3 CR Portfolio Dec2012

CR Computed
Radiography
Marco Riolfo
Unrestricted Internal Use

© 2011, Carestream Health
p.2
History and Technology Principles

• Patented first by Kodak in 1972, CR came into the market in the late 80’s as a breakthrough technology
• Technology
• History is based on storage phosphors screens as a replacement of standard film/screen systems
and Principle
• The physical process is based on « photo-stimulated luminance », for the recovery of the latent image
information with the use of highly focused light (LED laser beam), instead of the use of chemistry with
films.
• The acceptance by radiologists was quite fast when studies and publications confirmed the very good
image performance for diagnosis. This system is quickly gaining ground on analog systems.
• In addition, CR workflow for radiographers is very similar to the analog workflow  It allows them to keep
their habits.
• Everything have made the overall acceptance very easy by all users.
• The main CR vendors are Carestream, Fuji (also supplies Philips), Agfa and Konica. Other “smaller”
vendors such as iCRco or 3DISC are playing marginally in this business.

p.3
CR System Components
1 – Image Receptor 2 - Plate Reader 3 - Distribution
• A storage phosphor- • Patient, exam and cassette • Printing for diagnosis on film
coated screen inside a identification
cassette shell
• Image processing • Network distribution for
• Cassette formats fits in all image diagnosis and viewing
bucky’s and no special on diagnostic monitors
• Image review
cassettes are required.
• Image distribution • CD burning to be able to

• A cassette identifier can
share image files with other
be placed and located on
the cassette shell (bar- clinicians or radiologists
code/microchip)

p.4
Storage Phosphor Plate
• The imaging plate is made of a photostimulable storage phosphor layer coated on a

support, either rigid (Aluminium) or flexible (Rubber) according to the type of plate
reader and/or manufacturer.
• The screen is put inside a cassette shell. The system is available in 5 different sizes
: 18x24cm, 15x30cm, 24x30cm, 35x35cm, 35x43cm
• Specific cassettes and plates are made available for Long Length Imaging eg 35x84
cm
p.5
CR Imaging Cycle
X-Ray
Exposure With the Exposure, X-Rays penetrate the body part
and are absorbed by the screen.
Creation of a As a result of the xray interacting with the body

latent image part, a latent image is produced
m
bea Screen A laser beam emitting in the red spectral region,
s er
La Read-out scans the screen line by line. The energy released
by the stimulated phosphors (blue light) is captured
Emission
of light and a digital image is produced in few seconds.
Erasure Final step is the plate erasure. It is done by

flashing the screen with a white light bulb. This step
removes residual latent image and gets the screen
ready to be used for another exposure

p.6
Storage Phosphor Plate – Imaging Cycle

Cross section of a phosphor screen, also called image plate
Protective overcoat
Phosphor layer with

crystals (5µm) and
binder
support Aluminium or rubber
Storage phosphor screens look very much and perform similarly to

conventional intensifying screens

p.7

Exposure :
X-ray photons
Prompt emission of light
support
Many X-rays absorbed by the storage phosphor screen are converted into
light, thereby creating a latent image. This latent image consists of X-Ray
energies trapped within the phosphor particles.
p.8

Exposure :
X-ray photons
Depending
Depending on on the
the screen
screen phosphor
phosphor material,
material,
the
the latent
latent image
image remains
remains stable
stable for
for aa period
period
of
of time
time (from
(from hours
hours to
to day)
day) before
before
•Prompt itit decays
emission decays
of
to a level at which image
to a level at which image quality
light will be adversely
quality
(blue) will be adversely
affected.
affected.
support
Many X-rays absorbed by the storage phosphor screen are converted into
light, as in conventional intensifying screen, and a latent image consisting
of X-Ray energies trapped within the phosphor particles is created.
p.9

Read Out: Accomplished using a laser scanner. The laser
beam scans the screen line by line (around 2,500 lines), in
approximately 5 sec.
Stimulating RED laser

Emitted blue light
support
•Each point of the screen striked by the laser emits light. This light corresponds to the
level of X-ray energy « stored » within the phosphors.
•The stimulated light emitted from each point of the screen must be collected and
converted into an electrical signal
p.10

Read Out: A specially designed optical system collects the
stimulated light and couples it to a photomultiplier tube.
Photomultiplier tube
Emitted blue light
support
The photomultiplier tube (PMT) converts the varying light intensities (varying X-ray
energies « stored » in the plate) into varying electrical signals proportionately.
These electrical signals are amplified, sampled, and passed through an analog-to-digital
converter to produce binary values for the brightness of each pixel of the digital image.
p.11

Erasure: An intense white light is activated for a few
seconds to erase the screen
support
•The latent image information is completely removed
•The imaging plate is re-positioned back into the cassette. The system is ready to be
re-used for a new exposure
p.12
CR Reader – How it works

Inside the CR Reader
Laser emitting device (diode or tube)

Amplifier
PMT
Sensor
Optical device :
mirror, lenses…
Emitted light
Screen transport
Translation
Computer
Image display

p.13
The Output – Image Matrix
Depends on the screen size
Limiting
Image size pixels / mm Pixel size resolution File
Size (cm) (pixels x lines) (microns) (LP / mm) Size
35 x 43 2048 x 2500 5.8 168 ± 2 2.8 10 MB
35 x 35 2048 x 2048 5.8 168 ± 2 2.8 8 MB
24 x 30 2048 x 2500 8.33 115 ± 2 4.0 10 MB

18 x 24 2392 x 1792 9.95 97 ± 2 4.8 8 MB
The image depth is the same for all images : 4096 grey levels (12 bits)

p.14
The Output – Image Matrix

Depends on the screen size
Limit
Image size pixels / mm Pixel size resolution File
Size (cm) (pixels x lines) (microns) (LP / mm) Size
The
The noticeable
noticeable thing
thing is
is that
that there
there is
is roughly
roughly the
the same
same
35 x 43 amount
2048 x 2500
amount of
of pixels
pixels whatever
5.8
whatever the
the screen
168 ±size.
screen 2.8
2 (+/-2500x2000)
size. (+/-2500x2000) 10 MB
35 x 35 2048 x 2048the
ItIt makes
makes the resolution
resolution higher168
5.8 higher on ± 2 screen
on small
small 2.8
screen sizes.
sizes. 8 MB
(it’s
(it’s aa good
good thing
thing since
since these
these screens
screens are
are dedicated
dedicated
24 x 30 2048 xto
to2500
exams 8.33higher
exams requiring
requiring 4.0
115 ± 2:: extremities…)
higher resolution
resolution extremities…) 10 MB
18 x 24 23925,8
x pix/mm
5,8 1792 for
pix/mm 9.95
for large
large screen 97have
screen sizes
sizes ± 2 been
have 4.8
been considered
considered 8 MB
largely
largely enough
enough for
for standard
standard exams
exams :: chest,
chest, pelvis,
pelvis, spine…
spine…
The image depth is the same for all images : 4096 grey levels (12 bits), except for Fuji (10 bits :
1024 grey levels)

