# Presentation: 364430

## 313HP1 – VistARad for VI Coordinators

- VistARad It’s in Your Hands

## Order of program

- Welcome and introduction of speakers
- Presentations:
- VRad Templates/Hanging Protocols Implementation
- Gerald Perry
- Practical Setup and Creation of Standard Protocols
- General Radiology, US, CT, MRI
- Peter Rosenthal, MD

## General Radiology Hanging Protocol

## General radiology HP

| CURRENT EXAM  | COMP  1  |  COMP  2 |
| --- | --- | --- |
|  | free   | Comp 3 / free |

- Preview the comparisons, then
- Double click on preferred comp >>

- All ports are stacks

## General Radiology

- The users should already have placed the manager, preview and scout view port on the monitor designated for control functions.  They may already have opened some of the system protocols.  This sequence creates a template and protocol for reading general radiology exams with 2 or 3 prior exams, and space for an additional comparison.
- Set the workstation to operate with 2 active viewing monitors:

## Create a Template

- Create template:  click on customize button
- Click on Create
- Leave left monitor blank
- Left click on reading surface of right monitor, and drag to highlight 4 spaces (2 x 2) on the grid.   This creates 1 on 1 on left monitor, 4 on 1 on right monitor
- Click on save:
- Enter name of template:  “GEN RAD 1L4R 8-07”, and enter
- Close the template creation view.

## Filling in the Template Model

- Go to manager window – find a case to open.
- Make sure the check box in left mid panel of manager window is not checked
- Highlight desired exam and select “open with”
- Find your templates in the menu, and select “GEN RAD 1L4R 8-07”.  Case will load to preview window.
- Click on the master image, extreme left, in preview window, and drag this to the left monitor – it should show there.

## Activating Comparison Exams

- Look for at least 2 comparisons in the patient list.  Double click each one.
- Click and drag the comparisons to the upper left and right ports of the right monitor.
- Run through each image set with mouse wheel.  Adjust windows orientations.

## Create Hanging Protocol

- To create hanging protocol,
- -	Click on “customize” and “create hanging protocol”.
- -	Follow options in the pop-up window, beginning with current exam, then with comparisons.   Select options as directed.
- -	Save hanging protocol – name it to match its Template – “GEN RAD 1L4R 8-07”
- -	Close customize window.
- Close exam.

## Verify the New Protocol Function

- Re-open the case using only the current xray, as follows:
- “open with”    “HP”  “GEN RAD 1L4R 8-07”
- Case should load fully, current and comparisons.
- Double click one of the comparisons, and read exam!
_*If it works YOUR DONE go to the next one!*_

## US Hanging Protocol

## US: layout, 6L 6R

|   |   |
| --- | --- |
|   |   |
|   |   |

|   |   |
| --- | --- |
|   |   |
|   |   |

** ****current          ****	****           comparison**

**Basic layout – scroll by 6 using page up / page down -  can change to more or fewer images, or view as single stack at  full screen after double click**

## Ultrasound

- The users should already have placed the manager, preview and scout view port on the monitor designated for control functions.  They may already have opened some of the system protocols.  This sequence creates a template and protocol for reading US exams with 1 prior exam.
- Set the workstation to operate with 2 active viewing monitors:

## Create a Template

- Create template:
- click on customize button
- Click on Create
- Leave both monitors as full screens
- Click on save:
- Enter name of template:  “US 6L6R 8-07”, and enter.  (You will set the 6 on 1 grid in a later step, after opening an exam)
- Close the template creation view.

## Filling in the Template Model

- Go to manager window – find a case to open.
- Make sure the check box in left mid panel of manager window is not checked
- Highlight desired exam and select “open with”
- Find your templates in the menu, and select “US 6L6R 8-07”.  Case will load to preview window.
- Click on the master image, extreme left, in preview window, and drag this to the left monitor – it should show there as one full image, and runs as a single stack.

## Activating Comparison Exams

- Look for 1 comparison in the patient list.  Double click it to load to preview.
- Click and drag the comparison to the right monitor.
- On each monitor, left click on top left grid and drag to highlight 6 spaces – 2 across, 3 down.  Release, and you will have 6 US images on each monitor.
- Click on top left image of current exam, then adjust scale and window.  Use page down / page up button on key board to step through images in 6’s.  Do same with comparison.

## Create Hanging Protocol

- To create hanging protocol,
- click on “customize” and “create hanging protocol”.
- Follow options in the pop-up window, beginning with current exam, then with comparisons.   Select options as directed.
- Save hanging protocol – name it to match its Template – “US 6L6R 8-07”
- Close customize window.
- Close exam.

## Verify the New Protocol Function

- Re-open the case using only the current US, as follows:
- “open with”    “HP”  “US 6L6R 8-07”
- Case should load fully, current and comparison.
- Click on one of the current panels, then use page down / page up button.
- To switch to full screen, double click, to reset, double click.  To change to other numbers of images in view, use top left grid.  Repeat with comparison.
_*If it works YOUR DONE go to the next one!*_

## Alternate

- Other things you can do – switch current and comparison screens – click and drag one to the other.  Close comparison. Open other comparison exam to preview then to right monitor and view.

