Patent Publication Number: US-2006013462-A1

Title: Image display system and method

Description:
FIELD OF THE INVENTION  
      This invention relates generally to the field of image display and more particularly to an improved image display system and method.  
     BACKGROUND OF THE INVENTION  
      Commercially available image display systems in the medical field utilize various techniques to present image data to a user. Specifically, the image data produced within modalities such as Computed Radiograph (CR), Medical Resonance Imagery (MRI) and the like is displayed on a display terminal for review by a medical practitioner at a medical treatment site. This image data is used by the medical practitioner to determine the presence or absence of a disease, tissue damage etc. Many attempts to optimize the presentation of such image data to the medical practitioner have been made.  
      For example, U.S. Pat. No. 5,644,611 to McShane discloses an apparatus and method for maximizing the number of digital radiological images displayed on a display screen. Non-image portions of various medical image frames are reduced to maximize the number of images that can be presented on one image display screen. Also, the modified image frames are arranged on a display screen relative to one another in a plurality of rows and columns such that all image frames have the same widths and length.  
      Also, European Patent Application No. 1229458 to Shastri et al. discloses an image display method that provides a layout of image data based on a display protocol in which multiple display protocols are lined up in a predetermined order. The specific presentation protocols are stored in the memory of the displaying workstation such that a user can select a particular layout by specifying a particular display protocol sequence.  
      However, these image display systems only allow the medical practitioner to specify the specific output of image data in advance using preset preferences. Such preference-based systems do not allow the medical practitioner to dynamically interact with image data for optimal display purposes.  
     SUMMARY OF THE INVENTION  
      The invention provides in one aspect, a display system for displaying a new display entity and a previous display entity, said system comprising: 
          (a) a memory for storing data associated with the new and previous display entities;     (b) a processor coupled to said memory for selectively retrieving data associated with the new and previous display entities;     (c) a primary display coupled to said processor for displaying the new and previous display entities, said primary display having a primary display area being adapted to display at least one display entity box according to a first display entity layout;     (d) said processor further being adapted to: 
            (i) instruct the primary display to display the previous display entity in a display entity box defined by the first display entity layout;     (ii) determine whether the new display entity has been selected for display;     (iii) determine if primary display area is not full;     (iv) if (ii) and (iii) are both true, close the display entity box defined by the first display entity layout and determine a second display entity layout which accommodates the new and previous display entities; and     (v) display the new and previous display entities in the primary display area in display entity boxes that are defined by the second display entity layout.    
               

      The invention provides in another aspect, a method of displaying new and previous display entities on a primary display having a primary display area adapted to display at least one display entity box according to first display entity layout, said method comprising: 
          (a) storing data associated with the new and previous display entities;     (b) selectively retrieving data associated with the new and previous display entities;     (c) displaying the previous display entity on primary display in a display entity box defined by the first display entity layout;     (d) determining whether the new display entity has been selected for display;     (e) determining whether the primary display area is not full;     (f) if (d) and (e) are both true, closing the display entity box defined by the first display entity layout and determining a second display entity layout which accommodates the new and previous display entities; and     (g) displaying the new and previous display entities in primary display area in display entity boxes defined by the second display entity layout.        

      The invention provides in another aspect, a display system for displaying first and second display entities, said system comprising: 
          (a) a memory for storing data associated with the first and second display entities;     (b) a processor coupled to said memory for selectively retrieving image data associated with the first and second display entities;     (c) a display coupled to said processor for displaying the first and second display entities, said display having a display area being adapted to display at least one display entity box according to a display entity layout;     (d) said processor further being adapted to: 
            (i) instruct the display to display the first and second display entities in the display area in display entity boxes defined by a first display entity layout;     (ii) determine whether the second display entity has been selected for closure;     (iii) if (ii) is true, close the at least one display entity box defined by the first display entity layout and determine a second display entity layout which accommodates the first display entity but not the second display entity; and     (iv) display the first display entity in the display area in a display entity box defined by the second display entity layout.    
               

      The invention provides in another aspect, a method of displaying first and second display entities on a display having a display area adapted to display at least one display entity box according to a display entity layout, said method comprising: 
          (a) storing data associated with the first and second display entities;     (b) selectively retrieving data associated with said first and second display entities;     (c) displaying the first and second display entities in the display area in display entity boxes defined by a first display entity layout;     (d) determining whether the second display entity has been selected for closure;     (e) if (d) is true, closing the at least one display entity box defined by the first display entity layout and determining a second display entity layout which accommodates the first display entity but not the second display entity; and     (f) displaying the first display entity in the display area in a display entity box defined by the second display entity layout.        

      The invention provides in another aspect, a display system for displaying first and second display entities, said system comprising: 
          (a) a memory for storing data associated with the first and second display entities;     (b) a processor coupled to said memory for selectively retrieving data associated with the first and second display entities;     (c) a display coupled to said processor for displaying the first and second display entities, said display having a display area having left and top sides, said display also being adapted to display at least one first display entity box according to a first display entity layout and at least one second display entity box according to a second display entity layout;     (d) said processor being further adapted to: 
            (i) instruct the display to display the first display entity in the first display entity box according the first display entity layout;     (ii) determine whether a second display entity layout has been selected;     (iii) if (ii) is true, close the first display entity box defined by the first display entity layout and display the first and second display entities within second display entity boxes defined by the second display entity layout.    
               

      The invention provides in another aspect, a method of displaying first and second display entities on a display having a display area having left and top sides, said display also being adapted to display at least one first display entity box according to a first display entity layout and at least one second display entity box according to a second display entity layout, said method comprising: 
          (a) storing image data associated with the first and second display entities;     (b) selectively retrieving image data associated with the first and second display entities;     (c) displaying the first display entity in the first display entity box according the first display entity layout;     (d) determining whether a second display entity layout has been selected; and     (e) if (d) is true, closing the first display entity box defined by the first display entity layout and displaying the first and second display entities within second display entity boxes defined by the second display entity layout.        

      The invention provides in another aspect, a display system for displaying a display entity, said display entity having display sub-entities, said system comprising: 
          (a) a memory for storing data associated with the display entity;     (b) a processor coupled to said memory for selectively retrieving data associated with the display entity;     (c) an original display coupled to said processor for displaying the display entity, said original display having an original display area adapted to display at least one display sub-entity;     (d) an adjacent display coupled to said processor for displaying the display entity, said adjacent display having an adjacent display area that is adapted to display at least one display sub-entity;     (e) said processor further being adapted to: 
            (i) display the display entity within a display entity box within the original display area;     (ii) determine whether mirroring of the display entity has been selected; and     (iii) if (ii) is true, display the first display sub-entities of the display entity within the original display area and the second display sub-entities of the display entity within the adjacent display area.    
               

      The invention provides in another aspect, a method for displaying a display entity on an original display and an adjacent display, said display entity having display sub-entities, the original display having an original display area and the adjacent display, said method comprising: 
          (a) storing data associated with the display entity;     (b) selectively retrieving data associated with the display entity;     (c) displaying the display entity within a display entity box within the original display area;     (d) determining whether mirroring of the display entity has been selected; and     (e) if (d) is true, displaying the first display sub-entities of the display entity within the original display area and the second display sub-entities of the display entity within the adjacent display area.        

      Further aspects and advantages of the invention will appear from the following description taken together with the accompanying drawings. 
