REVIEWER

EMR Edition
User Guide
Version 1.9
Copyright © 2008-2010 Sorna Corporation. All rights reserved, worldwide.
Printed in the USA.
No part of this document may be copied or reproduced in any form or by any
means – including digital – without prior written consent of Sorna Corporation.

Sorna Corporation has made every effort to ensure the accuracy of this docu-
ment. However, it assumes no responsibility for any error(s) that may appear.
Sorna will make commercially reasonable efforts to make corrections to any
known errors in future revisions.

Sorna, Sorna Logo, Reviewer, Reviewer logo, Reviewer Embedded, Reviewer

CD, Reviewer MD, Reviewer Admin, Reviewer OB, MyBabyCD, MybabyCD
logo are trademarks of Sorna Corporation. eXpdo and eXpedo logo are regis-
tered trademarks of Sorna Corporation.

All other trademarks (registered and unregistered) are the property of their
respective owners.

Patent(s) pending. All rights reserved.

 REVIEWER ™

Reviewer Editions Attributes

If you wish to upgrade your edition of Reviewer to enable

greater functionality, call 651.406.9900, option 2 to acquire
an authorization code. No additional installation required!

Reviewer User Guide iii

  ™ 
With Reviewer™, you are able to receive, query & retrieve, and
explore local studies. What’s more, with built-in DUET® and BRA-
VO SE compatibility, Reviewer has brought burning and labeling
DICOM DISCs into the realm of Desktop ease and affordability.
Reviewer is the can-do tool, whatever you need to do:

Import externally created diagnostic images and reports from

CDs, DVDs, local and network drives, iPods® and removable
media.

Export local studies to PACS or Archive, a local drive, removable

storage.

Convert externally generated patient data and study informa-

tion to conform to internal facility requirements.

Create IHE PDI Media conformant CDs/DVDs containing DICOM

images.

De-identify and Re-identify (patient demographic correction)

Studies.

Scan Documents and Drag & Drop Dicomize Files.

iv Reviewer User Guide R

 Lexicon to the icons in this guide:

NOTE: Notes contain additional information pertaining to a

procedure or topic

TIP: Tips provide helpful insights about a topic or procedure

to improve speed or efficiency.

CAUTION! Cautions alert you to scenarios that could harm

equipment or data

WARNING! Warnings alert you to scenarios that could

cause personal injury

Reviewer User Guide iv Reviewer User Guide v

 The Reviewer System
The Reviewer System consists of the following components:
• Software: A multifunctional software "package" that imports, exports,
acquires, searches for , distributes, de-identifies, re-identifies, DICOM-
izes, integrates, and displays DICOM and non-DICOM medical images.
• Hardware: The DUET™ and Bravo SE™ CD/DVD production hard-
ware are optionally supported by the Reviewer software in Reviewer
Standard and MyBabyCD systems.

Brief Description of Use

The Sorna Reviewer Systems and software product line provide fully inte-
grated, manual, networked DICOM and OEM CD/DVD publishing system,
required for reliable and efficient electronic storage and retrieval of medical
images.

Intended Use
When interpreted by a skilled physician, this device provides information
that may be useful in screening and diagnosis. The user shall ensure that the
display hardware and the state of display calibration or other aspects of the
viewing environment are suitable for the intended use, as this may affect the
usability of the displayed images for diagnostic use. In such cases, patient
management decisions should not be made based solely on the results of the
image display.

Limitations
• All medical professionals and personnel using the Reviewer System and
software must be trained in the use of the device by Sorna Corporation.
• Note that digital mammography images may have been compressed.
Lossy compressed images may not be used as a primary interpretation
tool: they are for display purposes only.
• Effective use of the Reviewer System and software requires adher-
ence to imaging protocol requirements and the imaging manufacturer’s
instructions regarding maintenance and calibration of equipment.
• Measurement accuracy is limited to imaging system accuracy and site-
specific imaging techniques.

