Brilliance CT - Volume 1 Jog (option) 15-1
15.1 Axial jog
15.1 Axial jog

Axial jog mode allows an increase of the coverage of CT axial perfusion
scans, by allowing the patient table to move back and forth over the same
anatomical region. An even temporal sampling is achieved in all locations.
The temporal sampling for axial jog mode is the acquisition of 15 scans at
each of two anatomical locations within one minute.
During a complete axial jog cycle, the scanner performs an axial scan,
moves the patient table by one collimation, performs another axial scan and
returns the bed to the original position.
The axial jog tab includes these parameters:
• Number of jog cycles - determines the number of scans performed at
the same location. Number of jog cycles ranges from 8 to 15.
• Post injection delay - time between injection and first scan. Delay
countdown is started by SAS or by pressing Auto.
• Inter scan delay - displays the information automatically calculated to
the minimal possible interval.
The bottom region of the tab displays the number of images, CTDI, DLP
and Time indication for the total accumulated value over all jog modes.
Note During the planning and scanning portions of this procedure, the system
also displays a timing bar at the bottom of the screen.
15-2 Jog (option) Brilliance CT - Volume 1
Helical mode 15.2
15.2 Helical mode

Helical jog mode acquires multiple helical scans over the same anatomy
with a minimal delay between scans. This allows capture of perfusion scans
which require more than two times the collimation coverage. You will
define the number of scans to be performed as well as the start time for each
scan (minimal delay is a selectable option). Delayed scans can be performed
up to five minutes after the initial scan.
During a single helical jog cycle, the scanner performs a helical scan and
moves the patient table back to the start position.
The helical jog tab includes these parameters:
• Number of scans- determines the number of scans performed at the
same location. Number of jog cycles ranges from 2 to 20.
• Fixed InterScan Delay - When this parameter is turned on, the
intervals between the scans are identical. You can type in the desired
timing and select a voice message.
When the Fixed InterScan Delay is turned off, the intervals can vary.
You can select the desired timing intervals and voice messages from the
C
_ pull down lists.
1
0
6
4
3
4
The bottom region of the tab displays the number of images, CTDI, DLP
7
6 and Time indication for the total accumulated value over all jog modes.
5
3
5
4
s
m
e
t
s
y
S
l
a
ic
d
e
M
s
p
lii
h
P
15.3 Scan procedure
15.3 Scan procedure

Use this procedure to conduct a scan with jog.
1 Select a perfusion jog protocol with an appropriate perfusion scan type.
For axial mode, select Brain perfusion.
The system displays the Surview scan parameters.
2 Click Go to start the Surview scan. The system displays the perfusion
parameters.
3 Set the parameters accordingly. Make sure you set Auto processing to
the desired processing application so that it will launch when your scans
are complete.
4 Click Go to start the perfusion scan.
• The system automatically begins reconstruction during the scan.
• Images display in chronological order and are saved as multiple series.
• When the reconstruction is complete, the appropriate perfusion
package launches automatically.
Note You can stop the scan at any time using the Pause button. The Examination
flow dialog box displays, however Repeat Scan is the only available option.
15-4 Jog (option) Brilliance CT - Volume 1

anzubieten!
" Nützlich
% Nicht
nützlich
Generate a jog protocol 15.4
15.4 Generate a jog protocol

Before using jog mode, you must create a protocol with the appropriate
features. Use this procedure to create a jog mode protocol.
1 Select a scan type:
• Brain perfusion (axial jog)
• Perfusion (helical jog)
The system displays the main parameters tab.
2 Click the Jog tab to display the jog parameters.
3 Set the parameters to the required values.
4 Save the protocol.
C
_
1
0
6
4
3
4
7
6
5
3
5
4
s
m
e
t
s
y
S
l
a
ic
d
e
M
s
p
lii
h
P
16 Image reconstruction
16.1 Overview
Image reconstruction allows you to perform reconstructions of raw scan
data using one of these methods:
• On-line-reconstruction begins immediately after the scan is complete.
• Off-line-raw data can be accessed in the Brilliance CT directory for
additional reconstruction, after the study is ended.
• Re-recon can be used after the reconstruction is complete to do
additional recons prior to ending the study
Note • You can choose to perform raw data file offline reconstruction for one
patient at a time.
• The offline reconstruction function can be operated only on raw data files
C that are stored in the CIRS directory. However, it is possible to save raw
_
1
0 files for later reconstruction.
6
4
3
4
7
6
5
3
5
4
s
m
e
t
s
y
S
l
a
ic
d
e
M
s
p
lii
h
P
Brilliance CT - Volume 1 Image reconstruction 16-1
16.1 Overview
16.1.1 Launching images

Once the reconstruction is finished, the patient images are transferred to
the LOCAL folder for viewing and post processing.
1 Open the archive manager and choose from the LOCAL folder patient
images for post processing.
2 Click Processing , and from the opened menu chooses an application
for post processing. Image reconstruction can be done both on the
Brilliance CT Scanner and the Extended Brilliance Workspace. The
remainder of this chapter describes the reconstruction options
(including parameters) and procedures available on the Scanner (see
your Extended Brilliance Workspace user documentation for additional
reconstruction information).
16-2 Image reconstruction Brilliance CT - Volume 1
Online recon 16.2
16.2 Online recon

Online reconstruction of the clinical scan occurs immediately after the scan
is complete.
16.2.1 Evolving mode

When working with Evolving mode, the images are displayed in a separate
window, and are dynamically refreshed.
• If evolving mode was selected in the scan protocol, you have the option
to zoom, pan, or change the window center or width of the evolved
images before the final reconstruction begins. Click OK to begin the
Reconstruction.
• If evolving was not selected in the scan protocol, the final reconstructed
images display in the scan viewer without the option to pan and zoom.
16.2.2 Add Recon

