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GE Medical Systems
Technical Publication Direction 2243321-100 Revision 10 LightSpeed 2.X Application Tips and Work-Arounds
Copyrighted © by GE Medical Systems, 2003
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DAMAGE IN TRANSPORTATION All packages should be closely examined at time of delivery. If damage is apparent write “Damage In Shipment” on ALL copies of the freight or express bill BEFORE delivery is accepted or “signed for” by a GE representative or hospital receiving agent. Whether noted or concealed, damage MUST be reported to the carrier immediately upon discovery, or in any event, within 14 days after receipt, and the contents and containers held for inspection by the carrier. A transportation company will not pay a claim for damage if an inspection is not requested within this 14 day period. Call Traffic and Transportation, Milwaukee, WI (262) 785 5052 or 8*323 5052 immediately after damage is found. At this time be ready to supply name of carrier, delivery date, consignee name, freight or express bill number, item damaged and extent of damage. Complete instructions regarding claim procedure are found in Section S of the Policy And Procedures Bulletins. 14 July 1993. CERTIFIED ELECTRICAL CONTRACTOR STATEMENT All electrical Installations that are preliminary to positioning of the equipment at the site prepared for the equipment shall be performed by licensed electrical contractors. In addition, electrical feeds into the Power Distribution Unit shall be performed by licensed electrical contractors. Other connections between pieces of electrical equipment, calibrations and testing shall be performed by qualified GE Medical personnel. The products involved (and the accompanying electrical installations) are highly sophisticated, and special engineering competence is required. In performing all electrical work on these products, GE will use its own specially trained field engineers. All of GE’s electrical work on these products will comply with the requirements of the applicable electrical codes. The purchaser of GE equipment shall only utilize qualified personnel (i.e., GE’s field engineers, personnel of third-party service companies with equivalent training, or licensed electricians) to perform electrical servicing on the equipment. IMPORTANT...X-RAY PROTECTION X-ray equipment if not properly used may cause injury. Accordingly, the instructions herein contained should be thoroughly read and understood by everyone who will use the equipment before you attempt to place this equipment in operation. The General Electric Company, Medical Systems Group, will be glad to assist and cooperate in placing this equipment in use. Although this apparatus incorporates a high degree of protection against x-radiation other than the useful beam, no practical design of equipment can provide complete protection. Nor can any practical design compel the operator to take adequate precautions to prevent the possibility of any persons carelessly exposing themselves or others to radiation. It is important that anyone having anything to do with x-radiation be properly trained and fully acquainted with the recommendations of the National Council on Radiation Protection and Measurements as published in NCRP Reports available from NCRP Publications, 7910 Woodmont Avenue, Room 1016, Bethesda, Maryland 20814, and of the International Commission on Radiation Protection, and take adequate steps to protect against injury. The equipment is sold with the understanding that the General Electric Company, Medical Systems Group, its agents, and representatives have no responsibility for injury or damage which may result from improper use of the equipment. Various protective materials and devices are available. It is urged that such materials or devices be used. OMISSIONS & ERRORS Customers, please contact your GE Sales or Service represenatives. GE personnel, please use the GEMS CQA Process to report all omissions, errors, and defects in this publication.
