dicomPACS R

DX-R
X-ray Acquisition Software

Acquisition and
diagnostic software
for X-ray images from DR flat panels or CR systems in
human and veterinary medicine

Acquisition and diagnostic software for X-ray images

dicomPACS R
DX-R
X-ray Acquisition Software

Professional
acquisition
software for
X-ray images

Acquisition and diagnostic software for X-ray images

®
dicomPACS DX-R is a professional acquisition software for X-ray images
from flat panel systems (DR) and CR units (computed radiography with imaging
plates) by any manufacturer. In addition, the software controls X-ray generators
and X-ray units of various manufacturers, providing a smooth and systematic
workflow. A simple and user friendly GUI (graphical user interface) operated
by touchscreen or mouse completes the system.

®
The professional dicomPACS DX-R image processing can be adapted to
individual user‘ needs and offers outstanding image quality in human and
veterinary medicine. It has been specially developed to enable organ specific
optimisation, guaranteeing the highest quality X-ray images.

Many helpful integrated functions such as the radiographic positioning guide

and intuitive operation greatly simplify daily routine tasks.

®
In addition, dicomPACS DX-R allows integration with existing patient
management systems. The integrated full dicomPACS® viewer even enables the
user to diagnose X-ray images within the acquisition software. Therefore, the
system can also be applied as fully-fledged diagnostic workstation with the
option to upgrade to a PACS (Picture Archiving and Communication System).

®
dicomPACS DX-R forms the core of a direct digital X-ray unit, whether it
is a retrofit system to upgrade existing X-ray units, a complete new unit including
generator control, or a portable suitcase solution for mobile X-ray generators.
Function principles ®
dicomPACS DX-R software

Flat panel
X-ray devices
and CR systems (motorised)
(different manufacturers,
also dental panel)
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provided by DICOM DICOM images incl. all patient
HIS/RIS Worklist store and exposure data

PACS
(e.g. dicomPACS®)

2
 Benefits
User friendliness and smooth workflow

Modern graphical user interface (GUI) adaptable to almost

any language

Touchscreen operation – to ensure quick and efficient work and

a smooth workflow

Capture of patient data via DICOM Worklist, BDT/GDT, HL7

or other protocols – data may also be captured manually

Remote control
for X-ray units Use of DICOM Procedure Codes for the transfer of all relevant
examination data directly from the connected patient management
system (HIS/RIS)

Freely configurable body parts with more than 400 projections

and numerous possible adjustments in human and veterinary medicine
already included

Safe and fast registration of emergency patients

Allows the user to switch between examinations of a patient, for

instance to avoid having to re-position the patient frequently

Allows the user to subsequently add images to an examination, even

after that examination has already been completed
Wireless remote
control for the
taking of images Special tools for veterinary medicine, such as an extra dialog
box for patient and owner data, integrated hip dysplasia measuring,
special image filters, multi generator operation for alternating
between mobile and stationary X-ray systems and much more…

Entry of recurring examination procedures as macros,

e.g. thorax screenings or pre-purchase examination for horses

Fully integrated radiographic positioning guide for each examination

in human and veterinary medicine incl. comprehensive notes, photos, videos
and correct X-ray images

Option to control a digital X-ray system via wireless remote incl.

display of the worklist, preview of the image taken for checking
and much more

3
Screenshots ®
dicomPACS DX-R software

Job creation
Steve Miller
The correct settings dicomPACS R
DX-R
for adults and children - X-ray Acquisition Software

or for horses, dogs and

cats – are available
at a mouse click

Chart for
planning an
individual
X-ray job

Sw itc h to
s
pl an nin g X -r ay job
fo r ch ild re n
an d ba bi es

Radiographic positioning guide

s te p
S te p - b y - n d f o r
s o u
v id e o w it h io n in g
s it
p a ti e n t p o

S h ow s an a
ex am pl e of y
co rr ec t X - ra
im ag e

Presentation of helpful
hints for the positioning
of the patient, central beam,
tips and tricks, frequent
errors etc.