Warnings
• Shock potential when power applied improperly
Ensure that the system is connected to a power receptacle that provides
voltage and current within the specified rating for the system. Use of
an incompatible power receptacle may produce electric shock and fire
hazards.
• Shock potential when improperly grounded
Always connect the system power cord directly to an appropriate recep-
tacle with a functional ground.

vi Reviewer User Guide R

 • Shock potential when cleaning with power applied
Always turn off the power switch and unplug the power cord before
cleaning the outer surfaces or internal components of the device to avoid
a potential shock hazard. Failure to remove power to the monitor before
performing the procedure could result in an electrical shock.
• Shock potential from spilled liquids
Do not place containers with liquids on the device. Do not spill liquids
on the system. Fluid seepage into internal components create a potential
shock hazard. Shut down the device, disconnect from the power source
and wipe up all spills immediately. Do not operate the system if internal
components have been exposed to fluid.
• Electromagnetic fields
This device is a FCC Standards Class A product. In a domestic (U.S.)
environment, this product may cause radio interference with other
electronic devices, such as telephones and other medical equipment, in
which case the user may be required to take measures to reduce such
interference.

Precautions
• Installation and use of unrelated software
Unrelated software applications should not be installed or used on the
system as this may affect performance and may compromise or corrupt
patient medical records.
• Service
Only technically qualified personnel, trained by Sorna Corporation,
shall perform troubleshooting and service procedures on the software
and hardware components.

Contacting Sorna Corporation

For product support, sales or other issues, contact Sorna Corporation in one
of the following ways:
Telephone: 651-406-9900
Fax: 651-406-9904
Web site: www.sorna.com
E-mail: info@sorna.com
By mail:
Sorna Corporation
2020 Silver Bell Road
Suite 17
Eagan, MN 55122
USA

Reviewer User Guide vi Reviewer User Guide vii

 Welcome
This System Handbook provides a general overview of Reviewer
Software. There are two editions of Reviewer - Standard and
Admin. The functionality outlined in this guide represents the full
range of performance of Reviewer Admin. If at any time you de-
sire to upgrade your edition of Reviewer, simply call 1-866-SOR-
NACO to acquire the authorization code to enable enhanced
functionality – no additional installation is required!

In this User Guide, you will learn how to install, activate and con-
figure Reviewer Software, as well as how to navigate within the
application. Additionally, you will learn how to install any addi-
tional hardware options you have purchased.

Minimum System Requirements:

In order to run Reviewer, you need to have the following:

OS: 32bit (x86-32) Platforms:

• Windows XP SP3
• Windows Vista SP1
• Windows 7
64bit (x86-64) Platforms:

• Windows XP SP2
• Windows Vista SP1
• Windows 7
Processor: 2.8Ghz Pentium 4
Memory: 1GB of RAM
HD Space: • 700MB for CD production
• 5GB for CD and DVD production
• 10GB for CD/DVD production and
Local Studies.

viii Reviewer User Guide R

 Contents

1. Using the Study Explorer 1

1.1. Import 1
1.1.1. Receiving Studies directly into Local Studies‑ 1
1.1.2. Search & Retrieve a DICOM Study Stored on
Removable Storage‑ 1
1.1.3. Search a directory to locate a DICOM file‑ 2
1.1.4. Importing Studies from a DISC‑ 4
1.2. Changing how things look 4
1.2.1. Nesting Search Result Panels‑ 4
1.2.2. Column Headings‑ 5
1.2.3. Dockable Interface‑ 6

2. Viewer 7
2.1. Opening Viewer 7
2.2. Display 8
2.2.1. Series Display Viewports‑ 8
2.2.2. Image Display Tiles‑ 10
2.2.3. Moving from Series to Series‑ 12
2.2.4. Adding (Opening) New Series‑ 12
2.2.5. Moving from Image to Image‑ 13
2.2.6. Reference Lines‑ 14
2.2.7. Cycle Through Images‑ 15
2.2.8. Overlays‑ 17
2.3. Image Manipulation 18
2.3.1. Invert Colors‑ 18
2.3.2. Windowing Tool‑ 19
2.3.3. Image Orientation‑ 9
2.3.4. Scaling Image‑ 21
2.3.5. Magnifying Glass‑ 23