p.15
Image Processing
Since the CR curve is natively linear, this gives a much wider exposure range. As a result, the raw
image has no contrast.
The raw image is not to be used for diagnostic purposes and must be processed
Image processing is performed

automatically, according to the
type of exam, right after the
phosphor-screen read-out step.
It consists in applying a specific

algorithm to each specific body
part to enhance either contrast or
details of an image (unlike with
Analog)

p.16
Image Processing


Analog)

p.17
Image Processing


Analog)

p.18
System Configurations
Most of the CR vendors propose two ranges of CR readers :
• Centralized Systems
• Decentralized Systems
Centralized reader : high productivity; around 150 plates read per hour, multiple slots
for cassettes simultaneous insertion (from 4 to 8 slots). The read-out is performed
one cassette after the other. Such system is dedicated to hospitals or big Imaging
Centers. It is installed centrally in the imaging department and generally serves a large
number of exam rooms in the department.
It is coupled to a large laser imager or many smallers, and/or a PACS (Picture Archiving
and Communication Systems)
•Exam room
•Multi-slot CR reader
•Laser Imager(s)
p.19
Centralized CR reader : Remote Operation Panels
To avoid queues at the centralized reader, wall mounted panels (or PC’s) are
installed in each exam room to allow radiographers to remotely enter exam data
and identify cassettes. The radiographer only has to drop the cassettes at the
reader and return to the exam room to review and further process the images.
These remote panels can take any form according to the vendor : wall-mounted flat
screentouch screens, PC’s on a cart or shelf.
•Exam room
•Multi-slot CR reader
•Laser Imager(s)
p.20
Example : Remote Operation Panel

A wall-mounted package, including a
touchscreen monitor, a bar code reader,
and a network connection.
It provides the same functionalities as the
« main » monitor docked to the CR
Patient id and information management
Cassette identification (bar code reader)
Procedure (exam) management
Image review
Image processing
Gateway to many image destinations : laser
imager, PACS…

p.21
Decentralized CR reader
Such device has a single slot for cassette insertion, and a medium productivity
(around 100 plates / hour). It is dedicated to medium Imaging Centers, serving two
exam rooms maximum. It can even be placed individually inside each exam room,
if small enough.
They can be either «standard » or small tabletop readers.
It can be networked to a laser printer network or distributed for soft-copy read
(PACS).
•Laser Imager
•Exam room
•Single slot CR reader

p.22
Operator Workflow
1 – Radiographer keys patient and exam data into the system using either the CR reader
monitor or the ROP. (Note : patient data can be automatically sent to the CR via a
connection to the enterprise’s Radiology Information System (RIS) in the form of a
patient worklist.
2 - Takes the right cassettes for the exam
3 – Enters the exam room with the patient, positions him(her) and takes the exposure
4 – Goes back to the reader, identifies the cassettes (via the bar code reader)
5 – Loads cassettes
6 – Checks image quality, either on the CR reader monitor, or on the ROP, back in the
room
7 – Eventually processes the image, puts some layouts (marks, text…..)
8 – If images are acceptable, sends them to a preset destination (laser imager or PACS).
If some images are not acceptable, takes a new cassette and takes the exposure again
 back to step 3
9 – Re-enters the exam room and releases the patient

p.23
Screen Types
In conventional imaging there are different types of films and intensifying screens
according to the type of exam and the balance dose/image quality desired
In Computed Radiography there are also three types of screens :
a) General purpose screens (« GP » labelled at Carestream)
Thick phosphor, better sensitivity thus need lower exposure (dose similar to Tmat
films coupled with Lanex Medium/Fast intensifying screen). Used for standard
exams ; chest, pelvis, spine…
b) High Resolution screens (« HR » labelled at Carestream)
Thinner phosphor, better image sharpness but lower sensitivity, requiring higher
exposure (similar to Lanex Fine intensifying screens). Used for extremities
c) Mammographic screens
Specific to mammography exams; very high resolution, higher MTF, lower
noise…(« EHR-M3 » labelled at Carestream). For mammo exam, the image
resolution reaches 20,6 pixels / mm (double than for general radiography exams)

p.24
Example of CR Systems
Single-slot CR readers
Fuji Capsula X
Carestream VitaCR
Carestream CR Classic
Casettes can be loaded into the reader in many ways

; vertically, horizontally, oblique, on the edge....
Some systems ingest the cassette shell, some just
clamp it outside.
Agfa CR-30 X
p.25
Example of CR Systems
Multi-slot CR readers
Agfa CR-85 X
Fuji Profect CS
Carestream CR Max
Cassette drawers or « drop and go » systems.

Some systems ingest the cassette shell, some
just clamp it outside.
Konica Regius 190
p.26
CR Technology - Summary
1. CR systems, techniques and workflows are very similar to analog systems : they
still use cassettes and a screen reader (similar to the analog dayload system)
2. CR screen is made of a photostimulable storage phosphor layer coated on a

support base. This material as the capacity to “store” the X-ray energies when
exposed, and return them into light form when excited by a laser beam.
3. This variable light (point by point) is then captured, transformed into electrical
signal, sampled, then quantified into grey levels which will define the image.
4. The image appears on the CR reader monitor roughly 30s after the cassette
insertion.
5. The CR linear response curve allows a wide exposure latitude but compels the
image to be processed and get a “tailor-made” processing according to the
procedure type.
6. There are two types of CR readers : single slot readers serving relatively few
exam rooms, and multi-slots readers serving multiple room configurations

p.27
Attractiveness of CR vs. Analog

Wide dynamic range
• Broad exposure flexibility and capability to enhance either contrast or details of an image . With
Film/Screen systems you get one or the other, not both on the same image.
Reusable Detector
• Reduction in costs for consumables and equipment maintenance. In addition, through page
formatting, multiple images can be arranged on a single sheet of printed film
Full compatibility with existing X-ray equipment
• No major changes to equipment/exposure technique, and no massive investments needed

No chemicals and better usage of space
• No chemistry and plumbing about, darkroom is not needed any longer. Similarly, film archive is not
required as digital images can be stored on digital archives
Digital Images are widely distributed
• Gateway into PACS and Image distribution across other users/facilities

p.28
Latest Innovations in CR Technology

• CR technology has been widely adopted since early 90’s
• Hardware has been developed over the years and became extremely reliable
• Latest generations of computers and processors offer very high image processing
speed and multitasking activities
• Software has been heavily developed

– more user friendly interface
– improved image processing algorithms
– additional features to improve workflow and productivity
– full Dicom compliance and PACS connectivity
• Image storage plates also improved over the years:

– less dose is required
– higher image quality
• CR Market significantly grew up in the last 4-5 years.
The Ultimate Innovation in CR is called “Needle Phosphor Technology”

p.29
Needle Technology Outlook

New type of CR plate with structured needle phosphor crystals
designed to improve the sharpness of the images by reducing
light spread.
Same technology as the one used in DR with CsI detectors
With no binder to hold the crystals in place, higher efficiency is
achieved. Major benefits are the following:
a) Improved image quality, higher MTF
b) potential for patient dose reduction, higher DQE
This represents the new threshold in computed radiography.
18x24 Mammo 7mR DQE