Opens examples
of inaccurate
X-ray images
with comments

4
 Benefits
Flexible image acquisition

Integration of various flat panel and CR systems by different manufacturers

Option to connect up to 3 flat panels (bucky, wall stand and mobile)

to one system

The configurable generator interface enables the user to control

X-ray generators or X-ray systems by different manufacturers, delivering
the generator settings directly from the software

Option for the parallel operation of a flat panel and a CR system included
in the standard package. The user has the choice to take the next image with
either the flat panel or the integrated CR system. This flexibility also provides an
excellent emergency concept in case of a defect flat panel.

DR flat panel DR flat panel

radiology dental vet

CR-F Dental system

CR system vet

dicomPACS R
DX-R
X-ray Acquisition Software
The software allows the control
of one CR system and one or more
flat panels Network

AEC (Automatic Exposure Control) and ARP (Anatomical Programmed

Radiography) allow the user to automatically adjust all X-ray options
for each projection with an option to subsequently edit the
image manually

Integration of dose area product meters (DAP) – the readings are

saved directly to the relevant image

Electronic X-ray log

5
Benefits ®
The professional dicomPACS DX-R image processing

Perfect images at all times – generally no adjustment required

Integrated software for automatic image optimisation

Professional, adaptable image processing for each individual examination

to obtain best possible image settings for the needs of each customer

Due to specially developed processes, the image processing allows the

user to vary the X-ray settings on a large scale while the image quality
remains virtually the same (possibility of reducing the dosage)

Bones and soft tissue in one image – this enables the user to
significantly improve his diagnosis

Details of bones and microstructures are very easy to recognise

Noise suppression

Black mask (automatic shutters)

Automatic removal of grid lines when using fixed grids

GLI (gridless imaging) – reduction of scattered radiation:

GLI image comparison

Exposure without grid Same exposure with GLI scatter reduction

6
Exposure with Exposure with
conventional image processing dicomPACS®DX-R COP image processing

7
Benefits
Outstandingly sophisticated image diagnosis

Completely integrated dicomPACS® viewer for image diagnosis,

further processing and storage of images in an SQL database incl. image
manipulations, export options, layout adjustments, freely configurable
user interface and much more

Stepless zoom, PAN, magnifyer, ROI, crop, rotate, mirror etc.

Insert image annotations, e.g. free texts, arrows, ellipses etc.

Measur distances, angles, areas and density

Completely integrated
®
dicomPACS viewer
for image diagnosis

Extended acquisition functionality for use in mammography* [see Page 14]

Special purpose tools for the veterinarian (Specialised filters for

the optimised depiction of bones and soft tissue, measurements for TPLO
and TTA, MMP, distraction index determination, cardiac
measurements etc.)

Adjust window/level options and gamma correction,

sharpening filters, noise suppression

Many additional functions such as chiro tools, calculation of Cobb's

angle, HD measurements, pelvic obliquity measurements, integrated
capturing of diagnostic reports etc.

Easily upgradable to the integrated image management system (PACS)

*Pending CE and FDA conformity approval for the module.

8
Benefits
Image export

Export images to JPEG, TIFF, BMP and DICOM formats

Print images both on Windows printers and laser imagers via

DICOM Basic Print

Creat DICOM patient CDs with free WEB viewer

Inbuilt email tool to image distribution - no external email

application necessary

Email tool

Image print

9
Integrated viewer

Completely integrated
®
dicomPACS viewer for
image diagnosis

An integrated prosthesis
documentation module
provides preoperative
planning (optional).

The system enables fast

and easy customisation
of the operating
interface for individual
customer preferences.

10
 Useful tools such as the
configurable measuring
magnifier make diagnosis
much easier.

The stitching module

merges a number
of separate digital X-ray
images into a single
image.

Comprehensive search
tools enable the
comparison of X-ray
examinations of one or
more patients.

11
Cloud based ORCA
The DICOM cloud for medical images
and documents

ORCA (OR Technology Cloud Archiving) is a cloud based platform specially designed for
storing, viewing and sharing medical images and documents. ORCA offers two exciting
applications: ORCA Archive and ORCA Share.