    
    
     BRIEF DESCRIPTION OF THE DRAWINGS  
      For a better understanding of the present invention, and to show more clearly how it may be carried into effect, reference will now be made, by way of example, to the accompanying drawings which show some examples of the present invention, and in which:  
       FIG. 1  is block diagram of the image display system of the image display system of the present invention;  
       FIG. 2  is a diagram illustrating in more detail the displays of the image display system of  FIG. 1 ;  
       FIG. 3  is a flowchart illustrating the basic operational steps of the image display system of  FIG. 1 ;  
       FIG. 4A  is a flowchart illustrating the process steps conducted by the tiling module and the image processing module of  FIG. 1  when executing the user-initiated tiling features;  
       FIG. 4B  is a diagram illustrating the user-initiated tiling features provided by the tiling module of  FIG. 1  when the user wishes to position a new study and or to reposition an existing study;  
       FIG. 4C  is a flowchart illustrating the process steps conducted by the tiling module and the image processing module of  FIG. 1  when executing the automatic tiling features;  
       FIGS. 4D, 4E ,  4 F,  4 G,  4 H, and  41  are diagrams illustrating the automatic tiling features provided by the tiling module of  FIG. 1  when the user opens a new study without selecting a desired position;  
       FIG. 5A  is a flowchart illustrating the process steps conducted by the closure module and the image processing module of  FIG. 1 ;  
       FIGS. 5B and 5C  are diagrams illustrating the image closure features provided by the closure module of  FIG. 1 ;  
       FIG. 6A  is a flowchart illustrating the process steps conducted by the retiling module and the image processing module of  FIG. 1 ;  
       FIGS. 6B, 6C ,  6 D,  6 E,  6 F,  6 G,  6 H, and  61  are diagrams illustrating the retiling features provided by the retiling module of  FIG. 1 ;  
       FIG. 7A  is a flowchart illustrating the process steps conducted by the mirroring module and the image processing module of  FIG. 1 ;  
       FIGS. 7B, 7C ,  7 D, and  7 E are diagrams that illustrate the image mirroring features provided by the mirroring module of  FIG. 1 ;  
       FIG. 8A  is a flowchart illustrating the process steps conducted by the tiling and the image processing modules of  FIG. 1  in respect of image display;  
       FIGS. 8B and 8C  are diagrams that illustrate the “stack mode” image display functionality of the tiling and image processing modules of  FIG. 1 ; and  
       FIGS. 8D and 8E  are diagrams that illustrate the “tiling mode” image display functionality of the retiling and image processing modules of  FIG. 1 . 
    
    
      It will be appreciated that for simplicity and clarity of illustration, elements shown in the figures have not necessarily been drawn to scale. For example, the dimensions of some of the elements may be exaggerated relative to other elements for clarity. Further, where considered appropriate, reference numerals may be repeated among the figures to indicate corresponding or analogous elements.  
     DETAILED DESCRIPTION OF THE INVENTION  
      Reference is first made to  FIGS. 1 and 2 , which illustrates the basic components of an image display system  10  made in accordance with a preferred embodiment of the present invention. Image display system  10  includes an image processing module  12 , a tiling module  14 , a closure module  16 , a retiling module  18 , a mirroring module  20 , a display driver  22 , and a user preference database  24 . As shown, image data associated with one or more display entities  27  ( FIG. 1 ) (i.e. medical exams) is generated by a modality  13  and stored in an image database  17  on an image server  15  where it can be retrieved by image display system  10 . Display entities  27  can be in various forms including studies  30 , series  40 , or images  50 . In addition, it should be understood that one or more studies  30 , series  40 , or images  50  are typically associated with a particular patient. An index of studies  30  is provided in a study list  32  that is displayed on a non-diagnostic display  21 . Image display system  10  provides image data associated with studies  30  through display driver  22  to primary and supplemental diagnostic displays  23 ,  25  in response to commands issued by a medical practitioner user  11  through user workstation  19  as shown. Image display system  10  works contextually and dynamically to allow for direct manipulation of studies  30  resulting in a more intuitive diagnostic environment for user  11 .  
      User workstation  19  includes a keyboard  7  and a user-pointing device  9  (e.g. mouse) as shown in  FIG. 1 . It should be understood that user workstation  19  can be implemented by any wired or wireless personal computing device with input and display means (e.g. conventional personal computer, laptop computing device, personal digital assistant (PDA), etc.) User workstation  19  is operatively connected to non-diagnostic display  21 , primary diagnostic display  23  and supplemental diagnostic display  25 . Image display system  10  is used to provide image display formatting depending on user inputs through user workstation  19  and user pointing device  9 . Image display system  10  is installed either on the hard drive of user workstation  19  and/or on a central image server such that user workstation  19  works with central image server in a client-server configuration.  
      Non-diagnostic display  21  is optimized for study  30  selection and provides a user with a study list  32  ( FIG. 2 ). Study list  32  provides a textual format listing of display entities  27  (e.g. studies  30 ) that are available for display. Study list  32  also includes associated identifying indicia (e.g. body part, modality, etc.) and organizes studies  30  in current and prior study categories. Typically, user  11  will review study list  32  and select listed studies  30 . When user  11  selects a study  30 , the selected study  30  is displayed on primary diagnostic display  23  or supplemental diagnostic display  25 , depending on how many study  30  are already displayed on primary and supplemental diagnostic displays  23  and  25 , as will be discussed. Other associated textual information (e.g. patient information, image resolution quality, date of image capture, etc.) is simultaneously displayed within study list  32  to assist the user  11  in selection of studies  30 . Non-diagnostic display  21  is preferably implemented using a conventional color computer monitor (e.g. a color monitor with a resolution of 1024×768) with sufficient processing power to run a conventional operating system (e.g. Windows NT). High resolution graphics are not necessary for non-diagnostic display  21  since this display is only displaying textual information to user  11 .  
      Primary diagnostic display  23  provides high resolution image display of display entities  27  (e.g. studies  30 ) to user  11  on display area  35  ( FIG. 2 ). The studies  30  displayed on primary diagnostic display  23  are typically current study  30  (i.e. image data from “today&#39;s” exam). As shown in  FIG. 2 , studies  30  are displayed within study boxes  34  that are defined within display area  35 . Study boxes  34  have variable dimensions and are defined using an appropriate study layout  36  as will be described in more detail. Primary diagnostic display  23  is preferably implemented using medical imaging quality display monitors with relatively high resolution typically used for viewing CT and MR studies (e.g. black and white “reading” monitors with a resolution of 1280-1024 and up).  
      Supplemental diagnostic display  23  provides high resolution image display of study  30  to user  11  on display area  37  ( FIG. 2 ). Supplemental diagnostic display  25  is typically used by user  11  to display another set of display entities  27  (e.g. studies  30  from a prior study) for comparison with the set of display entities  27  (e.g. studies  30  from a current study) shown on primary display  23 . It has been determined that the left to right positioning of the three displays  12 ,  23  and  25  as shown in  FIG. 2  is generally preferred by medical practitioner users  11  since it allows the eye to flow from left to right, from non-diagnostic display  21  to the diagnostic displays  23 ,  25 . As shown in  FIG. 2 , studies  30  are again displayed within study boxes  34  that are defined within display area  37 . Also, as noted above, study boxes  34  have variable dimensions and are defined using an appropriate study layout  36  as will be described. As with the primary diagnostic display  23 , supplemental diagnostic display  25  is preferably implemented using medical imaging quality display monitors with relatively high resolution typically used for viewing CT and MR studies (e.g. black and white “reading” monitors with a resolution of 1280-1024 and up).  
      It should be understood that many other types of display configurations could be utilized within image display system  10  including the use of one, two or more displays.  