Needle-shaped phosphor crystals
60%
Powder-based
50% Phosphor
Needle Phosphor CSH
40%
DQE
30%
20%
10%
0%
Traditional powder-based phosphor crystals
0 2 4 6 8 10
© 2011, Carestream Health lp/mm
p.30
Standard vs Needle Screen Types

Powder Phosphor Needle Phosphor
BaFBr:Eu CsBr:Eu
•More scatter •Less scatter
•Less uniform •Uniform crystals
sensitive material •Grown on support
•Coated on support •No binder
•Binder required •Thicker sensitive
•Thinner sensitive layer
layer
Anti scatter back layer Anti scatter back layer
Support Structure Support Structure
Barium Fluoro bromide doped with Europium Cesium Bromide doped with Europium
Same structure as CsI (Cesium Iodide) scintillators
used on the LATEST DR Detectors
p.31
What does it mean Needle Ready CR?

• Capability to handle either standard storage phosphor plates or NEEDLE storage phosphor
plates
• Needle based technology brings CR performance as far as image quality (MTF) and dose
(DQE) are concerned to DR/FFDM level at a much more affordable price
– DR/FFDM still retain optimum performance for productivity
– CR with Needle screen types represent the BEST trade off in terms of IQ and
throughput
• Same CR hdw fits both plate types:

– standard screens fit the needs of Gen Rad
– needle screens fit the needs of specialties such as Mammo and Pediatric (CR
cassette 24x30cm size fit cribs)
• Customers who invest today on a CR “Needle Ready” can decide to start with the standard
screen types and move to “Needle Plates” when the technology is going to be more
affordable
– This helps customers to protect the investment for future upgrades and the CR reader
does not have to be replaced
• Any CR reader with technology based on FLEXIBLE screen type IS NOT compatible with
needle screens and can’t be upgraded in the future

p.32
DR Solutions
Different Detector technologies are offered today:
• Direct  convert XRay into electric signal
–Amorphous Selenium
• Indirect  sandwitch made by: scintillator+sensor (CCD/Photodiodes)
–GdOS (Gadolinium Oxy-Sulfite)  Powder based scintillator type
–CsI (Cesium Iodide)  Needle based scintillator type
–CCD Sensor types are going to phase out to be replaced by Photodiodes
DR Systems are available as:

- Full Room Solutions
- Retrofit XRay solutions with DR detectors
- Portable XRay Systems
- Mobile XRay Systems
Systems are very specific to the application type and a dedicated solution is required for
every specialty (eg GenXRay, Mammo, Dental)
Ideal for large institutions (MOH, Universities etc) where the decision criteria is
PRODUCTIVITY and to give the capability to the Radiology dept. to further expand in the
future

p.33
CR Solutions
Storage Plate Technology is based on:
- Standard Powder Phosphors available on either FLEXIBLE or RIGID screens
- Needle Based Phosphors available on RIGID screen type only
Plate Readers can be divided in two categories:
- Compatible with either standard plates or Needle plate types
- Compatible with standard screen types only
CR Solutions are ideal for facilities that require VERSATILITY among a broad range of different
type of applications (GenXRay, Dental, Mammo, Long Bone Imaging) such as:
- integration into a DR solution to fulfill the following needs:
a. back up solution
b. specialty exams (panoramic, mammo, long bone)
c. mobile solutions for ICU or OCU
- integrated Xray Digital Mobile Systems
- mobile solutions for mobile van/military/areas of disaster applications where units have
to be easily transported

p.34
Class A Hospital Radiology Workflow

Hospital
120-150 XRay exams/day
Enterprise
PACS & RIS
DR Retrofit DR Rooms CR Systems

Solutions as a
- Back up
- Mammo
- LLI
- Panoramic
- Pediatric

p.35
Class B&C Hospital Radiology Workflow

Polyclinic Health Center/Private
60-90 XRay exams/day 5-10 XRay exams/day
MiniPACS & Clients MiniPACS

or DR/CR Consoles & Web Clients
CR Solution
DR Retrofit CR Solution MOH

Solution
Unrestricted Internal Use Consultancy
p.36
A Recurring Dilemma: CR or DR?
CR DR
The correct answer is:
BOTH !
DR as the main solution for class A facilities to maximize productivity
CR solution for class A facilities as DR back up and for specialty exams
CR for class B and C facilities or for mobility solutions
CR gives good flexibility and connectivity to further expand workflow

CR Portfolio
2013

p.38
CR Systems from Carestream Health

INPUTS FROM CUSTOMERS
• Better patient care and productivity
• Reliability and serviceability
• Easy-to-use, intuitive user interface
• Flexibility to suit your needs
Two Product Families:

1. DirectView CR Solutions
2. Vita CR Solutions

p.39
Needle
1. DirectView CR Solutions Ready
CR Max
Elite CR
Classic CR

p.40
Needle
CR Max System Ready
Powerful. Drop-and-Go Workflow.

Boost CR productivity with a workflow leader
Drop-and-go cassette processing
• Handle 16 cassettes simultaneously
• Reduce time away from the patient
• Cassettes with RIGID PLATES tested to 45,000
cycles. Compatible with either:
–standard phosphor screens
–needle phosphor screens
High Res 48.5 um for mammography
FDA Approved for mammography
16 Bit grayscale data acquisition
Forward images to multiple network
destinations—improve productivity
Easy-to-use interface is designed for consistency
across Kodak DirectView CR and DR systems
Integrated UPS and hard disk drive for backup
when network and power are down
p.41
Needle
CR Max System Ready
Application
• Centralized general radiography and mammography
• Multiple x-ray imaging rooms
• Medium-to-high exam volumes
Dimensions
• Height 52 in. (132.1 cm) x Width 41 in. (104.1 cm) x Depth 30 in. (76.2 cm)
• Weight: 956 lb. (433.6 kg)
• Monitor: 19-inch flat-panel touch screen, full color, 1280 x 1024 matrix
Throughput
• Process up to 101 cassettes/hour
• 34 seconds or less (time to image display at CR)
• 40 seconds or less cycle time
• 8-bay input/8-bay output reader  16 plate slots

p.42
Needle
Classic & Elite CR Systems Ready
Improve workflow, productivity and patient throughput.