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LEGAL NOTES COPYRIGHTS All Material Copyrighted(c) 2003 by the General Electric Company, All rights reserved. REVISON HISTORY Revision
Date
Reason for change
0
10/13/00
9.3_2.8.2I_H2M3_H1.3M4 Pilot Release
1
12/8/00
11.3_2.8.2J_H2M3.1 Pilot Release
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3/22/01
12.2_2.8.2K_H2M4 Release
3
5/3/01
13.16_2.8.2L_H2M4.1 Release
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8/7/01
14.11_2.8.2L_H2.1M4 Pilot Release
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8/24/01
14.13_2.8.2L_H2.1M4 Release
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10/30/01
14.13_2.8L_H2.1M4 + patch ver1.sw.mobile Release
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11/5/01
2.2m3.11c_2.9E_1.1_20011011_H2.2M4 Release
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6/20/02
2.3.3_H2.3M3+Patch
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10/31/2002 2.3.7_H2.3M4 Release
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11/14/2003 2.4.2_H2.4M5 + patch
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TABLE OF CONTENTS Legal Notes...5 Table of Contents ...7 New Features Version 2.4.2_H2.4M5 Software...10 SOFTWARE VERSION ...10 CHANGES TO SHUTDOWN ...10 REPEAT SERIES ...10 AUTO MA ...11 PROVIEW ...11 LOW SIGNAL CORRECTION ...12 AUTO TRANSFER ...12 ANONYMOUS SCAN DATA SAVE ...12 IMAGE ANNOTATION ...13 CUSTOM ANNOTATION ...13 New Precautions 2.4.2_H2.4M5 ...15 SYSTEM ...15 SCAN ...15 TUBE W ARM UP/FAST CAL ...16 PERFORMED PROCEDURE STEP (PART OF CONNECT PRO OPTION) ...17 PROTOCOL MANAGEMENT ...17 SMARTPREP (PURCHASED OPTION)...17 RECONSTRUCTION ...17 RECON MANAGEMENT ...18 DISPLAY (APPLIES TO BOTH IMAGE W ORKS AND EXAM RX DISPLAY)...18 IMAGE W ORKS DISPLAY ...18 EXAM RX DISPLAY ...18 VARIVIEWER ...19 DIRECT3D - OPTION ...19 REFORMAT...19 CT PERFUSION 2 ON OC – PURCHASED OPTION ...20 ADD SUBTRACT ...20
ARCHIVE ...20 FILMING ...20 NETWORK ...21 IMAGE MANAGEMENT ...21 LEARNING AND REFERENCE GUIDE ...21 7
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Legacy Precautions ...23 SYSTEM ...23 TUBE W ARM UP/FAST CAL ...24 SCAN ...25 PROTOCOL MANAGEMENT ...27 SMARTPREP – PURCHASED OPTION ...28 PATIENT SCHEDULE ...28 CONNECTPRO (PURCHASED OPTION) ...28 PERFORMED PROCEDURE STEP (PART OF CONNECTPRO OPTION) ...29 RECONSTRUCTION ...29 RETRO RECON ...30 RECON MANAGEMENT ...30 VARIVIEWER ...31 SMARTSTEP – PURCHASED OPTION...32 DIRECT3D – PURCHASED OPTION ...32 CT PERFUSION 1 ON OC – PURCHASED OPTION ...33 CT PERFUSION 2 ON OC – PURCHASED OPTION ...33 SMARTSCORE PRO – PURCHASED OPTION ...33 CARDIAC SNAPSHOT – PURCHASED OPTION ...33 AUTO TRANSFER ...34 DISPLAY ...34 EXAM RX DISPLAY ...35 IMAGE W ORKS DISPLAY ...36 EDIT PATIENT DATA...37 3D/NAVIGATOR/DENTASCAN/ADD/SUBTRACT ...37 ADD/SUBTRACT ...37 REFORMAT...37 FILMING ...38 ARCHIVE ...39 NETWORK ...40 IMAGE MANAGEMENT ...41 MOBILE ...42
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NEW FEATURES VERSION 2.4.2_H2.4M5 SOFTWARE SOFTWARE VERSION LS2002M5 – This release of software contains fixes to address a number of issues that were reported on the LS2002M4 release concerning reconstruction retires for Scout images, intermittent loss of alignment lights and prescribed tilt capabilities, Show Localizer not displaying or having a mismatch, ScanRx shutdowns, AutomA changes to improve reliability, image quality fixes for ring artifact with Bone and Bone Plus algorithm, improved availability of images in the AutoLink viewport. There are some new features as well as enhancement to existing features.
