4.15-4.20 - Description of Operation PDF

ZIEHM
EXPOSCOP 7000
1%IMS
USERS M A N U A L
IMS-2760
INTEGRATED
DIGITAL I M A G E
SYSTEM
SECTION 4.15 - 4.20

Z I E H M - INTERNATIONAL MEDICAL SYSTEMS, INC. A L L RIGHTS RESERVED ©1997
EXPOSCOP 7000 OPERATORS SECTION 4.15-4.20 TABLE OF CONTENTS
Section Description Page #

Table of Contents 1
General Information 3
Terminology 3
Control Keyboard 6
14.15 Power O N / O F F 8
14.16 Text Annotation and New Patient Information Keys

14.16.1 Alpha Keys 8
14.16.2 Numerical Keys 8
14.16.3 Shift key 9
14.16.4 Delete / Space 9
14.16.5 Enter 10
14.16.6 New Patient 10
14.16.7 Text Insert 12
14.16.8 Right or Left Anatomical Marker 13
14.17 Acquisition / Fluoroscopy

14.17.1 Fluoroscopy 13
14.17.2 Pulsed Fluoroscopy / Pulsed Auto Store 13
14.17.3 Snapshot 14
14.17.4 M S A Max-Op / Mask Re-registration 14
14.17.5 RSA RoadMap / Mask Re-registration 14
14.17.6 DSA Digital Subtraction / Mask Re-registration 15
Re-registration Of DSA Mask 16
Dynamic Acquisition of Subtracted Images 17
Storing Image Acquisition 18
Storing Individual Images to Patient file 18
Protection 18
DSA Output Lookup Tables (Window and Level) 18
Level Adjustment 19
Size Adjustment 19
14.17.7 Edge (Real Time Edge Enhancement) 20
14.17.8 Noise Reduction 20
14.17.9 Last Image Hold Noise Reduction (LIH NR) 20
14.17.10 W N D W (Window Adjustment) 21
14.17.11 Text O n / O f f 21
14.17.12 Frame Rate 21
14.17.13 Mask 22
14.17.14 Cine Reset 22
14.17.15 Cine (Dynamic Image Acquisition) 22
Dynamic Image Acquisition Without Subtraction 22
Storing Image Acquisition 23
Display Messages for Cine Operation 23
Loop Un-stored 23
Frame Rate Display 23
Available 23
Cine Procedure 24
Protection On 24
Protection Off 24
Storing Individual Images to Patient File 25
Cine Features 26
Exposcop 7000 IMS2760 Image System Section 4.15 - 4.20 09/22/97

International Medical System Description of Operation Rev. 3 1
Cine Store / Auto Store 26
Cine Recall 26
Cine Edit 27
Shift Mask Re-registration of Mask to Image Loop 28
14.17.16 V C R Operation 28
Auto Record Start 28
Playback 28
Turn Off VCR 29
DICOM 3 NT-100 VIDEO CAPTURE REVIEW (VCR) 29
14.18 Review
14.18.1 Image FWD / REV 30
14.18.2 Image Page Display 30
14.18.3 Pat File .. Accept Patient, Delete Image, Delete Patient, Copy Image 32
14.18.4 MonLtoR 34
14.18.5 MonRtoL 35
14.18.6 Cine Edit 35
14.18.7 Cine Recall 35
14.18.8 Inv Video (Invert Video Values ) 35
14.18.9 Hardcopy (Film documentation camera / Video Paper Printer) 35
14.18.10 Digital Document Rotation 36
14.19 Store
14.19.1 Autostore, Auto Transfer, Auto Both, Auto Mag 36
14.19.2 Cine Store, Cine Auto Store 36
14.19.3 Image Store, Audio Alert 38
14.20 Process
14.20.1 Image Crop (Post Electronic Image Collimation) 39
14.20.2 4onl 40
14.20.3 W N D W ( Window / Level) 40
14.20.4 Mag W N D W (Image Magnification), Auto Magnification 42
14.20.5 Shift Mask 43
14.20.6 Arrow Keys 43
14.20.7 Sharp 44
14.20.8 Escape 44
1997 ZIEHM INTERNATIONAL MEDICAL SYSTEMS, INC. A L L RIGHTS RESERVED © 1997

COPING OF THIS MATERIAL WITHOUT DIRECT PERMISSION FROM Z I E H M - INTERNATIONAL M E D I C A L
SYSTEM S, INC. IS PROHIBITED BY LAW.

4.15 GENERAL INFORMATION IMS2760 KEYBOARD CONTROL
The IMS2760 Digital image system software has been written to be direct in its approach for user
operation. (In other words, it is more user friendly.)
When power is turned on, the image system will do a few self-tests. Several beeps may be heard and
are normal for boot-up routines. After approximately 30-40 seconds, the system will display R E A D Y
FOR FLUORO on the left Process display monitor. At this time, the image system is ready to acquire
images from the C-Arm T.V. chain.
The Exposcop Plus will start operation in the non-specified patient record. The non-specified patient
record allows the unfamiliar technologist to operate the Exposcop Plus with ease. They are not required
to enter patient name or I.D. number. The system will allow the images to be stored in a loop of 16 or 32
images depending on system options. This means if you start at #ONE (1) for a new procedure and you
have stored 32 images, the next image to be stored would be at # one (1). This will overwrite the
previously stored image at # one (1) on the image disk.
NOTE: We recommend the use of non-specified patient record for emergency procedures when long term
storage (more that just a few minutes) is not needed.
For archiving images to HARDCOPY film or paper printer. It is necessary to have all patient
information on the screen. We recommend using the patient file for this purpose.
All functions and features described in this manual may not be available on all
system unless certain options were purchased.
TERMINOLOGY USED IN OPERATION SECTIONS 14.15 -14.20.8
PROCESS MONITOR:
This generally refers to the left monitor display. However, in certain circumstances the left
monitor will be used as the reference display monitor. This will occur when the LIVE I M A G E
TRANSFER selection is made from the C - A R M control keyboard.
LIVE IMAGE TRANSFER KEY
The PROCESS MONITOR is used to display all live images for fluoroscopic procedures and
to display process image functions, i.e., four (4) on one (1), SHARP, WINDOW LEVEL, and
M A G WINDOW, etc . . .
REFERENCE MONITOR:
This generally refers to the right monitor display. However, in certain circumstances the
right monitor will be used as the process display monitor. This will occur when the LIVE
IMAGE TRANSFER selection is made from the C - A R M control keyboard.
NOTE: Optional SIMPLE IMAGE TRANSFER from left to right monitor can be selected by
service engineer.
C - A R M CONTROL KEYBOARD:
This refers to the C-Arm mobile keyboard controlling all c-arm functions, i.e.selection of
fluoroscopy, pulse fluoro, snapshot, collimator controls, k V / m A displays, etc.
Exposcop 7000 PMS2760 Image System Section 4.15 - 4.20 09/22/97

MONITOR C A R T CONTROL KEYBOARD:
This refers to the IMS2760 image processor control keyboard. The monitor cart control
keyboard provides the operation interface for the user to select functions of the image
processing system, i.e. store images, recall images, film documentation, make cine runs, store
cine runs, create patient data base for image records, e t c . . . .
The monitor cart control keyboard has several different overlays for key functions. The
overlays are designed to work with software version and options purchased.
IMS2760:
This refers to the image processors system located in the monitor cart of the Exposcop 7000 C-
A r m starting March 28,19 96. This image processor provides high speed image Analog to
digital conversion at 10 bits of gray scale. The real time image processors allows the storage
and recall of images at full 10 bit gray scale. This makes the IMS2760 one of the most
advanced image systems for C-Arm use today.
CINE:
This refers to the capture and replay of images in a continues loop.
M A G WNDW:
This refers to the use of the image processor to display a selected image magnified by a factor
2 or 4 times.
A U T O M A G : Refers to the option selected form the monitor cart keyboard by pressing the
auto store key several times to toggle through selections until you see A U T O M A G message on
the left monitor. The AUTO M A G feature provides a 2X magnification to the right monitor
when the operator releases the foot or handswitch automatically
4onl:
Feature allowing the display of four image on one monitor for documentation.
WNDW / LEVEL:
Processing feature allowing the image gray scale to be manipulated.
TEXT A N N O T A T I O N :
Refers to the use of text input for patient information for displays on monitors and image
identification for documentation.
TEXT INSERT:
Refers to the entry and display of information typed from the keyboard to place labels, or
graphic pointers for anatomical notation in the image.
NON-SPECIFIED PATIENT:
Refers to the operation of the image system when no patient record has been recalled or entered
for operation. This will be the default operation of the system and is used most commonly for
emergency situation were a patient file record is deemed not necessary for documentation of
images on hardcopy film or paper printer.
N E W PATIENT:
Refers to the new patient information screen where all new patient information is entered to
create a new patient file/record.