Fast single-plate CR system, Elite CR processes up to
90 plates per hour
High Res 48.5 um for mammography
FDA Approved for mammography
16 Bit grayscale data acquisition
Small footprint for easy placement
Easy to use, intuitive interface
Cassettes with RIGID PLATES tested to 45,000
cycles. Compatible with either:
–standard phosphor screens
–needle phosphor screens
Easy to install and set up
Reliable system that keeps downtime to a minimum
Scalable to meet changing needs
p.43
Needle
Classic & Elite CR Systems Ready
Application
• Distributed CR applications—radiology department,
mammography, ER, ICU, or other
• Medium-to-high exam volumes
Dimensions
• Height 40.5 in. (102.87 cm); Width 19.0 in. (48.26 cm);
Depth 22.7 in. (57.66 cm)
• Weight 300 lbs (136 kg) without keyboard, monitor, floor stand, etc
• Monitor 19-inch flat-panel; 19-inch flat-panel touch screen, full color, 1280 x 1024 matrix; 21
inch 3MP High Res full color
Throughput
• Elite 90 cassettes/hour; Classic 69 cassettes/hour
• Time to first image 33 seconds (time to image display at CR)
• 40 seconds or less cycle time
p.44
DIRECTVIEW CR Cassettes
Durable cassettes with rigid screen mounting
• Lightweight
• No mechanical contact of screen
• No screen bending during transport and
scanning
Designed for long life to reduce operational

costs - tested up to 45,000 cycles  expected
to last several hundred thousand of cycles !!
Available in sizes for a variety of applications:

• 35 x 35 cm, 35 x 43 cm, 18 x 24 cm, 24 x 30
cm,
15 x 30 cm (dental panoramic) and 14 x 33 in.
(long-length)
Available with a variety of sizes and types

• GenRad
• Mammography (either std M3 or SNP screen
types)
• Long Length
• Gridded Cassette
p.45
DIRECTVIEW CR Software
Excellent image quality supports increased diagnostic confidence
Robust software platform for

DirectView CR Systems offers power,
performance and advanced image
processing that puts the power of
optimizing image processing into the
users’ hands
Consistent and intuitive user interface across all

DirectView CR and DR systems
Support increased confidence and reduced reading time with state-of-the-art, built-in
Kodak DirectView CR software and Kodak DirectView Image Processing
Improved software enhances productivity, workflow, flexibility

p.46
DIRECTVIEW CR Software Features

Workflow Enhancement Options
Remote Operations Panel: Save time and steps in your work process. With this wall-mounted
panel, technologists can perform most of the functions of the main CR system without walking
to the machine itself.
IHE Scheduled Workflow: DIRECTVIEW V5 CR and DR Software saves time and boosts
productivity by automatically notifying your HIS/RIS of exam status.
DICOM Modality Worklist: Facilitates automatic transfer of patient and procedure data from
your HIS/RIS system, eliminating manual data entry, and increasing technologist productivity.
Simple Capture Link: Integration means efficiency. Connect two CR Systems or a CR and DR
System together. Scan and review images on any one of them, and watch productivity spike in
your high-volume areas.
Remote Patient Data Entry: Patients are your rst priority. Let radiographers dedicate more
time to them, by making data entry an office-based PC task. Reduces overall radiographer
workload, too.

p.47

Quality Enhancement Options
Administrative Analysis and Reporting Option : Improve your department’s overall

performance by taking analysis and reporting to a new level. This easy to use software
provides a single, consolidated source for viewing all performance metrics from your CR and
DR systems in a format that works for you. With this “digital dashboard” you are able to analyze
results and develop improvement plans.
Total Quality Tool: Keep work owing. Now, the same interface can be used for patient exams
and objective quality-control image tests on your CR and DR systems. With the Total Quality
Tool package — software, phantom and carrying case— you can perform these tests when it’s
convenient for you — without interrupting workflow or incurring the cost of third-party testing.

p.48

Image Processing Options
Grid Detection and Suppression: Get a clearer view. This option provides improved image
quality through automatic detection and suppression of gridline artifacts.
Tube and Line Visualization: With this feature, a companion image is created from the
original exposure with optimized processing for clearer, easier visualization of PICC lines and
tubes. It increases confidence that tubes and lines are placed correctly — and remain in
position.
Pneumothorax Visualization: Save time with software that creates a companion image from
the original exposure that is optimized to accentuate the appearance of free air in the chest
cavity.
Low-Exposure Optimization: Low-exposure optimization minimizes quantum noise
interference in low-exposure imaging areas to capture high-quality diagnostic details.
Procedure Mapping: Count on this platform’s simple RIS and procedure codes to speed data
entry and workflow. Exam Tutor gives technologists the exibility to acquire images in any
sequence.
Advanced Trauma Capability: Gain immediate access to patient records and depend on
predefined exam/procedure codes to speed workflow in trauma cases — and get patients to
treatment faster.
Patient CDs: Patients can walk out the door with a CD copy of their images including a DICOM
viewer to take to their referring physician. Auto-Correct for Image Display Save time with
software that will automatically display chest images in the proper orientation.
Prior Image Review: Retrieve and review images from PAC's and copy techniques to the
current exam.
p.49

SUPPORT FOR SPECIALTY APPLICATIONS
Mammography
Carestream's proprietary algorithms increase software performance for mammography-quality

images. Our Total Quality Tool for Mammography boosts the versatility of CR systems, for high
performance specic to mammography or mixed-use environments.
Pediatrics
Monitoring exposure is particularly critical in pediatric imaging. Depend on reliable

measurement and tracking with the IEC standard Exposure Index feature to ensure you are
within range. Gain performance versatility as well, with imaging options for seven different
pediatric body types linked to exposure techniques.
Long Length Imaging
The software includes features specifically designed for orthopedics. Image stitching is
performed automatically, providing seamless images in less time — no need to manually align
images.

p.50
DirectView Sfw ver 5.6

New Purchasable 5.6 software features New Purchasable 5.6 software features
• Enhanced multi-format print (see pictures below) • Pneumothorax Visualization

‒ Additional print layouts (and more) for improved flexibility and maximized film use • CR Autocorrect for Image Display
‒ Add markers simply by touching or clicking on the image • Prior Image Review for CR
‒ Image adjustment tab allows for rotate, flip, invert, zoom/pan, true size one or more images
• CR Pediatric Image Optimization and Enhancement
• Grid View Indexing (employs different image processing parameters based on • CR Pediatric Quality Package
detected grid)
• 2D Barcode Reader (available as an accessory)
• Express Viewer
• Proximity Badge Reader (available as an accessory)
• Combined Query/Work List Screen
• Additional Proximity Badges
• Image delivery to USB removable media
• Enhanced Admin & Reporting Software (additional
• DHCP Support data added to the report: IEC Index, Exposure and
DAP, TQT)
• Proximity Card Reader support (Proximity card purchased separately)
• IEC exposure Index support • Tech Assist Chest QA Software Package for CR
‒ Contrast-Noise Ratio
• Key Operator changeable AE title and IP address
‒ Anatomy Clipping
• Consistent Rendering for portable chest images
‒ Deviation Index
• Supports new HP 5800 PC
• CR Intensive Care Unit (ICU) Package
‒ Tube Line Visualization
‒ Autocorrect for Image display
‒ Pneumothorax Visualization

p.51
2. VitaCR Solutions
Vita XE
Vita CR
Vita LE

p.52
VitaCR Family
Compact, versatile systems for distributed CR applications
Serves the needs of specialty markets such as the military, orthopedics,

diagnostic imaging centers, in-room hospital applications, veterinary and
mobile solutions
NOTE:
- VitaCR’s DO NOT
SUPPORT
Mammography

p.53
VitaCR Specifications
Throughput (14x17in)
VitaLE: 23 plates per hour
VitaCR: 44 plates per hour
VitaXE: 63 plates per hour
Weight
<79 lbs (36 kg)
Dimensions (H x W x D)
13.4" x 29.5" x 21.7“ (34 x 75 x 55cm)
Grayscale Resolution
Acquisition: 16 bits per pixel
Display: 12 bits per pixel
Safety and Regulatory Approvals
FDA, CE, cTUVus
Screen Types supported

Carestream Flexible GP2 Screen

p.54
Vita – Reliability You Deserve!

