Echo viewer

Intended Use & Indication of Use

The Aware MD Cerebrum DICOM Viewer II is intended for viewing of DICOM images acquired from DICOM compliant medical imaging systems when installed on a suitable computer platform. Images and data are displayed by the viewer in color or greyscale mode. The Viewer can be used as a standalone application or as HTML embedded control.

The linear and area measurements and angle measurements are derived from DICOM data provided by medical imaging systems in the DICOM file. DICOM store component of the Cerebrum Viewer II is intended to receive and store the DICOM files received from DICOM compliant medical imaging systems. Modality worklist component of the Cerebrum viewer II is intended to receive and process DICOM queries from a DICOM Modality Worklist User.

Device Description

The Aware MD Cerebrum DICOM Viewer is a multimodality viewer with additional special cardiology features such as ability to show multiple playing cine loops of echo and stress echo tests together with embedded ECG data. Special mode for stress echo viewing is available allowing the comparison of corresponding slices before and during exercise on the same screen. A special cardiology measuring package is available together with regular measurements. The standard set of image post processing tools is available such as windowing, zooming, rotating, panning, flip, magnifying glass, sharp filter, and edge detection filter.

The device can be used as stand alone or HTML embedded web viewer. Images can be loaded directly from the computer disk or via HTTP/ HTTPS protocol. DICOM store component of the Cerebrum viewer 2 receives and stores the DICOM files received from DICOM compliant medical imaging systems. Modality worklist component of the Cerebrum viewer 2 receives and processes DICOM queries from a DICOM Modality Worklist User.

General Overview

Thumbnails of all available cine loops and still images are displayed on the right-hand column, to select a specific image/cine loop, double click on the desired thumbnail for viewing.

Thumbnails selected for viewing will be highlighted in green. To move from image to image, use the “Next” and “Previous” icon buttons.

Alternatively, one can use a mouse wheel to scroll up and down and cycle through "next" and "previous" images. The mouse must be on the thumbnail portion of the screen to use this function.

• The “options bar” is located to the right of the image thumbnail column.

• Displayed on screen, the viewer will show patient's name, exam date, heart rate, ECG, and frame rate (all imbedded into the original DICOM image).
• Color scale is also present if viewing an image in color.
• Loops will begin playing immediately.

Zoom and Video Speed Adjustment

Zoom Adjustment

To zoom in or out (different than the magnifying glass feature “MagGlass”), select the area of interest with the pointer, hold the right click mouse button, and move cursor up for zooming in, and down for zooming out. The adjusted zoom ratio will appear in the bottom right corner of the DICOM Viewer in real-time as adjustments are made.

The zoom function can be used simultaneously alongside the other functions and features.

Cine loop Speed Adjustment

The slider located at the top right portion of the screen allows the user to manually adjust the viewing speed on cine loops. Adjusting it to the far right will increase the speed, while adjusting it to the far left will decrease the speed.

To play cine loops frame by frame, click "Stop" button and adjust accordingly using the mouse wheel. Mouse must be on the image portion of the screen for this function.

Multi-Display Mode

By default, the DICOM Viewer is preset to view one image/cine loop at a time. 1,2,4, 6, etc. images/cine loops can be displayed on the same screen simultaneously, if desired.

The “multi-display mode” option is accessed by clicking the icons located directly underneath the “Previous” icon.  Clicking the “Next” and “Previous” icons will cycle through additional images/cine loops in the displayed order of the thumbnails while in multi-display mode.

Edge Function

The “Edge” function helps highlight the edges on the image/cine loop. Select the “Edge” button in the options to use this function.

Sharp Function

Sharpens the currently selected image/cineloop. To use the sharpen image function, select “Sharp” in the options bar. The sharp filter will automatically be applied to the entirety of the image.

Reset Function

Resets image/cine loops to default position, and removes any changes made with option functions. Select “Reset” icon in the options bar.

Windowing Function

To adjust the brightness/contrast of the selected image/cine loop, select the “Windowing” icon in the “options bar”.

While holding left mouse button, move the mouse to the left and right to change the contrast, or up and down to adjust the brightness to the desired level. The adjusted Window Width (contrast) and Window Centre (brightness) figures will appear in the bottom right corner of the DICOM Viewer in real-time as adjustments are made.

Windowing Advanced Menu

Allows user to choose windowing parameters manually.

Once selected, a new window will appear (as shown below):

The populated menu will show the settings of the original image as well as allow the user to input specific values for the window width and center settings. Selecting "CT Ranges" will open up another menu with pre-set values for selection.

MagGlass (Magnifying Glass) Function

The magnifying glass function allows users to magnify specific portions of the image/cine loop in the DICOM viewer. To use the magnifying glass function, select “MagGlass” in the “options bar”.

Once selected, to adjust the dimension of the magnifying glass simply click and hold the right mouse click button- adjusting the vertical dimension by dragging the cursor down, and the horizontal dimension by dragging the cursor to the right. Hold the left click button to adjust placement of magnifying area. To remove the magnifying glass (MagGlass) feature, simply double click on the MagGlass icon.

Gamma Function

Gamma function is similar to Windowing function- however it increases the contrast in a non-linear fashion (as opposed to Windowing which does so in a linear fashion). To use the Gamma function, select “Gamma” in the “options bar”. Press it again to deselect.

Measure (Measurements) Function

To use the measurement function, select “Measure” in the “Options bar”. A pop-up box will appear with “Line”, “Line Smart”, “Velocity”, “Area”, “Angle”, “Area Auto” and “Cancel/Close” icons as selectable options.

Line

To measure the distance of a specific area left click and drag from one end of desired area to be measured to the other.

Area Measure

To take an area measurement of the structure in the selected image/ cine loop, left click and hold the left-hand mouse button, while moving the mouse to outline the borders of the area to be measured.

Angle

To take an angle measurement of the selected image/cine loop within the DICOM Viewer, left click and draw the first line of the angle, left click once more to finish the angle. Angle measurements are taken in real-time as adjustments are made before deselecting.

To remove any measurement from the screen, simply right click on the measurement and select “Delete” option.

Measure List Function

Keeps a list of all measured values by user for reference.

TGS Function

The TGS function allows for specific windowing adjustments to be made on selected portions of the image. To use the TGS Function, select the "TGS" button on the "options" bar.

Once the "TGS" function has been selected, place your mouse cursor over the desired portion of the image you would like to adjust, then click and hold the left mouse click button and drag the cursor left to right. As you drag and move your cursor, the values shown in the bottom right will indicate the changed windowed values of that portion of the image.

Pan Function

The “Pan” function allows dragging the image or cine loop as a whole to the desired area.

Rotate Function

Rotates the image/cine loop 90 degrees clockwise. To use the rotate image/cine loop function, select “Rotate” icon in the options bar. Clicking the “Rotate” icon will continually rotate the image/cine loop 90 degrees clockwise as desired.

Flip V (Vertical Flip) Function

Flips the video/cine loop vertically. To use the vertical flip image/cine loop function, select “FlipV” icon in the options bar.

Flip H (Horizontal Flip) Function

Flips the video/cine loop horizontally. To use the horizontal flip image/cine loop function, select “FlipH” icon in the options bar.

Autofit Function

Once selected, it automatically fits the image/ video to the window/screen size.

Note: this button is preselected by default. You may unselect it if required.

About button

When the “About” button is clicked, it opens a pop-up window with information relating to the DICOM viewer.

CD function

The CD function can be used to export the images to a CD/USB/PC. On the DICOM Viewer, click “CD” option.

On the window, select "USB/Disc" option. Click three dots button besides Path to Write and select an existing folder or you may make a new folder for the images.