C
_
1
0
You have the option of inserting a reconstruction into the current study.
6
4
3
Using this feature results in a real-time reconstruction.
4
7
6 1 To insert a reconstruction into the current study, click Insert Recon.
5
3
5
The system displays the recon protocol parameters which are the same
4
s
as those of the planned scan or the previous Add Recon.
m
e
t 2 If desired, edit the parameters.
s
y
S
l
a
ic Note • If the windowing settings of the main and add recon are the same,
d
e changes made in evolving are applied to both. If the settingsare different,
M
s
p the changes made in evolving are applied on the main recon only.
lii
h
P
• If X/Y and FOV of the main and add recon are the same, changes made in
evolving are applied to both. If they are different, changes made in
evolving are applied on main recon only.
16.3 Offline reconstruction

Use this procedure to reconstruct raw data.
1 Under Selected Device in the Directory, click the IRS icon.
2 A list of patients displays. Select a patient.

3 Select the series to be reconstructed.
4 Select an option:
• View Recon to view images as they are reconstructed.
• Background Recon to reconstruct images in the background.
Note If the ECG information was captured, it also displays on the screen.
The system displays the parameters that correspond with the scan.
5 Change the reconstruction parameters, if desired.
• If you this study is not Cardiac or Pulmonary, continue to step 9.
Note You cannot change the Main reconstruction parameters.
6 For Cardiac and Pulmonary studies, you also have the option to
automatically reconstruct up to ten phases.
• If you do not have phases, continue to step 9.
• If you need to reconstruct phases, continue to step 7.
7 Click the Add phases button on the bottom of the Add Recons box.
Offline reconstruction 16.3
The Multi-Phase Tagging Protocol box opens.
8 Select the desired number of phases.

C
_ Note To delete one of the additional reconstructions, right click on it and select
1
0
6 Delete.
4
3
4
7 9 When you have completed the reconstruction settings, select an option:
6
5
3
5
• Click Start Recon to accept the settings and begin reconstruction. If
4
s
you are using background reconstruction
m
t
e • Click Cancel to revise your settings.
s
y
S
l
a
ic
d
e
M
s
ilp
i
h
P
16.3.1 Re-recon
During a study, you may determine that changes need to be made to the
images or that you need to perform unplanned additional reconstructions
of a specific area. The Re-recon feature enables quick and easy offline
reconstruction of part or all of the images with different parameters such as
these:
• Start, End, and Length of the scanned series end position.
• Thickness
• To change reconstruction Filter
• Enhancement
• Window
• Matrix
• Evolving mode is available when the reconstructed area has not been
properly located, and other values of X, Y and Zoom are required.
Note You do not need to locate raw data to use the re-recon function.
Use this method to Re-recon data offline:

1 After initial reconstruction is complete, the Re-recon function on the
toolbar is active. Click Re-recon. The system displays the protocol
parameters.
2 Adjust the parameters as needed.
3 Click Start Recon. If Evolving was selected, the images display.
4 Pan and Zoom the images as needed.
5 Click OK. The reconstruction begins.
Axial reconstruction parameters 16.4
16.4 Axial reconstruction parameters

Window Center, Window Width
Window Center and Window Width are used to set the gray levels of the
reconstructed image.
Filter
The Filter parameter is used to set the mathematical algorithm which
determines the sharpness or smoothness of the image. The noise in the
image increases as the sharpness of the image increases, and vice versa. In
general, the low contrast resolution decreases as the spatial resolution (and
image noise) increases.
Matrix
The Image Matrix parameter sets the number of pixels that the
reconstructed image will contain. The matrix sizes are 512 2, 7682, 10242.
Understanding the relationship between FOV, resolution mode and
reconstruction will help you make a matrix choice that produces the best
image quality:
C
1
_ Standard/Detailed resolution, matrix =1.6 x FOV
0
6
4 (except filter D)
3
4
7
6 Standard/Detailed resolution, filter D, matrix = 2.5 x FOV
5
3
5
4
HR: matrix = 3.2 x FOV
s
m
e UHR: matrix =5.0 x FOV
t
s
y
S
l
For example, if the scan mode is HR and the FOV is 300 mm, then the
a
ic
d
matrix is 3.2 x 300 = 960. The closest available matrix selection is 1024.
e
M
s Note Surviews are reconstructed in the 5122 matrix.
p
lii
h
P
16.5 Helical reconstruction parameters
16.5 Helical reconstruction parameters

Evolving mode
You can complete reconstructions with evolving mode on or off:
• Evolving mode on reconstructs a partial image, in step with the scan.
This mode enables you to see a quick overview of the scan and allows
you to set zoom, pan and window settings prior to final reconstruction.
• Evolving mode off reconstructs the images (in final quality) in parallel
with the scans.
Window Center and Window Width
Window Center and Window Width are used to set the gray levels of the
reconstructed image. The images will be stored with these values.
Filter
This parameter is used to set the mathematical algorithm which determines
the sharpness (or smoothness) of the image. The noise (and sometimes the
streak artifacts) in the image increase as the sharpness of the image
increases, and vice versa. In general, the low contrast resolution decreases as
the spatial resolution (and the image noise) increases.
Matrix
The Image Matrix parameter set the number of pixels that the
reconstructed image will contain. The matrix sizes are 512 2, 7682, 10242.
Understanding the relationship between FOV, resolution mode and
reconstruction will help you make a matrix choice that produces the best
image quality:
Standard/Detailed, matrix = 2.5 x FOV
HR:matrix = 3.2 x FOV
UHR: matrix = 5.0 x FOV