ORCA Archive transfers and stores image files from direct sources (e.g. digital X-ray,
CT, MRI and ultrasound systems) as well as from Picture Archiving and Communication
Systems (PACS). ORCA Archive can be used as a backup solution. Wherever the internet is
accessible, images archived in the cloud can be viewed at maximal resolution and quality
(DICOM) via the integrated browser based ORCA View program and our acquisition
®
software dicomPACS .

At the same time, ORCA is a platform for sharing data with external partners. The
application ORCA Share facilitates exchanging images and medical findings with staff,
colleagues and specialists. It can also be used to give patients access to medical reports
and images. Recipients are sent an access link via email. There is no need to install
software locally.

Share images and documents

Benefits of Cloud archiving through ORCA

Fast access: Register on https://orca.de.com and begin working with ORCA immediately.

No expensive equipment: ORCA provides access to remote servers and software solutions. There is
no need for an office filled with expensive equipment. Billing is usage based (flat rate or pay per use).
Archive images
and documents
Excellent scalability: System memory can be adjusted according to your requirements.

24/7 access: Images and documents are accessible at any time from all mobile and stationary devices
with an internet connection.

Straightforward: The user friendly interface is self-explanatory. Support is available online.

No more service contracts: ORCA is automatically updated and serviced without extra charges.

Data security: ORCA guarantees automatic data backups and high security standards.
Data loss as a result of malware or hardware failure is a thing of the past.

Accessibility: Excellent accessibility is ORCA top priority.

Fit for the future: ORCA archives all data in modern computing centres. The Server technology
is updated regularly.

Communication: ORCA is also a communication platform. Sharing images and documents

with doctors and other authorised persons is a breeze.

Optimal workflow: ORCA's many special functions and settings make workflow customisation easy.

12
 ORCA View is a web based
image viewer offering file
sharing capabilities (email
with integrated address
book, image anonymisation,
etc.), print and export
functions, as well as all basic
Print images and documents
functions for viewing and
analysing images:

Image annotation in various

colours (e.g., arrow, text)

Measurement (e.g., length,

angle)

Findings reports including

custom report templates

File attachment

Image comparison using

Medical reports including customisable report templates
different grids

Image rotation and mirroring

Brightness and contrast

adjustment

Image inversion, zooming

in/out

Full screen and fit image modes

Image panning

Image series scrolling

Various functions for image processing: image inversion,
brightness and contrast adjustment, resizing

13
Fit for mammography ®
dicomPACS DX-R includes a new module for mammography
exposures [optional]

Extended acquisition functionality for use in mammography*:

Specialised organ tree
Mammography Hanging Protocols
Documentation of additional examination parameters such as filter,
thickness, angle, implant
Mammography tools in the console viewer:
100% magnification
Mammo inversion function
Mammo grid function (quadrant diagnosis)

Job creation with specialised

mammography organ tree

For Divario CR-Tm following cassette formats and types

are available:

IP cassette type CH:

24 x 30 cm (10" x 12")
18 x 24 cm (8" x 10")

IP cassette type CC:

35 x 43 cm (14" x 17")
35 x 35 cm (14" x 14")
24 x 30 cm (10" x 12")
18 x 24 cm (8" x 10") Fully integrated viewer for
15 x 30 cm (6" x 12") diagnosing with specialised
mammography tools

*Pending CE and FDA conformity approval for the module.

14
15
Special Tools
dicomPACS® Diagnostic tools for Upper Cervical Chiropractic (NUCCA)

The Upper Cervical Chiropractic tool set has been created in cooperation with
leading NUCCA experts from the US and Canada. It offers a variety of ways to reach
a fast and accurate diagnosis. Templates like the Cephalometer, Grid, Circumscale,
and Relatoscope enable you to continue working as you are used to.

S-Line and Hard Palate Line

You simply set two points each on C1 and the hard palate to create the S-Line and
the Hard Palate Line. We will show you the horizontal angles.

Raw Data Box

All measured values will be shown in the raw data box. You can also show and hide values manually.

Atlas Plane Line and Atlas Check Line

The horizontal angle and the angle between Atlas Plane Line and Atlas Check Line will
be shown in the raw data box.

Squamous Sutures
Mark as many lateral aspects of the skull as you wish and even change the appearance of the markers.

