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 won’t 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

6. 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 HP’s 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

9. 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 it’s 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 HP’s also group under each users name: They don’t need to label it “Wilson’s 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 CPT’s” 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 HP’s can display any specific CPT as a prior, (or its “similar CPT’s”)

14. Creating your first custom HP You’ve 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 <ctrl>), “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”

16. 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

17. 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