Helical reconstruction parameters 16.5
Note Surviews are reconstructed in the 5122 matrix.
SP
This algorithm is aimed to compensate for the distortions that are inherent
with the cone-beam geometry of this multi-slice scanner. The images
obtained have a more homogeneous thickness over their area. Also some
artifacts present in conventional reconstruction are significantly reduced or
completely corrected.
The maximum available pitch becomes dependent on the FOV: the larger
the FOV, the smaller the maximum available pitch. This dependence is
even more restrictive for high and ultra high resolution modes.
SP filter is not be available with quad or dual mode selections that do not
extend out in the z-axis. For example, 2x 0.5 collimation has SP selection
set to No and you will not be able to select Yes- this is because this
algorithm is not required to optimize image quality.
Note When planning the scan, you must take into consideration that off-line SP
reconstruction following concurrent conventional (non-SP) reconstruction
will have the same limitations.
C
_
1
0
6
4
3
4
7
6
5
3
5
4
s
m
e
t
s
y
S
l
a
ic
d
e
M
s
ilp
i
h
P
17 Filming
17.1 Overview
The Filming application is used for viewing, rearranging, windowing and
zooming images prior to sending them to be printed. It can be activated
from the File menu of any application. It operates similarly to the Viewer
application with minor differences.
These are some of the advantages provided by the Filming application:
• The same image can be filmed with different zoom and window
parameters in the Dual mode.
• Better organization and economy of films can be achieved by filming in
the Multiformat mode.
• Measurements and annotations (done with graphic elements) can be
added or deleted from the images.
C
_
1
0
6
4
3
4 Warning Measurements on 3D images are not the same asin the 3D application. The
7
6
5
3
measurements are in the screen plane and not on the three-dimensional
5
4 curved surfaces.
s
m
e
t
s
y
S
l
a
ic
d
e
M
s
p
lii
h
P
Brilliance CT - Volume 1 Filming 17-1
17.2 Filming window
17.2 Filming window

The illustration below shows the Filming window:
1 Menu Bar 2 Tool Bar
3 Toolbox 4 Main Area
5 Message Line
17-2 Filming Brilliance CT - Volume 1
Filming window 17.2
• The Menu bar consists of several menu options which, when selected,
display a list of operations that can be performed.
For more information on these options, see Volume 2, Review Modes.
• File (Includes printer which allows you to select from several printers
or imagers, if they are connected, and other printing operations. If
there are any imager problems, use the Clear film Queue.)
• Edit
• View (includes the ability to set the format, multiformat and dual
modes; set the film format; and set the film size-depending on printer
capabilities)
• Graphics
• Operations
• Options (described later in this chapter) includes various film/printer
parameter selections and settings, and allows selective display of ROI
measurement data.
• The Toolbar contains icons for activating the frequently used functions.
The icons on the toolbar vary depending on the application you are
using. Each is described in detail in the applicable chapter.
C
_
1
0
6
4
3
4
7
6
5
3
5
4
s
m
e
t
s
y
S
l
a
ic
d
e
M
s
ilp
i
h
P
17.3 Toolbar
17.3 Toolbar
The toolbar contains the standard icons for activating frequently used
functions. Additionally, these icons are included:
Save allows you to save selected film images.
Set Number of displayed images/Film Format which enables you to

change the format of the film; the same format should be set manually
on the keypad of the Imager itself.
Print page for sending to the Imager or printer the currently displayed
page (may be activated in the Film Page display mode only).
Selection modes
Image(s) to select one or several frames.
• Groups to select one of two groups of images, such as one of the two
groups in dual mode.
• Whole window to select all the images in the window.
• All images to select all the images in the Filming.
Leaf & select Images for Fast Leafing and also for deselecting the
graphics, zoom, and pan buttons, thus enabling selection of images.
Enhance image allows you to drag mouse up or down to sharpen or

smooth the image(s)
Pan image for moving the selected images within the window.
Zoom image for magnifying and reducing the selected images.
Film images 17.4
17.4 Film images

In all applications there is an icon, Film, for sending the selected images,
window or series to the Filming application. Alternatively, filming options
are accessible from the File menu. The images filmed in the applications are
added to the images already in the Filming application.
Use this procedure to film images from an application:
1 Click on the appropriate selection mode. In some applications, only the
displayed image can be filmed.
2 Launch the film option using one of these methods:
• Click the Film icon on the toolbar.
• Select Film Images from the File menu.
Note In several applications, the Film series option may be selected for filming a
series of user-defined cuts.
3 From the File menu, select Filming.

4 Rearrange and adjust the images.
C
1
_ 5 Print the film pages (see the next sections for more details).
0
6
4
3
4
7
6
5
3
5
4
s
m
e
t
s
y
S
l
a
ic
d
e
M
s
p
lii
h
P
17.4 Film images
17.4.1 Film format

Use this procedure to change the film format.
1 Access the Film format dialog box using one of these methods:
• Click on the Film Format icon on the toolbar.
• Select Film Format from the View menu.
The dialog box opens.
2 Click on the desired format.