You need a solution that works! The Vita CR System is
designed to be durable and reliable.
A sealed design protects the unit from
damage in harsh environments and
reduces dust and other artifacts from
entering the scanner. The materials used
are rugged and durable, and meets strict
military standards for operation, storage
and transportation.
One main controller board makes

troubleshooting a snap.
Gentle screen handling minimizes wear
and LED-based erase is highly efficient
with exceptionally long life.
Limited moving parts reduce the chance
for something to break. This means your
system has minimal downtime resulting in
reliability you can count on.

p.55
Vita CR Meets Military Standards

From the extensive list of environmental tests performed, the table below quickly
highlights the Military Standards, and the corresponding results.
The Vita CR is ready, willing and able to participate in any Military tender.
Standard / Type of Brief Description Result

Method Test /
Parameter
Mil-Std 810E Operating The range of Operating temperature PASS

502.3 Temperature to be from 10o C to 40o C
Mil-Std 810E Storage The unit, contained in its packing PASS

507.3 shall be operational after the following
storage conditions:
Temp : -15o C to 60o C
Temp. and Humidity : 35o C , 95% RH
Mil-Std 810F Bench The unit, when un-packed, shall meet PASS
516.5-30 Handling the applicable bench handling
Procedure VI requirements without causing any
physical or non-operational damage.
Mil-Std 810E Military Drop/ The unit, when fully packed, shall PASS
514.4 Vibration meet the applicable drop and vibration
requirements without causing any
physical or non-operational damage
Mil-Std 810-4 Dust Test The unit shall be tested in a dust PASS
510.4 chamber
Procedure III –
Settled Dust

p.56
Cassettes and Flexible Phosphor Screens

Specially designed CR
cassettes incorporate
flexible phosphor
screens that ensure
high-quality images
even after extended
use.
Available cassettes
include standard
industry sizes and
optional sizes for Long
Length Imaging (LLI)
35x84 cm and Dental
Panoramic Imaging
15x30 cm cassettes.
• 8" x 10” • 14" x 17”
• 11" x 14” • 24 cm x 30 cm To maximize the life of
• 10" x 12” • 15 cm x 30 cm the phosphor screen,
• 14" x 33" (LLI) (dental panor.) Kodak screen cleaner is
• 14" x 14" recommended for
maintenance and care
Unrestricted Internal Use of your CR screens.
p.57
Options and Accessories – Just for You!
The Cart is an optional

wheeled cart that safely
mounts and transports the
Vita CR to virtually any
location in your facility,
making instant digital
imaging accessible at your
patients point of care.

p.58
Options and Accessories – Just for You!
With the optional Long Length Imaging (LLI)

System and 14”x 33” (35x84 cm) cassette with
Portable Caddy w/Gird flexible phosphor screen, you can easily perform
scoliosis and other long length images exams with
the Vita CR.
Combined cassette and screen weigh only 10.8lbs

(4.9kg) making it one of the lightest LLI solutions in
the market.
Unrestricted Internal Use Wall Stand w/Grid

p.59
Image Suite v.3 Software
Classic ImageSuite
VitaCR ImageSuite
VitaXE ImageSuite
VitaLE ImageSuite

p.60
Carestream Image Suite / V3 Software

CARESTREAM Image Suite/ V3 has been redesigned with the user in mind to be an
acquisition and optional Mini-PACS software solution with a simplified, more intuitive
user interface that meets the radiography needs of the community hospital, small
clinic, imaging centers and private practices (such as Chiropractic, Orthopedic and
Veterinary).
Enhancements made to the workstation interface, worklist, order entry screen, and
the image acquisition screen will be outlined in this presentation
Image Suite Acquisition will only locally store 2,000 images. When the limit is
reached then images will be removed by date unless the optional mini-PACS is
purchased.

p.61
Image Suite / V3
Base Software now includes the following
• Image Suite Acquire Module

– DirectView Image Processing
– Black Surround Masking
– Grid Detection and Suppression
– Low Exposure Optimization
– Exposure Guides
– Manual/Automatic Stitching (only have to purchase H/W – LLI cassette, wallstand, etc.)
• CD/DVD Burning
• DICOM Store SCU
• DICOM Print
• Web Appointment Software
• DICOM Modality Worklist
• TQT Software
• Number of Purchasable Options that enhance the capabilities of the software and facility – see next slide

p.62
Purchasable Options
Advanced Measurement Tools Set*
Mini-PACS Archiving Software
• Gonstead Measurement Tool
• Provides image archiving capability and includes the following
• Cervical Curve Measurement Tool
– Image Import Software
– IMAGE SUITE PACS Module
• Lumbar Curve Measurement Tool
– Web Viewer 4 License Bundle

• Measure from Vertical Tool
• Measure form Horzontal Tool
Clinical Report Software* • Vertical Axis Line Tool
• Provides ability to create/edit/view reports attached to studies • Line Extension Tool

• George's Line Tool
Web Viewer License* • Goniometry Measurement Tool
• Add additional web viewer license up to a max total of 8 • Coxometry Measurement Tool
Long-Length Imaging Cassette/Wallstand/Caddy** Veterinary Application**