IMAGE MARKERS:
Refers to the marking the image as a left or right view of the patient anatomy. By pressing
the L or R key on the monitor cart keyboard the operator can mark the image with an
" L " or "R".
IMAGE PAGE DISPLAY:

Refers to t he system operation that creates a 16 image display on the reference monitor. This
may also be caUed IMAGE C O L L A G E .
IMAGE CROP:
Refers the image processing function of electronic collimation using black overlay shutters to
crop unwanted sides, top and bottom areas an image for storing to digital disk or film
documentation.
DIGITAL D O C U M E N T A T I O N ROTATION (DDR):

Refers to the selection of digital image rotation in post image operations. This allows the
operator to rotate the image to it's correct orientation in reference to the text for
documentation purposes.
SHARP:
Refers to the processing function for post image enhancement of image details.
EDGE:
Refers to the real time use of image processing hardware for image detail enhancement in
live fluoroscopic procedures.
NOISE:
Refers to the real time application of weighted frame averaging to reduce noise in the image
for improved image quality.
L I H NOISE:
Refers to the function used a the end of a fluoroscopy when the radiation hand/footswitch is
released and the processing system averages images to reduce noise in the image to provide
better image quality.
INV VIDEO: (INVERT VIDEO)

Refers to the inverting of the image blk/wht levels to produce an image were the blks are now
white and the whites are now blk.
ESCAPE:
refers to the system function that allows the operator to leave most other functions and return
to the previous function or just exit the function to select another function or mode of operation.
DIGITAL DISK / D Y N A M I C DIGITAL DISK:

DIGITAL DISK refers to a device which can store vast amounts of information in digital
form stored one image at a time..
D Y N A M I C DIGITAL DISK refers to a device which can store vast amounts of digital image
information in a sequential order in a particular area of the storage media. Most often used
with 2 - 4 F/Sec image acquisition and playback.
HARDCOPY:
Refers to the ability of the system to provide a video image output that can be used to make
film and paper images for archiving patient images from the image processing system.

I M A G E STORE:
Refers to the operation of taking an image in the processor displayed on process monitor and
archiving it in to the digital disk for long term storage in the patient file/record.
PULSE AUTOSTORE:
Refers to the possible use of the auto store function to allow the last image in the pulse
fluoroscopy mode to be stored to the disk when foot or handswitch is released.
SINGLE IMAGE DELETE:

Refers to the operation of the image system that allows operator to delete a single image
form the patient s image file.
D I C O M 3:
Refers to the protocol by which digital images are transmitted to medical image PACS
systems.
KEYBOARD LAYOUT:
The keyboard on the next page demonstrates the full system options. Please use reference
guide to determine the page and section of each key function description.

Exposcop 7000 LMS2760 Image System Section 4.15 - 4.20 09/22/97
4.1 Power On/Off
The O N key is green and located in the lower middle right side of the monitor control
keyboard.
The O N key must be pressed to turn on power, at which time the image system will do a
few self-tests. Several beeps may be heard and are normal or boot-up routines. After
approximately 40-50 seconds, the system will display READY FOR FLUORO on the left
Process display monitor. At this time, the image system is ready to acquire images from
the C-Arm T.V. chain. The small L E D in the upper left corner of the key will light when
power is on
Example of O N key
The OFF key is red in color and located just above the O N key. When the OFF key is
pressed the system will turn off power for both the C - A R M and the monitor cart assembly.
Example of OFF key
14.16 TEXT ANNOTATION AND NEW PATIENT INFORMATION
14.16.1 Alpha Keys
The Alpha keys are arranged in a standard QWERTY key arrangement for easy entry of
text for both patient information and text annotation of images.
Most of the alpha keys have secondary functions for punctuation of text input such as,
period, colon, less than, greater than, back slash, question mark, etc...
To use secondary functions of alpha keys press the SHIFT KEY and hold it down while
typing the
Example of the Punctuation key
SHIFT
KEY
A ! s ?
D "
Press ( SHIFT KEY + A ) = !
14.16.2 NUMERICAL
2 The numerical keys are used to enter patient I.D. #, Date, Time, and service enter of default
values for system operation. The keys are located in the upper right corner of the monitor
. cart control keyboard.

14.16.3 SHIFT KEY
The Shift Key is used to provide the operator with additional features for the control
keyboard keys. The Shift key must be pushed and held before the function keys are pressed.
The following list of key functions describe the use of the Shift key
A l l functions may not be available on all system unless that option was purchased.
IMAGE CROP: Select Image Crop then press the SHIFT KEY holding it
down while pressing the U p / D o w n or Right/Left arrow
keys. The Image Crop function provides times 2
movement for closing or opening the electronic image
shutters.
WNDW/LEVEL: Select Wndw/Level from the control keyboard then

press the shift key holding it down while pressing the
* U p / D o w n or Right/Left arrow keys. The Wndw/Level
values will be changed to a rate of 2 times the normal
change.
M A G WNDW: Select Mag Wndw From the control keyboard then

press the shift key holding it down while pressing the
U p / D o w n or Right/Left arrow keys. The Mag Wndw
Movement will be changed to a rate of 2 times the
normal scroll and pan rate.
TEXT INSERT: Select Text Insert From the control keyboard then press the
shift key holding it down while pressing the U p / D o w n or
Right/Left arrow keys. The Text Insert Movement of the Arrow
or Text String will be changed to a rate greater than 2 times the
normal scroll and pan rate.
A L P H A KEYS: Some of the Alpha Keys have secondary functions for

punctuation of text input such as, period, colon, less
than, greater than, back slash, question mark, etc...
To use secondary functions of alpha keys press the

SHIFT KEY and hold it down while typing the key with
the punctuation needed.
Example: Press ( SHIFT KEY + A ) = !
14.16.4 DELETE/SPACE
Delete/Space key
DELETE Press the shift key and the Delete/Space key to delete one character each time the
key is pressed. If the operator needs to place a space in the entry of information, the
operator must push the Delete/Space key without the holding the shift key.

14.16.5 ENTER
Press to enter information that is needed to perform operations, i.e. after each line of
patient information, to start a function such as accepting a new patient record for
ENTER image processing, or to accept a highlighted operation, etc...
14.16.6 NEW PAT (NEW PATIENT)
The New Pat key located in the upper right corner of the control
keyboard.
Press the N E W PAT key to enter patient information menu.
The menu shown below in Fig 1. allows the operator to enter the patient information
line by line. The operator will type in the information needed then press the Enter
key as each line is completed or to skip to the next entry field. After the last line has
been completed the operator will be presented a verification notice in the lower third
of the screen to confirm the data is correct or to return to the information for correction.
SPECIAL INPUT FIELDS
Facility Name:
To enter a new facihty name press the Down Arrow key located in the lower right
corner of the control keyboard to move the cursor to the correct line. Once the New
Facility entry line is highlighted, the operator types in the new information then
presses ENTER or moves the cursor up to the patient information by using the Up
Arrow key.
Date/Time:
To enter a new Date or Time press the Down Arrow key to move the cursor to the DATE
or TIME field line. Once the operator has highlighted the Date or Time entry, the
operator will type in the new information then press ENTER to store the new
information. To move the cursor to the patient information again,, use the Up Arrow
key.
Example of date entry: 08/16/95

Example of time entry: 08:15:00
When entering time and date please make sure the format for entry is the same as the
example.
NOTE: Both Date/Time and Facility name are default information lines and are
stored and do not require the operator to change unless the information is incorrect due
to reinstallation in a new facility or date, time change has occurred.
To exit the New Patient information screen without saving information press the ESC
key.
When the operator completes the entry of information and presses the " Y " key the
system will close the file and update the process monitor on the left with the new
patient information. See Fig. 2

PRESS ESCHPI 10 EXIT
Figure 1
Figure 2

14.16.7 TEXT INSERT
The TEXT INSERT function provides the operator with the ability to insert
TEXT annotation and or arrows marking anatomical landmarks for special notations.
INSERT
The text used in the IMS2760 digital system is made to be seen no matter
what the background image brightness is. This means that the text can be
overlaid on any area within the image circle with out being lost in the
background.
Press the TEXT INSERT key and all the text from the left monitor will be
removed and TXT INSERT display message will be seen in lower
left corner of the screen and an arrow is displayed in the middle of
the image circle. To move the arrow or text on the monitor use the
U P / D O W N RIGHT/LEFT arrow keys. To make more arrows in the image
press enter then use the arrow keys on the control keyboard to move the
arrow marker to a new position.
To enter text press any alphanumerical key to start entering a text string.
The text can have 3 lines of 15 characters each. To move the text use arrow
keys on the control keyboard. To save the image press store or transfer the
image to the right monitor. The operator can make hard copies of the
image.

International Medical System Description of Operation Rev.3 12
14.16.8 RIGHT or LEFT ANATOMICAL MARKER:
RIGHT & LEFT marker can be selected and displayed in the upper left area of the
left monitor by pressing the R or L key on the monitor control keyboard. To turn off the
R or L marker simply press the R or L key a second time.
The markers are used to identify the image as being the right or left anatomical
view.
The R or L marker can only be applied to an image that is not already saved to the
image disk, once the image has been saved you can not add the R or L marker to the
image.
The marker will be seen on the right review monitor if the image is transferred from
the left monitor to the right monitor or if the image was saved with the marker and
is recalled form the patient image file.
The markers will also be seen on the image collage on the right review monitor for
quick identification of a Right or Left anatomicaUy marked view.
14.17 ACQUISITION / FLUOROSCOPY
14.17.1 FLUOROSCOPY
The Fluoroscopy key is located on the C-Arm control keyboard on the left side
middle.
This is the first available function following application of power. When the C-Arm
is turned on, the system will perform a self-test of the image system and display a
text message box in the lower left corner of the monitor screen. When the
[RDY FLUORO] message is seen and the C-Arm warm-up time ( approximately one
minute) has elapsed, the foot pedal or hand switch may be depressed to start
radiation. When the footswitch or hand switch is released, the image will be held
for display on the left or process monitor. Radiation alert may be set for
approximately once per second.
Note: Radiation alert beep can be enabled or disabled by the

service engineer.
14.17.2 PULSED FLUORO
This function will pulse the radiation on and off at intervals from 1 to 2 pulses per
second while the monitor displays the frozen image of the previous exposure.
The pulsed fluoro mode is used to reduce patient dose. This function is selected from
the Exposcop Plus C-Arm control keyboard. If the radiation alert is turned on you will
hear an audible tone at each pulse of radiation.
Pulsed Fluoroscopy can also provide an automatic last image store function by
selecting the A U T O STORE function when PULSED FLUORO is activated.
The image system will store to the patient file the last image form the pulsed
operation when the operator release the foot or handswitch.
Exposcop 7000 1MS2760 Image System Section 4.15 - 4.20 09/22/97