Reviewer User Guide viii Reviewer User Guide ix

 Contents (continued) 

2.3.6. Pan Tool‑ 24

2.3.7. Annotation Tool‑ 25
2.3.8. Density Tool‑ 26
2.3.9. Resetting Images‑ 27
2.4. Reports 28
2.5. Finishing Up 29

3. End User License Agreement 31

x Reviewer User Guide

1. Using the Study Explorer
Now you are ready to begin using Reviewer. These steps will
show you how to view and manipulate the studies you’ve re-
trieved.

1.1. Import
Locate a study on non-DICOM device (networked direc-
tory or removable storage device) and import it to your
local drive.

1.1.1. Receiving Studies directly into Local Studies

1. From the remote DICOM device, send the DICOM infor-
mation to Reviewer using the settings previously config-
ured under General Configuration (see Section 3-1).
2. Once the send is complete, the information will be dis-
played in the list of available local studies.
3. Click Search to refresh the Local Studies list.
1.1.2. Search & Retrieve a DICOM Study Stored on Remov-
able Storage
Locate & retrieve studies from a USB device (iPod®, USB
drive, etc) or CD/DVD.

NOTE: A tab will appear on the toolbar for each removable

device, as it is plugged into (or inserted) and recognized by your
computer

1. Select study location by clicking appropriate removable

device tab:

2. Click the Search icon on the Studies toolbar to display an

index of studies located on removable device.
3. Found studies will be displayed in the Studies list.

Reviewer User Guide 1

 4. Click on any study to select, and then click the Import but-
ton on the Studies toolbar:

5. As the study is imported, you will see the following progress

bar in the Progress Queue panel:

NOTE: You may cancel the Import process by clicking Cancel in

the Progress Queue panel.

6. When the import is complete, the following message will

be displayed in the Progress Queue:

1.1.3. Search a directory to locate a DICOM file

Locate and retrieve a study from your searchable directory
tree.

1. Select file location by clicking Browse Directory tab:

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 2. On the right side of the Search Options window, click on
Browse button:

3. Your searchable directory tree will be displayed.

4. Browse directory tree, and select desired directory by click-
ing file, then clicking OK.
5. Now click the Search button on the study explorer to popu-
late the Studies list.
6. If the location searched has XDM compliant medical
records, the EMR button will become active. Click the EMR
button to view electronic medical records with your web
browser:

7. Once a study has been selected from the directory, click

the Import button on the Studies toolbar:

8. As the study is imported, you will see the following prog-

ress bar in the Progress Queue panel:

NOTE: You may cancel the Import process by clicking Cancel in

the Progress Queue panel.

Reviewer User Guide 2 Reviewer User Guide 3

 9. When the import is complete, the following message will
be displayed in the Progress Queue:

1.1.4. Importing Studies from a DISC

Locate and retrieve a study from a DICOM or non-DICOM
DISC
1. Insert a DISC into drive. Note that a tab representing the
DISC appears on the Study Explorer toolbar.
2. Click the tab representing the DISC. If the study list is not
automatically populated, simply click the Search tab.

NOTE: You may use this method to import non-DICOM studies from
Amicas DISCS.

1.2. Changing how things look

Adjust display layout to your personal preferences.

1.2.1. Nesting Search Result Panels

Reveal or hide search results by collapsing or expanding
display area.
1. When Reviewer is launched, all search results are dis-
played as a study level list. To view series and instance
details within each study, you may expand a Study
Description to display Series Description and Instance by
clicking on the ‘+’ icon to the left of the Study Name:

4 Reviewer User Guide R

 2. Simply click the ‘+’ icon to re-expand a collapsed panel
again:

1.2.2. Column Headings

You can add or remove column headings in the Studies and
Series list displays
1. Right-click anywhere within the display panel. The follow-
ing menu will appear:

NOTE: The content of the Column Heading Menu will change to

Series- or Study-specific information dependent upon which pane
the cursor is in when you right-click.