CHANGES TO SHUTDOWN Shutdown - When shutdown is selected, you will be presented with 2 choices Restart or Shutdown. Restart shuts the system down and then automatically restarts the system. You no longer need to “Press any key to restart” the system. Shutdown brings the system down to the power off prompt. When shutdown is selected, you can to cycle power to the operator console to reboot the system.
REPEAT SERIES Repeat Series - Additional functionality for Repeat Series has been added for this release. Repeat Series now allows you to choose any series that has been scanned. When more than 1 series has been scanned a list of all scanned series will be displayed. Click on the series that you wish to repeat. If only one series has been scanned, Repeat Series will not display the Repeat Series menu.
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AUTO MA AutomA - changes have been made to the user interface to simplify the selection of parameters.
Reference Noise Index
Default or baseline Noise Index for the given protocol. Any changes to Dose Steps, Slice Thickness or Noise index are referenced to this value. This value can only be defined while in Protocol Management.
Noise Index
The noise level required for the study. As the Noise index increases the required mA decreases and image noise increases.
Dose Steps
Adjusts Noise Index by steps of 5%. Dose steps can be increased or decreased + values decrease image noise thus increasing required mA. Minus values increase Noise index, thus decreasing required mA. A Dose step value of 0 indicates that the prescribed Noise index is equal to the Reference Noise index for the protocol.
Reset
Resets the Reference Noise Index to the GE Target Noise Index Default for the anatomical area and slice thickness chosen in the protocol
PROVIEW ProView Filters – the number of filters have been expanded. For Edge, the filters E21, E22, E23 have been added for finer control for edge enhancement factors. For Smooth, the filters S11, S21 have been added for finer control for smoothing factors.
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LOW SIGNAL CORRECTION Advanced Artifact Reduction – low signal reconstruction correction has been updated for this release. A reduction in streak artifacts through shoulders and hips should be seen.
AUTO TRANSFER Auto Transfer - by image has been enhanced to transfer images in larger groups. This provides more efficient use of system resources while Auto Transferring by image. Auto transfer by image will transfer the first 50 images in 2 groups of 25, after that images will be transferred in groups of 50.
ANONYMOUS SCAN DATA SAVE Anonymous Scan Data Save - The system now provides the ability to save scan data with patient identifying information anonymized. This has been added to address HIPAA concerns about patient confidentiality. Scan files (raw scan data) saved anonymously and then restored will reconstruct with patient identifying information removed. The Patient Name and ID will be anonymized. Select Recon Management Select Save Scan Data Select Save Selected Anno. Data to save scan files as anonymous data.
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IMAGE ANNOTATION Accession Number – Image annotation field Req No.: has been replaced with annotation which more appropriately identifies it as the field for the accession number entered on the New Patient screen. The annotation on the image is Acc No.:.
CUSTOM ANNOTATION Custom Annotation – has added an additional custom annotation field for Accession Number. Selecting group 17 will allow the user to enable or disable display of the Accession Number field on the monitor or on film.
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NEW PRECAUTIONS 2.4.2_H2.4M5 SYSTEM The scan hardware may fail to reset on reboot. Select Service Desktop, System resets, Scan, Run to reset the scan hardware. If the reset still fails, then shutdown and reboot the system to recover. The system may not show typed information on the New Patient or ViewEdit screen. The system will update after a short time. The system may be slow to respond to keyboard entry and mouse clicks. If the system fails to respond stop and let the events catch up. The first character in the Exam description may not be shown in the text field but is shown in the Browser description.