(' • tit
14.17.3 SNAPSHOT
When the handswitch is pressed, the C-Arm makes one quick high 8 m A exposure
with default of 16 image noise reduction and displays the image on the monitor until
the handswitch is pressed again. The next snapshot will update the monitor screen
with the new image. This function is selected from the Exposcop Plus C-Arm control
keyboard. If the radiation alert is turned on you will hear an audible tone at each
pulse of radiation.
Note: Snapshot can only be made with the handswitch.
MSA (MAXIMUM OPACIFICATION)

MSA preserves during the contrast injection regions with greatest contrast in the
image. This results in maximum visualized opacification of the vascular injection.
To perform M S A ( M A X I M U M OPACIFICATION)
Press the M S A key on the C-Arm control or the monitor control keyboard to enable
maximum opacification.
Perform scout fluoroscopy using the standard fluoroscopy mode and position the
patient.
Press the hand or footswitch and when the audible alert is heard start the contrast
injection. The hand or footswitch is release when a fully opacified image is obtained.
The process monitor will display the procedure with preservation of regions with
greatest contrast occurring in the image during the contrast injection.
Turn on A U T O STORE to store the image when footswitch is released.
MSA(Max-OP) Re-registration of mask:

In the case of patient movement during a subtracted procedure the SHIFT
M A S K can be used to realign the mask to the patients new position.
Press the SHIFT M A S K key. Manipulate the arrow keys to realign the mask.
Re-registration of mask:
Pressing one of the arrow keys once will move the mask 1/4 pixel in the direction of
the arrow key pressed.
Pressing and holding the shift key and the arrow key will result in a 1 pixel
movement.
Pressing and holding the arrow keys will cause repeated movement of mask image.
14.17.5 RSA ( R O A D M A P )
RSA is a subtracted vascular pathway which is displayed while a balloon,

RSA catheter or guide wire under live fluoroscopy is guided to its desired position.
Road
Map To start RSA (ROADMAP) perform scout fluoroscopy using the standard fluoroscopy
mode and position the patient.

Press the RSA key on the C-Arm control or the monitor control keyboard to enable the
R O A D M A P FUNCTION. Peak opacification will automatically be enabled for the
first part of the procedure.
Press the hand or footswitch and when the audible alert is heard start the contrast
injection. The hand or footswitch is release when a fully opacified image is obtained.
The process monitor will display the procedure with preservation of regions with
greatest contrast occurring in the image during the contrast injection.
To continue the R O A D M A P procedure press the foot or handswitch, the subtracted

R O A D M A P will continue to be displayed live on the process monitor while the right
monitor will display an un-subtracted live image.
Re-registration of mask in second part of the Road Map function:

In the case of patient movement during the second part of the subtracted procedure
the SHIFT M A S K can be used to realign the mask to the patients new position.
Press the SHIFT M A S K key. Manipulate the arrow keys to realign the mask. Then
continue the dynamic replay of the procedure as if uninterrupted.
movement.
Pressing and holding the arrow keys will cause repeated movement of mask image.
To exit the RSA procedure press the RSA key again or press EXIT on the monitor
control keyboard.
Auto store may be turned on with MSA to store the image at the
time the foot or handswitch is released.
14.17.6 D S A (DIGITAL SUBTRACTION) Selected Form Monitor Cart
DSA selected from monitor cart control should be used for any fluoroscopic
procedure that requires a single subtracted images without dynamic image
DSA acquisition, subtracted image. DSA provides simple fluoroscopic subtracted
imaging with last image hold.
To perform a simple DSA (DIGITAL SUBTRACTION)

Perform scout fluoroscopy using the standard fluoroscopy mode with appropriate
body region key selected and position the patient.
Press the DSA key on the monitor control keyboard to enable the simple DSA
operation with last image hold. Press the hand or footswitch and when the audible
alert is heard start the contrast injection. Release the footswitch or hand switch
when a fully opacified vascular image is obtained. The image processor will freeze
the image on the left monitor. Turn on AUTO STORE operation to automatically
store the image when footswitch or handswitch is released

Image Properties When Selecting Dsa From Monitor Cart:
When you select the DSA key on the monitor cart control keyboard the system
changes the CCD camera operations to provide proper image parameters which are
special for doing subtracted image acquisitions. The digital image system also
selects predetermined L U T , window / Level values, High Noise reduction and other
image acquisition parameters for the image display.
The use of special image correction parameters in the C C D camera control and image
system provides a special image gray-scale different from the normal fluoro
operation.
D S A Operation:
Do a scout fluoro of the anatomical region using the appropriate body region key ,
This sets the k V / m A to a value close for DSA acquisition.
Select DSA by pressing the DSA key on the monitor keyboard control panel.
Press hand or footswitch, The C-Arm will start radiation and after 3 - 4 sec the
system will lock the k V / m A and the A G C functions of the C C D camera system.
This prevents the image from changing due to the injected bolus which might cause
density fluctuations in A G C and DOSE.
The system then starts to acquire the image mask using High Noise Reduction.
After the mask is acquired the system then displays the real time image on the right
monitor. The image will be of a different level of intensity and contrast during the
acquisition than would normally be seen during fluoro however this is normal.
The image on the left monitor will at this moment display a message in the lower
center of the screen " INJECT " this alerts the operator to the fact the system has
captured a mask and is ready for the injection.
A n audio alert signal for the operator is provided to signal the start of image
acquisition. The image system now subtracts the mcoming live images from the mask
captured and displays the subtracted image on the left monitor.
Release the footswitch or hand switch when the desired vascular anatomy has been
visualized.
Re-registration of M A S K in D S A function:
In the case of patient movement during part of the subtracted procedure
Press the SHIFT M A S K key. Manipulate the arrow keys to realign the mask with
the patient position to better visualize the subtracted vascular anatomy.
Pressing one of the arrow keys once will move the mask 1 /4 pixel in the direction of
movement.
Pressing and holding the arrow keys will cause repeated movement of mask
image.
Exposcop 7000 1MS2760 Image System Section 4.15 - 4.20 09/22/97

CINE with DSA (DYNAMIC ACQUISITION OF SUBTRACTED IMAGES)
CINE/DSA selected from monitor cart control panel or the D S A key selected
from the C-Arm control panel should be used for quality Dynamic Subtracted
image acquisitions. Such as peripheral injection, Femoral arteries, Leg
runoffs, etc
When you select the DSA key of the C-Arm Control keyboard the system changes
the C C D camera operations to provide proper image parameters which are
special for doing Subtracted image acquisitions. The digital image system also
selects predetermined LUT, window / Level values, High Noise reduction and
other image acquisition parameters for the dynamic image acquisition.
Frame rates of 1/2 to 30 F/Sec can be selected depending on options and procedures.
DSA Operation From C-Arm Control Or Selected From Monitor Cart:
Perform fluoroscopy of the anatomical region with the appropriate body region key
selected for position and orientation. This sets the k V / m A for the DSA acquisition.
Select DSA by pressing the DSA key on the C-Arm control panel.
Now Select the frame rate by pressing the frame rate key of the monitor cart if the
default frame rate is not appropriate .
Press hand or footswitch, The C-Arm will start radiation and after 3 - 4 sec the
system will lock the k V / m A and the A G C functions of the C C D camera system. This
stops the image from changing during the run from fluctuations in A G C and DOSE due
to the injected bolus.
The system then starts to acquire the image mask using the selected image noise
reduction. After the mask is acquired the system than displays the real time image
on the right monitor. The image will be of a different level of intensity and contrast
during the acquisition than would normally be seen during fluoro however this is
normal.
The image on the left monitor will at this moment display a message in the lower
center of the screen " INJECT " this alerts the operator to the fact the system is
acquiring images. A n audio alert signal for the operator is provided to signal the
start of image acquisition. This can be turned off by the service engineer.
The image system now subtracts the incoming images from the mask captured and
displays the subtracted images on the left monitor at real time rates independent of
the selected image acquisition rate. The image will display only the subtracted
image during the capture and replay.
However during replay the operator may choose to press the DSA key on the monitor
cart keyboard to remove the subtract image mask from the replay and view images as
un-subtracted.
To Exit the CINE/DSA mode press the cine key again or press the exit key.

