IDEXX Diagnostic Imaging Reference Guide

Capturing Images

Proper preparation is key to capturing high-quality diagnostic images. Ensure collimation is adjusted correctly, the selected shot type matches the body part, and the technique chart provided by IDEXX is used for exposure settings (time and kVp).

Preparing to Capture an Image:

1. In the Home window, initiate the capture process. This can be done by selecting from the Pending or Census list (if integrated with practice management software), clicking 'New Patient' and entering details, finding an existing patient record and clicking the 'X' in the patient card, or clicking 'X' on to assign the image to a patient later.
2. Update the study title and veterinarian/technician names in the Shot Selection window.
3. In the Visual Shot Tree, select the desired region. If a text list is displayed, select the species first.
4. Choose a series name to select all shots in that series, or select individual shots in the desired order.
5. Click 'Done'. The first shot will be highlighted, ready for capture.
6. For ImageVue* DR50 Systems, select the appropriate checkbox (e.g., >10 cm or >15 cm) if the anatomy meets the size criteria.
7. Optionally, click 'Add Options' for special settings.
8. Prepare the animal, measure the thickest part of the anatomy, and set the generator technique.
9. Set physical markers and proceed with capture.

For IDEXX I-Vision CR Systems:

1. Take the radiograph.
2. Click 'Capture', then insert the cassette into the scanner.
3. Repeat for remaining radiographs.
4. Click 'Done' when finished.

Tip: To pause a study, click the 'Pause' button (||). To restart, select the paused request from the Pending list or click the 'X' on the patient card.

For IDEXX DR Systems:

1. Prep the x-ray switch. The system will beep when ready. For ImageVue DR50 systems, prep after the ready button turns green.
2. Press the switch fully to capture the radiograph.
3. Repeat for remaining radiographs.
4. Click 'Done' when finished.

Tip: To pause a study, click the 'Pause' button (||). To restart, select the paused request from the Pending list or click the 'X' on the patient card.

Finding a Patient and Viewing a Saved Image

To locate a patient record and view an image:

1. In the Home window, enter search criteria (patient name, ID, client name, or ID) and click 'View'. Alternatively, select a time period and filter (e.g., species) to display search results as patient cards.
2. Click a thumbnail in the patient card to open the study in the Image Viewer. If no thumbnails are present, click the empty thumbnail area to view the patient record.
3. In the Image Viewer, click a thumbnail to open the specific image.

The IDEXX Web PACS Option

IDEXX Web PACS is a subscription service for cloud-based radiograph storage, offering:

• Anytime, anywhere access to radiographs with advanced viewing and enhancement tools.
• Comparison with a library of reference images.
• Direct submission of radiographs to the Orthopedic Foundation for Animals (OFA).
• Unlimited, secure cloud storage.

For more information, contact IDEXX Diagnostic Imaging.

Working with Images

To enhance and manage images:

1. Locate the patient record and open the image in the Image Viewer.
2. Click the small arrow on the right edge of the window to view the image full screen.
3. Use the tools below the image for annotation, enhancement, restoration, or reprocessing.
4. Use the tools below the image history pane (right side) to reassign, clone, share, save, print, or delete the image.
5. To view other images: Look for studies in the image history pane, click the down-arrow to open a study, and click a thumbnail to view the image.
6. To return to the Home window, click the 'R' button.

To Compare Images:

1. Click 'Compare' above the image history pane.
2. Select up to three thumbnails to compare with the current image.
3. To return to single view, close individual images by clicking the 'X' in their upper right corner, then click the single view button.

Using the Favorite Shots List

To Create a Favorite Shots List:

1. Begin an image capture for any patient.
2. In the Shot Selection window, choose the desired shots and click 'Done'.
3. In the Image Viewer, click the checkmark icon (☑) above the image history pane.
4. Enter a name for the list and click 'Save'.

To Select a Favorite Shots List:

1. Start the image capture process.
2. In the Shot Selection window, select the tab for the desired favorite shots list, located above the visual shot tree.