      Modality  13  is any conventional image data generating device (e.g. computed radiography (CR) systems, computed tomography (CT) scanners, magnetic resonance imaging (MRI) systems, positron emission tomography (PET), ultrasound systems, etc.) utilized to generate image data that corresponds to patient medical exams. The image data generated by modality  13  is then utilized for making a diagnosis (e.g. for investigating the presence or absence of a diseased part or an injury or for ascertaining the characteristics of the diseased part or the injury). Modalities  13  may be positioned in a single location or facility, such as a medical facility, or may be remote from one another. Image data from modality  13  is stored within image database  17  within an image server  15  as conventionally known.  
      Image processing module  12  coordinates the activities of tiling module  14 , closure module  16 , retiling module  18  and mirroring module  20  in response to user commands sent by user  11  from user workstation  19  and stored user display preferences from user preference database  25 . Specifically, image processing module  12  is adapted to receive a request from user workstation  19  that indicates that particular display entities  27  (e.g. studies  30 ) being displayed on the various display monitors  21 ,  23  and  25  are to be displayed in a reformatted manner selected to improve the usability of the overall medical imaging system. The various types of image display formatting and display options provided by the present invention will be discussed.  
      Tiling module  14  is utilized by image processing module  12  to provide user  11  with tiling functionality within primary and supplemental display areas  35  and  37  ( FIG. 2 ). As new display entities  27  (e.g. studies  30 ) are added, they are added to display areas  35 ,  37  in a preferred format. Specifically, study boxes  34  are added into a display area  35 ,  37  such that they share a proportional portion of display area  35 ,  37  with study boxes  34  that were already being displayed. In addition, as the maximum number of study boxes  34  ( FIG. 2 ) are formed within display area  35 ,  37  studies  30  are “wrapped” over to the other display area  37 ,  35  according to a left-to-right or a right-to-left opening protocol. Tiling module  14  allows a user to compare various studies  30  by tiling them rather than by launching new overlapping image windows that block or cover existing study(ies)  30 .  
      Closure module  16  is utilized by image processing module  12  to provide user  11  with image closure functionality within primary and supplemental display areas  35  and  37 . Closure module  16  allows user  11  to directly manipulate the size and placement of display entities  27  (e.g. studies  30 ) within primary and supplemental display areas  35 ,  37  by dragging a desired study  30  over unwanted stud(ies)  30 . This results in the unwanted study(ies)  30  being closed and the desired study  30  being resized to occupy in addition the display area previously taken by the unwanted studies  30 .  
      Retiling module  18  is utilized by image processing module  12  to provide user-initiated retiling functionality within primary and supplemental display areas  35  and  37 . Retiling module  18  allows user  11  to select display entities  27  (e.g. study boxes  34 ) and cause them to dynamically grow and shrink to fill all available space reducing the need for user  11  to specifically and individually resize studies  30  (i.e. reducing necessary user-interface interaction).  
      Mirroring module  20  is utilized by image processing module  12  to provide user  11  with image mirroring functionality within primary and supplemental display areas  35  and  37 . Mirroring module  20  allows user  11  to continue the progress of display entities  27  (e.g. series  40  within a study  30 , or images  50  within a series  40 ) across primary and supplemental display areas  35  and  37 . The mirroring function uses a display protocol (e.g. “advanced by one”) to display related images within series  40  for a particular study  30  on original and adjacent displays as will be described.  
      Display driver  22  is a conventional display screen driver implemented using commercially available hardware and software. As shown in  FIG. 2 , display driver  22  ensures that various display entities  27  (e.g. studies  30 , series  40 , images  50 , etc.) are displayed in a proper format within display areas  35 ,  37  using an appropriate layout (e.g. study layout  36 , series layout  46 , image layout  56 , etc.)  
      Specifically, studies  30  are displayed within study boxes  34  that are defined within display areas  35 ,  37  using study layouts  36 . Each study box  34  contains a study toolbar  31 , as well as an series toolbar(s)  41  and an series box(es)  44 . Each series box  44  is used to display a series  40 . Study boxes  34  are defined within display areas  35 ,  37  using a study layout  36 . Study layouts  36  are used to divide display areas  35 ,  37  into a number of regions within which study boxes  34  are arranged.  
      Similarly, series boxes  44  are defined within study boxes  34  using series layout  46  ( FIG. 2 ). The particular limit of subdivided regions within a study layout  36  or a series layout  46  is only limited by the ergonomic limitations of the displays being used and user preferences. The specific choice of study layout  36  and series layout  46  is made by image processing module  12  according to which display feature (i.e. tiling, image closure, retiling or mirroring) is being activated by user  11 .  
      Also, as shown in  FIG. 2 , images  50  can also displayed within series box  44  using an image layout  56 . Images  50  are preferably provided without any special border or “box” around them, although it should be understood that images  50  could also be displayed in this fashion. Display driver  22  provides image data associated with studies  30  appropriately formatted so that studies  30  are properly displayed within a study box  34  and/or so that series  40  or images  50  are properly displayed within an series box  44 .  
      While the functionality of image display system  10  will be discussed in relation to the display and arrangement of studies  30  within study boxes  34  in display area  35  (i.e. at the “study” level), it should be understood that the functionality of image display system  10  is equally applicable to the display and arrangement of any other display entity  27  within a prescribed display area (e.g. patient display boxes (not shown) within display area  35 , series  40  and images  50  within series boxes  44 , etc.) More generally, it should be understood that the functionality of tiling module  14 , closure module  16 , retiling module  18  and mirroring module  20  can be applied to any display system that is used to display display entities  27  to user  11 .  
      Referring now to  FIGS. 1, 2 , and  3 , the basic operation of image display system  10  is illustrated.  FIG. 3  illustrates the basic operational steps  50  of image display system  10 . As noted above, while the general operation of image display system  10  will be discussed in respect of study(ies)  30 , it should be understood that the tiling functionality described is equally applicable to any other kind of display entity  27  such as for example, individual series  40 , images  50  and the like.  
      At step ( 52 ), it is determined whether user  11  is requesting the display of a new study  30  using keyboard  7  and/or mouse  9  of user workstation  19  (e.g. by clicking on desired studies  30  listed in study list  32  on non-diagnostic display  21 ). A user can open a new study  30  in at least two ways and in each case, tiling module  14  is activated, as will be described. First, user  11  can select a study  30  from a study list  32  on non-diagnostic display using a mouse  9  button and drag the study  30  to a particular location on primary or supplemental diagnostic display  23 ,  25  and then release the mouse  9  button. Second, user  11  can simply select a study  30  from study list  32  (e.g. by double clicking on the textual representation of study  30 ). It should be understood that these are only two exemplary methods of opening a new study  30  and that many other methods could be utilized and recognized by image processing module  12  as an indication to trigger tiling module  14 .  
      If the user has requested display of a new study  30 , then at step ( 54 ), image processing module  12  requests the image data associated with the requested new study  30  from image server  15 . Image server  15  identifies the requested image data and retrieves it from image database  17 . Then at step ( 56 ), image processing module  12  activates tiling module  14  to perform tiling in respect of the new study  30  as will be described in more detail. Generally speaking, a new study  30  selected by user  11  for display causes previous study(ies)  30  currently being displayed (if any) to be reformatted so that the previous study(ies)  30  and the new study  30  share a proportional portion of display area  35 ,  37  as defined by an optimized study layout  36 . In addition, as the maximum number of study boxes  34  are formed within a display area  35  or  37  studies  30  are “wrapped” over to the other display area  37 ,  35  according to a left-to-right or a right-to-left opening protocol. These particular functions will be discussed in more detail. At step ( 58 ), the new study  30  along with any previous studies  30  are displayed within study boxes  34  as defined by an optimized study layout  36 . That is, the image data associated with the new study  30  along with retiling instructions are provided to display driver  22 . Display driver  22  in turn causes the new study  30  and any previous studies  30  to be displayed on primary and/or supplemental display  23 ,  25  as appropriate.  