Storing The Image Acquisition:
During playback of the image acquisition the operator may press the store image key
on the C-Arm control keyboard or the cine store key of the monitor cart control
keyboard to store the whole dynamic image acquisition to the hard drive.
When storing the dynamic image acquisition at frame rates of 1/2 to 4 F/Sec the
system simply protects the acquisition as it was already acquired to the dynamic
image disk drive. Therefore storing 1/2 to 4 F/Sec requires less than 1 second for the
whole run.
When storing the dynamic image acquisition at frame rates of 8,15 and 30 F/Sec the
system must transfer the images from the extended dynamic image memory to the
dynamic image disk drive. As stated previously the system will transfer the images
at a rate of 4 F/Sec to the image drive. The acquired image sequence will require 37.5
seconds to store to the dynamic disk drive.
The display on the left monitor will change to show the run has been stored after the
store key is pressed and the image run has been fully stored to the disk drive-
Storing Individual Images To The Patients Image File Directory:
To store or transfer images to the patient file for hard copy printing press the image
forward or reverse key of the C-Arm control or the monitor cart to place the image
playback in the step mode to view the acquired image sequence one by one. Once the
image playback is stopped select the image to transfer to the patient file, then press
the store key on the C-Arm or the image store key of the monitor cart.
When you press the store key in the step mode of image replay the left monitor w i l l
display a message " Stored to 0018 " This means the image from the acquisition has
been copied to the patient file as image number 18.
Protection:
As described earlier in this information protection of the dynamic image acquisition

can be set for automatic protection when Dynamic DSA image acquisition is selected
or can be set after the selection by pressing the " CINE RESET " on the monitor cart.
The operator can also use the multi-function contrast key of the C-arm control panel to
override protection. Press either key when the protection message is seen on the left
monitor.
DSA OUTPUT LUT ( Look lip Tables) : WINDOW AND LEVEL
Note: To use Output Look Up tables to adjust image contrast on cine replay
acquisitions. The cine run must be selected 1- 9 and then press ENTER to accept
the patient cine replay as the current cine run. Once the image sequence is loaded or
is replaying on the left monitor select the W N D W and Level key on the monitor car.
The image system will now allow you to change image contrast and brightness.
The RIGHT and LEFT ARROW keys adjust the WINDOW SIZE value and the
UP and D O W N ARROW keys adjust the WINDOW LEVEL.

Level Adjustment:
By adjusting the LEVEL value the OUTPUT LUT will increase or decrease the
background brightness level of the subtracted image seen immediately on left
monitor. This will provide a much wider range of brightness in the image to
meet a variety of image preferences. See Fig 1 below.
Size Adjustment:
By adjusting the SIZE of the OUTPUT LUT curve from linear to a very steep
curve the operator can control the subject contrast in the vascular anatomy.
The subject contrast during replay is seen immediate on the left monitor.
See Fig. 2 below.
FIGURE 1
LUT
L E V E L : adjust position of curve in

O U T P U T LUT. This will increase or
d e c r e a s e image brightness
FIGURE 2
1024
Curve A
OUT C U R V E A = 600S Lower Contrast

C U R V E B = 2 0 0 S : Higher Contrast
1024
IN
SIZE: Adjusts the Angle of curve in
O U T P U T LUT. This will increase or
d e c r e a s e subject Contrast
Exposcop 7000 rMS2760 Image System Section 4.15 - 4.20 09/22/97

14.17.7 EDGE (REAL TIME EDGE ENHANCEMENT) OPTIONAL
The Edge Enhancement function sharpens the edges of imaged anatomical

structures. Selection of four discrete levels is permitted. Selection of this function is
made on the left lower side of the monitor cart. The settings are as follows 1 = 20%,
2= 35%, 3=50%,and 4=65% enhancement to the image.
The Edge Enhancement key can only be pressed when fluoroscopy is not
active. The monitor will display a message in the lower right corner of the
left or process monitor when EDGE is on. The display message is shown in
Fig. 2.
Best results with Edge Enhancement in fluoro live video is obtained when
at least a Noise Reduction level of N R LOW is used. See section 14.17.5 for Noise
Reduction. Edge enhancement is not a post-processing function and cannot be used to
change a previously-stored image.
14.17.8 NOISE REDUCTION
To reduce "noise" in a fluoroscopic image by three discrete steps press the

NOISE key during or before fluoroscopy is started.
NOISE
The message N R LOW, N R M E D , and N R HIGH is displayed in the lower
right corner of the left monitor to indicate the level of noise reduction currently
employed. Noise Reduction is not a post-processing function and can not be used to
NOTE: Noise reduction is accomplished by using weighted frame averaging of the

current and previous images; this may cause an increase in image lag-time
in the video display.
14.17.9 LIH NOISE (LAST IMAGE HOLD NOISE REDUCTION)
The LIH noise reduction function reduces the "noise" in the image only at the time the
radiation switch is released. The advantage of LIH noise reduction is that during a
LIH normal fluoroscopic image, the Dr. may be moving the patient and, or the C-Arm
NOISE causing the image to smear with normal noise reduction, but when the Dr. stops the
movement and releases the radiation footswitch the image system will then average
the images at the end and provide an image with reduced noise displayed on the
monitor. LIH Noise Reduction is not a post-processing function and cannot be used to
The operator may also choose to have a N R LOW setting for live noise reduction and
set a higher value with the LIH H I G H to be applied when the footswitch is
released.
Four settings are available:

L I H Low, LIH Med, LIH High. LIH OFF is a special case.
There may be times when the operator does not wish to have the image displayed on
the monitor after release of the footswitch. Press the LIH Noise key several times
until the message LIH OFF is seen on right monitor bottom right.

14.17.10 WNDW (WINDOW)
The Window function changes both the contrast and the brightness of the video image
by changing the window of grey scale and the level of brightness within the window
WNDW of grey scale with 3 to 6 levels. The W N D W key is located in the acquisition section
lower right corner of the control keyboard.
WNDW is not a post-processing function and cannot be used to change a previously-

stored image.
TEXT ON/OFF
The function turns on or off the display on the left or process monitor. The following
TEXT
patient information and display messages will be removed from the display when
ON/OFF the text is turned off. Patient name and I.D., Dr. name, facility name, procedure
title,date, time, and the IMS logo. See Fig 3 for location and monitor display without
text. When text is turned off the system stores the information for each image in the
patient record.
Patient information is removed when Text Off is sleeted.
Figure 3
14.17.12 FRAME RATE
The F R A M E RATE key sets the frame acquisition rate for cine runs and
the play back frame rates. The frame rate can be set at 1/2 f/sec, 1 f/sec, 2 f/sec , 4
FRAME f/sec, 8f/sec, 15f/sec and 30 f/sec with Optional packages . The system can acquire
RATE at one frame rate and replay at another frame rate if desired below lOf/sec.
Acquisitions o f l / 2 - 4 f / s e c can not be replayed at 8 - 30f/sec rate.
By pressing the Frame Rate key the operator sets the frame rate before acquiring
images. The left monitor displays the selected frame rate in the right upper corner.
FRAME RATE can be used with previously stored image Loops retrieved from
memory.

14.17.13 MASK SELECTION IN DSA MODE
M A S K key performs two specific operations.
SET IMAGE MASK:

1) Pressing the M A S K key will stop the subtracted image loop replay and allow
the operator to use the FWD or REV image keys to select a new M A S K number from
the run to be used as the new M A S K . The operator then presses the FRAME RATE
key to start the loop replay again.
VARIABLE L A N D M A R K J N G I N DSA REPLAY:

2) In some situation it may be difficult to detennine the position of vascular
anatomy. In these situation landmark is used to fade bony anatomy into the
image.
To use L A N D M A R K press the M A S K key during the replay of the subtraction

procedure. Press the UP arrow key to fade more of the mask away and the
D O W N arrow key to fade the mask back in. Once you have brought the mask
to a desired level or fully back into the image you may continue the procedure as
if uninterrupted by pressing the FRAME RATE key.
14.17.14 CINE RESET
The cine reset key when pressed will turn off the protection for images stored at 10,15,
30 frames per second. The protection is used to prevent the operator from acquiring
another run in memory overwriting the pervious image acquisition.
14.17.15 CINE ( D Y N A M I C I M A G E ACQUISITION) Without Subtraction:
CINE key selects the dynamic image Acquisition mode for acquiring
images in a sustained sequence from 1/2 to 30 f/sec and replay at a maximum of 4 or 30
f /sec depending on optional packages. The images acquired at 4 f /sec are stored
directly to a dynamic digital disk and require no transfer from volatile memory for
storage before another run can be made.
With the optional 30 f/sec package the images are transferred to the dynamic disk
drive from memory by pressing the CINE STORE key. They are transferred at a rate
of 4 f/sec. The transfer time is 37.5 sec for 150 images.
Dynamic Image Acquisition Without Subtraction:
When you select the " CINE " key on the monitor cart keyboard control panel the
C-Arm does not change it's Image Properties as is the case in the DSA dynamic
image acquisition operation. The C-Arm will stay in the fluoroscopy body region
that was selected.
The " Cine " or dynamic image acquisition without subtraction provides the
operator the ability to perform procedures such as Cholangiography, Barium
Swallows, Urinary Studies, ERCP, or any other procedure where a sequence of
images maybe required.
Operator may view the images as a subtracted image loop by pressing the
DSA key of the monitor cart during replay of the acquired image sequence. It

(
should be noted however that the image quality of the subtracted image will not be
as good as with the special image properties of the Dynamic DSA function
selected from the C-Arm control Panel.
i
Storing The Image Acquisition:
During playback of the image acquisition the operator may press the store image
key on the C-Arm control keyboard or the cine store key of the monitor cart
control keyboard to store the whole dynamic image acquisition to the hard drive.
When storing the dynamic image acquisition at frame rates of 1/2 to 4 F/Sec the
system simply protects the acquisition as it was already acquired to the dynamic
image disk drive.
When storing the dynamic image acquisition at frame rates of 8,15 and 30 F/Sec
the system will transfer the images from dynamic image memory to the dynamic
image disk drive. The acquired image sequence is 150 frames and requires 37.5
seconds to store image sequence.
The display on the left monitor will change to show the run has been stored
whenever the store key is pressed.
DISPLAY MESSAGES FOR CINE OPERATION
LOOP UN-STORED:
This message in the left lower corner of the monitor display reminds the operator
that present image loop being replayed has not been stored.
The display message LOOP UN-STORED will change to the protected run number on
the dynamic digital disk when the CINE STORE key is pressed. See Fig. 4
FRAME RATE DISPLAY 1/2 - 30 F/sec

message informs the operator what frame rate has been selected for acquisition and
play back.
To change the frame rate, press the frame rate key before you start an acquisition or
when a captured image loop is replaying. The message is located in the upper right
corner of the left monitor display. See Fig. 4
NOTE:
With < 4 F/sec option the software defaults to 4 F/sec whenever CINE is selected
from the monitor cart control or when DSA is selected from the C-Arm control.
With 8 to 30 F/sec option the software defaults to 30 F/sec whenever CINE is

selected from the monitor cart control or when DSA is selected from the C-Arm
control.
AVAILABLE:
This display message informs the operator the number of images remaining
that can be stored. The available number of images that can be stored will
decrease as the number of stored images increases with 1/2 - 4f/sec. With 10 - 30f/sec
the display will only show the maximum images that can be stored.