• Software included in based Image Suite / V3 • Available in Acquire module – no need to purchase PACS
• Vet-specific order entry (breed, species, unique identifies
DICOM Store Service Class Provider (SCP)* like tattoos and chip ids and more) and exam views
• Provides ability to perform DICOM store for other Modalities • Animal reference images
(CT, MR, US) - CR store is provided by default at no charge • Customized animal-image processing database
• Specialized veterinary measurement tools
TQT Phantom**
– Hip Dysplasia Measurement Tool
• Software included in based Image Suite / V3
– VD Thorax Measurement Tool
– Vertebral Heart Score (VHS)
Mammography Feature Software (Outside USA)** Measurement Tool
– Tibial Tuberosity Advancement (TTA)
Measurement Tool
– Tibial Plateau Leveling Osteotomy
(TPLO) Measurement Tool
– Laminitis Measurement Tool
Unrestricted Internal Use * PACS Only
© 2011, Carestream Health **Acquire & PACS
p.63
CARESTREAM Image Suite / V3 Software - Base
Acquisition Only SCANNING ROOM
RECEPTION ROOM Classic CR
OR
Exam Scheduling
•HIS/RIS - HL7
•Web Patient Entry
Vita, Vita XE, Vita LE
OUTPUT
IMAGE SUITE
HOST WORKSTATION
Exam Scheduling
Acquisition
Image Processing/Viewing/Editing
CD/DVD
Print
Customer’s TCP/IP
USB Connection
p.64
CARESTREAM Image Suite / V3 Software with Options
SCANNING ROOM
DICOM STORE SCP *
RECEPTION ROOM CR, DR, MR, CT, US Classic CR
OR
Exam Scheduling
HIS/RIS - HL7
Web Patient Entry
Vita, Vita XE, Vita LE
PHYSICIAN ACCESS*
ON-SITE OR REMOTE
OUTPUT
IMAGE SUITE
HOST WORKSTATION
Exam Scheduling
Acquisition
Image Processing/Viewing/Editing
Reporting *
Import/Export * CD/DVD
Print
Web Viewing / Editing / Reporting *
Customer’s TCP/IP Archive *
Unrestricted Internal Use USB Connection
© 2011, Carestream Health * Optional
p.65
Image Suite Target Markets
Complex
Large Hospitals, DRX-1, Evolution,
Academic Medical RIS/ Elite, Classic
Centers PACs
Community Hospitals
Elite & Classic

RIS/PACs
Large Practices,
Imaging Centers,
Chiro MX-Clinic View Mini-PACs
Image Suite Acquisition/Mini-PACs
Classic, Vita
Physician Offices, LE/Vita/Vita XE
Clinics, Podiatry,
Vet, Chiro, Mobile,
Image Suite Acquisition w or w/o Mini-PACs
Military, Ortho
DirectView SW
Simple
Customer Software Hardware

p.66
Target Customers & Applications

Customers
• Offices performing up to 12,000 procedures per year such as

– Private practices
– Urgent care centers
– Small offices/clinics with 1-3 physicians – Orthopedics, Chiropractic, Podiatry
– Veterinarian offices
• Not connected to an enterprise PACs System

• Interested in using Classic or Vita/Vita XE/Vita LE CR
Applications
• General radiology (including mammography Outside US)

• Orthopedic medicine
• Chiropractic medicine
• Podiatry medicine
• Veterinary

p.67
Positioning - Image Suite vs. Vue PACS

• HCIS offering (Vue) is more feature rich, and thus more expensive to end user
• Goal is not to compete with this other CSH offering, but to position Image Suite as a
“different” level of capability that is more value priced
Image Suite Vue

 Site is a good fit for Classic CR, PoC or Vita CR  Site is purchasing a non-Carestream CR
 Site performs <12K procedures per year. Does not foresee need
for significant PACs feature expansion
 Site performs 12K or more procedures per year, but may need
a larger PACs functionality in the future as volume increases
(enterprise system, hosted archives, etc.)
 Prefers software to be installed on acquisition hardware to
eliminate need for additional PC  Prefers software to be installed on separate PC to eliminate
single point of failure
 Desires ability to process full bit-depth images (“for processing”
images) at the host PC  Satisfied with image processing (window/level) of “For
Presentation” mode images
 Is satisfied with standard editing tools (pan, zoom, length, angle,
rotate, flip, annotation, etc.)  Requires advanced tools/applications (3D, Specialized
Mammo, advanced Orthopedic measurements, etc)
 Local archive or CD shelf archiving ok
 Primarily a stand-alone site with limited external interaction need,  Need Managed external archive
(minimal need above Web Viewing or Uploading to Central  Must have integration of data from multi-sites, including
replication, synchronization, redundancy, central archiving
Archive)

p.68
Value Proposition - Dealers/Distributors

• For Dealers/Distributors who need
– Image acquisition products for Private Practices, Chiropractic Offices and Small Clinics
– Products that are easy to install and service
• Competitively priced software solution that offers the dealer’s customers the following
– Exam scheduling
– Image acquisition and processing
– Enhanced measurement tools*
– Reporting*
– Archiving*
– Remote access*
• Which provides
– Competitively price software solution focused on their target markets
– Key features and tools for the dealer to target specialty markets such as Vet, Chiro, and Ortho
– Innovative software solution that can be bundled together with either the Vita or Classic CR products

p.69
Value Proposition – End Users

Medical Veterinary
• For Private Practices, Chiropractic Offices • For Veterinary Practices who need
and Small Clinics who need
– Image acquisition
– Image acquisition – Archiving capabilities
– Archiving capabilities
• Competitively priced software solution
• Competitively priced software solution that offers
offers – Vet specific exam scheduling*
– Exam scheduling – Vet specific image acquisition and processing*
– Image acquisition and processing – Vet measurement tools*
– Enhanced measurement tools* – Reporting*
– Reporting* – Archiving*
– Archiving* – Remote access*
– Remote access*
• Which provides
• Which provides – Simplified routine radiology workflow
– Simplified routine radiology workflow – High image quality
– High image quality – Secure storage
– Secure storage – Reduced turnaround time leading to improved owner
– Reduced turnaround time leading to improved satisfaction
patient satisfaction

p.70
Typical Workflow
Acquire Module PACS/Archive Module

Workstation PACS Archive List Web Archive List
Schedule Acquire/View/Edit
Workstation PACS Viewer Web Viewer
CR Worklist Print/Burn CD
Workstation PACS Print Report

p.71
Schedule
Features Benefits
AT A GLANCE
Register patients remotely with Web-based Enhances productivity and
software decreases patient wait time  Simple
Request multiple images in a single order Increased flexibility for orders

 Register patients
remotely
 Request multiple
Selection figure graphics Allows for quick and easy images in a
picking of the body parts and single order
views
 Powerful
Body part & view position enhancements Increased ability to meet the
 New default body parts & views

sites specific needs  Enhance &
modify body
 Ability to add & edit existing body parts parts & views
 Apply custom processing across views
 Connectivity via
DICOM or HL7
Connect with DICOM or HL7 Complaint Simplified workflow with
PM/EMR/RIS systems increased connectivity

p.72
New Order Entry Screen - Human
Custom
Mandatory Fields
– as much or as
little of information
needed
(highlighted in
orange)
Additional patient
information
entered but not
required listed on
information tab
Selection Figure Graphic - allows for quick

and easy picking of the body parts and views

p.73
Selection Figure Graphics
Custom Mandatory
Fields – as much or
as little of
information needed
(highlighted in
orange)
New fields created
for Vet to allow for
DICOM Vet
compliance
Additional patient
information
entered but not
required listed on
information tab
such as unique
identifies like
tattoos and chip
ids and more
Selection Figure Graphic - allows for quick and easy picking

of the body parts and views and is displayed based on
Species (e.g. canine, feline, equine, avian, etc) selected

p.74
Acquire
Features Benefits AT A GLANCE
Ultra-intuitive, user-friendly interface Offers simplified navigation and an

enhanced user experience which boosts
 Simple
speed and productivity
 User friendly
Touch friendly monitor capability Allows simple navigation of User interface
Interface for a enhanced user
experience  Supports
Mammo (outside
Access to clinical tools and Increases workflow and productivity US) and LLI
applications (circular masking,
histogram, ROI pixel value and more)
 Affordable
Reference positioning images and Improve image quality and accelerate
sample x-ray images workflow by using these as guides  Works with wide
range of
Barcode Reader capability Allows for association of a cassette with scanners
a specific patient on both Classic and
Vita CR Systems  Powerful
Requires any Hand Held USB Bar Code  Consistent high

quality images
Reader (configured as a keyboard
emulator and programmed to read
Unrestricted Internal Use Interleaved 2 of 5)
p.75
Acquisition Screen – Simplified Tools
Patient/Exam
info available
for review/edit
Tool palette
is divided
by
category,
and
provides
everything
All Views in a tech
the Exam will needs to
be displayed review an
in the scroll image
box
Add new Views easily