SCAN Show localizer does not show the Scan Field of View when prescribing scans. When scanning head studies, verify that you have your patient centered at ISO center to assure that the entire head is included in the SFOV. Show Localizer may fail to display. If toggling the Show Localizer button does not display the scout, then display the scout in a free viewport and use Report Cursor to find your scan locations and A-P and R-L centers, manually enter these on the ViewEdit screen. Show Localizer may remove the localizer lines when page down or page up is selected and will not advance to the next scout. To recover from this, toggle Show Localizer off /on. If Scout Image 2 is displayed use Page Up, to go to scout image 1 use Page Down. Show Localizer may display a scout from a previous patient along with the current exam scout. Even though this scout is displayed, the scan prescription lines will not be shown on this scout. The Show Localizer button may get in a stuck state and not display a scout image if the last scout scanned has an azimuth other than 0, 90, 180, 270. Manually display a scout in a free viewport and user report cursor to find your scan locations and then manually type in the Start and End location, RL and AP Centers as desired. A scan abort may occur between 2 scan groups with gating enabled. To avoid this prescribe the shortest delay possible. Auto Voice may fail to play for prescriptions with 2 groups and Auto mA enabled or with manual mA when the mA changes between the groups. An Auto Voice has failed to play message will be posted on the right monitor is the message area on the upper left of the right screen. The pause button on the screen in Tube warmup does not function. Use the stop scan button on the SCIM. You may be prompted to run DAS gain cal prior to starting Fast Cal. The system may not allow changing of the landmark even though no scans have been taken in the series. A landmark that is set at the edge of the scannable range most often causes this. To reset the landmark, choose Select New Protocol. Always verify the mA table prior to scanning when using Auto mA. The dynaplan screen may fail to update is selected during scanning.
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Scan continued S Auto mA may set the min and the max value to 10 when selecting a protocol or adding a group. Always verify the mA tables prior to confirming the scan to verify the mA values in the table are reasonable for the patient being scanned. If the values do not look reasonable select the mA button and verify the Auto mA parameters. S Auto mA may show the max mA from a previous group instead of the max mA prescribed. Always verify that the max mA parameters are correct before confirming a scan. S Auto mA may set the Max mA to 50. Always verify the mA table prior to scanning.
The gating button may turn red when the patient experiences a big jump in heart rate such as in a PVC. The system usually will recover and read the signal. Sometimes you may have to toggle the gating button Off/On to get the heart rate signal synched again. Care should be taken in starting the scan if the patient continues to have PVC’s The cut lines in Show Localizer and in Cross Reference in the vertical presentation appear multicolored on the monitor. The lines are a solid color when printed on film or screen saved. Heart rates of greater than 120 are not valid for prospective gating for SmartScore acquisitions. The system will not stop scanning if the heart rate exceeds 120 BPM; however if the user observers higher than acceptable heart rates, they should pause the scan and resume when heart rate is in a valid range. The Start/End locations and Gantry Tilt fields may show strange characters when |Add Group| is selected quickly after |Show Localizer| is selected and a Direct Vis application (Direct 3D, VariViewer) is enabled for the series. Wait until the localizer is displayed before performing any edits for the series. Scan Abort may occur if firmware detects the Axial drive not ready. Select Resume and continue. AutoVoice may fail to play if the table is moved between groups where a long group delay has been prescribed. Alignment lights may fail to turn on. Perform a system reset. If alignments lights still fail to turn on. Shut the system down and turn off power at the main breaker and then restart system. Show Localizer may remove the slice lines when page down or page up is selected and may not advance to the next scout image. To recover, toggle Show Localizer off / on. System performance may become slow if the optimize screen for mA is left open. Make selection in the optimize pop-up screen and then close the window by clicking on Optimize button. Selection of up front delay in Optimize is very slow, it may take 10-20 seconds for the system to respond. Add group may not work. Try selecting One More and changing the number of slices to desired number. In GraphicRx, it maybe difficult to select a group that is inside the range of another group. Select group on the ViewEdit screen to make that group active in Show Localizer. If you have two protocols within the same exam that have different patient positions, the system may not move to the correct start location for the series with changed patient position. If patient position is going be changed in regards to head first verses feet first, please start a new exam.
TUBE WARM UP/FAST CAL S Fast Cal may give error that Collimator Cal failed. Resume Fast Cal and contact GE Service.
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PERFORMED PROCEDURE STEP (PART OF CONNECT PRO OPTION) S The PPS server may stop and fail to send the request. You may have to select Complete multiple times
to get the series to update to the complete state. S Add Sub does not update images for PPS correctly
Perfusion2 will not launch if images contain PPS information. If the total number of prospective images in an exam is greater than 2500, PPS may fail to complete.