2. You may adjust display appearance within this panel by

selecting either Auto Size Columns or Default Columns.

3. You may also add or remove columns within the panel

to customize display features by selecting or deselecting
any of the listed column headers by simply clicking on
them.

Reviewer User Guide 4 Reviewer User Guide 5

 1.2.3. Dockable Interface
Rearrange the order and location of display panels in the
Study Explorer by dragging and dropping them into place.
1. Click-and-hold the top “handlebar” of any display panel
you wish to move.
2. When you begin to drag the handlebar, the panel will be
visually represented by a transparent blue rectangle.
3. A series of blue positioning guides will be illuminated to
assist you in placing the panel:

4. Simply drag-and-drop the blue rectangle to the guide

location you wish to use, and the panel will be displayed
in the new location.

NOTE: This technique is also useful for viewing multiple studies side-
by-side. Simply drag Study View tab to one of the outside position-
ing guides. Now you may open by clicking a second study:

6 Reviewer User Guide R

 2. Viewer
In this section you will learn how to maximize the reading of im-
age data through optimal use of the viewer.

2.1. Opening Viewer

1. To activate the viewer, choose or browse for a study from
any tab within the Study Explorer.

2. Select by double clicking the study you wish to view.

NOTE: Alternately, you may click the study once and then click
the View button on the Studies Toolbar:

Reviewer User Guide 6 Reviewer User Guide 7

 3. The viewer will automatically open the study:

NOTE: If you wish to open only a single series, you may choose to
double click just on the desired series, or click once on the series
and click the View button on the Studies toolbar.

NOTE: To display DICOM Header Information, use the command

[Ctrl+Shift+D].

2.2. Display
You can customize how studies are displayed by choosing
the number of visible viewports. Default setup is found in
the Configuration: Modalities menu.

2.2.1. Series Display Viewports

Once the viewer is open, you may select the number of
viewports (each representing a series within the study)
visible on the screen. You may choose to have as many
viewports displayed as you have series.
1. On the Reviewer toolbar, click Series.
2. In the drop-down menu, mouse-over Series Layout to
reveal layout configuration options:

8 Reviewer User Guide R

 NOTE: Alternately, you may simply click the Series Layout button
on the Viewer toolbar.

3. Click one of the following configuration options:

a. 1 x 1 = one large viewport
b. 1 x 2 = two vertical viewports
c. 2 x 1 = two horizontal viewports
d. 2 x 2 = four equal sized viewports

2 x 2 Series Display Configuration

Reviewer User Guide 8 Reviewer User Guide 9

 NOTE: Images automatically display a Ruler if measurement data
is included in the file. Additionally, when you mouse over image,
small arrows will indicate x- and y-axis location of mouse location.
You may turn off display of rulers by clicking the Ruler button:

2.2.2. Image Display Tiles

Within the displayed viewports, you may further subdivide
each series to display multiple images (tiles) at a time.
1. Select by clicking the series viewport you wish to subdi-
vide/merge.
2. In the Reviewer toolbar, click Image.
3. In the drop-down menu, mouse-over Image Layout to
reveal layout configuration options.
4. Click one of the following configuration options:
a. 1 x 1 = one large tile
b. 1 x 2 = two vertical tiles
c. 2 x 1 = two horizontal tiles
d. 2 x 2 = four equal sized tiles

10 Reviewer User Guide R

 NOTE: Alternately, you may simply click the Image Layout button
on the Viewer toolbar.