Cephalometer and Central Skull Line

Use the Cephalometer to draw the Central Skull Line. Laterality and Skull Tippage will be
calculated automatically. The Four Elements and Listing Information will be inserted.

Plane Line
Set two points and the line will be shortened automatically. The distance to the Atlas
Plane Line will be shown in the raw data box.

Condylar Circle
Choose between the three point and four point Condylar Circle. The middle point will be shown. You can set
the calculated measurement manually to the value you prefer. The Relatoscope will use the shown value.

Axial Circle
The Body Center Line will be set automatically and the Axial Circle will be calculated and shown on the side of
laterality. You can set the calculated measurement manually to the value you prefer.

Circumscale and Grid

Activate the Circumscale or Grid template to double check the measurements of Condylar and
Axial Circle and to set the points of the Axial Circle properly.

Odontoid Center on Vertex

Mark the lateral aspects of the dens and the Odontoid Center Line will be inserted.

Vertex Square
After marking the C2 canal, the Vertex Square will be inserted and the Spinous value
will be calculated depending on the Condylar Circle.

Odontoid, Spinous and Relatoscope

Use the Relatoscope to apply the Spinous value from Vertex to Nasium View. Mark the lateral
aspects of the dens and the (corrected) Odontoid will be inserted automatically.

Lower Angle and Angular Rotation

The Lower Angle and Angular Rotation will be calculated automatically after setting the Inferior
Point. You can also set a corrected Inferior Point.

Intermastoid Line
Mark the inferior tips of the mastoid processes. The measured value, its orthogonal
divergence from the Central Skull Line, will also appear in the raw data box.

Vertex Atlas Line

After marking the transverse foramina of the atlas with three points each, we
will draw the Vertex Atlas Line and show the convergence of C1 and C2.

16
dicomPACS® Chiro tools for optimal diagnosis
12°

The Chiro Tools have been developed in cooperation with experts

from the US and Canada. They help to make an accurate diagnosis and
L: 8°
plan further treatment efficiently. After you select points of interest manually,
the tools generate automated center lines and points, defined curves,
angle measurements and much more for you. Of course all standard
tools are included, e.g. distance measurements, angle, Cobb angle and
mark spots.

Axis line
The tool creates a vertical or horizontal axis, depending on the direction,
in which the mouse pointer is moved.

Orthogonal line
This tool is used to mark perpendicular lines on existing or yet to be drawn baselines.
The divergence from the x/y-axis (nearer axis) is displayed by default.

Vertebrae line
This tool generates a vertical line of six points (2x3) along the spinal canal and displays
the lateral divergence and side of laterality in degrees.

George's line
This tool is used to draw vertical lines on each vertebra along the spine in a lateral view
and to calculate their distances (in mm or inch).

Horizontal or vertical level

This tool calculates the horizontal or vertical level. By default the nearer axis is used
for calculation.

Circumscale
An arc is drawn through three defining points and the diameter of the corresponding
circle is displayed by default.

Spinal curve
This tool is used to draw an arc in the lateral view of the spine. The annotation uses a
fixed radius set by default to 220 mm. Radius or degree can be adjusted manually. 17
d=4"

Center point
This tool calculates the center point between two points.

Distance comparison
This tool compares the distances between three set points (between point 1and
point 2 and between point 2 and point 3) and shows the larger distance.

Pelvic obliquity
This tool is a measurement that is calculated automatically after two simple
clicks which generate two horizontal lines showing the distance between these
two parallels.

Edit / combine annotations

You can change the appearance of each annotation individually as well as the
default. Annotations (points and measurements) can also be combined with 52.9mm

already drawn points and lines.

17
Special functions
for veterinary medicine

Digital X-ray images have the advantage that exact measurements can be taken
at the monitor and the image quality can be improved by a number of manipulations.
dicomPACS®DX-R now offers some special functions.

MMP (Modified Maquet Procedure)

The MMP (Modified Maquet Procedure) is a method of
measurement for dogs with a cruciate ligament disorder, in
which the distance for the placement of the MMP Wedge
is determined. Since angles and lines are calculated
automatically, determining the wedge size only requires
a few steps.
For this annotation we created an illustrated annotation
guide with a help text indicating the correct step-by-step
method of the measuring procedure. If lines or dots were
placed inaccurately, corrections can be made throughout
the measuring process by means of the Alt key.

