User Release Notes

CARESTREAM Solutions
Version 11.1

Pub. #9G2934 2010-08-18

TITLE: User Release Notes for CARESTREAM Solutions Version 11.1 PART #: 9G2934 VERSION # 1.0 PAGE 1 of 15

1. Introduction
This document provides general information about the new software release and includes information not specifically covered in other documentation. It is divided into the following sections: o o o o New Features in Version 11.1 Major Defects Resolved Known Problems and Limitations Installation Requirements

2. New Features in Version 11.1

The following features are new since Version 11.0.

Client New User Interface

Version 11.1 introduces a new user interface which simplifies using the application. The major changes in the new UI are: Ribbon-based interface The application toolbars are now based on the ribbon interface (following the Office 2007 concept). o o o The ribbon interface groups the related functionality into tabs, making it easier to find the requested function. Commonly used tools are presented as larger sized icons. Referring physician mode offers a simpler representation of the user interface with fewer tabs being exposed by default (you can switch to advanced mode if you need to access the additional functionality). Film Pre-Viewer now has its own ribbon, providing quicker access to the most useful functionality (such as print, layout management, etc).

Customizable toolbars and menus The new user interface can be easily customized by each user, directly from the application using right-click mouse button. Some of the aspects that can be adjusted are: o Assign any operation to the right-click menu and/or into a designated ribbon bar (My Tab). An administrator can control the content of my tab and lock if desired to create a more manageable system for the referring community. A shortcut can be assigned to any button/menu. A summary list of shortcuts can be printed for reference. Commonly used layouts can be assigned to my layouts bar for quick access. Default ribbon tab can be configured. Group level toolbars and scroll bars can be pinned or eliminated from the interface as needed.

o o o o

Group and Image level toolbars Various operations are now accessible directly from the group/image level, providing quicker access and a better understanding of each operations context (or which object the operation applies to). Revised layout management The layout mechanism has been completely revised in this version: o o Layout system is now monitor-based rather than viewbox-based. A new navigation system simplifies navigation between various opened applications (viewboxes). Applications can be brought up to view through tabs, keyboard or shortcuts.

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o o o

The layout can be set through various methods starting with keyboard shortcuts, toolbar buttons and the layout wizard. Tile mode provides easy way to show a group tiled over multiple monitors. Easily toggle between one or two monitor presentation for clinical application.

Note: Due to various changes in the layout management system, there are various restrictions that may apply: Clinical applications now use a full monitor (or more) and cannot be opened on a partial monitor. A viewbox must occupy the entire screen. A group cannot split between two monitors unless being displayed in Tile mode.

Those restrictions may cause old DPs to be displayed incorrectly. During the upgrade, your DPs will be converted by the system in order to ensure that they will not violate those rules. Note that although we try to optimize the presentation as much as possible, there might be some DPs that will have to be manually re-designed for optimal display. Patient Mini Archive The patient mini archive has been rebuilt and now offers enhanced functionality. The new Patient mini archive can be used either in full screen mode or strip mode to optimize the screen space as needed. o Full screen mode provides a complete insight into patient jacket including access to studies, series thumbnails, reports and sticky notes. o Improved filtering capabilities, as well as the timeline group, ease the process of searching for a particular prior study. Full screen mode can be used in various layouts. You interdependently control the size of its components.

Strip mode docks into the image viewing area and provides easy access to the study thumbnails.

Browsing prior studies and partial loading In both modes, the PMA allows browsing prior series BEFORE loading the actual studies. In addition, dragging an unloaded series automatically loads that specific series, hence providing means to examine large priors selectively.

Client Performance Enhancements

Interactive Loading Similar to streaming, the application now prioritizes the load operation according to the ROI being viewed. Improved Image Memory Management When loading a large dataset, the application can discard and reload images as needed, making it possible to view any number of images (in 2D) regardless of the physical constraints such as amount of memory installed on the workstation and/or type of operating system. Low memory alerts When using 3D applications, the system now monitors the usage of memory and will attempt to provide low memory alerts if there is not enough memory to complete an operation.

Client Image Review and Analysis Tools

PowerViewer o o Zoom Synchronization The zoom/pan synchronization automatically adjusts all linked groups and uses the same mm per pixel to compensate for any differences in scanners / FOV. Current Study Indication The current study is now marked using brackets ([ ]) over the study date annotation.