3 Click Ok.
Print film (with and without delete) 17.5
17.5 Print film (with and without delete)

From any of the applications, use one of the Filming methods given in the
section Film images (or use the File menu’s Add selection) to send the
images to be filmed to the Filming application.
1 When desired, you have two options to send the images from the
Filming application to the printer or imager:
• Click the Print icon.
• From the File menu select Print. This dialog box displays:
C
_
1
0
6
4
3
4
7
6
5
3
5
4
s
m
t
e 2 From the dialog box, you can print the current (or all) film pages and
s
y either automatically delete the images, or print without deleting the
S
l
a images.
ic
d
e
M
s
• If desired, change the number of images printed by selecting Number
ilp of copies from the Options menu.
i
h
P
17.5 Print film (with and without delete)
17.5.1 Selecting another printer

The system may be connected to several printers or imagers. Use this
procedure to select a printer other than the printer currently set for your
system:
1 From the File menu, select Printer. This opens the Print dialog box
presenting you with a list of the available printers.
2 Select the desired printer from the list.
3 Click Ok.
17.5.2 Clear film queue

If there are any problems with the Imager, the films that are waiting to be
printed (in the internal system spooler) can be deleted as follows:
1 From the File menu, select Clear Film Queue. A prompt appears with a
confirmation message.
2 Select an option:
• Click on Ok to delete the films.
• Click on Cancel to exit without deleting.

anzubieten!
" Nützlich
% Nicht
nützlich
Modifying film parameters 17.6
17.6 Modifying film parameters

The Options selection, allows you to modify general film parameters as well
as parameters specific to the film printer that is currently active.
Use this procedure to access modify the parameters:
1 Click Options on the menu bar. These selections display:
• Do Not Mix Patients! - When activated (box is yellow), if there are
images from a previous patient already on the page, and you send
images of a new patient to the Filming application, a new film page is
started.
• Automatic Printing - When activated, once a page is filled it is
automatically sent to the film printer.
• Enhancement Square Size - The size of the square over which the
enhancement is performed when the Enhance operation is activated.
• Reset to Defaults - Reverts to the default film format.
• Display Utilities - Drops down a menu that offers various display
C options.
_
1
0
6 2 Click an option to select it.
4
3
4
7
6 The following is a list of many of the printer parameters that can be
5
3 modified.
5
4
s Film format Format of the printed film.
m
e
t
s Film or ientation Por trait or Landscape.
y
S
l
a
ic Pr int pr io rity Pr io rity o f the film in the pr int queue.
d
e
M Number of copies Number of copies to be pr inted.
s
ilp
i
h
P
Note This list is representative. Only those parameters associated with the
current printer setting display when you select O ptions.
17.7 Image manipulations
17.7.1 Image selection

The image selection modes operate exactly as they do in the Viewer. Refer
to Volume 2, Review Modes for more details.
Note • The selected images are enclosed within a gray frame.
• The active image is enclosed within a white frame. Operations are
performed in real-time on the active image, while the rest of the selection
is updated during pauses.
17.7.2 Rearranging images in the Filming

Images can be moved from one frame to another by using the Cut, Copy,
Paste and Swap functions.
Cut and paste

Use this procedure to move a selection to another place in the Filming
application:
1 Select the image or group of images to be moved.
Note In order to move only one image, make sure you are using the correct
selection mode.
2 Cut the image using one of these options:

• Press <Ctrl> + <X> on the keyboard.
• From the Edit menu select Cut.
The selection is now deleted from the window and is stored on the
clipboard (temporary storage memory).
Image manipulations 17.7
3 Click on the frame where you want to insert the selection.

4 Paste the image using one of these options:
• Press <Ctrl> + <V>.
• From the Edit menu, select Paste.
The selection is inserted from that frame onward. The rest of the frames
will be pushed down or moved to the right.
Swap
Use this procedure to swap between two images:
1 Click on one of the images to be swapped.
2 Launch swap mode using one of these methods:
• Press <Ctrl> + <W>.
• From the Edit menu select Swap.
The pointer changes to indicate swap mode.
3 Click on the second image to be swapped. The two images are now
exchanged.
C
_
1
0
6 Note The two imageshave to be visible at the same time.
4
3
4
7
6
5
3
5
Copy and paste
4
s
m Use this procedure to copy a selection to another place in the Viewer:
e
t
s
y
S
l 1 Select the image or group of frames to be copied.
a
ic
d
e 2 Copy the image using one of these options:
M
s
p
• Press <Ctrl> + <C>.
lii
h
P
• From the Edit menu select Copy.
The selection is copied onto the clipboard and is not deleted from the
screen.
3 Click on the frame where you want to insert the selection.
4 Paste the image using one of these options:
• Press <Ctrl> + <V>.
• From the Edit menu select Paste.
The selection is inserted from that frame onward. The rest of the frames
will be pushed down or moved to the right.
17.7.3 Add parameters frame

The image parameters can be displayed as an image and can be filmed:
1 Click on the image whose parameters are to be inserted.
2 From the View menu, select Add Parameters Frame. The Image
Parameters display in the image window to the right of the selected
image and all the images following the selected image will be shifted by
one space.
17.7.4 Add blank image

Use this procedure to insert a blank image frame:
1 Click on the frame where you want to insert the blank image.
2 From the View menu, select Add Blank Image. All the images from the
selected image and onwards will be shifted by one space and a blank
image will be inserted in the current frame.
Note Text and graphics may be inserted in the blank frame and can be filmed;
however, saving to archives is not possible.
17.7.5 Remove parameters frame or blank image

Use this procedure to remove a frame or image
1 Select the item you want to remove by clicking on it.
2 Delete the image using one of these methods:
• From the Edit menu, click Delete Selected Image(s).
• Press <Ctrl>+D on the keyboard.
17.7.6 Dual images