      If the user  11  has not opened a new study  30  then it is determined whether user  11  is directly manipulating any of the studies  30 . In order to directly manipulate a study  30 , the user must first select a study  30  to manipulate. User  11  can select a study as discussed above, by selecting a study from study list  32 . user  11  can also select a study  30  for direct manipulation by selecting (i.e. “clicking on”) any section of the study toolbar  31 . In addition user  11  can select the HANDLE tag  97  associated with study  30  in order to change the dimensions of the study box  34 .  
      Specifically, at step ( 61 ), it is determined whether user  11  has dragged a first study  30   a  over a second study  30   b . Typically, this function is used where user  11  is not interested in viewing the second study  30   b  any longer and wishes to increase the image area of the first study  30   a . User  11  can accomplish such an effect by at least two ways. First, user  11  can drag a first study  30   a  over a second study  30   b  by selecting the HANDLE tag  97  ( FIG. 2 ) associated with the first study  30   a  using a pointing device  9  and moving the HANDLE tag  97  of the first study  30   a  over an (e.g. bottom) edge of the study box  34  of the second study  30   b  ( FIG. 5B ). Secondly, user  11  can draft a first study  30   a  over a second study  30   b  by selecting the study toolbar  31  associated with the first study  30   a  and dragging it over an edge (e.g. bottom) edge of the study box  34  of the second study  30   b.    
      If user  11  has dragged first study  30   a  over a second study  30   b , then at step ( 63 ), image processing module  12  activates closure module  16  to close second study  30   b . At step ( 65 ), image processing module  12  activates retiling module  18  to resize the study box  34  associated with first study  30  to take advantage of the display area freed up by the recently closed second study  30   b  as will be described.  
      At step ( 62 ), it is determined whether user  11  has directly requested retiling of a study  30 . Specifically, user  11  indicates that retiling is desired when user  11  selects the graphical HANDLE tag  97  at the bottom right corner of study box  34  and drags it within study box  34  to form a resized study box  34 . Alternatively, user  11  can also activate the retiling functionality of retiling module  18  through a button/pull down menu located within study toolbar  31 .  
      If user  11  has directly requested retiling of a study  30  then at step ( 65 ), image processing module  12  activates retiling module  18  to conduct retiling. First retiling module  18  determines the appropriate study layout  36  that most closely matches the retiling study box produced by the user  11  in dimension. Once user  11  releases the HANDLE tag  97 , then retiling module  18  utilizes the selected study layout  36  associated with the last selected resized study box and uses it to redisplay all displayed study(ies)  30  within the study layout  36  as will be described.  
      At step ( 64 ), it is determined whether user  11  has selected mirroring functionality. A user  11  selects mirroring of an image series currently being displayed on an original diagnostic display (e.g. primary diagnostic display  23 ) by first enabling the adjacent diagnostic display (e.g. supplemental diagnostic display  25 ) by dragging a study  30  over to that area and then by selecting the MIRROR button  99  ( FIG. 7B ) that appears within study toolbar  31  as a result. By executing these steps, the user  11  indicates a desire to display a mirrored series on the adjacent diagnostic display (e.g. supplemental diagnostic display  25 ).  
      If user  11  requests mirroring functionality, then at step ( 66 ), image processing module  12  activates mirroring module  20  to conduct mirroring of studies  30 . Mirroring module  30  takes the series  40  of a particular study  30  being displayed on an original diagnostic display (e.g. primary diagnostic display  23 ) and displays a particular image set (e.g. the second image of each series  40 ) on the adjacent diagnostic display (e.g. supplemental diagnostic display  25 ) according to a display protocol as will be further described.  
      At step ( 68 ), the image data associated with the requested study(ies)  30  along with retiling instructions are provided to display driver  22 . Display driver  22  in turn causes the new study  30  to be displayed on primary and/or supplemental display  23 ,  25  as appropriate. All study(ies)  30  to be displayed are resized and reformatted using the functionality of tiling module  14 , closure module  16 , retiling module  18  and mirroring module  20  as well as preferred default display settings selected by user  11  and stored in user preference database  24 .  
       FIGS. 4A and 4B  together illustrate the user-initiated tiling functionality of image display system  10  when user  11  directly engages the tiling functionality of image display system  10  by dragging a new study  30  onto a selected diagnostic display  23 ,  25 . Specifically,  FIG. 4A  is a flowchart diagram that illustrates the process steps  100  that are executed by tiling module  14  and image processing module  12  to provide user-initiated tiling functionality in the situation where the user  11  selects a new study  30  and specifies where the study  30  should be positioned on diagnostic display  23 ,  25 . It should be noted that the terminology “new study” will be used to describe the study that the user  11  has most recently selected for manipulation. Also, while this feature of user-initiated tiling module  14  will be discussed in respect of study(ies)  30 , it should be understood that the user-initiated tiling functionality described is equally applicable to individual series  40  opened within a particular study  30 .  
      At step ( 102 ), user  11  selects a new study  30   a  for user-initiated tiling in a number of ways. Firstly, user  11  can select a study  30  from study list  32  using a mouse  9  button and drag the study  30  to a particular location on primary or supplemental diagnostic display  23 ,  25  and then release the mouse  9  button. Secondly, user  11  can select a study  30  (or series  40 ) that is currently being displayed by selecting study toolbar  31  (or series toolbar  41 ) and dragging it to another position on primary or supplemental diagnostic display  23 ,  25 . The latter option allows the user  11  to “swap” the respective positions of study(ies)  30  (or series  40 ). Again, it should be understood that these are only two exemplary methods of triggering the user-initiated tiling functionality of image display system  10  and that many other methods could be utilized.  
      At step ( 108 ), tiling module  14  displays visual “cues” or “targets” which help the user  11  determine where the current study  30   a  can be positioned or “dropped” ( FIG. 4B ). Specifically, tiling module  14  instructs display driver  22  to display indicia at the horizontal and vertical edges of the previous study  30   b  as shown in  FIG. 4B  where the new study  30   a  can be positioned (e.g. dotted lines at the horizontal and vertical edges). In addition, as shown on primary diagnostic display  23   a , an indicia (e.g. a circle) is also displayed in the middle of previous study  30   b  to illustrate where user  11  could “drop” current study  30   a  in order to replace previous study  30   b  with new study  30   a  ( FIG. 4B )  
      At step ( 110 ), tiling module  14  and image processing module  12  determines whether user  11  has dragged new study  30   a  to the middle (where the replacement circular indicia is displayed as shown in  FIG. 4B ) of previous study  30   b  and released the mouse  9  button. It should be understood at this point that user  11  could be dragging a study  30  from study list  32  or from a displayed position using the study toolbar  31  to “swap” positions with previous study  30   b . If so, then at step ( 112 ), on primary diagnostic display  23   b  (FIG.  4 B), image processing module  12  calls closure module  16  to close the previous study  30   b  and to open and position the new study  30   a  in place of the previous study  30   b.    
      At step ( 114 ), tiling module  14  and image processing module  12  determine whether user  11  has dragged new study  30   a  to a horizontal edge (the dotted horizontal lines shown in  FIG. 4B ) of previous study  30   b  on a display (e.g. primary diagnostic display  23   a ) and released the mouse  9  button. It should be understood at this point that user  11  could be dragging a study  30  from study list  32  or from a displayed position using the study toolbar  31  to “swap” positions with previous study  30   b . If so, then at step ( 116 ), tiling module  14  determines and selects an optimal study layout  36  for horizontal tiling within the selected diagnostic display  23 ,  25 . It should be understood that the optimal study layout  36  will depend in part on which horizontal tiling indica is selected by the user  11 . Other factors for consideration include the number of previous studies  30   b  already being displayed on selected diagnostic display  23 ,  25  and user preferences as stored within user preference database  24 .  