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Clinical Applications o Vessel / Coronary Tracking: Automatic coronary extraction This algorithm automatically segments the coronary arteries and gives names to the major ones (for example, LAD, RCA, LCA). Automatic body vessels This algorithm automatically segments the major arteries in body scans and gives names to the major ones (for example, the iliac arteries). Improved Vessel Management A new set of tools provide additional means to extend, truncate or branch from active vessels. In addition, the application allows defining of new vessels without changing the layout (Quick vessel); renaming vessels and recalculating their contours after editing changes are made to the vessels.

Tissue Definition A new freehand contour tool allows you to freely segment tissues in individual slices (either using the axial, coronal or sagittal planes), while the tool automatically morphs between the intervening slices. Volume Rendering Enhancements A new volume rendering engine completely replaces the old engine. The new engine offers better images as well as configurable trade-off between quality and speed. Note: For high performance computers, set the rendition mode to enhanced mode, and the interactive quality to high. For older machines set the rendition mode to non-enhanced. Bone Removal Algorithm The bone removal algorithm is now augmented by an additional tool that removes residual bones if these are present. You can use this tool in cases where some fragments remain after the automatic tool runs.

Mammography o Nipple / Vertical Alignment Using either a nipple detection algorithm or information coming from a CAD object, the system can automatically align related images vertically by locating both nipples over the same horizontal line. Study Replacement Provides means of replacing an entire study with a different one, either through study date annotation or by dragging a study from the patient mini archive. The replacement process loads the new study and apply its views to replaced locations as designated by the DP. Reference Lines and Relate Reference lines tools provide cross correlation of a given ROI, between several mammograms based on the distance from the nipple. Viewbox Shortcuts You can now assign keyboard shortcuts through the DP to the designated viewbox. Once clicked, this triggers the navigation system and brings up the designated viewbox.

o o

Client Miscellaneous
Search Tools The search tab offers direct integration with various 3rd party search tools (such as StatDX, YottaLook and Google) for quick web search. Enter search terms manually or extract them automatically from the DICOM header. Additional search engines may be configured as needed. Improved Help System The following additions to the help system makes the system easier for use and more intuitive to learn. o Balloon Assistant Various functionality is now accompanied by the ad-hoc assistant, which provides usage hints and tips. This assistant can be turned off as needed (Do not show this again). o Training Videos A library of online training videos is now provided as part of the online Help resources. Videos are accessible either by demand or as part of the Balloon assistant (where the system automatically links to the relevant video based on the functionality being used)

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o Welcome/Messages Page Upon first login to V11.1, you are presented with a welcome page that offers various links to online Help resources. This page can be customized according to the sites needs and can also be used at later stages to communicate various site-specific messages (such as planned system downtime, upgrades, etc). The system has a built-in mechanism to track the page update time, so each user is being presented with messages only once per update.

Client Administration Tools

Starting at version 11.1, all administration tools require the JAVA Runtime Environment - JRE 1.6. JRE 1.6 is installed automatically (if it does not already exist) when running an applet for the first time. Faster uptime Remote connections supported from outside the hospital network (SRSA, ADSL). Improved plug-in tool. Can be loaded through an administrator web page (Standalone Admin Tools).

Server HCFFs
As part of the new load mechanism, header files are now stored in the file system at the study level. Expected file size is negligible. HCFFs for new studies are created during the Store process. HCFFs for existing studies will be created gradually by the new WFM Framework.

Server Series Icons

To accommodate the new PMA group-level icons, the icons are now created and stored in the database at series level. Expected icon size is 16 kb per series (the size is configurable). Note that the existing imagelevel icons configuration is overwritten to provide image-level icons only for specific modalities. In the PACS environment, icons should not be disabled, since this leads to missing icons in the PMA.

Server Changed Behavior

RC01 Database Removal: RC01 (rcat) database will no longer be used for database backups. It will be removed during upgrades and not installed during new installations.

Server HL7 Message Validation

Enables IS Link to set Policy validating messages sent from RIS; it enables several levels of validations. Syntax Validation - Check that incoming HL7 messages are constructed according to HL7 rules. Data Validations Check that HL7 messages are consistent with the data stored in the system to prevent updates that may result in patient safety issues.