When you press the FORWARD or REVERSE image key the numbers will then be
displayed in the upper right corner for the image that is presently on the monitor
display during this single step of the dynamic image run.
When there is less than 50 images left on dynamic disk drive the system will inform
the operator that he/she cannot start another dynamic image acquisition until space
is available. This can be accomplished by deleting image runs from another patient
file or from the same patient.
To exit the cine function you must press the CINE key again or press the ESC key.
ONE PROCEDURE (IMAGE LOOP ACQUIRE)
Start procedure by positioning C-Arm of the selected anatomical region and select
the appropriate body region key for image acquisition, checking position with
fluoroscopy.
When the operator is ready to start the acquisition press the " CINE " key on the
monitor cart control keyboard.
Now select frame rate of the dynamic image acquisition. 1/2 to <30 F/Sec. depended
on the system options.
The left monitor will display CINE in the lower left corner. The activity light will
be on in corner of the CINE key and the frame rate selected is displayed in the right
upper corner of the monitor.
The system is now ready for the cine acquisition. Press and hold hand or footswitch to
start fluoroscopy and wait for the audible alert and INJECT message on the left
monitor to start the injection.
Hold the exposure switch until the desired vascular anatomy has been visualized.
The acquired images will start to playback in continuous loop from the dynamic
digital disk or from memory depending on frame rate and optional equipment.
The acquired images are located on the dynamic disk drive at < 4f/sec. At > 8 f/ sec
images are stored in the dynamic image memory.
NOTE: A l l images are unprotected unless the run is stored by pressing the
CINE STORE or if the AUTO PROTECTION function is turned on.
Therefore if the operator presses the foot or handswitch again the dynamic image run
will be over written by a new dynamic image acquisition.
To protect the acquired image loop press the CINE STORE key or turn on the
protection with the CINE RESET key.
PROTECTION OFF:
To start another dynamic image acquisition with out storing the previously acquired
image loop press the foot switch and when the audible tone is herd start the new
injection.
PROTECTION O N :
To start a new run the operator must press one of the CONTRAST key's on the C-Arm
control keyboard or the ESCAPE key on the monitor cart.

If scout fluoroscopy is necessary between runs just press the CINE key, or the EXIT key
to leave the CINE mode and return to normal fluoroscopy.
NOTE: all images are stored as raw images and therefore can be reviewed in the
un-subtracted image format as a dynamic image loop. However by pressing the DSA
key when the dynamic image loop is in replay the operator may view the run in a
subtract image mode on the left monitor.
NOTE: The replay of the CINE acquisition in a subtracted mode however is not the
same as acquiring the run with DSA selected. The image acquisition
parameters of kV, mA, and Camera are different and therefore some areas
of the subtracted image may be to dark for good visualization of the subject
contrast.
Storing Individual Images To The Patients Image File Directory:
To store or transfer images to the patient file for hard copy printing press the image
forward or reverse key of the C-Arm control or the monitor cart to place the image
playback in the step mode to view the acquired image sequence one by one. Once the
image playback is stopped select the image to transfer to the patient file, then press
the store key on the C-Arm or the image store key of the monitor cart.
When you press the store key in the step mode of image replay the left monitor w i l l
display a message " Stored to 0018 " This means the image from the acquisition has
been copied to the patient file as image number 18.

CINE FEATURES
IMAGE STEP
During Cine replay the image play back can be stopped and reviewed one image at a
time and stored to the patient file for documentation later.
FWD
Presses the Image FWD or REV key to stop the dynamic image playback. The F / R
message in the upper right corner of the monitor will now display the message F / R
OFF. This means the image loop has stopped and the operator can press the F W D
IMAGE
(forward) key or the REV (reverse) key to step image by image through the dynamic
image loop. If the operator holds either key down, the system will step the images at
a rate near the selected frame rate speed.
REV
While in the step function the operator can store any image from the run into the
patients file by pressing the IMAGE STORE key located in the lower middle of the
control keyboard. The system will display on the monitor in the lower center of the
image area the following message, STORE T O #000. This is displayed when the
images from dynamic cine image loop are stored from the CINE step mode to the
patient file. See FIG. 4
CINE STORE
CINE STORE key protects the cine run acquired to the dynamic digital disk.
CINE Pressing the CINE STORE key protects the last cine run acquired on the dynamic
digital disk to one (1) of the 5 runs allowed for the present active patient.
Each run protected may contain the maximum available images at the time the cine
run was acquired.
CINE A U T O STORE:
NOTE: When Cine is selected and the service option of cine auto store is activated
the operator can choose to select by pressing the auto store key the automatic storage
of the acquired dynamic acquisition. When this is active the A U T O STORE message
will be seen on the left monitor.
CINE R E C A L L
CINE R E C A L L selects cine runs to review. CINE RECALL key is located in the lower
middle portion of the monitor control keyboard.
CINE
RECALL Press CINE RECALL key to display a list of the image loops with numbers from 1 to 9.
Press the corresponding number of the run to view the patient cine run. The run will
start immediately when selected. Images are stored in a raw image format with out
subtraction. Therefore the cine run can be viewed with or without subtracted mask.
To view the cine run selected in a subtracted mode press the DSA key while the cine
loop is running. This will automatically select the second image in the run as the
mask and then continue to playback the cine run in the subtracted mode.
To display the cine run playback without subtraction press the DSA key and the cine
run will continue without the subtraction of the mask in the image.

CINE EDIT
CINE EDIT selects cine runs to delete from the present patient file.
Pressing CINE EDIT key displays a list of the image loops with numbers from 1 to 9.
Press the corresponding number of the run to be remove from the patient cine image
directory.
NOTE: Once the operator selects and confirms the image loop to delete, the image loop cannot
be retrieved.
3 4}
PROCEDURE TITLE IMS

Figure 4
SHIFT MASK " MASK REGISTRATION'

M A S K can be used to realign the mask when replaying the DSA image loop.
SHIFT
MASK Press the SHIFT MASK key. Manipulate the arrow keys to realign the mask. Then
press the FRAME RATE to continue the dynamic replay of the procedure as if
uninterrupted.

Re-registration of DSA mask:
movement.
Pressing and holding the arrow keys will repeat the movement after mask image is
moved in relation to the image loop.
14.17.16 VCR OPERATION
The V C R key provides the integrated operation for recording and playback of the
images to the monitors.
VCR
To use the VCR you must first turn on the VCR power then press the VCR key located
on the right lower side of the monitor cart keyboard in the ACQUISITION section of
the keyboard.
Once the VCR is on and the VCR key has been pressed the VCR message text will
appear in the lower right corner of the left monitor above the ready for Fluoro text.
This is to inform the operator that the Exposcop 7000 system is in the VCR record
mode and at the same time the VCR will automatically go into the record pause
mode.
The system is now ready to start recording when ever the foot-pedal or handswitch
is pressed. When the foot or handswitch is released the VCR will stop recording.
AUTO RECORD START:

When the VCR is in the record pause mode the VCR will start the recording every
time the operator presses the foot or handswitch. The system can not tell if the
operator is recording over previously recorded areas of tape, therefore the operator
must exercise caution when replaying previously recorded portions of tape. They
must make sure the tape is fast forwarded to a clear area before allowing the doctor to
start a new recording .
NOTE: the VCR takes about 1 to 3 sec to fully come up to speed and record images,
therefore make sure the foot or handswitch is held long enough to capture images
before releasing . Starting and stopping to quickly will lead to very short recordings
that may record the needed information.
PLAYBACK:
When the VCR is in the P L A Y B A C K mode the Exposcop 7000 will prevent
fluoroscopy from starting until the VCR is placed in the STOP, REW, or FF modes.
During P L A Y B A C K , STILL or SEARCH modes the Exposcop 7000 will display the
video 525 line operation to match the line rate of the VCR.
During the times the system starts and stops the recording the tape will have small
areas that have no information as the VCR comes up to speed. During the playback of
the V C R these areas of lost information will cause the monitor to jump and display
noise bars in the image as the monitor tracks the video sync signal. Therefore it is
important that the operator makes recordings of at least 20 sec mirumum to reduce the
effects of these jumps and noise bars.
Exposcop 7000 LMS2760 Image System Section 4.15 - 4.20 09/22/97

TURN OFF VCR OPERATION:
To turn off the VCR operation press the VCR key on the monitor cart keyboard again.
The V C R text will disappear from the left monitor and the VCR will not respond to
the foot or hand switch operation.
Please read the operators manual for the VCR and become familiar with it's use.
NOTE: The Image resolution is not the same as that of the image system display. Therefore
the image quality may not be as good as the original image of the display monitors.
14.17.17 DICOM VIDEO CAPTURE REVIEW (VCR) OPERATION:
IMAGE REVIEW:
The DICOM NT-100 intergrated operation requires a means by which the operator
can review the stored images of the NT-100 DICOM system.
Therefore if the user has purchased the DICOM option they can review the stored
images by pressing the VCR key in the acquisition section of the monitor control
keybaord and view the images on the right monitor.
The system will not allow the operator to recall or display imafges on the right
monitor until the operator has pressed the VCr key again or they press the ESCAPE
key. However if the operator presses the foot or handswitch the image system will
exit the DICOM review mode and return to the normal operation and start radiation
within 2 sec.
IMAGE CAPTURE:
To store image to the DICOM NT-100 the operator presses the Print Key on the
C-Arm control panel which activates the NT-100 capture sequence and stores the
image displayed on the left monitor.
To store the image form the monitor cart press the H A R D COPY key and if nescessary
rotate image to correct position then press the hardcopy key again. To bypass the
digital document rotation just press the hardcopy key a second time.
DICOM NT-100 OPERATION:

For detailed information on the operation and setup of the DICOM NT-100 please
read companion DICOM NT-100 operators and service manuals. COpies of the
manual are shipped with the system and should be placed in a safe pake for future
references.