Additional sub screens allow user to
print, export, and stitch
p.76
Acquisition Screen – Advanced Tools
Advanced
Tool palette
is divided
by category

p.77
Reference Images - Human
Selected View Reference Images

(Lateral Wrist – orange border)

© 2012,
2011, Carestream Health
p.78
Acquire
AT A GLANCE
Features Benefits
 Simple
Supports CARESTREAM portfolio of Wide range of scanners (with varying
CR Scanners plates per hour and price) to fit the  User friendly
customers needs interface
Includes Enhanced Visualization- Consistent high quality images every  Supports

Automatic (EV-A) image processing time Mammo (outside
US) and LLI
Supports Mammography (outside US) Specialty applications at an affordable  Affordable

and Long Length Imaging* price
 Works with wide
range of
scanners
 Powerful
 Consistent high
quality images
*Mammography available with Classic and Long length imaging available with Classic or Vita/Vita XE/Vita LE

p.79
View/Edit
Features Benefits
AT A GLANCE
Free-rotation tool** Ability to customize your image orientation
offers increase flexibility
 Simple
Supports eight concurrent web Increased flexibility so that images can be
viewer sessions* viewed remotely or throughout customer’s visit  Easy to use slide
bars for image
Simple slide bars for image Simple image processing can be tuned for processing
adjusting** brightness, contrast or detail
 Powerful
Delivers full scanner bit-depth Highest image dynamic range for image
images at the host workstation* processing at acquisition and post archiving  Full scanner bit-
depth images
Tools for mammography sites Increased functionality with features such as  Advanced
(Outside US only)** Mammo print output, ability to store specific measurement
exposure values and custom processing and tools
new with V3 the ability to add all views with
one button click  Veterinary User
Interface
Automatic and Manual Stitch Allows the ability to manipulate and paste
Editors** individual images together to create precisely
the view you need
p.80
Free Rotation
Ability to
freely rotate
the image
simply by
clicking and
turning the
wheel

p.81
Manual Stitch Editor

p.82
Manual Stitch
Click and drag the component

thumbnails into the image viewer
Zoom in to the overlap area

between the 2 selected images
Stitch – allows the images in the
viewer to be stitched together after the
images have been correctly
positioned

© 2012,
2011, Carestream Health
p.83
View/Edit
Features Benefits
AT A GLANCE
Advanced measurement Increased usability for specialty offices with
tools for specialized
practices*
advanced tools for improved diagnostics.
Tools include  Simple
• Gonstead Measurement Tool  Easy to use slide

bars for image
• Cervical Curve Measurement Tool processing
• Lumbar Curve Measurement Tool
• Measure from Vertical Tool  Powerful
• Measure form Horzontal Tool  Full scanner bit-
• Vertical Axis Line Tool depth images
• Line Extension Tool  Advanced

• George's Line Tool measurement
tools
• Goniometry Measurement Tool – new with
V3
 Veterinary User
• Coxometry Measurement Tool – new with Interface
V3

p.84
Advanced Measurement Tools
Measurement from Vertical Measurement from Horizontal

Cervical Curve Line Extension
Gonstead Lumbar Curve
Coxometry
Cardiothoracic Ratio
George’s Line Lippman-Cobb Angle
Unrestricted Internal Use Goniometry

p.85
View/Edit
Features Benefits
AT A GLANCE
Enhanced Customized application to meet Vet specific needs and workflow
Veterinary
Application** • Vet-specific order entry (breed, species, unique identifies like
tattoos and chip ids and more)
 Simple
• Animal reference images are provided to support accurate  Easy to use slide
positioning, while sample veterinary X-rays provide guides for bars for image
enhanced image quality processing
• Customized animal-image processing database fine-tunes  Powerful

processing parameters for specific species, breeds, body parts
and views
 Full scanner bit-
• Specialized veterinary measurement tools help you arrive at depth images
precise diagnoses faster than ever before.
– Hip Dysplasia Measurement Tool - measures the Norberg-angle of the hip in dogs and cats  Advanced
measurement
– VD Thorax Measurement Tool - measures the ratio of the Cardiac Width to the Thorax Width
– Vertebral Heart Score (VHS) Measurement Tool - measures the size of a animal’s heart
tools
–Tibial Tuberosity Advancement (TTA) Measurement Tool - determines the appropriate tibial
tuberosity advancement distance
–Tibial Plateau Leveling Osteotomy (TPLO) Measurement Tool - measures the tibial plateau angle, or
 Veterinary User
tibial slope. Interface
– Laminitis Measurement Tool - measures the angle of rotation of the pedal bone relative to the dorsal
hoof wall

p.86
Veterinary Measurement Tools
Vertebral Heart Score

Hip Dysplasia
VD Thorax
Tibial Tuberosity
Tibial Plateau Leveling Laminitis
Advancement
Osteotomy

p.87
Diagnose/Report
Features Benefits
AT A GLANCE
Dual monitor support on Web clients Enables increased efficiency by allowing
the viewing of multiple images at once -  Simple
used to view current/priors or other
modalities & CR images side by side  Dual monitor
increases
Process full bit-depth (raw/full- Increases image quality by offering the viewing
fidelity) images at workstation PACS ability to control brightness, latitude, efficiency
contrast, sharpness and noise – Now and
Later  Powerful
Optional DICOM store SCP software Offers the ability to receive & review  Archives full bit-
images from CT, MR, ultrasound and depth images
additional CRs
 Store & view US,
CT, MR & other
Total Quality Tool Software Perform quality testing at the time most
CR images
convenient for you
Reject Analysis Feature Track issues with exams for additional

