VistaRad in Your Hands Part 2

1
VistaRad in Your Hands- Part 2

• Creating Hanging Protocols for US, CT, and MRI

2
Tiling versus viewports

• Tiled One series (and one viewport) is split
  into multiple images
• US 9 images visible at a time
• ?No info lines along bottom of each image
• Layout can be easily changed
• Viewports Each viewport contains one image or
  one series of images
• Layout of the viewports cannot be changed in the
  viewer window
• Layout can be easily changed in the browser

3
Stages

• Different layouts in the same hanging protocol
• Approach it as if it is all one layout If a
  series is displayed on one stage it wont be
  displayed on another unless specifically directed
  
• Useful when one layout is not adequate
• Useful to display a case differently with or
  without prior exams.

4
Browser

• Extremely flexible viewer window
• Can be placed anywhere, any size
• Current or prior exam can be displayed on it by
  double clicking the title bar in the preview
  window
• Is not incorporated into the HP
• Useful to see priors that did not initially hang
  as part of the HP
• Also can be used to view any exam
• Color images can be viewed

5
Initial preparation

• Find and save names of cases in each modality
• At least 1 prior exam
• Similar related priors if appropriate
• Abdomen series prior CXR
• Shoulder MRI prior shoulder radiograph
• Longer exams are better
• Larger number of series in MRI and CT
• Both for the current exam and prior

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Initial preparation

• Try the default Hanging Protocols for each case,
  by simply double-clicking on the current study
• You can do this with other Radiologists to get a
  consensus
• Note things you would like to change
• Some of these changes can be made on the system
  HP
• Some changes will require creating a new HP

7
Initial Preparation

• Identify common exams that have a standard
  technique
• MRI shoulder, MRI brain
• Can be a problem if you have different magnets,
  or different CT scanners
• Try to get the series names to be similar
• Save cases with priors
• The default HPs may not have linked images to
  your preference

8
Initial preparation

• Review and add templates
• System templates
• 1up 1up
• 1up 2up
• 2up 2up
• 4up 4up
• 9up 9up
• 1 wide
• Use the same naming system for new templates
• 2up 4up
• Note if it is on a monitor with outlying
  resolution (i.e. 5MP when everyone else uses
  3MP) 1up 1up 5MP

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Templates

• Naming is very important
• Each time a user creates a HP, the template used
  will be saved by them and they will need to type
  the name in. It will say This name already
  exists, so when it is re-saved you want to be
  sure its the identical template.
• Be sure to note a different resolution for this
  reason because the outlying template will be
  filtered out on a different resolution monitor
  and cannot be used in a default HP

10
Naming Hanging Protocols

• The list displays in alphabetical order, not by
  modality
• List can become long
• Begin each HP name with the modality
• MR shoulder
• CT chest
• This way they will group together
• The HPs also group under each users name They
  dont need to label it Wilsons CT chest

11
Auto selection of an HP

• When you open an exam the HP used automatically
  will be selected in this order
• Personal CPT-specific HP
• System custom CPT-specific HP
• Personal modality-specific HP
• System custom modality-specific HP
• Default HP (usually modality-specific)

12
Initial preparation With VISTA team

• Review printsets
• Better to have these adjusted prior to creating
  specific hanging protocols
• For example Chest/abdomen/pelvis CT Keep
  chest separate? It could hang separately and be
  dictated separately
• Pelvis and hip films We always take a pelvis
  film with the hip film they are linked as a
  printset
• Simplifies dictating

13
Initial preparation With VISTA team

• Review and adjust similar CPTs and Modality
  and body part groupings
• These are groups of CPT codes you can create
• Abdomen 3V, abdomen 1V
• CXR 1V, CXR 2V, CXR obliques
• Do you want that prior to display as a comparison
  exam?
• Only for studies that are truly similar
• HPs can display any specific CPT as a prior, (or
  its similar CPTs)

14
Creating your first custom HP

• Youve identified a case that does not open in a
  way you like with default HP
• You have a complete case with priors
• Go to the Manager View/settings/viewport and
  adjust the apply to set boxes
• If creating HP for CT/MRI/US, check all of the
  boxes on
• If creating HP for CR/DX, unclick W/L and
  orientation

15
Creating your first custom HP

• Next Select the current exam and priors (using
  ltctrlgt), open with button, and then choose the
  appropriate template
• Start by creating the Stage that displays prior
  exams A later stage will display the current
  exam on both monitors, and that can be marked to
  open when there is no prior

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Ultrasound Stage 1

• Left monitor current exam. One viewport Images
  are displayed in a tile of 9.
• Can easily change the HP to display a different
  number, thus a different size of images

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Ultrasound Stage 2

• No prior
• Default box in case information of HP
• Current exam displays on both monitors
• Unfortunately, images go horizontally across both
  monitors
• Use the page down button when viewing

18
CT

• Stage 1
• 2up 2up
• Soft tissue and lung windows (explicit map)
• Current and prior
• Stage 2
• Choose template based on typical long exam (ex 4
  series)
• 4up 4up
• All series display, default modality

19
MRI

• Stage 1 9up 9up
• Current on left monitor, prior on right
• Stage 2 4up 4up
• No priors all current exam
• 6up 6up may not enlarge the image size compared
  to 9up 9up