14.18 "REVIEW" AREA OF THE CONTROL KEYBOARD
14.18.1 IMAGE FWD/REV
The IMAGE FWD / REV keys provide the operator with several option
for use. The following describe the operation of these keys in relation to all
potential uses.
1) . Cine operation for reviewing forward or reverse by one single image

out of a dynamic image loop. See Section 14.17.11 for more details.
2) When the operator has not selected image page, patient file, or cine the
FWD or REV key allows operator to view images from the current patient record
one at a time. The image number increments one higher for each press of the F W D
or REV key.
The images are displayed on the right reference monitor. By holding the
FWD or REV key down the system will recall images from the digital disk
at a rate of approximately 1.5 frames per second or faster depending on
system options.
3) Image recall with IMAGE PAGE DISPLAY on. In this function the
FWD or REV key is used to move the selection box within the 16 image
page displayed on the right reference monitor for selection of a particular
image.
5) Image recall with PATIENT FILE displayed on the right monitor. In

this mode the FWD or / R E V key recalls images from the digital disk in a
1/16 image file size display area. By holding the FWD or REV key down
images can be recalled at 1 to 7 frames per second depending on system
options
6) When the 4 on 1 mode is selected and the patient file closed and no
other mode is active the F W D / R E V keys are used to move the selection box
around in the 16 image page display to select the images for inclusion in
the 4 on 1 image display on the left monitor.
IMAGE PAGE
The key is located in the middle of the keyboard and when selected the small light
in the corner will be lit to identify that the IMAGE PAGE display is active.
The IMAGE PAGE display provides the user with a quick and easy way to find
images from the digital disk for hard copying and processing.
The right monitor will display 16 images with the corresponding image number i n the
left upper corner for easy identification.
Using the U p / D o w n and Right/Left arrow keys and/or the F W D / R E V image keys
the operator can scan through the images and when the selection box goes off the page
toward a higher or lower image number, the next set of images displayed will be the

next higher or lower number with 16 new images on the screen, i.e. if the operator
moves down the screen and the last highest number was 16 the next image page will
start at 17 and go to 32. See Fig 5 for example of image page display.
The image page display will be automatically selected if the operator is not in the
patient file function when 4 on 1 is selected to allow quick and easy access to images
for inclusion in the 4 on 1 image display on the left monitor.
Exit Image Page Display:
To exit or leave image page display press the IMAGE PAGE key once again or press
the ESC key. If you are in the 4 on 1 function and you press the IMAGE PAGE key to
escape the system will display a single image on the right monitor and the operator
then uses the F W D / R E V keys to recall images for the 4 on 1.
IMAGE PAGE DISPLAY

16 I M A G E C O L L A G E P A G E
FIGURE 5

14.18.3 PAT FILE (PATIENT FILES)
The P A T FILE key function provides the operator with many choices in handling
patient images. When the operator selects the PAT FILE the system will open the
patient records for viewing and turn on the small light in the corner of the key to
identifying the patient file as active.
Once the selected the operator can select another patient file to be active process
images, make hardcopy images, copy images to floppy disk if system option is
available, and delete patient files.
The following features are provided in the PAT FILE activity menu at the
top of the right monitor when the PAT FILE is selected
PATIENTS FILE
When the operator first selects the PAT FILE and a patient file was being used other
than the non specified patient, the system will open the patient file to the current
active patient and place an activity box around that patient information , i.e.
patients name, I.D # date and time file was created.
The Activity menu at the top of the screen is highlighted for whatever function is
active. See Fig 6.
To view other patient files not on the screen press the UP or D O W N ARROW key
browse the patient files forward or backward. The patient files are organized
according to date and time they were created not in alphabetical order. Therefore to
view the newest patient files press the down key to move forward in the patient files.
ACCEPT PATIENT
To accept a patient file for use the operator must use the RIGHT or LEFT ARROW key
to highlight the Accept activity function at the top of the monitor screen or make sure
the activity box is around the patient you wish to select then press the ENTER key.
The system will accept that patient as the current patient file for use.
NOTE: If you had selected IMAGE CROP or W N D W / L E V E L then you have to escape
those functions to free the arrow keys to select another patient file
VIEW IMAGES
The operator may view any images in the patient file by pressing the image
F W D / REV keys without selecting the patient file to the active. Just move the
activity box up or down until the correct patient file you want to view is in the box and
press the FWD/REV keys to view the images for that patient.
DELETE IMAGE:
To delete a single image from a patient file the operator selects the proper patient
then uses the RIGHT/LEFT arrow keys to highlight the DELETE IMAGE box on the
activity menu . The operator then selects using the FWD or REV image recall keys to
display the image in the image review area with the highlighted box and then press
the ENTER key. This function will delete that single image only. If the operator has
chosen to have a confirmation message displayed before deleting the image file. The
alert message will ask for confirmation if you really want to delete this Image file.
If you press " Y , " then the system will delete the information. NOTE: IF Y O U DELETE
A PATIENT IMAGE IT C A N NOT BE RETRIEVED.

DELETE PATIENT
When you need free image space on the digital disk use the U P / D O W N ARROW
keys to place the activity box around the patient information you wish to delete.
Then use the RIGHT/LEFT arrow keys to highlight the delete box on the activity
menu and then press the ENTER key. This will delete the complete patient file. The
alert message will ask for confirmation if you really want to delete this patient file.
If you press " Y , " then the system will delete the patients information.
WARNING: IF YOU DELETE A PATIENT FILE IT CAN NOT BE RETRIEVED
COPY IMAGE
The COPY function provides the operator with the ability to make image copies from
the patient files to a floppy disk.
The image file format is a " B M P " DOS/Windows bit-mapped graphic file. Any
program that will display and allow manipulation of image files with the .BMP file
extension will be able to display and print the image files if your V G A , Super V G A ,
or extended V G A display card can produce a minimum of 256 gray scale or 24 bits of
color and the nunimum resolution is 640 X 480.
Example of some programs that support the .BMP file extension, Photoshop,
Corel draw, Wordperfect for Windows, Microsoft Word, etc..
A Laser printer with at least 600 x 600 resolution and supports 256 gray scale should be
capable of printing the image file to photo quality paper.
To copy images to the floppy select the patient file and the image to copy to the
floppy then use the right/left arrow keys to select the copy box from the activity
menu on the right monitor.
Next place an IBM pre-formatted 3.5" floppy disk in the floppy disk slot directly
under the front of the monitors and press the ENTER key. The system will recall the
image from the digital disk then reformat the image to be compatible with the .BMP
file format and reduce the image from a 10 bit gray scale to an 8 bit gray scale. When
the system has completed this it will start to copy the image to the disk. The copy
transfer will take approximately 30 sec to complete.
WARNING:
Do not remove the floppy while the image transfer is in progress or the system will
stop working and you must turn off all power wait 20 sec then turn back on the power
making sure you remove the floppy disk from the system.
Never Insert a used floppy as this may cause damage to the floppy drive and effect
the reliability of the system.
Never install a floppy with any software as the system will destroy the software on
the floppy when it copies the image files and may cause harm to the image system.
A new IBM pre-formatted floppy disk will hold four images. The images
size is approximate 306 Kbytes.
Exposcop 7000 IMS2760 Image System Section 4.15 - 4.20 09/22

International Medical System Description of Operation Rev. 3
Figure 6
14.18.4 MONITOR L TO R (TRANSFER IMAGE LEFT TO RIGHT MONITOR)
The MON L to R transfers the image from the left monitor to the right or reference
monitor.

14.18.5 MONITOR R TO L (TRANSFER IMAGE RIGHT TO LEFT MONITOR)
The M O N R to L transfers the image from the left monitor to the right or reference
monitor.
14.18.6 CINE EDIT
This key function allows the operator to select and delete cine runs from the present
patient file. The operator presses the CINE EDIT key and the monitor displays a list
of the image loops stored and a number next to them. The operator then presses the
corresponding number of the run to be deleted from the dynamic disk drive.
NOTE: Once the operator selects and confirms the image loop to delete the image
loop can not be retrieved.
14.18.7 CINE RECALL
CINE R E C A L L allows the operator to recall any of the five runs stored to the present
patient by pressing the CINE RECALL key then selecting the image run number from
CINE the menu. The CINE RECALL key is located in the lower middle portion of the control
RECALL keyboard.
14.18.8 INV VIDEO
Pressing the INV VIDEO key will interchange the dark and light areas in the video
image, changing a "positive" video image to a "negative" one.
INV
VIDEO Inv Video is a post-processing function and can be used with previously stored image
retrieved from memory or it can be used with "real time " fluoroscopy.
14.18.9 HARDCOPY
The HARDCOPY key is used to transfer images from the left process
O On HARD monitor to film or paper printer.
1 2 U COPY
Film Documentation Camera
When the film cassette is present in the film documentation camera number 1
light will be lit and when the HARDCOPY key is pressed the center light will
flash at a rate of about 1-2 times per second. When the exposure is completed the
light will go out. If you have ordered a two frame film camera, the 2 second light
will stay on until the operator presses the HARDCOPY key a second time to
exposes the second film. After the number 2 light goes out all lights will be off
and you may remove the film cassette after closing the shutter.
Large Paper Printer

When you have a paper printer integrated into the monitor cart the operator must
press the SHIFT key and HARDCOPY key at the same time to make sure the
proper image is transferred to the paper printer. The system will trigger the
paper printer and transfer the image to the proper video output for paper printer.