2 x 2 Series Display with one tile set for 2 x 2 Image Display

Reviewer User Guide 10 Reviewer User Guide 11

 2.2.3. Moving from Series to Series
While using the viewer, you will need to navigate between
series within a study. You may always click on another
series viewport when you are in a multi-series display mode,
but using the following tools to move from series to series
are particularly useful when you have limited your study
display to a single viewport.
1. On the Reviewer toolbar, click Series
2. To move forward in the succession, click Next Series.
3. To move backward, click Previous Series.

NOTE: Alternately, you may simply click the Previous Series or

Next Series button on the Viewer toolbar:

Previous Next
Series Series

2.2.4. Adding (Opening) New Series

While using the viewer, you may desire to open an addi-
tional series. Use the following tool to display more than one
series simultaneously.
1. On the Reviewer toolbar, click Series
2. To add the next series, click Add Next Series.

12 Reviewer User Guide R

 3. To add the previous series, click Add Previous Series.

NOTE: Alternately, you may simply click the Add Previous Series or
Add Next Series button on the Viewer toolbar:

Add Previous Add Next

Series Series

2.2.5. Moving from Image to Image

While using the viewer, you will need to navigate between
images within a series. You may always click on another
image pane when you are in a multi-pane display mode,
but using the following tools to move from image to image
are particularly useful when you have limited your series
display to a single pane.
1. On the Reviewer toolbar, click Image
2. To move forward in the succession, click Next Image, or
click Last Image to skip to the last image in the series.

Reviewer User Guide 12 Reviewer User Guide 13

 3. To move backward in the succession, click Previous Im-
age, or click First Image to skip to the last image in the
series.

NOTE: Alternately, you may simply click the Previous Image, First
Image, Next Image or Last Image button on the Viewer toolbar:

Previous Last
Image Image

First Next
Image Image

2.2.6. Reference Lines

You may use reference lines to determine selection orienta-
tion on images. Reference lines, once activated, are visible
on all images displayed, and do not need to be applied on
a pane-by pane basis.
1. On the Reviewer toolbar, click Study.
2. In the drop-down menu, mouse-over Reference Lines to
reveal options:
3. Click one of the following options:

a. None: removes previously applied settings

b. Selected: shows slice location of image you are cur-
rently viewing.
c. Range: delineates full area within which the study’s
image slices were taken.
d. All: shows where all slices were taken, with a high-
lighted reference line to indicate current view.

14 Reviewer User Guide R

 2.2.7. Cycle Through Images
When a series contains several different images, you can
opt to limit the series display to a single pane, and cycle
through the images manually, by using the wheel on your
mouse, or in cinema mode at various speeds.
1. Manual Mode:
a. Select a series pane by clicking.
b. Roll the wheel on your mouse in an upward direction
to cycle through the images:

c. When you reach the end of the range, you may

reverse the direction you are rolling the wheel and
scroll through the images in the other direction.
2. Cine Mode:
a. Select a series pane by clicking on it.
b. You may specify the scroll direction by toggling back
and forth between either Loop (forward) or Back and
Forth by clicking the button on the viewer toolbar:

Loop

Back & Forth

c. Click Play on the viewer Cine Mode toolbar to begin:

Play

Reviewer User Guide 14 Reviewer User Guide 15

 d. Cine Mode continues until you click Pause or Stop:

Pause

Stop

NOTE: When you click ‘Stop,’ the image reverts to original size.
Clicking ‘Pause’ freezes motion, but doesn’t affect display size.

e. You may vary speed by clicking either Slower or

Faster:

Slower Faster

NOTE: If you have activated Range Reference Lines, you will

be able to follow the location of the cycled images on another
perspective (series). The orange line, representing the current im-
age location, will move across the span between the two green
(range) lines:

Selected

Range

16 Reviewer User Guide R

 2.2.8. Overlays
Viewer overlays, which contain patient demographic and
image attribute information, can be turned on and off ac-
cording to your preferences.
1. On the Reviewer toolbar, click Series, and then click
Overlays to turn overlays on or off

NOTE: Alternately, you may simply click the Overlays button on

the viewer toolbar, which functions similarly as a toggle to reveal
or hide overlays:

Overlays

Reviewer User Guide 16 Reviewer User Guide 17

 2.3. Image Manipulation
The viewer allows you to change the appearance of im-
ages, including colors, position, scale, orientation, and
windowing.