Dual Images replicates each image in the Viewer and displays it to the right
or below the original.
1 From the View Menu, select Dual.
2 A sub-menu appears. Select Horizontal or Vertical mode, depending on
the film format. The images are then duplicated to the right of the
original image (Horizontal mode) or below (Vertical mode). The Select
group mode is automatically activated.
C
_
Window and Zoom each of the groups separately for viewing two
1
0
6
different tissues or anatomical regions.
4
3
4 3 To cancel the Dual mode, from the View menu, select Dual and then
7
6 select Off.
5
3
5
4
s
m
t
e
s
y
17.7.7 Sorting images
S
l
ic
a The images are initially displayed in the order that they were listed in the
d
e Archive Manager. In some cases it may be necessary to view the images in a
M
s different sorting order.
ilp
i
h
P • To do this, from the View menu, select Sort Images.
• For further details, see Sorting Images in Volume 2, Review Modes.
17.7.8 Multiple groups/stack filming

The Multi-Groups viewer filming mode allows the viewing of several
groups of images simultaneously in the Viewer window, while enabling
scrolling and manipulation of each group independently. See Volume 2,
Review Modes for more details.
17.7.9 Additional options

The options in the following list are also available for manipulating the
images. See the noted sections for further information on the functionality
of these options:
Zoom
To magnify or reduce the size of the image.
Pan
To move the image for centering the feature of interest in the image frame
(see Volume 2, Review Modes).
Enhance
To sharpen or smooth images (see Volume 2, Review Modes).
Windowing
See Windowing in Volume 2, Review Modes.
Graphic elements for measurements and annotations
All graphic elements are available for measuring and annotating features on
the images (see Volume 2, Review Modes).
Note ROI values will vary based on image zoom on the screen compared to the
film.
Flip image
Images can be flipped from left to right or up and down. For details (see
Volume 2, Review Modes).
Scrolling through the images

Scrolling is performed on a page-by-page basis each page is a single sheet
that can be sent to the Imager. If multiple groups are defined, the scrolling
can cause a large number of gaps (empty frames) to appear on a page. In the
Options menu if the auto Re-Align pages is on, then the first image from
all groups will always be aligned with the first row of the first page.
Gray scale
To display (and/or print) a gray scale on the image in the Filming
application, from the View menu select Show Grayscale.
17.7.10 Multiformat
Use the Multiformat function for printing multiple images in a single frame
on film. The function is typically used this way:
C
1
_ • Spine images in which the interesting area takes only a small part of the
0
6
4
frame area. The images can be zoomed by a factor of 1.5-2.5 and filmed
3
4 in a multiformat of four per frame.
7
6
5 • The last images in head studies where the images at the top of the head
3
5 are small.
4
s
m Use this procedure to film images in Multiformat:
e
t
s
y
S
l 1 Select the images to be grouped in the multiformat frames. In the All
a
ic mode, all the images display in multiformat.
d
e
M
s
p
2 From the View menu, select Multiformat .
lii
h
P
3 From the sub-menu, select Create. This dialog box opens:
4 Click the number of images to be placed within each frame.

5 Click Ok to confirm. The multiformat images display and can now be
stored and filmed.
18 Directory
This section details the Directory specifications and explains the screen
layout and features as well as the mouse and keyboard operations. These
options are available while in the Directory:
• Select and retrieve images from local and remote storage devices.
• Copy images and files from one device to another.
• Erase data from local devices.
• Format and rescue removable storage media.
• Quickly review images in the Quick Viewer.
• Display the remaining free space on storage devices.
18.1 Director y window
18.1 Directory window
The Directory window consists of the following areas:
1 Workflow bar 2 Tool panel
3 Devices area 4 Studies (Patient List) area
5 Series, States, and Raw Data 6 Preview Image

areas
7 Message Bar
Each area of the Directory window is explained in detail in the following

sections.
18-2 Directory Brilliance CT - Volume 1

Directory window 18.1
18.1.1 Workflow bar

The Workflow bar across the top of the window guides your activity
sessions. The bar has buttons that become highlighted to guide you as you
work your way through a session.
18.1.2 Message bar

Located at the bottom of the window, the message bar contains messages to
the user.
18.1.3 Tool panel
Viewer
C
_
The viewer allows you to view patient studies quickly and easily in various
1
0
6
modes. The CT Viewer is the default viewer of Brilliance CT. (Click the
4
3 down-arrow to switch to the Legacy Viewer or Cardiac CT options.)
4
7
6
5
3
5
4
s
m
e
t
s
y
S
l
a
ic
d
e
M
s
ilp
i
h
P
Brilliance CT - Volume 1 Directory 18-3
Application
In addition to being able to open a study into one of the Viewers, you can
load an application directly, and begin image processing and analysis
functions.
1 Click on the down-arrow next to the application icon to drop down a
matrix of application icons, as shown below.
2 Click an icon to load a study into the application.
Reconstruction tools
These tools are active if your system when the IDRS directory is selected
The Recon manager is active when there is more than more than one image
series in the reconstruction queue.
See Reconstruction in this volume for details.
Directory tools
The Directory toolbox provides access to various file-management
functions.
Image Browser - Launches the browser of the database containing the
JPEG, TIFF, AVI, and MPEG files that have been previously saved.
Quick Film - Allows you to send images to Filming directly from the
Directory. If the sub-selection option is active, decide on the series and/or
derived images before clicking Quick Film.
Copy To - Copies the currently selected items to another device. A dialog
box opens with lists of available Local and Remote archive devices.
Archive Status
Local - Shows the relative free space on the Local disk
EOD - Shows the relative free space on the Erasable Optical Drive.
CDR - Shows the free space on the CDRecord.
C
DVD-RAM - Shows the relative free space on the DVD-RAM disk.
_
1
0
6
4
QM (Queue Manager) - Shows how many items are in the queue for
3 transfer and how many have failed to transfer.
4
7
6 • Click the Queue Manager button to load the Queue Manager. Details
5
3
5
4
on using the Queue Manager are provided later in this chapter.
s
m
e
t
S
s
y Preferences
l
a
ic Allows you to change various configurations of the system (see Preferences
d
e
M utility, on page 18-22 for more information).
s
p
lii
h
P
Logout
To exit Brilliance CT, click Logout.
18.1.4 Devices area
Selected Device - To prevent patient list confusion, only one device may be
selected at a time (in this case, the Local drive).
Stop Connection - When connect to a remote device, this button is active.
Click it to end the network connection to a remote device.
Device List - Click the down-arrow next to the Selected Device icon to
view the device list. The list offers local and remote locations. Click on the
device you want to access. If the device is not available, a message will
indicate that.
Device functions menu - To access the device functions (which vary