Server External PIX Support (PIX Consumer)

Enables the system to interface with a PIX Manager, in accordance to IHE PIX Profile. PIX Consumer can be configured to update the system on external patient ids from MPI/PIX manager.

Server - Fast Loading Protocol

Version 11.1 introduces a new fast loading protocol over fast lines. The new protocol provides a better user experience by increasing the interactivity of the loading service. This is performed by sending all the image headers and a selection of prioritized images in the first stage of the load and then loading the rest of the images while giving priority to currently displayed images and their surrounding images. The image header arrival time for the whole study is significantly faster. To increase the image headers arrival time, image headers are pre-stored in files called HCFFs (Header Container File Format) and are fetched and sent to the client in the beginning of the load session. Once headers arrive at the client, a scroll to any location in the study invokes a load command to the displayed images (if not loaded yet), and then additional images are fetched from closet to furthest of the

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current displayed locations. This is contrary to the normal load protocol that retrieves images in a linier order from first to last with no flexibility. Changing the displayed images will change the loading priorities so that nearby images are always more available and responsiveness is improved. Another improvement is the ability to load and view very large studies. This is performed by selectively loading the parts of the study that are needed for viewing and/or processing up to the capacity the client can manage. Unneeded parts of the study are eliminated from the view, for example, if the focus has shifted to another section of the study in order to load more relevant sections of this study. All sections of the study can be reloaded if needed again. Note: PACS will continue to support the previous "fast" load protocol for back support over grid.

Server Streaming (slow) Loading Protocol

The Streaming loading protocol benefited as well from the introduction of the HCFFs. As of version 11.1 these replace the existing DB Header Blobs as the source for creating the streaming headers. Since there is no need to perform a complex query to fetch the headers, the throughput of headers in the server has improved significantly and the load on the service has been reduced as well. A major improvement was achieved by compressing each sent streaming header. Individual headers can be compressed to about 60 percent of their original size. Both improvements have increased the effective headers rate in streaming by 50% to 200% depending on the study size, number of series, etc. The use of HCFFs has also resolved several problems that were the results of limitations of the Streamed DB Headers mechanism. One last noticeable change is the removal of the "STOP" button in streaming. Again, now that the button is no longer useable, related bugs are no longer relevant. It is important to note that the actual protocol of streaming has not been broken and this is supported both backward and forward up to version 11.0_P001 (which introduced an overall protocol change for all CONN services).

Server Large Multiframe Support

Multiframe images, especially large ones, were hard to deal with in terms of resource consumption like CPU, memory and network. In previous versions, when using the Fast load protocol, this toll was taken from the client who had to receive the whole multiframe image, split and render it. Regardless of that, some very large multiframe images proved difficult or impossible to deal with on the client side (Fast) or server side (in streaming). In this version, the following improvements have been made: The Fast load protocol now splits multiframe images in the server same as streaming. This improves the responsiveness to the client and locality of the images received (most interesting rather then the whole multiframe in linear order). Another Improvement is the added support of very large multiframe images (several hundred mega bites of compressed pixel data). These are now decompressed (if necessary) and split using the MEM package, allowing us to support the splitting of up to some gigabytes of raw data.

Server Tool LDR

Added support to load studies using the new Fast Loading protocol to the utility.

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Server Tool HCFF

Added a tool to view and extract the content of stored header file (HCFFs), similarly to the tool DCFF.

Server Perf Driver

Added a tool to measure the optimum performance of the headers and loading phase of the Fast and Streaming protocols without any dependency on a client. The tool is similar to FetchDriver, which measures the image rate of the regular image load process used in SVDSER and SVLDR.

Server MEM Configuration Improvements

MEM trace for debugging purposes as well a specific side version of MEM for debug. Configuration per machine and product. MEM Scan utility to map the memory of given process.

Server Performance Counters

Added internal counters and statistics for the Fast and Streaming protocols. Performance counters measure the rate of headers and images in the server, the loader client and MP client.

CD Direct Multiple PID support

In the following places, CD-Direct uses multiple PIDs (all the PIDs that exist for the burnt patient): In the Advanced Viewer (see CARESTREAM Client support of multiple PIDs). In the DICOMDIR and DICOM images burned on the CD. In the following places, CD-Direct uses only one PID: In the print label of the burned CD. In the reports burned on the CD. In the CD html pages. In CD-Direct queue manager. When CD-Direct uses only one PID, it is the PID of the default issuer (defined in the WFM).