Keyboard and Mouse Shortcuts

To Enable Shortcuts:

1. In the Home window, click 'Settings' (☑).
2. In the System Settings window, click 'User Settings' on the left.
3. Select 'Enable Imaging Shortcuts' and click 'Save'.

To Use Shortcuts When Viewing Images:

Importing Images from a Remote DICOM Server

To Import an Image:

1. In the Home window, click 'Tools' then 'Query Retrieve'.
2. Enter search criteria and select the remote server from the 'Location' box. (Servers are listed if defined in DICOM settings; contact IDEXX for details).
3. Click 'Search', select the study(ies) to import, and click 'Retrieve'.
4. Click 'OK'.

To Check Import Status:

1. In the Home window, click 'Connections' in the toolbar. On the DICOM row, click 'Queue'.
2. Select the 'Inbound' tab and find the request. The status indicates if the study has been imported.

Sharing Images

Images can be shared via email, patient CD, telemedicine, or DICOM.

1. From the patient card in the Home window, click 'Menu' then 'Share', or from the bottom right of the Image Viewer, click 'Share'. The sharing window opens.
2. If the desired image is not displayed, use the arrows at the top to scroll through studies.
3. Click thumbnails or 'Add Study'/'Add Series' to select images, which then move to the right side of the window.
4. Click the button for the desired sharing method (email, patient CD, telemedicine, or DICOM) at the bottom of the window.
5. Provide any additional required information. With IDEXX Web PACS, radiographs can also be submitted directly to the OFA. Contact IDEXX Diagnostic Imaging for details.

Adding or Updating Client/Patient Records; Reassigning a Study

To Add a New Client/Patient Record:

1. In the Capture panel of the Home window, click 'New Patient'.
2. Enter client and patient information, then click 'Save and Continue'. The Shot Selection window opens.
3. If not capturing images immediately, click 'Done' in the Shot Selection window and then 'Enter' in the Capture window. The record is saved.

To Reassign a Study to a Different Patient:

1. With the image open in the Image Viewer, click 'Reassign' (below the image history pane).
2. Select whether to reassign to an existing or new patient.
3. Enter the necessary information to find/select an existing patient or create a new record, then click 'Reassign'. All images in the study are reassigned.

IMPORTANT: If IDEXX-PACS is integrated with Cornerstone*, the reassigned study is moved from the current Patient Clipboard to the new patient's clipboard.

Tip: For STAT requests, reassign the study to a patient promptly. The patient card will be labeled '+STAT Patient'.

Tips for Taking High-Quality Radiographs

• Radiation Safety: Follow guidelines and the ALARA principle (As Low As Reasonably Achievable) by minimizing exposure time, maintaining distance, and wearing protective clothing (lead apron, gloves).
• Measurement and Technique: Use a caliper to measure the thickest part of the anatomy and consult your technique chart for appropriate generator settings.
• Positioning: Ensure correct animal positioning for the anatomy being radiographed. Refer to the IDEXX Diagnostic Imaging positioning poster or contact IDEXX for assistance.
• Collimation: Collimate the generator to focus the x-ray beam on the area of interest.
• Shot Type: Select the correct shot type, as different types apply specific image processing parameters.

Maintaining Your System for Optimal Performance

Backing Up Images and Data:

Regular backups of image files and patient data are crucial. IDEXX recommends an automatic cloud-based solution like **IDEXX Web PACS** for secure, unlimited storage and advanced features. Contact an IDEXX Digital Systems Consultant at 1-855-627-6573 for subscription options. If not using Web PACS, store images on a separate computer, such as an IDEXX-PACS software server, especially if capturing many radiographs.

Maintaining Your Image-Capture Computer:

• Restart your computer once daily. The digital imaging system can also be turned off overnight.
• Use your IDEXX imaging computer solely for imaging tasks to prevent viruses and malware. Avoid non-imaging internet activity.