2.3.1. Invert Colors

The viewer offers you the ability to invert image colors for
optimal contrast & viewing ease.
1. On the Reviewer toolbar, click Image, and then click
Invert to turn inversion on or off:

NOTE: Alternately, you may simply click the Invert Colors button
on the viewer toolbar, which functions similarly as a toggle to turn
inversion on or off).

Invert
Colors

2. If you wish to return image to original settings, simply click

the Reset Image button on the viewer toolbar:

Reset
Image

18 Reviewer User Guide R

 2.3.2. Windowing Tool
1. To use the Windowing tool, click the Windowing button on
the viewer toolbar:

Windowing

2. Your mouse cursor will now appear as the windowing tool

icon.
3. Click on the image you wish to manipulate: you can now
adjust windowing by holding down the left mouse button
and moving the cursor through the image.
4. To turn the windowing tool off, simply click the Windowing
tool button again, or click the Selector tool button on the
viewer toolbar.

Selector

5. You may reset the image to described file presets by

selecting (clicking) the image you wish to reset, and
then clicking the Windowing Preset button on the viewer
toolbar. Next click desired file preset, and your image will
return to source defined values.

6. For Customized Presets, please see Viewer Configuration

in the System Configuration section in Part A of this Guide.

2.3.3. Image Orientation

You may wish to change the orientation of the image to fa-
cilitate viewing. The viewer enables you to do this by either
rotating (turning) or flipping (mirroring) the image.
1. Click on the image you wish to manipulate.

Reviewer User Guide 18 Reviewer User Guide 19

 2. On the Reviewer toolbar, click Image, and then on the
dropdown menu, mouse-over Flip/Rotate.

3. Click one of the following options:

a. Rotate Left: rotates image 90° to the left.
b. Rotate Right: rotates image 90° to the right.
c. Flip Horizontal: flips image from left to right to create
mirror.
d. Flip Vertical: flips image from top to bottom to create
mirror.

NOTE: Alternately, you may simply click one of the Flip/Rotate

buttons on the viewer toolbar:

Flip/Rotate Buttons

20 Reviewer User Guide R

 2.3.4. Scaling Image
You may wish to change the size of an image to clarify the
view of a specific feature. You may do this by fitting the
image to window size, zooming in or out, or using a scale
percentage.
1. Fit to Window:
a. Select by clicking the image you wish to scale.
b. Click Image on the Reviewer toolbar.
c. Mouse-over Zoom to reveal a list of options.
d. Click Fit to Window to expand the image to fill the
entire pane.

NOTE: Alternately, you may simply click the Fit to Window button
on the viewer toolbar.

Fit to
Window
e. Clicking Original Size on the Zoom options list will
return image to file preset.

NOTE: Alternately, you may simply click the Original Size button
on the viewer toolbar:

Original
Size

Reviewer User Guide 20 Reviewer User Guide 21

 2. Zoom:
a. Select by clicking the image you wish to scale.
b. Click Image on the Reviewer toolbar.
c. Mouse-over Zoom to reveal a list of options.
d. Click Zoom In to incrementally expand the image.
e. Click Zoom Out to incrementally shrink image.

NOTE: Alternately, you may simply click the Zoom In or Zoom Out
button on the Viewer toolbar:

Zoom In/
Zoom Out

f. If you wish to return image to original settings, simply

click the Reset Image button on the viewer toolbar:

Reset
Image

22 Reviewer User Guide R

 3. Scale Percentage:
a. Select by clicking the image you wish to scale.
b. Click Image on the Reviewer toolbar.
c. Mouse-over Zoom to reveal a list of options.
d. Click the percentage to which you would like to ex-
pand or shrink image.