HD measuring technique for dogs

Hip dysplasia (HD) as a progressive fault in the hip joint
is undoubtedly a common problem for the veterinarian,
especially because the larger races are affected by it in 108.85°

particular. X-ray examination is a reliable way of judging 105.07°

the severity of the condition. A precondition for a

meaningful diagnosis is the exact placing of the examined
animal in a supine position with parallel extended femurs,
the kneecaps turned in to line up with the direction of the
X-rays. Additional exposures can be made with the femurs
in a "frog position" or sideways (latero-lateral) to the X-rays.
The Norberg Angle is an important assessment criterion. It
is defined as the angle described between the centre of
the femur head and the front edge of the socket.

18
TTA (Tibial Tuberosity Advancement)
The TTA measuring technique for treating crucial ligament
ruptures in dogs is one of the numerous functions of
®
dicomPACS DX-R.
When applying TTA (Tibial Tuberosity Advancement) as
opposed to TPLO, osteotomy is applied to the non-load-
bearing part of the tibia. Accordingly, the TTA measuring
tool is used to apply the translated length measurements
at the tuberositas tibiae.
TPLO/TTA measurement

TPLO (Tibial Plateau Leveling Osteotomy)

It was necessary to implement this function, since crucial
ligament ruptures in dogs are increasingly treated by
changing biomechanics, using osteotomy – an operation
procedure involving precision cutting through the bone
and securing it in a changed position by means of plates
and screws, with a view to permanently correct
displacements. The TPLO measuring tool helps to TPLO/TTA measurement

determine the existing slope of the tibial plateau and its

theoretical optimization. The TPLO provides the surgeon
with a promising method to treat crucial ligament ruptures
in dogs, allowing the patient to walk again without any pain
within a short period after the operation.

Buchanan‘s Vertebral Heart Score

It has been designed specifically for cats and dogs. The
length and width of the heart are put into relation to the
individual animal’s vertebral body width. Therefore, racial
distinctions are brought to bear on the examinations results.
The Vertebral Heart Score (VHS) is measured by the long axis
(L) and the short axis (S) which are transposed onto the
vertebral column and recorded as the number of the
vertebrae beginning with the cranial edge of T4.

19
Special functions for veterinary medicine

Prosthesis documentation module

There are two options to plan an operation with
prosthesis templates:

1. Planning and / or documenting operations by digitised

prosthesis templates do not require a film identical image
display. The prosthesis template is simply selected from a set
of templates and displayed in the image as an annotation.

2. Planning with existing transparency prosthesis templates

(provided by the manufacturers) requires a film identical
image to be displayed on the monitor in the same size as
an equivalent analogue X-ray image on film.

Measuring the distraction index

The distraction index measures how loose the hip joints are
and is thus an important measuring instrument to assess hip
dysplasia.
The distraction index serves to determine the displacement DI: 0,035

of the femoral head from the joint socket of the hip joint.
This measuring function provides an easy tool for veterinary
medicine to assess this displacement.

Special filter for the optimization of bones

and soft parts
Image manipulation of conventional image processing
systems is usually limited to brightness / contrast (Window
level), dynamics or image sharpness. The disadvantage lies
in the fact that changes always affect the whole image. This
has the effect that special details do not become better
visible without changing the whole image. In addition the
manipulations do not accommodate the specific image
quality in different regions of the X-ray image. For the best
possible visualisation of details, the digital qualities of just
the Region of Interest (ROI) should be electronically
modified. Image copy with
Original image magnifying glass filter

20
21
Modalities ®
Which flat panels and CR systems does dicomPACS DX-R support?

dicomPACS®DX-R is a generally open system. Its conception and

development was independent of hardware manufacturers. Flat panels

Components from the following manufacturers have already been

integrated (We are continuously working on the integration of new
models and manufacturers): CareRay

PZMedical

VAR AN
medical systems

CR systems

Generator control
The generator screen displays all recommended values and settings (kVp,
mAs, focus etc.). These settings may be adapted to the system used. OEM device

22
 Extension ®
Options for upgrading dicomPACS DX-R

dicomPACS®DX-R may not only be used as a software for the acquisition

and processing of X-ray images, but can also be upgraded to a MiniPACS or
even to an Enterprise Multi Modality PACS. Thousands of installed workstations in
over 60 countries (as of 4/2014) prove that our customers are satisfied.