      At step ( 120 ), tiling module  14  and image processing module  12  instruct display driver  22  to arrange new study  30   a  and previous study  30   b  in a horizontally tiled manner using the optimized study layout  36  ( FIG. 4B ). Specifically, study box  34  of previous study  30   b  is reduced in area such that previous study  30   b  and new study  30   a  can proportionally share the surface area of primary diagnostic display  23  (in this example) using the optimized study layout  36 .  
      At step ( 118 ), tiling module  14  and image processing module  12  determine whether user  11  has dragged new study  30   a  to a vertical edge (i.e. the vertical dotted lines shown in  FIG. 4B ) of previous study  30   b  on a display (e.g. primary diagnostic display  23   a ) and released the mouse  9  button. It should be understood at this point that user  11  could be dragging a study  30  from study list  32  or from a displayed position using the study toolbar  31  to “swap” positions with previous study  30   b . If so, then at step ( 121 ), tiling module  14  determines and selects an optimal study layout  36  for vertical tiling within the selected diagnostic display  23 ,  25  as discussed above. At step ( 122 ), tiling module  14  and image processing module  12  instruct display driver  22  to arrange new study  30   a  and previous study  30   b  in a horizontally tiled manner using the optimized study layout  36  (not shown).  
       FIGS. 4C, 4D ,  4 E,  4 F,  4 G,  4 H and  4 I illustrate the automatic tiling functionality of image display system  10  when user  11  selects a new study  30  (i.e. that hasn&#39;t been displayed before) for display on a diagnostic display  23 ,  25 . Specifically,  FIG. 4C  is a flowchart diagram that illustrate the process steps  150  that are executed by tiling module  14  and image processing module  12  to provide image automatic tiling functionality on primary and supplemental diagnostic display  23 ,  25  when the user  11  selects a study  30  for automatic display (i.e. just by “double clicking” without dragging the study  30  to a diagnostic display  23 ,  25  or otherwise indicating the target position of study  30  for display). While this feature of tiling module  14  will be discussed in respect of study(ies)  30 , it should be understood that the automatic tiling functionality described is equally applicable to individual series  40  opened within a particular study  30 .  
      At step ( 152 ), user  11  initiates automatic tiling routine  150  by selecting study  30  from study list  32  (i.e. by “double clicking”).  
      At step ( 154 ), tiling module  14  determines whether the new study  30   a  is the first study  30  to be displayed. If so, then at step ( 155 ), study  30   a  is displayed in a maximum sized study box  34  on primary diagnostic display  23  as shown in  FIG. 4D . That is, the optimal study layout  36  for this situation is to have a study box  34  having an area equal to the maximum display area of primary display area  35 . Typically, medical practitioners select the most current study  30  available for display on the primary diagnostic display  23  and so this preference is reflected in the example opening protocol discussed here. However, it should be understood that many other opening protocols could be selected by user  11  and implemented within image display system  10 .  
      If the new study  30   a  is not the first study  30  for display (as is the case in  FIG. 4E  where a first study  30   a  is already being displayed in primary diagnostic display  23 ), at step ( 156 ), tiling module  14  determines whether supplemental display area  37  is full. That is, it is determined whether the study layout  36  associated with supplemental diagnostic display  25  can be further subdivided. If study layout  36  can be further subdivided (as in the case shown in  FIG. 4E, 4F ,  4 G), then at step ( 158 ), the study layout  36  is re-optimized. That is, new study  30   a  is considered along with any other studies  30  already being displayed within supplemental diagnostic display  25  and an optimal study layout  36  is selected. In the example shown in  FIG. 4E , the new study  30   b  is the only study  30  to be displayed within supplemental diagnostic display  25 . At step ( 160 ), a new study box  34   a  is positioned within the display area of supplemental diagnostic display  25  according to the optimized study layout  36 . Again, as shown in  FIG. 4E , the optimized study layout  36  is simply the entire area of the display area of supplemental diagnostic display  25 .  
      As shown in  FIGS. 4F, 4G ,  4 H, and  4 I it is necessary to re-optimize study layout  36  each time a new study  30   a  is added to a number of previous studies  30   b  within supplemental display area  37 . Each time, the pre-existing previous studies  30   b  are considered along with new study  30   a  and the optimal study layout  36  is selected based on a number of criteria. The criteria includes the number and type of studies  30  as discussed above. Also, it should be noted that the new study  30   a  is preferably positioned at the top or the top left position of the other previous studies  30   b  according to a user friendly image display protocol, although it should be understood that many other opening protocols could be utilized. Also, it should be understood that automatic tiling could be conducted in either a horizontal or vertical manner, depending on the optimal orientation and dimensions of the study  30  at issue as well as user presets stored in the user preference database  24 .  
      It is contemplated that the determination of which display entities  27  (e.g. studies  30 ) are selected and arranged within display areas  35 ,  37  is preferably based on a specific set of rule-based criteria that determine the “relevancy” of various studies  30 . The actual decision as to whether a particular display entity  27  (e.g. study  30 ) should be selected and where it should be positioned (e.g. alongside another existing display entity  27 ) can be made using relevancy rules. The specific rule-based criteria could be stored within user preference database  24  and implemented by tiling module  14  using relevancy rules as follows. This approach should be understood as noted above to apply to any type of display entity  27  (e.g. studies  30 , series  40 , images  50 ).  
      Tiling module  14  checks the characteristics (e.g. time of creation, image type, body type, modality type, procedure, patient, etc.) of a particular display entity  27  (e.g. study  30 ) and evaluates the associated relevancy rules. These relevancy rules can be used to determine whether a new display entity  27  should be selected for display and where it should be displayed (i.e. grouped alongside another dispay entity  27 ). Typically, data relevance is used to select and group display entities  27  within image display system  10 . However, the other criteria noted above and many others could be used along with or in place of date relevance in such a determination.  
      If it is determined at step ( 156 ), that the supplemental display area is full (i.e. at  FIG. 4H ) then at step ( 162 ), tiling module  14  determines whether primary display area  35  is also full. That is, it is determined whether the study layout  36  associated with primary display area  35  can be further subdivided. If the study layout  36  of primary display area  35  can be further subdivided (as in  FIG. 4H ), then at step ( 164 ), the study layout  36  is re-optimized. That is, pre-existing previous studies  30   b  are considered along with new study  30   a  and the optimal study layout  36  that is formatted to contain the first study  30  and the newly introduced study  30  is selected. At step ( 166 ), the first study box  34  is resized and repositioned at the most prominent position (i.e. at the top of primary display area  35  as shown in  FIG. 41 ) within study layout  36  and new study  30   a  is displayed below the first study box  34  ( FIG. 41 ).  
      If the primary display area  35  is also full, then at step ( 168 ), tiling module  14  determines that the maximum number of study boxes  34  have been reached for each diagnostic display  23 ,  25  and returns. The maximum number of study boxes  34  that can be formed within a study layout  36  can be preset by a user (i.e. depending on a user&#39;s eyesight and personal preference) within in user preference database  24  or it can be a system default based on image quality-related considerations (e.g. image resolution, type of modality image at issue, etc.) It should be understood that many other responses when all display areas  35 ,  37  are “full” could be provided. For example, the oldest previous study  30  could be highlighted in case user  11  wishes to close the associated study box  34  to make room for new study  30   a.    