depending on the device), right-mouse click on the device’s icon:
• Local devices (includes local folders) - verify connection, free space,
quick rebuild and full rebuild
• CD - verify connection, eject
• CDR - verify connection, free space, eject, record, and clear
• DVD - verify connection, free space, rebuild, clear, and eject
• DVD-RAM - verify connection, free space, quick rebuild, full
rebuild, eject
• EOD - verify connection, free space, quick rebuild, full rebuild,
format, eject
• IRS - remote devices
18.1.5 Patient list
C
_
1
0
6
4
3
4
7
6
5
3
5
4
s
m
e
t
s
y
S
l
a
ic
d
e
M
s
ilp
i
h
P
The patient list displays the studies that are archived on the selected device.
Sorting - Click on the column title to sort the data in the column. The sort
will be done alpha-numerically. Click again on the column to sort in the
reverse order.
Column Display - You can specify which columns will display in the
patient list by right-mouse clicking on one of the column headings to bring
up the selection box shown at left. In addition to the standard items, these
columns are also included
• Transferred icon (first column on the left) appears when the study has
been successfully archived.
• New icon study/series (second column from left) displays appears when
a new study is entered into the directory.
• Reviewed icon (second column from left with check mark) appears
when the study has been reviewed.
• Referring physician can also be displayed.
Filtering the list

The filter operation limits the patient list by a data field, and/or by the
elapsed time since the study arrived to the device.
In the left-hand drop-down list, you can select to filter by various study
parameters.
In the middle text field you can enter text that will be used to filter. (For
example, if you select Patient ID and enter 12345, you are telling the filter
to display only studies whose patient ID numbers begin with 12345.)
In the right-hand drop-down list, you can select to filter by date.
Find - When you have selected the filtering parameter(s), click the Find
button. The Patient List will be updated with only the filtered studies
displayed.
Remove Filter - Resets the filtering function, restoring the full list of
patients.
Update Screen Content - Refreshes the patient list with newly arrived
studies.
C
_
1
0
6
4
3
4
7
6
5
3
5
4
s
m
e
t
s
y
S
l
a
ic
d
e
M
s
p
lii
h
P
Filtering for PACS

If you use Directory with a PACS, the typically large number of studies
may take a very long time to access.
Be sure to apply a filter before accessing a PACS.
Brilliance CT has a “Large Archive” configuration option that you can
activate to warn you with the following message:
“To search this device please enter the patient Name or the ID Number and
press the “find” button.”
18.1.6 Series list
The Series List located beneath the Patient List allows you to display and
select various series and other image and data files associated with a patient
study.
Selecting a Series to View or Analyze

Click in the text line of the series you want to access. It will be highlighted
in a light blue color. Once highlighted, you can click Viewer or Application
to begin viewing or analyzing.
Checking only the Original box filters the series to display original data
only (for example, surview, Bolus Timing, axial, helical).
When a mixed series is selected and only the Original box is checked, then
only the original images are selected from that series.
Unchecking “derived” will load original images, only if they are marked
“mixed”
OT label is Other Types.
Checking only the Derived box filters the series to display derived data only
(for example, derived, secondary capture, movies, and JPEG files).
Column Display - You can specify which columns will display in the Series
list by right clicking on one of the column headings to bring up the
selection box shown at left.
C
_
Sorting - The Series List can be sorted in the same way as the Patient List,
1
0
6
described earlier.
4
3 • A different icon distinguishes between read/unread and lock/unlock.
4
7
6 • A different icon distinguishes between a volume and non-volume series.
5
3
5
4
s
m
e
t
s
y
S
l
a
ic
d
e
M
s
ilp
i
h
P
Series list menu

Right click in one of the series entries to bring up this menu.
Warning The Change patient name option should not be used with patients entered
from the HIS/RIS system.
Clicking on View DICOM Info brings up the following typical window:

anzubieten!
" Nützlich
% Nicht
nützlich
States (bookmarks) 18.2
18.2 States (bookmarks)

The bookmark function is available in several applications, including AVA
and Cardiac CT Angio. You would use bookmarks during work sessions to
“save the state” of the application. You may want to save the state at an
intermediary point, intending to return to try a different analytical
procedure, or you may create a bookmark and quit the current work
session, returning at a later time to continue where you left off.
A state is a group of one or more bookmarks, saved from one case in one
application.
A saved state is accessible from the Directory in the form of mini images
under the States tab. This allows you to directly open the saved study in the
application and resume working where you left off when you created the
bookmark.
Using bookmarks from the Directory

1 Select the study from the Directory list.
C
_
2 Click on the States tab.
1
0
6
4
3
4
7
6
5
3
5
4
s
m
e
t
s
y
S
l
a
ic
d
e 3 Select an option:
M
s • Double click the bookmark mini image to load the last bookmark
ilp
i
h
saved in this state.
P
• Right click to select from the list, the bookmark you want to load.
18.2 States (bookmarks)
The study will automatically open in the application and display the study
as it was when the bookmark was created.
Editing states
You can edit states from the Directory. Under the States tab, right click on
the state mini image, and the following menu drops down:
You can rename states in from the Rename States dialog box.
Sub selection 18.3
18.3 Sub selection