3. Major Defects Resolved

Server Resolved Defects
When the FIR and SMA are installed on the same machine, SMA backup requests are being sent to the FIR AE title Gradual_take_over.pl misses a few days on parsing rule - preceding sub string does not copy as expected Migrate - oracle process consumes up to 40 % CPU constantly while running Merge failed (detect only in log) when source has more than 1 location Assertion in svdser/svldr when DCFF doesn't exist, which leads to failover not working Update patient's details via admin tool updates the details in mst but not mdl Centera files should be written only to /usr/tmp/centera_cache 'mst_add_dicom_parse_cardiac.pl' does not add the parsing rule

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sync_main gets stuck and fails to sync from satellites to DC After performing several Manual RIS-Sync operations, the DB Admin tool gets stuck http://<server address>/MediStore/ brings old Algotec Webpage DIT cannot run from the Web on Windows VISTA 64bit Fixed The WADO isn't working on Oracle RAC Fixed License to 3D is not released when mp is crashed Fixed Specific study does not display the shutter on CSC (it's shown in WX)- from site Loading mammo key images in UNIX fails due to a crash in svstream (11.0 and 11.1) Partial study will be sent to burn when using Copy and not Burn (see attachment) URL: when setting patient ID, sometimes the application got stuck LoaderExe crashes while images are pushed 2 US with MF images are loaded very slow, and might react slow even after load is done From site: corrupted images with Overlay (site has a workaround) App crash after windowing auto selected ROI borders reached image frame (form site too) Specific study - EK_HI00067045 - Lossy US images displayed corrupted ADSL - Loading problems (complete to lossless etc)

Client Resolved Defects

Error while loading - Complex^Combination^Test (PR) ADSL - Loading problems (complete to lossless etc) Once PMA get the focus, scroll on viewer doesn't work (until selecting the gda again) The RW annotation can handle only up to 65 groups, groups beyond that are ignored App crash after windowing auto selected ROI borders reached image frame (form site too) 2 US with MF images are loaded very slow, and might react slow even after load is done Feature request: add sort by key image's creation time Problems in loading specific US studies. Loading a presentation with linked group when one is in off spacing doesn't save the scroll Specific study doesn't display the shutter on CSC (it's shown in WX) The opacity slider is disabled when adding additional classes The VolR protocol is not closed when the application is locked (applies to other dialogs) VolR Protocol: Adding a new class does not appear on the VolR image. The rendition type annotation in the MPR is not displayed on the reference images MPR: Changing to Mip\Min PR - only the result image is influenced MPR: Right click on the rendition type annotation on the ref. images is unavailable RIS-PACS integration: PMA always displayed under the RIS after upgrade despite CFG flag When no report available for a study, the browser immediately displays a prior's report if exists Once Explore Archive has been used the "load worklist" option gets disabled

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DP repair tool cannot be opened in xpsp2 The spooler may not remove some transactions from the queue due to file locks Diagnostic profile with one concatenate in 3D - 2nd user can't read 3D until 1st is logged out license to 3D is not released when mp is crashed The last accessed by field should be added by default to the AE field chooser URL: when setting patient ID, sometimes the application got stuck Saving presentation after loading to MPR- Presentation will be saved as MipPR reset-windowing option disappears from the win right click menu Loading mammo key images in unix fails due to a crash in svstream (11.0 and 11.1) com interface - The COM function IsSessionOpen always returns value 1 COM Interface - call to close session for status = READ study fails from site: corrupted images with Overlay (site has a workaround) URL: sending line with Patient ID/Acc=X*, AE will be opened with Archive list instead of the relevant studies when icons are set to small and switching to Strip, the report/SN/ order buttons disappear Changing the zoom/windowing while loading does not change it for the entire group Bed removal Progress text in status bar is not translated MG: save as JPG/BMP/etc for MG images doesn't work. Only annotations are drawn Presentations are not loaded because of an incorrect data. (see attachment for details) Crashes when defining two vessels of two different studies on two-monitor station The "Save" icon is disabled even when you have a permission to save to local 2 US studies from sites crash in load (also in push via DIT)