      The resulting effect is that studies  30  are opened and tiled from right to left (i.e. from supplemental diagnostic display  25  to primary diagnostic display  23 ) such that studies  30  fill the right display (i.e. supplemental diagnostic display  25 ) before beginning to populate the left display (i.e. primary diagnostic display  23 ). The rationale for this opening and tiling protocol is that previous studies  30   b  (i.e. those studies  30  that were previously opened) are typically supplementary to the new studies  30   a  that are being opened. However, it should be understood that many different opening and tiling protocols could be implemented within tiling module  14 . Also, as discussed above, various ways of selecting and grouping display entities  27  can be implemented using “relevancy rules” based on a number of characteristics (e.g. time of creation, image type, body type, modality type, procedure, patient, etc.)  
       FIGS. 5A and 5B  illustrate the closure functionality of image display system  10  which allows user  11  to directly manipulate the size and placement of studies  30  within primary and supplemental display areas  35 ,  37  by dragging a desired study over unwanted studies  30  to close them. Specifically,  FIG. 5A  is a flowchart diagram that illustrates the process steps  200  that are executed by image processing module  12  and closure module  16  to provide study closure functionality as will be described. As noted above, while the general operation of image display system  10  will be discussed in respect of study(ies)  30 , it should be understood that the closure functionality described is equally applicable to any kind of display entity  27  such as for example, individual series  40 , images  50  and the like.  
      At step ( 202 ), user  11  selects HANDLE tag  97  ( FIG. 5B ) that is located in the bottom right corner of a first study box  34   a . At step ( 204 ), closure module  16  determines whether HANDLE tag  97  is being used to drag first study box  34  over the spatial perimeter defined by second study box  34   b . This is defined as where the position of the cursor holding and dragging HANDLE tag  97  passes over one of the perimeter edges (e.g. either left or right vertical edge or to or bottom horizontal edge or a combination thereof) of the second study box  34   b  as shown in  FIG. 5B .  
      If this occurs, this action by user  11  is interpreted as meaning that user  11  has no interest in viewing the studies  30  associated with the “dragged over” study boxes  34  (e.g. study box  34   b  ( FIG. 5B ) or study boxes  34   b ,  34   c ,  34   d  ( FIG. 5C )). Accordingly, then at step ( 206 ), closure module  16  and image processing module  12  instruct display driver  22  to close the “dragged over” study box(es)  34 . At step ( 208 ), closure module  16  calculates the total display area that was taken up by first study box  34  (e.g. study box  34   a  in  FIGS. 5B and 5C ) and the other “dragged over” study boxes (e.g. study box  34   b  in  FIG. 5B  or study boxes  34   b ,  34   c ,  34   d  in  FIG. 5C ). At step ( 210 ), closure module  16  and image processing module  12  instruct display driver  22  to re-optimize the study layout  36  so that first study box  34   a  is positioned alongside any non-dragged study boxes  34  in an optimal manner on primary or supplemental display areas  35  or  37 .  
       FIGS. 6A, 6B ,  6 C,  6 D,  6 E,  6 F,  6 G,  6 H, and  61  illustrate the user-initiated retiling functionality of image display system  10 . Specifically,  FIG. 6A  is a flowchart diagram that illustrates the process steps  300  that are executed by image processing module  12  and retiling module  18  to provide user-initiated retiling functionality on primary or supplemental diagnostic display  23 ,  25 . The retiling functionality of image display system  10  is provided to allow a user  11  to display more of the open studies  30  that are available for a patient for comparison purposes. As noted above, while the general operation of image display system  10  will be discussed in respect of study(ies)  30 , it should be understood that the retiling functionality described is equally applicable to any other kind of display entity  27  such as for example, individual series  40 , images  50  and the like.  
      Generally, starting with a typical study box  30  as user  11  drags HANDLE tag  97  within the associated study box  30 , a highlight box  95  is displayed ( FIG. 6D ) showing the user  11  where they have moved HANDLE tag  97  and resulting area selected. Also, as the user  11  drags HANDLE tag  97 , the user  11  is also provided with dynamic previews of the resulting resized study boxes  34  (in dotted outline as shown in  FIGS. 6E  to  6 I) that show user  11  how resized study boxes would appear if the user  11  released the HANDLE tag  97  (i.e. release mouse  9  button) at that point. Depending on where the user  11  releases the mouse  9 , the box is then subdivided into multiple study boxes  30  so that more of the open study boxes are displayed as will be described.  
      Specifically, referring to  FIG. 6B , the user  11  begins the retiling process by viewing a single study  30  displayed onscreen in a study box  34  as shown. Then, at step ( 302 ), user  11  selects HANDLE tag  97  on the study box  34  within primary display area  35 . It should be understood that the retiling function is triggered when a user  11  selects the HANDLE tag  97  and drags it within the associated study box  34 . As discussed above, if the user  11  selects the HANDLE tag  97  and drags it outside the associated study box  34  and over the perimeter of other study boxes  34 , then the user  11  will be understood as wanting to expand the study box  34  and closure module  16  will be invoked to provide closure functionality to free up display area to allow for an expanded study box  34  as discussed above.  
      Display area  35  (or  37 ) contains horizontal and vertical borderlines. For example, as shown in  FIG. 6C , study box  34  contains vertical and horizontal half border lines (H), vertical and horizontal third border lines (T), and vertical and horizontal quarter border lines (Q). As user  11  moves HANDLE tag  97  across these various horizontal and vertical borderlines, retiling module  18  displays the appropriate highlight box  95 , determines the number of studies that the user  11  would like displayed and determine the corresponding column and/or row format. For example, by moving HANDLE tag  97  to the position shown in  FIG. 6D , the HANDLE tag  97  traverses the vertical halfway borderline (H) and the horizontal halfway borderline (V). Accordingly, retiling module  18  determines that the user  11  would like to display two studies horizontally and two studies vertically and that the corresponding column/row format should be a two-column and two-row format. If the user  11  releases the mouse  9  button at this point, four studies  30  (if available for the patent at issue) will be displayed in a two-column and two-row format within display area  35 .  
      It should be understood that the specific selection of column/row format depends on whether vertical or horizontal borderlines are traversed by HANDLE tag  97 . Also, it should be understood that both horizontal and vertical borderlines can be traversed and that as such, each crossing is dealt with on an independent basis. That is, if both vertical and horizontal half borderlines are traversed as shown in  FIG. 6D , then retiling module  18  will determine independently that two studies are desired to be displayed and two-column format selected (for vertical crossing) and another two studies desired to be displayed and a two-row format selected (for horizontal crossing). Together, this means that retiling module  18  will display the appropriate highlight box  95  (situated within both vertical and horizontal borderlines), determine that the user  11  would like four studies  30  displayed and determine the corresponding 2×2 column and row format for preview display and ultimately, implementation, if/when the user  11  releases the mouse  9  button.  
      Accordingly, referring back to  FIG. 6A , at step ( 304 ), retiling module  18  and image processing module  12  determine whether HANDLE tag  97  has traversed the vertical or horizontal half line of original study box  30 . If so, then at step ( 306 ), the appropriate highlight box  95  is displayed in dotted outline (e.g.  FIG. 6E  shows the case where the vertical half borderline has been traversed) and it is determined that user  11  wishes to display two studies  30  and the appropriate two-column preview is displayed ( FIG. 6E ). It should be noted that the original study box  34  continues to be displayed in the background. It should be understood that either two vertical columns and/or two horizontal columns will be displayed depending on whether the vertical and/or the horizontal half lines are traversed. As shown in  FIG. 6E , based on the position of HANDLE tag  97 , user  11  would like two studies  30  displayed within a two-column view (i.e. studies  30   a  and  30   b ) and retiling module  18  provides the appropriate layout preview. The layout preview is not implemented until user  11  releases mouse  9  button as will be described. At step ( 308 ), two study and two-column study layout  36  is selected, pending confirmation by user  11  (i.e. by releasing mouse  9  button).  