Troubleshooting:

• Images Will Not Open: If the software has been running but inactive, it may lose its database connection. Exit and restart the software. Daily restarts are recommended.
• Problems Capturing Images:
  • For ImageVue® DR40, I-Vision® DR, and IDEXX-DR® 1417 systems: Power off the computer and control boxes. Check all cable connections for security and damage (nicks, cuts, crimps).
  • For ImageVue DR50 systems: If LEDs are off or cable connections are problematic, contact customer support. Ensure the generator is on and the footswitch/handswitch is functional. If the generator still fails to fire, contact your local generator technician. Check ImageVue DR50 connections and refer to the icons for battery status and connection modes (Wired: cable connected; Wireless: connection active; Battery: Full).

Cleaning Scanners, Cassettes, and Rollers

Follow these guidelines for optimal performance and image quality.

IDEXX I-Vision CR Imaging Systems

Clean rollers monthly:

1. Remove cassettes and screens.
2. In the Home window, navigate to Settings > Imaging > Scanner Configuration Settings.
3. Log in if prompted (User: 'user', Password: 'Idexx123' - case-sensitive).
4. Insert the cleaning tray until it locks.
5. Remove protective paper from the cleaning plate, exposing the adhesive. Save the paper.
6. Place the cleaning plate on the tray, oriented as indicated.
7. In the Maintenance area, click 'Dismiss' if active (blue), then 'OK' to reset the cleaning reminder.
8. Depending on software version, click 'Prepare' or 'Activate Rollers Cleaning', then 'OK'.
9. Gently push the cleaning plate slightly into the scanner and release. The rollers will pull it in and eject it. The cleaning tray unlocks.
10. Repeat steps 7-8 two more times, ensuring the tray is locked each time.
11. Remove the plate and tray. Cover the adhesive with the protective paper (wax side down) and store in the protective envelope.
12. Click 'OK'.

ImageVue CR20 Imaging Systems

Perform these steps monthly:

• Scanner: Vacuum air vents to remove dust. Run the cleaning cycle by removing the cassette and simultaneously pressing the 'Standby' (1) switch and 'Eraser' button (2) for about 5 seconds.
• Cassette: Wipe the exterior with a clean, dry cloth. Do not use solvents.

Cleaning Imaging Screens/Plates

IDEXX I-Vision CR Imaging Systems

Screen Orientation: Ensure the correct side of the screen faces the x-ray tube (top of the cassette). For all-white screens, the side marked "back side" should face the back (black) of the cassette. For Kodak® screens, the black side faces the back of the cassette.

Remove the Screen:

1. Slide the extraction tool edge over the back edge of the cassette and pull down until it enters the square slots.
2. Hold the cassette horizontally, push the slider in the extraction tool's central opening towards the cassette edge until the screen edge is visible.
3. Carefully pull the screen out and place it on a clean, dust-free surface.

Clean and Return the Screen:

1. Fold a lint-free cloth, dampen with a small amount of screen-cleaning solution (do not pour directly on the screen). Refer to your Hardware Guide for the recommended cleaner.
2. Gently wipe the screen section by section, folding the cloth to expose a fresh area. Apply pressure if needed.
3. Allow the screen to dry completely before reinserting.
4. Position the dry screen with 2-3 inches hanging off a clean surface. Slide the open end of the cassette over the screen's edge and slide the screen in, tipping the cassette up so gravity assists.
5. Pull the release lever to remove the extraction tool.

ImageVue CR20 Imaging Systems

Erase Plate Daily:

1. Before inserting a cassette, press the 'Eraser' button on the scanner. The status light turns orange.
2. Insert the cassette; erasure begins automatically.
3. Remove the cassette when the 'Cassette Removal' lamp blinks.

Clean Streaked Images:

1. Press cassette latches, tilt open the top, and remove the plate.
2. Using provided towelettes, wipe the plate surface lightly in the order shown (A, then B).
3. Return the plate to the cassette with the barcode visible in the window.