## CT Hanging Protocol

## CT:  all stack, 9L 2R

| Current 
Med win | Current Lung win  | free 
  |
| --- | --- | --- |
| COMP  1 med win 
 | COMP  1 lung win 
  | free
  |
| COMP  2 med win 
  | COMP 2 lung win 
  | free 
  |

| Primary viewing port
  |
| --- |
| Comp viewing port
  |

## CT

- The users should already have placed the manager, preview and scout view port on the monitor designated for control functions.  They may already have opened some of the system protocols.  This sequence creates a template and protocol for reading CT exams with up to 3 prior exams, and space for additional comparison/s.
- Set the workstation to operate with 2 active viewing monitors:

## Create a Template

- Create template:
- Click on customize button
- Click on Create
- Left click on reading surface of left monitor, and drag to highlight 9 spaces (3x3)
- Left click on reading surface of right monitor, and drag to highlight 2 spaces like one box stacked on another (i.e. split across middle) on the grid.   This creates 9 on 1 on left monitor, 2 on 1 on right monitor
- Click on save:
- Enter name of template:  “CT 9L2R 8-07”, and enter
- Close the template creation view.

## Filling in the Template Model

- Go to manager window – find a case to open.
- Make sure the check box in left mid panel of manager window is not checked
- Highlight desired exam and select “open with”
- Find your templates in the menu, and select “CT 9L2R 8-07”.  Case will load to preview window.
- Click on 2 image sets in turn in the preview window - one lung and one mediastinal window, and drag them into upper left and upper middle ports on left monitor.

## Activating Comparison Exams

- Look for at least 2 comparisons in the patient list.  Double click each one.
- Click and drag the comparisons to the mid left and center ports (first comparison) of the left monitor; and second comparison goes to the lower left and lower center ports.
- Run through each image set with mouse wheel.  Adjust windows.

## Create Hanging Protocol

- To create hanging protocol,
- click on “customize” and “create hanging protocol”.
- Follow options in the pop-up window, beginning with current exam, then with comparisons.   Select options as directed, including the order of indexing the comparisons
- Save hanging protocol – name it to match its Template – “CT 9L2R 8-07”
- Close customize window.
- Close exam.

## Verify the New Protocol Function

- Re-open the case using only the current US, as follows:
- “open with”    “HP”  “US 6L6R 8-07”
- Case should load fully, current and comparison.
- Click on one of the current panels, then use page down / page up button.
- To switch to full screen, double click, to reset, double click.  To change to other numbers of images in view, use top left grid.  Repeat with comparison.
_*If it works YOUR DONE go to the next one!*_

## MR Hanging Protocol

## MR:  all stack, 9L 4R

| Seq 1
 | Seq 2
 | Seq 3 
  |
| --- | --- | --- |
| Seq 4 
 | Seq 5 
  | Seq 6
  |
| Seq 7 
  | Seq 8 
  | Seq 9
 |

| Seq 10 | Seq 11 |
| --- | --- |
| Seq 12 | Seq 13 |

## MR

- The users should already have placed the manager, preview and scout view port on the monitor designated for control functions.  They may already have opened some of the system protocols.  This sequence creates a template and protocol for reading MR exam initially without comparison.
- Set the workstation to operate with 2 active viewing monitors:

## Create a Template

- Create template:
- Click on customize button
- Click on Create
- Left click on reading surface of left monitor, and drag to highlight 9 spaces (3x3)
- Left click on reading surface of right monitor, and drag to highlight 4 spaces (2x2) on the grid.   This creates 9 on 1 on left monitor, 4 on 1 on right monitor
- Click on save:
- Enter name of template:  “MR 9L4R 8-07”, and enter
- Close the template creation view.

## Filling in the Template Model

- Go to manager window – find a case to open.
- Make sure the check box in left mid panel of manager window is not checked
- Highlight desired exam and select “open with”
- Find your templates in the menu, and select “MR 9L4R 8-07”.  Case will load to preview window.
- Click image sets in turn in the preview window – and drag them into sequential ports beginning at upper left, then mid and right, mid left through right, lower left through right, then onto right monitor upper, if there are that many sequences.  (If you will use this for reading spine MR, one scout sequence is useful on the grid, if you have room.
- Run through each image set with mouse wheel.  Adjust windows.

## Create Hanging Protocol

- To create hanging protocol,
- click on “customize” and “create hanging protocol”.
- Follow options in the pop-up window.   Select options as directed.
- Save hanging protocol – name it to match its Template – “MR 9L4R 8-07”
- Close customize window.
- Close exam.

## Verify the New Protocol Function

- Re-open the case as follows:
- “open with”    “HP”  “MR 9L4R 8-07”
- Case should load fully.  For larger images, either double click to full, or switch from left monitor to right, where the ports are larger.
_*If it works YOUR DONE go to the next one!*_

## Cases Without Comparison

- Try a few cases without comparisons.  Then find a case with a comparison, highlight current and comparison cases, then open with “MR 9L4R 8-07”.  The cases will load one behind the other.  Click on one of the images, then look for the stage shift arrow, and use it to switch from current to comparison and back.  Shifting images will be limited unless you have some free spaces to use.   You can close sequences to create more space, but it can be challenging.
- An alternative is to open the current, review it, close its sequences after making some scrap book images, then opening the comparison.  The comparison will load fully if the monitors have been completely cleared before the comparison load is selected.

## THE END!!!!!!!!!!!

*You have successfully designed and developed various Templates and Hanging Protocols! Good Job......Good Luck!*
***Questions?***