CTI2IL016 Family One – Operation Lab

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 Objectives
When you have successfully completed this lab, you will be able to:
• Explain the user interface layout
• Power up the system
• Warm up the X-ray tube
• Perform air calibrations
• Conduct a surview scan
• Plan a study and conduct Axial scans
• Conduct a Helix (Spiral) scan
• Verify operation of the ACS/DOM function
• Find, view and delete images from the home page
• Manipulate the images
• Perform a post-reconstruction
• Power down the system

Prerequisite Lessons
• System Introduction Lecture
• Safety Lecture

Tools/Reference Materials
• Access Dual/CT, MX16, Incisive CT Instruction for use manual

Time
2 hours

Introduction
The purpose of this module is to make the student familiar with the basic operation of the Access CT/DUAL, MX16
and Incisive CT systems. Refer to the correct CT system “Instructions for Use” throughout this entire lab.

The student will properly apply power up the system, warm up the x-ray tube, perform air calibrations, and
remove power from the system.

The basic system functionality is verified by performing scans to created surview, axial and helical images. This lab
allows the student to become familiar with the methods of image selection and manipulation on the CT systems.

During each of the following labs the students will properly power up and power down the system with a
functional scan at the start and end of lab to ensure the scanner is working.

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 Procedure Preview
In this lab exercise, the learner will perform:
• Power up and down the system
• Basic functional scan
• Image manipulation

Special Instructions/Precautions
<CAUTION:
Damage to the equipment and personnel can occur if you are not careful. If you do not know the outcome of a
motion before initiating, DON’T DO IT! Please seek help from the instructor if unsure.>

Instructions
Tube Warm Up/ Short Tube Conditioning

For Access and MX16 warming up the tube before performing a scan is called Warm Up (Dunlee Tube). Short tube
conditioning is the name used by Incisive CT (MRC tube)

1. Power up the system

2. Login as CT

Tube Warm Up

For Access CT/DUAL and MX16, tube warm up is mandatory:

1. Go to the processing screen by clicking the “Processing” button in the upper right of the
screen
2. Select the “Service” button
3. In the upper left, under the Tube Heat Caution box, on the “Daily” tab select “Tube Warm
Up” and click “Start”
4. Exit the warm up when complete.

For Incisive CT, short tube conditioning is highly recommended:

1. Select the “Service” button.
2. Select “short tube conditioning” and click “Start”
3. Exit the warm up when complete.

Question:
What is the tube heat after warm up?

Can you change this heat percentage when logged on as user CT? (Non-Service Mode)

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Page 3 of 18
 Air Calibration

Once a week it’s recommended to perform Air Calibrations. It

needs to be performed at the average room operating
temperature, like the middle of the day. Air calibrations are used
to compensate for different amplifications of the detector pre-
amplifiers.

Follow the operator’s manual to perform the air calibrations. To

reduce scan time, select one speed and 120 kV.

Question:
Can you perform specific calibrations for one protocol only?
If yes, how?

Surview Scan

The purpose of this step is to learn how to make a surview scan and plan a study using the
surview image.

1. Ask your instructor for a “Mystery Box” and put it on the patient table. Activate the laser
indicator.
2. Position the mystery box just before the inner laser.
3. Make a surview scan of the mystery box. The position of the patient table can now be read
from the gantry control panels.

Question:
What is the position of the patient table according to the gantry control panel?

Do not manually change the table position during this part of the lab.

4. Schedule a patient. Using the following information:

Patient ID: 111-Axial
Last Name: Box
First Name: Mystery
Gender: Male (check box)
The fields with the * are mandatory.

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 Question:
Why do we have to indicate how the patient is positioned on the table?

5. For Access and MX16 you need to press the arrow to go to the next screen for selecting a
protocol. For Incisive CT the protocol selection is done on the same screen. Select the “Brain
Exam (Ax)”
6. First perform the surview scan. On the surview image there will appear a blue box / window
which can be used to plan the scan.

Questions
What is the position of the X-ray tube during a 90 surview?

Look at the image, what do you think is inside the black box?

What is the default slice thickness for this protocol?

What is the default collimation for this protocol?

What is the meaning of the increment (mm) parameter and how much will the couch move
after the first axial scan?

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Page 5 of 18
 Planning a Scan

1. Click on the blue box / window displayed on the surview image.

2. Change the size and position of the box / window until the “Mystery Box” is completely
covered.

Question
How many images will be made to cover the complete “Mystery Box”?

What will change if you change the size of the blue box / window in vertical direction?

And what if it is changed in horizontal direction?

3. Change the default mAs value to 46 and execute the plan by pressing the green “GO”
button.

Questions:
How many images are made?