      At step ( 310 ), retiling module  18  and image processing module  12  determine whether HANDLE tag  97  has traversed the vertical or horizontal third line of original study box  30 . If so, then at step ( 312 ), the appropriate highlight box  95  is displayed (e.g.  FIG. 6F  shows the case where the vertical third borderline has been traversed) it is determined that user  11  wishes to display three studies  30  and the appropriate three-column preview is displayed ( FIG. 6F ). It should be understood that either three vertical columns and/or three horizontal columns will be displayed depending on whether the vertical and/or the horizontal third lines are traversed. As shown in  FIG. 6F , based on the position of HANDLE tag  97 , user  11  would like three studies  30  to be displayed within a three-column view (i.e. studies  30   a ,  30   b ,  30   c ) and retiling module  18  provides the appropriate layout preview. The layout preview is not implemented until user  11  releases mouse  9  button as will be described. At step ( 314 ), three study and three-column study layout  36  is selected, pending confirmation by user  11  (i.e. by releasing mouse  9  button).  
      At step ( 316 ), retiling module  18  and image processing module  12  determine whether HANDLE tag  97  has traversed the vertical or horizontal fourth line of original study box  30 . If so, then at step ( 312 ), the appropriate highlight box  95  is displayed (e.g.  FIG. 6G  shows the case where the vertical fourth borderline has been traversed) it is determined that user  11  wishes to display four studies  30  and the appropriate four-column preview is displayed ( FIG. 6G ). It should be understood that either four vertical columns and/or four horizontal columns will be previewed depending on whether the vertical and/or the horizontal quarter lines are traversed. As shown in  FIG. 6G , based on the position of HANDLE tag  97 , the user would like four studies  30  displayed within a four-column view (i.e. studies  30   a ,  30   b ,  30   c ,  30   d ) and the appropriate layout preview is provided. However, the layout preview is not implemented until user  11  releases mouse  9  button as will be described. At step ( 320 ), four study and three-column study layout  36  is previewed, implementation of which is pending confirmation by user  11  (i.e. by releasing mouse  9  button).  
      As discussed above, user  11  can manipulate HANDLE tag  97  so that it simultaneously traverses both vertical and horizontal borderlines.  FIG. 6H  illustrates the case where user  11  has manipulated HANDLE tag  97  so that it cross both the quarter vertical borderline and the half horizontal borderline within original study box  34 . As a result, retiling module  18  displays the highlight box  95  as shown that user  11  has created by dragging HANDLE tag  97  in such a manner. Retiling module  18  also determines that the user  11  would like eight (i.e. 4 times 2) studies  30  displayed and determines that the optimal study layout  36  will be a four-column and two-row layout and provides the appropriate layout preview. If the user  11  releases mouse  9  button (as will be described below), the previewed layout will be implemented and all available studies (as shown in  FIG. 6I  only studies  30   a ,  30   b ,  30   c ,  30   d ,  30   e  and  30   f  are available to be displayed) for that patient will be displayed.  
      At step ( 322 ), retiling module  18  determines whether user  11  has released mouse  9  button when HANDLE tag  97  is at one of the above-noted positions. That is, if user  11  releases mouse  9  button while one of the column/row previews are being displayed, it is assumed that the user  11  has selected that column/row configuration for implementation. Accordingly, the study layout  36  associated with the column preview being displayed is then selected and implemented to form a series of study boxes  34  within display area  35 ,  37 . Retiling module  18  and image processing module  12  then instruct display driver  22  to display the selected number of study boxes  34  as defined by the appropriate previewed study layout  36 .  
      At step ( 325 ), retiling module  18  determines whether the number of study boxes  34  now being displayed is larger than the original set of studies  30  available for display. If so, then at step ( 326 ) any additional studies  30  (that were previously off-screen) are displayed within the additional study boxes  34  within display area  35 ,  37  as described above ( FIG. 6I ). As shown in  FIG. 61 , this feature allows user  11  to see more studies  30  for a patient onscreen once additional study boxes  34  have opened up. That is, a user  11  may start with a single study  30  displayed within display area  35  or  37  and select HANDLE tag  97  to resize the study boxes  34  within display area  35 ,  37 . If user  11  releases mouse  9  button while one of the column/row previews are being displayed, it is assumed that the user  11  has selected the column/row preview displayed. This previewed study layout  36  is then implemented and a series of study boxes  34  are displayed within display area  35 ,  37 . Any additional studies  30  associated with that original study  30  first displayed, will now fill the study boxes  34  so that more studies  30  are shown for that patient. In the case of  FIG. 61 , there are only six studies  30  available to fill the eight study boxes  34  of study layout  36 .  
      As discussed above in respect of the tiling module  14 , it is contemplated that the determination of which studies  30  are brought into study boxes  34  is preferably based on a specific set of rule-based criteria that determine the “relevancy” of various studies  30 . The actual decision as to whether a particular display entity  27  (e.g. study  30 ) should be selected and where it should be positioned (e.g. alongside, above or below another existing display entity  27 ) can be made using relevancy rules. The specific rule-based criteria could be stored within user preference database  24  and implemented by tiling module  14  using relevancy rules as follows. This approach should be understood as noted above to apply to any type of display entity  27  (e.g. studies  30 , series  40 , images  50 ).  
      Retiling module  18  checks the characteristics (e.g. time of creation, image type, body type, modality type, procedure, patient, etc.) of a particular display entity  27  (e.g. study  30 ) and evaluates the associated relevancy rules. These relevancy rules can be used to determine whether a new display entity  27  should be selected for display and where it should be displayed (i.e. grouped alongside another dispay entity  27 ). Typically, data relevance is used to select and group display entities  27  within image display system  10 . However, the other criteria noted above and many others could be used along with or in place of date relevance in such a determination.  
       FIGS. 7A, 7B ,  7 C,  7 D, and  7 E illustrate the mirroring functionality of image display system  10 . Specifically  FIG. 7A  is a flowchart diagram that illustrates the process steps  400  that are executed by image processing module  12  and mirroring module  20  to provide mirroring functionality for a displayed study  30  on primary and supplemental diagnostic displays  23 ,  25 .  FIG. 7D  illustrates the graphical user implementation of the MIRROR button  99  within study toolbar  31  when mirroring functionality has been enabled.  FIGS. 7B, 7C  and  7 E illustrate an example of the mirroring function applied to a study  30 . It should be understood that while the discussion of the mirroring functionality makes reference to a primary and supplemental displays  23 ,  25 , it should be understood that mirroring could be applied to a primary display  23  along with any number of supplemental displays  25 . Also, it should be understood that any kind of indicia (i.e. not necessarily a MIRROR button  99 ) could be provided by mirroring module  20  for user to select to enable mirring functionality of image display system  10 . Finally, as noted above, while the general operation of image display system  10  will be discussed in respect of series  40 , it should be understood that the mirroring functionality described is equally applicable to any other kind of display entity  27  such as for example, studies  30 , images  50  and the like.  
      At step ( 402 ), user  11  selects a study  30  on an original display (i.e. either primary display  23  or supplemental display  25 ) for mirroring functionality using keyboard  7  and/or mouse  9 . As discussed above, user  11  can select a study  30  for direct manipulation by selecting the HANDLE tag  97  associated with a study  30  ( FIG. 7B ). When the user  11  moves the HANDLE tag  97 , the user  11  can change the dimensions of the study box  34  and move it over various display “surfaces” ( FIG. 7C ). In this way the user  11  can manually adjust the dimensions of the study box  34  so that it extends onto the adjacent display.  