PROTOCOL MANAGEMENT The Dose information in protocols used from Most Recent does not reflect the dose actually used for the protocol. If the protocol contains manual mA, retype the mA value to update the dose display. If Auto mA is used, the dose will not be reflected in Protocol Management, but will be updated at scan time for the patient being scanned based off a valid scout image.
SMARTPREP (PURCHASED OPTION) SmartPrep may fail to confirm to take the baseline image. Try confirming again, if this does not clear the problem then a system reboot will be needed to get SmartPrep working again. The SmartPrep baseline image may fail to display even though it is recon’d and in the database. Go back to ViewEdit and rescan the baseline image to continue.The Monitor phase image and graph information will not update if the table height has changed from the Baseline to Monitor phase. Do not change the table height after the baseline scan has been taken to avoid this. When transitioning to the Scan Phase from Monitor phase if the XR Auto View layout is selected the upper left viewport will be black. Move your mouse cursor over the viewport to redisplay the image.
RECONSTRUCTION Streak artifacts may be seen in images when a tube spit has occurred. Image recon may fail and then shutdown. Select Recon Management, select Pause queue, Restart queue, if this does not restart recon then a Restart of the system will be needed. Cardiac recon modes of Burst 2 or Burst 4 cannot be selected via column edit. Please select the individual row to edit recon mode selection. The dynaplan screen may fail to update if Priority Recon is selected during scanning Anatomy scanned off center from ISO center such as extremities, may have loss of resolution when data is acquired helically. Always make sure to center to anatomy of interest as close to ISO center as possible. Cine acquisitions may have retries or image suspension. Unsuspend images in recon management.
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RECON MANAGEMENT Scan File save is not complete even though the Saved File message has been posted. The problem is due to the time it is taking to unmount the MOD. You may have to wait 5-7 minutes for the MOD to unmount. The write light on the MOD will be green when the MOD is unmounted Scan Files restored from a different system will be reconstructed using the product name of the system it is 16 restored on. For example, restore scan files from a H1 SDAS QX/i or a H2 SDAS Plus to a LightSpeed 16 and the product name on the images will be indicated as LightSpeed instead of LightSpeed QX/I or LightSpeed Plus. All other patient and parameter information is correct.
DISPLAY (APPLIES TO BOTH IMAGE WORKS AND EXAM RX DISPLAY) An active user annotation graphic will not film the box or arrow that is displayed on the screen. Font size for the ROI Text Page is smaller compared to prior release of software.
IMAGE WORKS DISPLAY The primary focus may change if the space bar is selected multiple times when entering accelerator line commands. Verify that primary focus is on the image desired. The Accelerator Line is a dark green in Image Works instead of a light green as on the ExamRx desktop. It is active and will accept commands. When changing from 3D to Navigator, sometimes the threshold value is automatically set by the system and the user is unable to change it.
EXAM RX DISPLAY The Trackball may fail to initialize properly at system reboot. Try rebooting the system again to recover The Icon for paging/WL and Auto Link is not visible Display windows may display on the left screen instead of the right. This will most often occur when switching desktops rapidly. A system reboot will be needed to recover. Pressing page up 2 times causes the ww and wl to change on the scout on it’s own. Readjust the ww and wl to continue. The first time the trackball is used for paging after a system reboot window level will be changed instead of paging the images even though the P icon is displayed. Click once to switch to W mode then click again to place the trackball in paging mode. The AutoView or Auto Film viewport may display a very magnified image. This image may be filmed in Auto Film. Review your films and verify that all filmed images look correct. Viewport format may not be able to be changed and requires switching layouts to correct. This occurs if F3 or Shift F3 is used for filming and next image is used. The viewport format is now locked. You will have to switch to another review or Auto View layout to correct. MIROI may fail to produce a graph if next/prior is selected while creating the ROIs. Redisplay the series and begin again. Cross Reference image may not print sometimes instead the last image will be printed twice.