The Sub Selection feature allows you to select and load only certain studies
within a patient series. You can also limit the number of images loaded
from within a study
You can turn Sub Selection on or off by clicking in the check box in the
Control Panel.
• When it is checked, it will activate the Prepare Selection window

every time you open a patient series.
• When it is not checked, the Prepare Selection window will still open
if there are system limitations, for example if you have chosen to load
2000 images into CT Viewer, but the limit is 1500.
C
_
1
0
6
4
3
4
7
6
5
3
5
4
s
m
e
t
s
y
S
l
a
ic
d
e
M
s
p
lii
h
P
18.3 Sub selection
18.3.1 Prepare selection window
The window consists of two sections, the series information panel on the
left, and the image area on the right.
If the Load and Continue button is grayed out, the number of images is
too large for the Viewer or Application selection.
Series information - The window defaults to the Image position, which is
displayed in the From: and To: fields. The image number can also be
selected. The patient studies and other associated files are listed under the
Series tab. By default, the first study is highlighted (study 108592, above).
Image area - If the series includes a surview it is displayed as a background
image, as shown by the near-full body image above. (If there are dual
surviews, both will be shown.)
If there is no surview, the background will be blank.
Sub selection 18.3
• Blue rectangle - A shaded blue rectangle appears in the main image

area. The blue rectangle corresponds to the starting and ending
images of the highlighted series.
• Mini images - In the upper and lower right corners are mini images
that correspond to the starting and ending images bounded by the
blue rectangle.
Click on each series and the blue rectangle moves to show the range covered
by that series.
18.3.2 Reducing the number of images to load

There are a number of ways to select or limit the loading of images.
Deselect the series - Click in the series’ sub-selection box to exclude it from
loading. A red X will appear, as shown at left, and that series will not be
loaded.
Image number - You can select images to load by number. (To load a single
image, select, for example, From: 5 and To: 5.)
C
_
Image position - Type in the to: and from: values.
1
0
6
4 Select every nth image - Click the select every check box, then enter the
3
4
7
desired number, to select every 2nd image, 3rd image, etc.
6
5
3
5
Dragging the blue box - This redefines the range. The slice number and
4
table position is displayed. Use the pencil on the surview (or the shaded
s
m
e
rectangle if a surview is not loaded) to manipulate either the top or the
t
s
S
y bottom. The mini images will update.
l
a
ic
d
To pan the whole range in the XZ direction, hold the mouse and drag the
e
M box to the desired location.
s
ilp
i
h
P
18.3 Sub selection
Split series
Split series (virtual series) are for run offs, having one long series split into
two series.
The splits are identified by the blue line on the orthogonal views in CT
Viewer.
18.3.3 Clone a range

Clone allows you to copy a defined range from one series to all series or any
one of the series. This is especially useful in cardiac scanning. These options
are available:
• Zoom and Pan
• Window and Level with the middle mouse wheel
• Load and Continue
• Cancel
• Reset
Note On the surview you cannot clone past the area you scanned.
18.3.4 Quick review

Click the Preview button to launch the Quick Review application with the
selected series loaded, as shown below. Preview enables subselection (batch)
Sub selection 18.3
and filming without launching the CT Viewer. It also enables viewing a

second patient during review of a primary patient.
C
_
1
0
6
4
3 2D tools, Quick review
4
7
6
5
3
Quick Review opens in the 2D Tools mode. Refer to the CT Viewer - 2D
5 mode chapter for descriptions of Layout and Flip & Rotate 2D tools.
4
s
m
t
e Combine slices - This function is similar to Combine in CT Viewer - 2D
s
S
y mode, but it does not perform non-continuous combining of images. To
l
ic
a combine a “from-to position,” perform combine first, then batch.
d
e
M
s
p
lii
h
P
18.3 Sub selection
Quick review’s batch tools

From, To - Specifies the starting and ending images of the batch.
Plan on Surview - Plan on Surview becomes active when the surview is in
the active window. The <> buttons select the series. In this mode the batch
start and end images of the batch can be defined:
• by typing in the start and end image numbers
• by moving the borders of the blue rectangle
All - Selects all images for the batch.
Clear - Clears the current batch settings.
Skip Every - Excludes the specified number of images from the batch.
Add Surview Image - Allows production of new ES Surview, when you
plan a range and Save and Film it. You can place the surview at the start or
end of the batch.
Add Parameters Frame - You can place the parameters frame at the start or
end of the batch.
Save - Directly saves the series you plan to the location(s) configured in
“Default Storage Device.” Refer to the Preferences section later in this
chapter.
Save To - Saves the batch to the location(s) you choose.
Save and Film (S&F) - Saves and films the batch simultaneously.
Film - Film the batch.
Sub selection 18.3
Series control panel

This control panel allows you to individualize surviews, no line surview,
executed surview and planned surview.
By choosing the surview and axials, you can then plan on surview for sub-
selection.
Select multiple series by holding <Ctrl> and clicking on individual series.
C
_
1
0
6
4
3
4
7
6
5
3
5
4
s
m
e
t
s
y
S
l
a
ic
d
e
M
s
ilp
i
h
P
18.4 Preferences utility
18.4 Preferences utility

The Preferences utility is used to access the system configuration setup. It is
launched from the Applications window (near the Logout button).
From this utility you can modify the system configuration.
Warning Only advanced users may use this application, as it changes the system’s
behavior.
These options are available once you’ve completed your preference

selections:
• OK-Save all changes and exit application
• Cancel-Discard all changes and exit application.
• Default-Set the current preset to it’s default values. These values appear
in brackets next to the selected field.
Note Click on any Workflow button (Directory, Review) is regarded as clicking
“Cancel” – all changes are discarded.
Note Some fields do not have a default value and are not be changed by this
button.