Did you discover any other items inside the “Mystery Box”?

4. We will now plan a second series of axial scans on the mystery box. The same surview will
be used. On Access/MX16 press the “Plan Scan Button” then the “Insert Protocol” Button
and then select the “Exam protocols” tab. On Incisive CT press the Insert Exam Card Icon.

5. Select the “Brain Exam. (Ax)” protocol, change the slice thickness to 5mm and increment to
10.

Question
What’s the meaning of the different colors used for the different protocols?

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 How many different slice thicknesses can be selected in this protocol?

At which couch position will the first scan be made?

How many images will be made to cover the mystery box?

What is the couch position for the last axial scan (calculate)?

6. Press “GO” and perform the scan.

Question:
What is the scan position after the scan series?

Is this the same as your calculation?

7. After the scan has finished, end the study.

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Page 7 of 18
 Helical (Spiral) Scan

The purpose of this step is to learn how to make a helical scan and to understand the meaning
of the different parameters used.

Make use of the Instructions for Use manual to make an abdomen helical scan.

1. Position the mystery box.

2. Register a patient using the following data:

Patient ID: Training_Spiral

Last name: Mystery
First name: Box
Gender: Female

3. Select the “Abdomen Protocol Group” and the Abdomen Exam Protocol.

Question:
How many procedures are in this examination?

4. Go to the next screen.

5. Make sure that the length = 400 and the couch direction is in line with the positioning of the
black box.
6. Change the mA to 30.
7. Execute the Surview scan. After the scan the image will be displayed and the blue box to
plan the helical scan is also shown.

Question:
What is the difference between a helical and an axial scan?

8. Adjust the blue box so that the complete mystery box is covered.

Question:
In this protocol what is the default setting for the pitch? What is the meaning of pitch?

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Page 8 of 18
 How many images will be made?

9. Go back and decrease the pitch.

Question:
Did the number of images change, and why?

10. Increase the pitch to default again.

11. Change the “Collimation” to 2*5, “Thickness” to 3mm. Under ‘Increment’ select
‘Continuous’.

Question:
Did the number of images change and why?

12. Change the thickness to 4mm and change the “increment” to 4mm.

Question:

Did the number of images change and why?

13. Leave the increment parameter on 3mm. If you change the length to 300mm the scan time
will also change.
14. Check your helical plan and see if it still covers the mystery box. Execute the scan as planned
and wait until all images are reconstructed. Later we will use this data for post
reconstructions and volume reconstructions. After all images are reconstructed, end the
study.

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Page 9 of 18
 Find, View and Delete image

1. After closing the helical study, you will see the Patient register page. On Access/MX16 click
the “Home” button on Incisive CT click Completed.

The following screen is used to find, retrieve and delete patient images and raw data on Access
and MX16.

Access/MX16

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Page 10 of 18
 Incisive CT
1

3
The right side of screen shows a window which is split up into three parts.

The first session allows you to see and choose different data storage devices available on the
system (1).
The second session contains the patient examinations (2).
The third session shows the series that were made during the exam (3). There are three tabs:
Series, Images and Reports. Selecting a series and then clicking on the image tab will show all the
images in that series.
Preview of the images can be seen in the lower right corner.
Explore the directory page and perform the following operations:

Questions:
Name different possibilities to store patient image?

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Page 11 of 18
 When copy Patient data to a CDR, which data (Images, Raw, or Both) will be copied to the CD?

2. Select an image series (not a surview) and press the ‘viewer’ button under the ‘Data
options’. For Incisive UI, select the image series and press the “review” button.
This action will load the series to the viewer and will show the review screen. The viewer
can be used to diagnose the images.
3. Look at the image and try to adjust the Window Width (WW) and the Window Level (WL).

Question:
How did you change the WW and the WL?

4. On the lower left of the screen there is a ‘Windowing’ section. Click on the ‘Modified>>’
button and select the ‘lung’ window.

Question:
How can you apply the ‘Lung’ Window on all the images?

5. Locate the Image Parameters button and view the Image information. For Incisive UI,
navigate to the Information list located at the top icon bar.
6. Exercise other options in the viewer.
7. Exit the review window.

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Page 12 of 18
 ACS & DOM Functionality

ACS (Automatic Current Selection) is a volume-based function that helps clinicians get
consistent noise characteristics for different sized patients.

C-DOM (Combined Dose Modulation) is a prospective scanning mode in which the X-ray tube
current is modulated according to patient’s size in both the rotation and Z directions, this
reduces streaking artifacts, and improves image noise consistency along the Z direction.

For Incisive, ACS and C-DOM are combined in 3D-Dose Modulation

This exercise demonstrates how to verify the modulations functions are working properly.