2.3.5. Magnifying Glass

Occasionally, you may wish to briefly zoom in on a specific
area, without changing the entire image magnification. You
may do this using the Magnify Glass in the viewer.
1. Select by clicking the image you wish to scale.
2. Click the Magnifying Glass tool in the viewer toolbar: the
mouse cursor will now take the shape of the Magnifying
Glass icon:

Magnify

Reviewer User Guide 22 Reviewer User Guide 23

 3. Click-and-hold the mouse icon (Magnifying Lens) over the
area you would like to magnify. The magnified window
will remain visible as long as you hold down the mouse
button:

4. You may also move the cursor with the mouse button
depressed, and the magnified view will move around the
image within the selected pane.
5. To change the magnification factor, scroll the mouse
wheel while holding down left mouse button.
6. The magnified window will disappear once you release
the mouse button.
7. Turn off the Magnifying Glass feature by clicking the Mag-
nifying Glass button again (cursor returns to Selector),
or another mouse feature button on the viewer toolbar,
such as Selector, Move or Windowing:

Selector

2.3.6. Pan Tool

In order to focus on a specific area, you may wish to move
the image within the pane.
1. Select by clicking the image you wish to move.

24 Reviewer User Guide R

 2. Click the Pan Tool button:

Pan

3. The mouse cursor will now take the shape of the Pan Tool
icon.
4. You may now ‘grab’ the image and move it around by
click-and-holding the mouse button. Release the mouse
button to ‘drop’ the image where you like.
5. To return to the standard mouse cursor, simply click the
Selector button on the viewer toolbar:

Selector

2.3.7. Annotation Tool

The viewer allows you to measure and mark image features
with symbols such as lines, circles, ellipses and rectangles.
1. Select by clicking image you wish to annotate.
2. In the viewer toolbar, click the Annotation Tool button.
3. Choose by clicking one of the following options:

a. Line: draws a line and simultaneously measures dis-

tance.

NOTE: Line measurements are given in the measurement units

embedded in the image header. If no measurement units are
provided, the number of pixels will be displayed.

b. Circle: draws a scalable circle.

c. Ellipse: draws a fully scalable ellipse.
d. Rectangle: draws a fully scalable rectangle

Reviewer User Guide 24 Reviewer User Guide 25

 e. Cobbs Angle: calculates angle between two lines
which you use tool to draw.
f. Region of Interest: draws a freeform boundary around
a specified area, and calculates Measurement of
Area, Area Pixel Mean, Pixel Standard Deviation and
Maximum Pixel Value:

NOTE: To use Region of Interest tool, click once at beginning

point, then move tool around circumference of region, clicking
along curves to establish boundary anchor points. Once you are
satisfied with the shape, click twice to close shape and display
calculated measurements. You may use this tool to mark several
regions of interest at one time:

NOTE: Annotations are adjustable – simply click on Selector tool

after making annotations. Then use tool to select and move end-
points on annotations.

g. Clear All: clears all existing annotation from image

(including density tool marks)
4. You may make as many image annotations as you wish,
however they will not be saved once you exit the series/
study.
2.3.8. Density Tool
This viewer tool allows you to measure and mark points of
density within the image.
1. Select by clicking image you wish to annotate.
2. In the viewer toolbar, click the Density Tool button.

Density

26 Reviewer User Guide R

 3. The mouse cursor takes the shape of the density tool icon.
You may view the varying density of any point in the im-
age by hovering over that area with the mouse (density
reading changes automatically as you move the mouse).
4. If you wish to record a point of density on the image,
simply click that area. You may record as many points of
density as you wish:

5. To return to the standard mouse cursor, simply click the

Selector button on the viewer toolbar.
6. To Clear density marks, click on the Annotation Tool but-
ton in the viewer toolbar, and then click Clear All.
2.3.9. Resetting Images
1. If you wish to return image to original settings, simply click
the Reset Image button on the viewer toolbar:

Reset
Image

Reviewer User Guide 26 Reviewer User Guide 27

 2.4. Reports
The viewer allows you to read any available structured text
reports attached to a study.

1. While viewing a study, click Study on the Reviewer tool-

bar, then click View Reports:

2. The report will appear as a separate window:

NOTE: Alternately, you may simply click the Reports button on

the viewer toolbar:

Reports

3. When finished reading the report, you may return to

viewing the study by simply clicking the Close button in
the upper right hand corner of the report window.