anzubieten!
" Nützlich
% Nicht
nützlich


anzubieten!
" Nützlich
% Nicht
nützlich

anzubieten!
" Nützlich
% Nicht
nützlich

Dieses Dokument teilen

' ( ) $ *
Das könnte Ihnen auch gefallen
GE HI-Speed NXi Dual

Slice CT EQ#6294
InternationalMedical
CT B-iCT-64 Brochure
Cao Minh Trí
Antena 20mhz -- 6ghz

Cris VM
ZeitschriUen Podcasts
Noten
Product Data Brilliance

iCT
Jimmy Camones
-2_2
Abood Ali
Schede_IngElettrica_28.pdf
shaheerdurrani
CT-Scan
Elektromagnetische Verträglichkeit
Medizinische Bildgebung
Elektromagnetische Interferenz
Servo Star 600 Series

maheshwar299
9900RM User Manual

RevG
Christopher Loukinas
EMC Manual Servodyn-T, -

D
JW
case 2
Damar Kj
Cigre Paper on Ct Failure

ahmadshoeb19
b170
gustavofx21
Mehr anzeigen
Über Support
Über Scribd Hilfe / Häufige Fragen
Presse Zugänglichkeit
Unser Blog Hilfe beim Kauf
Werden Sie Teil unseres AdChoices

Teams!
Herausgeber
Kontaktieren Sie uns
Freunde einladen Gesellscha!liches

Geschenke
Instagram
Scribd für unternehmen
Twitter
Facebook
Rechtliches
Pinterest
GeschäUsbedingungen
Datenschutz
Urheberrecht
Cookie-Einstellungen
Holen Sie sich unsere kostenlosen Apps
Bücher • Hörbücher • ZeitschriUen • Podcasts •
Noten • Dokumente • Snapshots • Verzeichnis
Sprache: Deutsch
Copyright © 2021 Scribd Inc.

Was ist Scribd? +
Millionen von Titeln nur einen Klick

Startseite entfernt
Bücher Hörbücher Dokumente
Nur €9,99/Monat. Jederzeit kündbar.

Operation Manual PDF CT Scan Electromagneti 34

Uploaded by

Copyright:

Available Formats

Operation Manual PDF CT Scan Electromagneti 34

Uploaded by

Document Information

Original Title

Copyright

Available Formats

Share this document

Share or Embed Document

Sharing Options

Did you find this document useful?

Is this content inappropriate?

Copyright:

Available Formats

Operation Manual PDF CT Scan Electromagneti 34

Uploaded by

Copyright:

Available Formats

Suche

Hochgeladen von Bayarkhuu Sukhbaatar

" 0 Bewertungen · 63 Ansichten · 492 Seiten

Verfügbare Formate English

PDF, TXT oder online auf Scribd lesen

Dieses Dokument teilen

$ Instr uctions for U se

Sind diese Inhalte unangemessen? Dieses Dokument melden

Verbessern Sie Ihre Erfahrung &

1 Introduction ..................................................................................... 1-1

1.1 About this guide ...................................................................................1-1

Brilliance CT- Volume 1 Contents i

2.10 Oil leaks .............................................................................................2-13

3.1 Regulatory controls...............................................................................3-2

4.1 Overview ..............................................................................................4-1

5.1 Operating station.................................................................................. 5-2

ii Contents Brilliance CT - Volume 1

5.11 NetForum ..........................................................................................5-26

6.1 Overview ..............................................................................................6-1

7.1 Overview ..............................................................................................7-1

Brilliance CT - Volume 1 Contents iii

7.19 Create Dose Summary Image ............................................................. 7-64

8.1 Overview ..............................................................................................8-1

9.1 Classifying protocols ............................................................................. 9-2

10.1 Introduction....................................................................................... 10-1

iv Contents Brilliance CT - Volume 1

10.6 Start planning the Step & Shoot scan ...............................................10-23

11.1 Overview ............................................................................................11-1

13.1 Overview ............................................................................................13-1

Brilliance CT - Volume 1 Contents v

13.2 D-DOM (angular modulation)........................................................... 13-2

14.1 Overview ............................................................................................14-1

15.1 Axial jog .............................................................................................15-2

16.1 Overview ............................................................................................16-1

vi Contents Brilliance CT - Volume 1

16.5 Helical reconstruction parameters .......................................................16-8

17.1 Overview ............................................................................................17-1

18.1 Directory window ...............................................................................18-2

Brilliance CT - Volume 1 Contents vii

19.3 Preventive maintenance ...................................................................... 19-3

viii Contents Brilliance CT - Volume 1

Über 1 Million zufriedene Mitglieder

Probieren Sie Scribd KOSTENLOS für 30 Tage

The Philips CT systems are advanced continuous-rotation computed

1.1 About this guide

Brilliance CT - Volume 1 Introduction 1-1

1.1 About this guide

Note Highlight unusual points as an aid to an operator.

1-2 Introduction Brilliance CT - Volume 1

About this guide 1.1

Brilliance CT - Volume 1 Introduction 1-3

1.2 Intended use

1.2 Intended use

Note Equipment described in this manual is designed to be compatible with PMS

1-4 Introduction Brilliance CT - Volume 1

Brilliance CT - Volume 1 Introduction 1-5

The Maintenance schedule identifies the procedures and frequency of their

This symbol appears on components on your CT scanner system. It

1-6 Introduction Brilliance CT - Volume 1