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VARIVIEWER Batch film may fail after a system reboot if the format selected is different than the default film format on reboot. An error dialog will be posted informing you of the error. You may have to select filming multiple times to successfully send the request. If the scout is taken after the series used for VariViewer operation, the system may be unable to find the scout for graphic batch prescription. Manually enter the range for the batch prescription. Any zoom applied to a Variviewer image is not maintained as you page through the images. VariViewer session may not be able to be started if there are multiple Pause scans during the acquisition of data. VariViewer is not compatible with a gantry tilt. Switching back from a 768 viewport is VariViewer causes the VariViewer viewport to be forward instead of the Auto View viewport. Use the page turner to toggle back to the auto view Viewport.
DIRECT3D - OPTION Batch film may fail after a system reboot if the format selected is different than the default film format on reboot. An error dialog will be posted informing you of the error. You may have to select filming multiple times to successfully send the request. 768 image size may display split in 2 if resize is selected with the Auto View viewport forward. Always have the Direct3D viewport forward when selecting resize. To recover from this problem select resize twice. If you resize the viewport in Direct3D, the image may not initially be displayed. User the Page Turner in the lower left corner of the viewport to toggle to the time. The Direct3D model may not initially build properly. Enter Interactive Review and re-render the model and then the model will build correctly. The Save State, which allows the user to rebuild the Direct3D model on the AW using the VR algorithm from D3D, does not work on the OC even if Volume Viewer is installed. The user will get an error message informing that the images are missing.
REFORMAT Reformat will only allow filming in Batch to the first 30 cameras in the list. If another camera is desired save the batch images to disk and use Print Series to film the images. Images saved from batch mode may appear to have jagged edges or not have optimal Image Quality. Manually save the images to improve image quality. Large image series may fail to load when using Reformat detail. This can be caused by small spacing interval between images or image sets greater than 1000 images. Select a sub set of images if this occurs or use Reformat Standard to build the model. A series that has more than 1 group with 0.625mm slice thickness will fail to load for reformat or will fail in Volume rendering on the AW. This is due to a mismatch in the spacing between the groups. To avoid this have only one scan group if possible, otherwise selectively highlight the images from the first group for Volume Analysis.
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Reformat continued Sagittal images created from a head first prone data set scanned in the direct coronal position will appear elongated.
CT PERFUSION 2 ON OC – PURCHASED OPTION S Computation of perfusion maps and automatic detection of the artery or vein may not function when the data displayed in Perfusion is initially black and the WW and WL values need to be set to large negative values (WW 40, WL –1020) to make the images viewable. The threshold should be set to the maximum negative value for air to assure that automatic detection of the artery and vein and that Perfusion maps are displayed correctly. S Perfusion will not launch if the images contain PPS information. S Saving TIFF files of the graph and images is not supported because there is no floppy drive hardware available on the OC. S Set the color ramp to gray scale for screen saves images if you are going to network the images to another station such as PACS to improve quality of the screen save.
Initially as CT Perfsuion2 is loading, you may see garbage flash along the left side of the screen. Processed data does not display if New Protocol is selected within Perfusion2. To avoid this always close Perfusion2 before selecting a new protocol.
ADD SUBTRACT Comb images will not contain the e/s/i used for the added image.
ARCHIVE Even though the Sony MOD drive states that it is a 5.3 gb drive. The archive software only supports a maximum size of 2.3 gb. 2.3 gb 512 bytes per sector is the preferred archive media size to utilize on the system. Archive may fail and slow the system when more than 200 images are queued by image. Try to archive by series if possible to avoid this. The system may report that the media is full even though the media has just been labeled when Save by image is selected. Try selecting a smaller range of images to avoid this.
FILMING Image setting such as WW WL and flip rotate, zoom, roam are not maintained across all images when imitating F4 print series from a MID Viewport format. Use a 512 size viewport to initiate F4 Print Series.
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