1. Position the non-linear phantom on the table top with use of the phantom holder.

2. Start a new study and select a Lung protocol. (surview and helical)
3. Perform the surview scan and make sure to capture the whole phantom + 5 cm overlap on
both sides.
4. Plan the scan and make sure of the whole phantom + overlap will be scanned and duplicate
this series.
5. Deselect dose modulation for the first series and check if for the second series the dose
modulation is activated.
6. Execute both scans. When the images are previewed pay attention to the mA values. The
first series should show a stable mA value through the slices. In the second series as the
phantom size differs the mA value will change.

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Page 13 of 18
 Archiving Images
Archiving images is done from the home page of the application software. For Incisive UI you
need to select the “completed” button.
The Dicom images, the raw data and the calibration tables are stored on the D and E drive of the
host computer. There is no automatic deletion of the Dicom images from the host computer.
Manual deletion of the Dicom images should only be done after they are archived. Archiving can
be done to a PACS system, CD-R, DVD or any other (correctly configured) device.
For this exercise we will archive patient data to a CD-R.

1. Go to the home page.

2. Right mouse click on a patient exam. It will give you a selection menu as shown in the
screenshot below:

Question:
What is the function of the “lock” button and can you lock individual series?

What is the function of the “Modify” or “Edit” button and which patient data can still be
modified?

Will the original data still be available after you modified the patient data?

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Page 14 of 18
 Is it possible to delete only the raw data and keep the images? How can you do this?

3. Use the “copy to” button to copy the images you made to CD-R.

Question:
Can you hide the patient information (anonymize) from the images being written to CD?

If no, is there another solution to anonymize patient data?

Export raw data:

4. You can export the raw data by Right click on the series list and select “Export Rawdata” to
service directory D:\Service\

5. Copy the raw data to a CD, DVD or any external storage device.

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Page 15 of 18
 Post Reconstruction
The purpose of this exercise is to learn how you can execute a post reconstruction from
available RAW data.

1. Navigate to the IRS data storage device. Before you can make a post reconstruction you
must have RAW data available on the host computer.

For Incisive UI you need to select the raw data tab in the completed window

Question:
How can you check if there is raw data available?

2. Select the Raw data for ‘training Spiral’ study. Click on the Recon button on left side of the
screen under ‘Recon’ section.
3. Change the following parameters:
Slices Thickness: 5mm
Increment: 5mm
FOV: 250mm
Metal Artifact Reduction: ON
4. Perform the reconstruction. After the reconstruction is finished, click ‘Exit’. This will bring
you back to the home page.

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Page 16 of 18
 Changing Users/ Logging Out

When handing over the system to the customer, it is very important to leave the service mode.
This will prevent the user to access windows operating system.
Leaving the system incorrect can be a system security and instability treat.
From being logged in as SERVICE, Log out from the HOME screen. Notice the system logs out
and leaves you at the service desktop, with multiple shortcuts to different tools, i.e. my
computer, backup/restore…
We DO NOT want to return the system to the customer in this state, with access to the desktop
icons. To leave the system at the correct point:
1. Launch the host application from the Icon on the desktop.
2. Log in as: philips_service, pwd: service_only
3. Navigate to > Service and select the “Switch User” button
4. Now login as user: CT
5. Navigate to the Home screen and logout from the application.

Notice on the desktop; only the START button in the lower left corner and a system Icon is
available.
After every service call, leave the system in this state before you turn it over to the customer.

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 Additional Information
<For further information about the topic, read/do….>

Content Change Summary

Revision Date Modified By Revision Summary

(dd-MMM-yyyy) (Name)
05-DEC-2019 Frank Broeders Initial release

Template Change Summary

Revision Date Modified By Revision Summary Approver Name

(yyyy-MMM-dd) (Name) & Date (yyyy-MMM-DD)
Initial Release
2015-JAN-01 D. Preston Changed copyright year to 2015 G. Argento 2015-JAN-01
2015-SEP-18 G. Argento Changed this column’s title G. Argento 2015-SEP-18
2016-JAN-06 D. Preston Changed copyright year to G. Argento 2016-JAN-06
2016
2016-NOV-23 G. Argento Changed copyright year to 2017 G. Argento 2016-NOV-23
2018-MAY-09 D. Preston Changed copyright year to 2018. Sue Hove 2018-May-10
To comply with GCS-ED-PR-00003:
Added “Content Change Summary”
table; changed this table to
“Template Change Summary”;
changed date format to YYYY-MMM-
DD; updated table headers. Changed
<Insert module title> to <Insert
Course code and title>. Deleted
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statements and made footer
applicable to all pages.

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