training and improved workflow

p.88
Print/Burn CD/Archive
Features Benefits
AT A GLANCE
On-demand or scheduled backup Flexible security for data backup
capabilities*  Simple
Storage of both “for processing” & “for Reprocessing of stored images –  Multi-format
presentation” images* both simple and advanced printing
adjustments – unlike any other PACS
 JPEG & DICOM
export tool
Manually store exposure values Critical for Mammo applications,
required for x-rays in many countries  Affordable
Perform backups to CDs and/or Flexibility in storage options
removable USBs  Backup for CD or
USBs
JPEG or DICOM export tools Flexibility to use images outside of
system/facility (e.g. PowerPoint  Powerful
presentations)
 Full-bit image
Support multi-format print composition Eliminates the need for additional available for post
with independent image editing printing programs like MasterPage archive
capability** reprocessing –
No other PACS
does this!
* PACS Only
p.89
PC Requirements

p.90
Competitive Comparison

p.91
Competitive Comparison – Multi-format Printing

MasterPage Directview V5.5 Image Suite QC‐Full MX Directview V5.6
General Features
WYSIWYG Preview Yes No Yes Yes Yes Yes
Header‐Footer Preview Yes No Yes Yes Yes Yes
Mix Patients on film Yes No Yes Yes No No
Print Jobs
Send to Multiple Destinations No Yes No No No Yes
Can Specify print Job consisting of multiple
pages Yes No Yes No Yes No
Can Specify Number of copies of Page Yes Yes Yes Yes Yes Yes
Can Specify the Film Size for a Print Job Yes Yes Yes Yes Yes Yes
Print Job Status Reporting Yes No Yes Yes Yes Yes
No ‐ depends on
Render Entire Page as a Single Image Yes Printer Yes Yes Yes Yes
Page Layout
Custom Layouts (User Defined) Yes ‐ custom layouts can No Yes No Yes ‐ only No ‐ can be added
be created via xml file Symmetric through script
Header No No Yes Yes Yes No
Footer Yes Yes Yes Yes Yes Yes
Image/Logo in Header or Footer Yes ‐ via xml file No Yes Yes Yes Yes
Custom Header/Footer content Yes ‐ via xml file Yes Yes Yes Yes Yes
Specify Font/Size in Header and Footer Yes ‐ via xml file No Yes No Yes Yes
Asymmetric Layouts Yes No Yes Yes Yes Yes
Assign Same Image to muliple postions in
layout w/ Independent editing Yes No Yes Yes Yes Yes
Image/Patient Data overlayed on image Yes No Yes Yes Yes Yes
Image Editing (On Preview)
Window Level Yes No Yes Yes Yes Yes
Zoom Yes No Yes Yes Yes Yes
Pan Yes No Yes Yes Yes Yes
Rotation Yes Yes Yes Yes Yes Yes
Can Add Markers on Preview Yes No Yes Yes Yes Yes
Max Zoom % No Limitation 100% 1000% No 800% 400%
•Image Suite is competitive with regards to multi-format printing to MasterPage.

p.92
Mammography – Image Suite vs DirectView

Image Suite Software DirectView Software
1 predefined look Up to 9 predefined looks

Custom processing can be applied across all views Custom processing can be applied across all views
simultaneously simultaneously
Use of EFP processing for MCC Use of EFP processing for MCC
View Position and Laterality are kept in separate DICOM tags View Position and Laterality are kept in separate DICOM tags
Raw images can be sent to CAD for processing Raw images can be sent to CAD for processing
Breast image is stored as MG IOD Breast image is stored as MG IOD

Breast image is printed with 12 bit resolution Breast image is printed with 12 bit resolution
SNP Not supported with this version Supports SNP cassettes
Support TG-18 target import and printing/delivery Support TG-18 target import and printing/delivery
Exposure technique not automatically recorded – can be Exposure technique (kV, mAs, etc) can be recorded with
manually recorded for each image the image automatically with optional Livingston Bridge
Available on Classic – not with Vita Available on Classic, Elite and CR Max
No FDA for Mammo - Not available in the US FDA Mammo Approved - Available worldwide

p.93
Upgrade Strategy
Classic
• No upgrade from DirectView Software to Image Suite
• Image Suite Upgrades
– If on V1 - system must first be upgraded to V2
– Once at V2, the V3 upgrade CD Software can be applied
PoC/Vita
• Only Vita Product Line is supported in V3 at launch, PoC (140/360) CRs will follow EOY/Q1 2013
• Image Suite Upgrades to V3 handled the same way as Classic
– If on V1 - system must first be upgraded to V2
– Once at V2, the V3 upgrade CD s/w can be applied (i.e. QA will only test upgrading from V2 to V3)
• Upgrades from Vita Software (QC) to Image Suite V3 requires data migration
– Image data will be transferred via DICOM transfer
– Patient data will be transferred via a Migration tool
– It does NOT matter if system is on Vita Software V2.5/V3.0/V3.1/V3.2 or what Vita Model
• Upgrades from Examion Vet Software not supported, must completely re-install


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CR Computed

Unrestricted Internal Use

History and Technology Principles

Unrestricted Internal Use

1 – Image Receptor 2 - Plate Reader 3 - Distribution

• Image distribution • CD burning to be able to

Unrestricted Internal Use

Storage Phosphor Plate

• The imaging plate is made of a photostimulable storage phosphor layer coated on a

Creation of a As a result of the xray interacting with the body

Erasure Final step is the plate erasure. It is done by

Unrestricted Internal Use

Storage Phosphor Plate – Imaging Cycle

Phosphor layer with

support Aluminium or rubber

Storage phosphor screens look very much and perform similarly to

Unrestricted Internal Use

Storage Phosphor Plate – Imaging Cycle

Prompt emission of light

Storage Phosphor Plate – Imaging Cycle

Storage Phosphor Plate – Imaging Cycle

Stimulating RED laser

Storage Phosphor Plate – Imaging Cycle

Storage Phosphor Plate – Imaging Cycle

•The latent image information is completely removed

CR Reader – How it works

Laser emitting device (diode or tube)

Unrestricted Internal Use

The Output – Image Matrix

Depends on the screen size

35 x 43 2048 x 2500 5.8 168 ± 2 2.8 10 MB

35 x 35 2048 x 2048 5.8 168 ± 2 2.8 8 MB

24 x 30 2048 x 2500 8.33 115 ± 2 4.0 10 MB

Unrestricted Internal Use

The Output – Image Matrix

Unrestricted Internal Use

Image processing is performed

It consists in applying a specific

Unrestricted Internal Use

Image processing is performed

It consists in applying a specific

Unrestricted Internal Use

Image processing is performed

It consists in applying a specific

Unrestricted Internal Use

Example : Remote Operation Panel

Unrestricted Internal Use

Unrestricted Internal Use

2 - Takes the right cassettes for the exam

7 – Eventually processes the image, puts some layouts (marks, text…..)

9 – Re-enters the exam room and releases the patient

Unrestricted Internal Use

Unrestricted Internal Use

Casettes can be loaded into the reader in many ways

Cassette drawers or « drop and go » systems.

2. CR screen is made of a photostimulable storage phosphor layer coated on a

Unrestricted Internal Use

Attractiveness of CR vs. Analog

Full compatibility with existing X-ray equipment

• No major changes to equipment/exposure technique, and no massive investments needed