CD-Direct Resolved Defects

Jpegs of multiframe images are reversed on the HTML page Login window is opened when launching CD-direct-Advanced viewer, asks for user name and password

4. Known Problems and Limitations

Client General
In various extreme cases when using INTERNET EXPLORER 8, the browser may crash during the installation. The problem is a result of various software conflicts. Typical workarounds may be (you can apply each one independently): o If you have an old install of MSJAVA, uninstall it (note that this software is no longer supported by MICROSOFT since XP SP3). See more details in: http://www.helpwithwindows.com/WindowsXP/howto-21.html http://www.microsoft.com/mscorp/java/default.mspx Uninstall Google Toolbar if you have that Add-on installed.

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Turn OFF the IE8 DEP mechanism on IE toolbar, Click Tools->Options->Advanced. Under the Security tab, make sure Enable Memory Protection is unchecked.

Some DPs may not be converted properly due to various new UI restriction that were introduced in V11.1 (for example, a DP containing multiple MPR application in the same monitor, can not be converted as is, as you such a layout is no longer supported). For a complete list of DP limitations refer to the configuration section of this document.

Server Database
NEARLINE studies will not have series icons created for them: o The WFM framework will create series icons when the studies return to online. o This means that when a NEARLINE study is being loaded (without pre-fetch or bringing it to ONLINE), the PMA will not show its group icons until the study is completely loaded. IS Link sync does not support ADT-A29 Delete Patients Document Agent file size limitation The maximum file size that can be imported to the system is 100M

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Server INTERNET EXPLORER 8 Windows and Tabs

INTERNET EXPLORER 8 (IE8) windows and tabs share the same session unless you select "File -> New Session" or run iexplore.exe -nomerge explicitly. This may cause an admin tool to connect to a database of another host, previously used in another tab! As a workaround, right-click the IE8 shortcut (Icon on desktop, Start Menu, Quick Launch bar or taskbar), and choose Properties from the right-click context menu. Then, append -nomerge to the end of the program path in Target text box at Shortcut tab. For example:

CD-Direct Server
In SMA, The option of Burn at a scheduled time is not functioning. In a Grid configuration, when burning a study from the global worklist, if the study and the report come from different servers the report will not be burned. In a windows cluster, CD-Direct is installed by default as a windows server, but it does not function. CD-Direct Auto-Delete deletes all the tasks that are in 'DONE' status (regardless of the free disk space configuration). Installing CD-Direct server in an NPD environment After installing CD-Direct, change the NPD rules: do not copy images arriving in CD Direct server. RIMAGE printing template file For languages Japanese, Chinese, Korean, Hebrew, and Arabic: change the font of the text fields (using the CD Designer program). The currently selected font does not support these languages. The template file: [Install Dir] \ CDSURF \ RESOURCES \ CDSURF_NEW.BTW Cannot burn to a remote/network RIMAGE installation.

CD-Direct Monitor
Opening the CD-Direct monitor from the web on a machine other than the CD-Direct server requires setting the java property permission java.security.AllPermission; in the local java.policy file (usually under D:\Program Files\Java\<JRE-HOME>\lib\security)

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CD Direct Client
HTML viewing of a non-DICOM study brings Jpegs of other studies burned on the same media Error message when opening the html of a large study on INTERNET EXPLORER 7 from a Summary CD WINDOWS VISTA Installations requires SP1 (or the latest hot fixes from MICROSOFT: see http://support.microsoft.com/default.aspx/kb/935200) The CD does not work on MACINTOSH computers. SR type images are not converted into JPG lossy images and are not displayed in the web-based viewer. SR series appears as empty series.

5. Installation Requirements
Server Supported MICROSOFT WINDOWS Versions
WFM/App Server MICROSOFT WINDOWS 2008, R2 (64bit). No other versions are supported. RAC WFM MICROSOFT WINDOWS 2003, R2 (64bit) MICROSOFT WINDOWS 2008 R1 is being investigated. Before installation, consult with Technical Support for the required operating system version. LTSM MICROSOFT WINDOWS, 2008 R2 with NETBACKUP Server 7 Upgrades may stay with MICROSOFT WINDOWS 2003 R1/R2 SP2 (32bit) and the currently installed NETBACKUP version. Cluster Servers MICROSOFT WINDOWS 2008 R1 (64bit) with VERITAS 5.1, SP1, MP1 SA MICROSOFT WINDOWS 7 Upgrades can stay with MICROSOFT WINDOWS XP, SP3 (32bit). For this configuration, the ORACLE server software will not be upgraded. CD Direct MICROSOFT WINDOWS 7 Upgrades can stay with: MICROSOFT WINDOWS XP, SP3 (32bit) MICROSOFT WINDOWS 2003 R1/R2, (32bit), SP2 For the 32bit configuration, the ORACLE server software will not be upgraded.