®
A single workstation system with installed dicomPACS DX-R software
can be upgraded with the following options (extract):

Further optional viewer functions:

May be installed on Apple MAC and Linux systems

Generation of full leg / full spine images (Image stitching)

Preparation of diagnostic reports with integrated images

in MS Word

Connection of several diagnostic monitors

Capturing additional patient and examination data and

freely configurable statistical analysis

Working with digital prosthesis templates for surgery

planning and documentation - Prosthesis templates can be
selected from a set and inserted into the image as
annotations

Additional radiological functions such as Maximum Intensity

Projection (MIP), Multiplanar Reconstruction (MPR), hanging
protocols and mammography tools

The stitching module merges a Fast and easy preparation of equine pre-purchase
number of separate digital X-ray
examinations with automatically inserted X-ray images
images into a single image. You can
load, correctly align and merge any (only for Germany)
number of original images.

And much more…

23
Extension
Upgrade to an integrated
multi-modality PACS

DICOM reception from any DICOM sources, e.g. CT,

MRI, scintigraphy, ultrasound etc

DICOM distribution with freely configurable rules

DICOM DIR import for archiving patient CDs by

other manufacturers

DICOM Query/Retrieve (SCP/ SCU)

DICOM Auto Pre-fetching

DICOM Print Server to convert DICOM Basic Print into

Windows print jobs

DICOM Compression according to freely

configurable rules

DICOM CD/DVD Backup Module, also via robot systems

Integration of film and document scanners

Digitalisation of standard and non-standard video signals,

e.g. endoscopy, angiography etc.

Fully automatic synchronisation of two image databases,

e.g. laptop and main archive

Exchange of images and diagnostic reports between

individual clinics by means of teleradiology

MobileView: distributes images within a hospital and

displays the images in a web browser

ORCA cloud based solution: enables worldwide image

distribution to referring doctors and patients via
the internet

24
Network overview

X-ray DR system

MRI/CT/NM CR system

Mammography Ultrasound/
endoscopy

Patient CD Image sources Mobile suitcase

writer

X-ray scanner
Video projector

Document
Image scanner
Laser printer dicomPACS R

displaying
Network Surgery
documentation
Laser imager

Picture archiving Jukebox

Viewing station
CD backup
system
Image viewing
Multi monitor Image processing
work station Archive server

Home Interface to
workstation HL7 / BDT

Diagnostic Telemedicine/
workstation web server
Version 007_07_2017

Portfolio Overview - products of OR Technology

DR retrofits - digital upgrade set for

existing X-ray systems incl. dicomPACS®DX-R
Medici DR Systems acquisition software, also available for stationary
and mobile X-ray machines

DR suitcases - compact suitcase solutions

®
Leonardo DR Systems for portable X-ray incl. dicomPACS DX-R
acquisition software

Complete digital X-ray systems (incl. stand,

®
bucky, generator, flat panel incl. dicomPACS DX-R
Amadeo X-ray Systems acquisition software etc.) as well as mobile and
portable X-ray solutions

CR solutions - CR systems for digital

Divario CR Systems ®
X-ray with cassettes incl. dicomPACS DX-R
acquisition software

Accessories for X-ray

X-ray Accessories (e.g. radiation protection walls, gloves etc.)

Image management (PACS) - comprises

dicomPACS R
acquisition, processing, diagnosis, transfer and
archiving of image material

Cloud-based archive solution - safe, long-term

archiving of patient data with intelligent usage of internal
ORCA databases, communication platform with colleagues and
specialists and transfer of image data to patients

dicomPACS R
DX-R X-ray acquisition software [only for OEMs] -
acquisition and diagnostic software for X-ray images
X-ray Acquisition Software from flat panels or CR systems

RAYTECHDIAGNOSTICS
https://www.raytechdiagnostics.com
[email protected]
613-799-4171