DIGITAL DOCUMENT ROTATION:
NOTE:
If your system was purchased with a Realtime Edge Enhancement(RTE) or with the
VIM module the following applies to your system.
In addition to the previously mentioned operation of the H A R D COPY key when you
press the H A R D COPY key the first time the left monitor will display a message at
the bottom of the screen.
The message instructs the operator to use the RIGHT or LEFT ARROW keys to
perform digital rotation to reposition the image before making a documentation film.
The technologist selects an image and transfers to the left monitor from the PAT
VIEW screen, or single image from the right monitor in image collage mode. The
operator then uses the features of DDR to rotate the image to the correct position.
To print the image to paper or film the operator just presses the hard copy key again.
If the operator does not wish to perform digital rotation the operator just presses the
HARDCOPY key again without touching the RIGHT or LEFT ARROW keys.
14.19 STORE
14.19.1 AUTO STORE
A U T O STORE allows the operator to select four different modes of operation.
1) . Auto Store:
Automatically stores the images held on the screen of the left monitor to the
digital disk drive when fluoroscopy footswitch or hand switch is released.
2) Auto Transfer
Automatically transfers the image from the left monitor to the right monitor.
The last image on the left or process monitor will be transferred to the reference
monitor or right monitor at the next initiation of fluoroscopy.
3) Auto Both:
In this mode, the system will perform both the previous functions simultaneously,
storing and transferring the images automatically.
5) Auto Magnification: ( Only available on systems with RTE and or VIM module)
Operator selects A U T O M A G by pressing the AUTO STORE key until the left
monitor displays the A U T O M A G message. When operator releases the foot or
handswitch the last image on the left monitor will be magnified and displayed
with a BI-CUBIC Interpolation applied to the image to smooth it's appearance
on the right monitor. Very effective in pain management procedures or any
procedure that requires magnification views.
When the A U T O M A G is on the system will not automatically store the image.
Press the AUTO STORE key once for auto store, press again for the next function.
Pressing the key several times to toggle through the different function selections.
To exit or turn off the auto store functions just press the key until the
display is removed from the lower left side of the left monitor.
Exposcop 7000 EMS2760 Image System Section 4.15 - 4.20 09/22/97

Warning: The Auto Store function will continuously store images every time the operator
releases the foot or handswitch . This may cause undo storage of images. The system
will only store up to the maximum limit of the image space on the digital disk at the
time the AUTO STORE was turned on, therefore, the operator must make sure enough
room is available to store the expected images for exams. When limit is reached, a
warning screen message will be displayed at which time you must delete another
patient record to free image space to continue. SEE FIG. 7
The warning screen will be displayed every time the user selects A U T O STORE or
attempts to STORE any image to the digital disk. You must press the Enter key to
escape the warning screen
The operator must delete another patient record to store more images. Therefore
the following is a guide to deleting another patient record.
DELETING A PATIENT RECORD
1) Press the "PAT FILE" key in the lower middle of the monitor cart control
keyboard. This will open the patient files.
2) Select a patient file to delete using the arrow keys. Now select the delete
function from the activity menu at the top of the right monitor.
WARNING: BE SURE YOU ARE DELETING THE CORRECT PATIENT RECORD

FILE, YOU CANNOT RECOVER DELETED PATIENT RECORDS OR IMAGES !
3) Now press ENTER on the control keyboard and at the prompt, press " Y " for yes.
The system will delete all images and patient information for the selected
patient file.
4) Make sure you have freed enough room on the digital disk to complete the present
exam. This may mean deleting more than one patient record file.
5) Once you have deleted the necessary patient images, select the patient file you
were working with and press the "ESC" key to continue the fluoroscopy procedure.

'HE FHCILITV NHME
DR. NHME
Figure 7
14.19.2 CINE STORE / CINE AUTOSTORE
The operator can protect dynamic image acquisition on the dynamic digital disk by
pressing the CINE STORE key located in the middle of the keyboard next to the
CINE image store key when in the CINE ACQUIRE mode. The system can store up to 5 runs
STORE per patient and each run can have up to the maximum images still available in the
system at the time the dynamic image acquisition is started.
CINE A U T O STORE:
The system can be programmed to always store the cine run after each dynamic
acquisition automatically, or allow the operator to turn the CINE A U T O STORE on
with the A U T O STORE key or the system can be set never to store the cine runs
automatically.
14.19.3 IMAGE STORE
The operator may store the images on the left or process monitor screen by pressing the
IMAGE STORE key located in the lower middle right of the control keyboard. Once
IMAGE the image is stored, it may be retrieved later for image processing , i.e. Sharp, Mag
STORE W N D W , 4 on 1 etc.if the system is equipped with described features.
There are two image store keys for storing images: one is located as previously
mentioned on the monitor cart; the other is located on the C-Arm mobile keyboard in
the lower right corner. Both keys provide the same function.
Press the IMAGE STORE key during live fluoroscopy to store images to the digital
disk drive without interrupting the fluoroscopic exam.
By holding the IMAGE STORE key down an image will be stored at the rate of 1
frame every 1.5 seconds, you can store two images in three seconds. The live
fluoroscopy will not be effected by the storing of images.

NOTE: this function is not operational when CINE acquisition is in operation.
The left monitor screen will display a small message "STORE" at the bottom of the
image area to alert the operator that the image is being stored. This will happen
every time you store an image to the digital image disk. If so equipped an audio alert
will be given by the system when ever an image is stored. See AUDIO ALERT.
A U D I O ALERT:
On version > 06 9-17-97 an audible beep will be heard when storing images.
The audio beep can be turned on or off by the service engineer as required.
Note: this is only available if your system purchased with the VTM or RTE modules.
14.20 PROCESS
14.20.1 I M A G E CROP (POST ELECTRONIC I M A G E COLLIMATION)
IMAGE CROP is used to collimate the right/left and top/bottom sides of the image to
block out unwanted image areas for storing or transfer to the film documentation
camera, or paper printer.
When the IMAGE CROP is selected the left monitor will display small message
" I M A G E CROP" and all other text is removed from the screen. See Fig. 9 The
electronic shutters will be located just outside of the image circle. To position the
electronic shutters the operator will use the right/left arrow keys and the u p / d o w n
arrow key.
Positioning Electronic Shutters

To close the electronic shutters vertically press the D O W N arrow key.
To open the electronic shutters vertically press the UP arrow key.
To close the electronic shutters horizontal press the RIGHT key.
To open the electronic shutters horizontal press the LEFT key.

Store Image Crop
Press the IMAGE STORE key to store the image cropped with electronic shutters.
Transfer Image Crop

Press transfer M O N L to R key to transfer the image to the right monitor
once the electronic shutters are positioned correctly by in the image.
Electronic Shutters
Once the Operator has moved electronic shutters the next time the operator
selects IMAGE CROP the electronic shutters will default to the position
in the previous image . If the operator turns off the system IMAGE CROP
will default to a position just outside of the image circle.
14.20.2 4 on 1 (IMAGE MINIFICATION)
The 4 on 1 or minify mode is used to organize up to four images onto one monitor
display for documentation printing . The minify mode helps to eliminate the need for
4 ON 1 a multi-format camera to present four images on the film.
When pressed the left monitor screen is cleared. The 4 O N 1 message is displayed in
the lower right corner of monitor display. The numbers 1,2,3,4 are positioned to
correspond to the image locations.
Once the left monitor screen is updated the right monitor will display in
approximately 1 second, the 16 image page display with the selection box on the first
image.

Select the image from the image collage on the right monitor using the IMAGE F W D
or REV key or the U P / D O W N , RIGHT/LEFT arrow keys.
When the correct image is selected by the activity box press the M O N RIGHT to LEFT
key to place the image in the 1st field in the upper left corner and the 2nd is placed in
the upper right corner; the 3rd is placed in the lower left corner and the 4th is placed
in the lower right corner.
The operator may recall any image from the present patient record. If more than four
images are transferred, the fifth image will override position 1 on the monitor, the
sixth position 2, etc. See Fig. 10
Note: with revision >06 software 4 on 1 images can not be stored to disk.
Next Image To Transfer

And Minify Will Be Placed
At Position # 2 Etc
14.20.3 W N D W / L E V E L (WINDOW/LEVEL)
Pressing the W N D W / L E V E L key changes the contrast of the video image by

changing the window of gray scale. The Level function modifies the brightness of the
WNDW video by changing the level of brightness within the window of gray scale.
Press the W N D W / L E V E L key and the left monitor will display a text message 'W"
values and the " L " values in relative numbers to the level set.
ADJUSTMENT OF " W N D W "

Pressing the RIGHT ARROW key will increase the numbers and decrease the relative
contrast scale in the image (MORE B L A C K and WHITE). By pressing the LEFT
ARROW key the operator will lower the number thereby increasing the relative
contrast scale in the image (MORE SHADES of GRAY).
ADJUSTMENT OF " L E V E L "