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Server Minimum Storage (Basic Installation)

The minimum storage required for the ORACLE server software is as follows:
Environment SOLARIS WINDOWS Required storage 10GB 10GB

The minimum storage required for the DB is 40GB for the Online DB file system. The DB-backup file system should be twice the size of the Online DB file system. The memory requirements for WINDOWS/UNIX:
Full WFM Cluster WFM RAC WFM LTSM Applications Server CD-Direct (not SA) SA/CD-Direct SA 8GB 8 GB each node 8 GB each node 4 GB 4 GB 4 GB 8 GB For 32bit, 4GB

Client Minimum Requirements

Discontinued Hardware Support PENTIUM 3 is not supported by version 11.1. Supported Operating Systems - Version 11.1 supports MICROSOFT WINDOWS XP 32/64 (SP2/3), WINDOWS VISTA 32/64 SP1 and WINDOWS 7 32/64. Note: WINDOWS 2000 is no longer supported. Minimum Requirements
RAM CPU Video Depth

Workgroup Profile

Operating System

VA/VE/MX

VR/VM

Power User VR

WINDOWS XP SP2/3 32/64 WINDOWS VISTA SP1 32/64 WINDOWS 7 32/64 WINDOWS XP SP2/3 32/64 WINDOWS VISTA SP1 32/64 WINDOWS 7 32/64 WINDOWS XP SP2/3 32/64 WINDOWS VISTA SP1 32/64 WINDOWS 7 32/64

512 MB

Single-core 2.0 GHz or higher Dual-core 2.0 GHz or higher Quad-core 2.0 GHz or higher

16 bit

2 GB

32 bit

6 GB

32 bit

MICROSOFT .Net software - dotNet framework (2.0SP1, 3.0, 3.5) MUST be installed on any workstation running V11.1 CARESTREAM Client, including the Advanced Viewer (CD-Direct client)

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The following is a summary of the new directory structure on the different platforms: Administrator Installation \Program Files\Kodak\PACS\ $SERVER$ \ProgramData\Kodak\PACS\ $SERVER$ Administrator Installation \Program Files\Kodak\PACS\ $SERVER$ \Documents and Settings\$USER$\Local Settings\Application Data\Kodak\PACS\$SERVER$ User Installation \Users\$USER$\AppData\Local\Kodak\PACS\ $SERVER$ \Users\$USER$\AppData\Local\Kodak\PACS\ $SERVER$ User Installation \Documents and Settings\All Users\Application Data\Kodak\PACS\$SERVER \Documents and Settings\$USER$\Local Settings\Application Data\Kodak\PACS\$SERVER$

WINDOWS VISTA \ WINDOWS 7 Program Data WINDOWS XP Program

Data

CD-Direct Server Minimum Requirements

2GB RAM CD-Direct remote mode

CD-Direct PACS Client (Advanced Viewer) Minimum Requirements

INTEL PENTIUM 4 processor or higher 512 MB RAM If the Advanced Viewer is used on a client with less than 512 MB RAM, a warning message appears when loading the study.

CD-Direct Supported Operating Systems

PACS Client (Advanced Viewer) o o WINDOWS XP operating system with SP1 or later WINDOWS VISTA OS with latest hot fixes from MICROSOFT, or SP1

Burners and Media o o o RIMAGE Producer - Ver 6.1 to Ver 8.1: CD or DVD (ver 7.3 requires a patch from RIMAGE to work with CD Direct). Local burner: CD / DVD / BD. Media supported: CD-R, DVD-R, BD-R

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CARESTREAM is a trademark of Carestream Health, Inc. The Kodak trademark and trade dress are used under license from Kodak.

Carestream Health, Inc. 2010 150 Verona Street Rochester, NY 14608

0086
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