      At step ( 404 ), it is determined whether user  11  has dragged the study to the adjacent monitor. If so, then at step ( 406 ), mirroring module  20  directs display driver  22  to expand study box  34  from being displayed only on original display onto both the original and adjacent displays. As shown in  FIGS. 7B and 7C  when user  11  selects HANDLE tag  97  of study box  34  on original display, and moves it over to an adjacent display  25 , the study  30  is expanded onto two displays. Specifically, a particular image (e.g. image  1 ) of the various series  40  associated with study  30  is displayed within each series box  44  which are displayed within the expanded study box  34 . The specific number of series boxes  44  that are displayed in this fashion can be selected by user  11  in a number of ways (e.g. using the retiling protocol discussed above, using a preferred series layout  46  stored within user preferences database  24 , etc.)  
      At step ( 407 ), mirroring module  20  enables the display of MIRROR button  99  within study toolbar  31  as shown in  FIG. 7B . This provides the user  11  with the option of selecting mirroring functionality. Selecting mirroring functionality will reduce the number of series  40  that are displayed but will allow the user  11  to “drill down” into the series being displayed on the original display as will be discussed.  
      At step ( 408 ), it is determined whether user  11  has selected MIRROR button  99 . If so, then at step ( 410 ), mirroring module  20  instructs display driver  22  to remove the series  40  currently being displayed on the adjacent display from display. At step ( 412 ), mirroring module  20  applies a display protocol for the images within the series  40  displayed on original display. One example display protocol is the “advance one” display protocol which takes the series  40  shown on the original display and displays the same series  40  on the adjacent display but with the images advanced by one ( FIG. 7E ). For example, as shown in  FIG. 7E , the first images of series  1 ,  2 ,  3 ,  4  are shown on primary display  23  and the second images of the series  1 ,  2 ,  3 , and  4  are shown on supplemental display  25 .  
      At step ( 414 ), mirroring module  20  causes the display of the resulting series  40  (i.e. advanced by one image) on the adjacent display. That, is mirroring module  20  mirrors the series  40  of study  30  being displayed on the original display (e.g. primary display  23 ) on the adjacent display (e.g. supplemental diagnostic display  25 ) according to a user preferred display protocol (e.g. an “advance-one” display protocol discussed above).  
      At step ( 416 ), it is determined whether the user  11  has deselected the mirroring functionality. It should be understood that the user  11  can deselect mirroring functionality in a number of ways. First, the user  11  can simply deselect the MIRROR button  99  from series toolbar  41 . Secondly, user  11  can select and drag back the study box  34  from the adjacent display back to the original display using the HANDLE tag  97  as described above. If so, then at step ( 418 ), the mirroring function is disabled and the MIRROR button  99  is removed from study toolbar  31 . If not, then step ( 416 ) is re-executed.  
       FIGS. 8A, 8B ,  8 C,  8 D and  8 E illustrate the specific image  50  manipulation functionality that is implemented by tiling module  14  and image processing module  12 . Specifically,  FIG. 8A  is a flowchart diagram that illustrates the process steps  500  that are executed by image processing module  12  to provide image display functionality as will be described. As noted above, while the general operation of image display system  10  will be discussed in respect of the display of images  50  within series boxes  44 , it should be understood that this display functionality is equally applicable to any kind of display entity  27  such as for example, studies  30 , series  40  and the like.  
      At step ( 502 ), user  11  selects a particular series  40  for display within series box  44 . At step ( 504 ), it is determined whether user  11  has requested that the images  50  of series  40  be displayed in stack mode (i.e. where images  50  are positioned on on-top of another so that only one image  50  is viable at any one time). It should be understood that there are many ways in which user  11  may request that the images  50  of series  40  be displayed in stack mode. For example, user  11  may select a menu option from a pull-down menu that is presented within series toolbar  41 . Alternatively, user  11  may enter a “short-cut key” representation of such representation (e.g. “F1”).  
      If it is determined that user has requested that the images of series  40  are to be represented in stack mode, then at step ( 505 ), image processing module  12  sets the “display mode” to be “stack mode” and then proceeds to step ( 508 ) at which point image processing module  12  retrieves images  50  for the particular series  40 . At step ( 510 ), image processing module  12  causes images  50  to be displayed in stack mode within series box  44  as shown in  FIGS. 8B and 8C .  
      As shown, image  50   a  is displayed within series box  44  and an image slider  55  is provided at the top of series box  44  such that user  11  can progress through the various images in the image stack by sliding the image tab  57  along the length of image slider  55 . As shown in  FIG. 8B , a first image  50   a  is displayed within series box  44 . At step ( 512 ), it is determined whether user  11  has selected image tab  57  and moved it along image slider  55 . If so, then at step ( 514 ), another image  50   d  (i.e. further down in the stack) is selected and displayed within series box  44  ( FIG. 8C ). It should be understood that user  11  can also move through images  50  in “stack mode” using a variety of means (e.g. by rolling a mouse button forward/backward, or using up/down arrows on keyboard  7 . Also, while image display of images  50  within series  40  has been discussed in respect of the movement of an image tab  57  along an image slider  55 , it should be understood that many different types of indicia could be used instead (e.g. pull-down menu tabs, etc.)  
      At step ( 506 ), it is determined whether image tiling mode has been selected by user  11 . Again, selection of “tiling mode” can be accomplished in a number of ways as discussed above in respect of the selection of stack mode (e.g. using pull-down menu option or short-cut key entry). If not, then image processing module  12  continues to monitor whether the user has selected a desired display mode and step ( 504 ) is re-executed.  
      If it is determined that user has requested that the images of series  40  are to be represented in tile mode, then at step ( 507 ), image processing module  12  sets the “display mode” to be “tile mode” and then proceeds to step ( 508 ) at which point image processing module  12  retrieves images  50  for the particular series  40 . At step ( 510 ), image processing module  12  causes images  50  to be displayed in tile mode within series box  44  as shown in  FIGS. 8D and 8E . As shown, in  FIG. 8D  a single image  50   a  is displayed within series box  44  and an image slider  55  is provided above series box  44  such that user  11  can select the number of images to be displayed within series box  44  by sliding the image tab  57  along the length of image slider  55 . At step ( 512 ), it is determined whether user  11  has selected image tab  57  and moved it along image slider  55 . If so, then at step ( 514 ), images  50   a ,  50   b ,  50   c  and  50   d  (i.e. original image  50   a  along with three other images further along in the series  40 ) are selected and displayed within series box  44  in a 2×2 configuration ( FIG. 8E ).  
      It should be understood that many other types of configurations are possible (e.g. 1×4 when four images are selected) and that once a certain configuration of images  50  are selected, the specific images being displayed can be advanced or retracted as discussed in respect of the “stack mode” approach (i.e. by rolling a mouse button or using up/down arrow keys etc.) Also, while image display of images  50  within series box  44  in certain configurations has been discussed in respect of the movement of an image tab  57  along an image slider  55 , it should be understood that many different types of indicia could be used instead (e.g. pull-down menu tabs, etc.) by user  11  to select a particular image  50  configuration.  
      While image display system  10  has been described in the context of medical image management in order to provide an application-specific illustration, it should be understood that image display system  10  could also be applied to any other type of image or document display system.  
      While certain features of the invention have been illustrated and described herein, many modifications, substitutions, changes, and equivalents will now occur to those of ordinary skill in the art. It is, therefore, to be understood that the appended claims are intended to cover all such modifications and changes as fall within the true spirit of the invention.