Pressing the UP ARROW key will increase the numbers and increase the relative
brightness of the image ( BRIGHTER IMAGE). By pressing the D O W N ARROW key

will lower the number thereby decreasing the relative brightness of the image
( D A R K E R IMAGE).
WNDW and LEVEL are post-processing functions and can be used to change a
previously-stored image.
USING THE W I N D O W / L E V E L FUNCTION

Select an image to be windowed and leveled, transfer it to the left monitor then press
the W N D W / L E V E L key. The W N D W / L E V E L function will automatically adjust
the image to a normalized image contrast and brightness level for you, however if
this value is not to the operators liking the operator need only use the arrow keys to
adjust the image to the desired levels.
At this point the operator may store the image to the digital disk or transfer the
image to the right monitor or make a hardcopy of the image by pressing the hardcopy
key if film camera is available or the shift hardcopy key for paper printer if
available.
The operator by pressing the W N D W / L E V E L key again will return the image back to
it's original image contrast and brightness levels.
Press the "ESC" key or just press the W N D W / L E V E L key second time.
14.20.4 M A G W N D W ( I M A G E MAGNIFICATION)
The M A G W N D W key will magnify the image by a factor of 2 or 4 times. The system
will display the original image on the process or left monitor and the magnified
image on the right monitor.
USING THE M A G W N D W MODE

Select an image from the PAT FILE, IMAGE PAGE, or use the IMAGE F W D / R E V keys
to recall an image to the right monitor. Transfer the image to the left monitor using
the M O N R to L key. Now press the M A G W N D W key the system will remove the
text display from the left monitor and display a window the size of the magnified
image area on the right monitor. The right monitor then displays the image
magnified by 2 times.
The window displayed on the left monitor is moved by pressing the U P / D O W N or

the RIGHT LEFT keys. When the window is moved the image on the right monitor
will pan and scroll.
To increase the magnification to 4 times press the M A G W N D W key again the

window on the left monitor will be smaller representing the area on the right monitor.
Pressing the M A G W N D W key a third time will turn off the mag W N D W function
and return the image on the right monitor back to normal size with text display. The
right monitor will continue to display the previous magnified image at the time you
exit the M A G W N D W mode.
STORE M A G W N D W
Magnified images can be stored to the digital disk or hard copied to the paper printer
or the film documentation camera.

A U T O MAGNIFICATION:
( Only available on systems with RTE and or VLM module)
Operator selects A U T O M A G by pressing the A U T O STORE key until the left

monitor displays the A U T O M A G message. When operator releases the foot or
handswitch the last image on the left monitor will be magnified and displayed
with a BI-CUBIC Interpolation applied to the image to smooth it's appearance on
the right monitor. Very effective in pain management procedures or any
procedure that requires magnification views.
When the A U T O M A G is on the system will not automatically store the image.
14.20.5 SHIFT M A S K " M A S K REGISTRATION"
In the case of patient movement during a subtracted procedure the SHIFT MASK can
be used to realign the mask. Press the SHIFT M A S K key. Manipulate the arrow keys
to realign the mask to continue the procedure as if uninterrupted.
When used with C I N E / D S A press the FRAME RATE to continue the dynamic replay
of the procedure as if uninterrupted after re-registration of mask.
MSA(Max-OP) Re-registration of mask:

M A S K can be used to realign the mask to the patients new position.
RSA Re-registration of mask in second part of the Road Map function:

In the case of patient movement during the second part of the subtracted procedure
Re-registration of mask D S A function:

In the case of patient movement during part of the subtracted procedure
Press the SHIFT M A S K key. Manipulate the arrow keys to realign the mask with
the patient position to better visualize the subtracted vascular anatomy.
the arrow key pressed. Pressing and holding the shift key and the arrow key will
result in a 1 pixel movement.
The SHIFT M A S K operation can be used with RSA, MSA, DSA and C I N E / D S A modes
of operation.
A R R O W KEYS
The ARROW KEYS are located at the lower right corner of the monitor control
keyboard. They have many functions depending on the mode or function that is active
at the time. The following description outlines some of functions they perform.
IMAGE PAGE DISPLAY
Moves the image selection box up,down,right and left
PAT FILE
Selects the function box at the top of the right monitor screen for function operations.
Moves the selection box up and down in the patient file for viewing of patient images.

M A G WNDW
Pans and scrolls the magnification window on the left monitor.
IMAGE CROP
Closes and opens the electronic collimation shutters
WNDW/LEVEL
Increases and decreases the window and level values.
TEXT INSERT
Placement of text and arrow in the image circle.
4onl
14.20.7 With image page display on the arrow keys move the image selection box on the
right monitor
SHARP
SHARP key increases the edge sharpens of anatomical structures. Selection of two
SHARP discrete levels is permitted.
Selection of this function is made on the lower left side of the monitor cart keyboard
and has two settings 1 = 20%, 2= 35% enhancement to the image. (The values can be
changed by the service engineer if needed)
Press the sharp key and wait approximately 2 seconds for the results. If more edge
detail is required press the SHARP key again and wait a few moments for the results.
If you wish to return to the original image just press the SHARP key again and the
sharp enhancement will be removed from the image or press the ESC key to exit this
function.
The operator can store, transfer, or hardcopy the image at any time after the image
has been enhanced.
The SHARP enhancement key can only be used if fluoroscopy is not active. The
monitor will display a message in the lower right corner of the left or process monitor
when SHARP is on.
SHARP enhancement is a post-processing function and can not be used to enhance a

live fluoroscopic image.
14.20.8 ESCAPE
The ESCAPE key allows the operator to exit most functions of the system.
ESCAPE


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SECTION 4.15 - 4.20

Section Description Page #

14.16 Text Annotation and New Patient Information Keys

14.17 Acquisition / Fluoroscopy

Exposcop 7000 IMS2760 Image System Section 4.15 - 4.20 09/22/97

1997 ZIEHM INTERNATIONAL MEDICAL SYSTEMS, INC. A L L RIGHTS RESERVED © 1997

Exposcop 7000 IMS2760 Image System Section 4.15 - 4.20 09/22/97

TERMINOLOGY USED IN OPERATION SECTIONS 14.15 -14.20.8

LIVE IMAGE TRANSFER KEY

Exposcop 7000 PMS2760 Image System Section 4.15 - 4.20 09/22/97

This refers to the capture and replay of images in a continues loop.

Processing feature allowing the image gray scale to be manipulated.

Exposcop 7000 IMS2760 Image System Section 4.15 - 4.20 09/22/97

IMAGE PAGE DISPLAY:

DIGITAL D O C U M E N T A T I O N ROTATION (DDR):

INV VIDEO: (INVERT VIDEO)

DIGITAL DISK / D Y N A M I C DIGITAL DISK:

Exposcop 7000 IMS2760 Image System Section 4.15 - 4.20 09/22/97

SINGLE IMAGE DELETE:

Exposcop 7000 IMS2760 Image System Section 4.15 - 4.20 09/22/97

Example of OFF key

14.16 TEXT ANNOTATION AND NEW PATIENT INFORMATION

14.16.1 Alpha Keys

Example of the Punctuation key

Press ( SHIFT KEY + A ) = !

Exposcop 7000 IMS2760 Image System Section 4.15 - 4.20 09/22/97

WNDW/LEVEL: Select Wndw/Level from the control keyboard then

M A G WNDW: Select Mag Wndw From the control keyboard then

A L P H A KEYS: Some of the Alpha Keys have secondary functions for

To use secondary functions of alpha keys press the

Example: Press ( SHIFT KEY + A ) = !

Exposcop 7000 IMS2760 Image System Section 4.15 - 4.20 09/22/97

14.16.6 NEW PAT (NEW PATIENT)

Press the N E W PAT key to enter patient information menu.

SPECIAL INPUT FIELDS

Example of date entry: 08/16/95

Exposcop 7000 PMS2760 Image System Section 4.15 - 4.20 09/22/97

Exposcop 7000 IMS2760 Image System Section 4.15 - 4.20 09/22/97

Exposcop 7000 IMS2760 Image System Section 4.15 - 4.20 09/22/97

14.17 ACQUISITION / FLUOROSCOPY

Note: Radiation alert beep can be enabled or disabled by the

14.17.2 PULSED FLUORO

Exposcop 7000 1MS2760 Image System Section 4.15 - 4.20 09/22/97

Note: Snapshot can only be made with the handswitch.

MSA (MAXIMUM OPACIFICATION)

Turn on A U T O STORE to store the image when footswitch is released.

MSA(Max-OP) Re-registration of mask:

RSA is a subtracted vascular pathway which is displayed while a balloon,

Exposcop 7000 PMS2760 Image System Section 4.15 - 4.20 09/22/97

To continue the R O A D M A P procedure press the foot or handswitch, the subtracted

Re-registration of mask in second part of the Road Map function:

14.17.6 D S A (DIGITAL SUBTRACTION) Selected Form Monitor Cart

To perform a simple DSA (DIGITAL SUBTRACTION)

Exposcop 7000 IMS2760 Image System Section 4.15 - 4.20 09/22/97

Exposcop 7000 1MS2760 Image System Section 4.15 - 4.20 09/22/97

DSA Operation From C-Arm Control Or Selected From Monitor Cart:

Exposcop 7000 IMS2760 Image System Section 4.15 - 4.20 09/22/97

As described earlier in this information protection of the dynamic image acquisition

DSA OUTPUT LUT ( Look lip Tables) : WINDOW AND LEVEL

Exposcop 7000 IMS2760 Image System Section 4.15 - 4.20 09/22/97

L E V E L : adjust position of curve in

OUT C U R V E A = 600S Lower Contrast