28 Reviewer User Guide R

 2.5. Finishing Up
How to close a study, and return to Study Explorer

1. When you are finished viewing a study, close it by click-

ing Close (X) button at the upper right hand corner of the
viewer window.

NOTE: Be certain you are clicking the Close button of the inner
viewer window, and not the outer Close button for the entire Re-
viewer application, which, when clicked, will shut down the entire
application.

NOTE: You may return to Study Explorer at any time by simply click-
ing the Study Explorer tab at the top of the Explorer Menu, how-
ever the study you were viewing will remain open until closed.

Reviewer User Guide 28 Reviewer User Guide 29

30 Reviewer User Guide
3. End User License Agreement

SORNA REVIEWER™ SOFTWARE LICENSE AGREEMENT

PLEASE NOTE THAT YOU HAVE ACCEPTED THE TERMS AND

CONDITIONS OF THIS SOFWARE LICENSE BY INSTALLING AND/
OR USING THE SOFTWARE.

IMPORTANT: THIS SOFTWARE LICENSE AGREEMENT

(“AGREEMENT”) IS A LEGAL AGREEMENT BETWEEN THE
PERSON, COMPANY, OR ORGANIZATION THAT HAS LICENSED
THIS SOFTWARE (“YOU” OR “CUSTOMER”) AND SORNA COR-
PORATION (“SORNA”). BY INSTALLING AND/OR USING THE
SOFTWARE, YOU ACCEPT THE SOFTWARE AND AGREE TO THE
TERMS OF THIS AGREEMENT. READ IT CAREFULLY BEFORE
COMPLETING THE INSTALLATION PROCESS AND USING THE
SOFTWARE. BY INSTALLING AND/OR USING THE SOFTWARE,
YOU ARE CONFIRMING YOUR ACCEPTANCE OF THE SOFT-
WARE AND AGREEING TO BECOME BOUND BY THE TERMS OF
THIS AGREEMENT. IF YOU DO NOT AGREE TO BE BOUND BY
THESE TERMS, OR DO NOT HAVE AUTHORITY TO BIND CUS-
TOMER TO THESE TERMS, THEN DO NOT INSTALL AND/OR USE
THE SOFTWARE AND RETURN THE SOFTWARE TO YOUR SUP-
PLIER FOR A FULL REFUND IN ACCORDANCE WITH THE SUP-
PLIER’S REFUND POLICIES.

1. DEFINITIONS.
1.1 “Documentation” shall mean all manuals, user documentation, and other
related materials pertaining to the Software which are furnished to You by
Sorna in connection with the Software.

1.2 “Software” shall mean the Sorna Revewer™ software, as well as all
computer programs in machine readable object code form, and any subse-
quent error corrections or updates supplied to You by Sorna pursuant to this
Agreement. The definition of Software shall also include any documentation
and technical manuals.

1.3 “Sorna” shall mean Sorna Corporation and any Reseller of Sorna supply-
ing Customer with Sorna Software products.

1.4 “Revewer” shall mean the Sorna Revewer™ software product including
any updates, enhancements or bug fixes supplied at any time in the future.

Reviewer User Guide 31

2. GRANT OF RIGHTS.

2.1 Grant. Subject to Section 2.2, Customer may install and use the Soft-
ware on a single computer. Except as otherwise specifically provided in
Section
2.2, a license for the Software may not be shared, installed or used concur-
rently on different computers. The Software may not be accessed and used
via a server or network storage device.

2.2 Audit. You agree that Sorna may audit your use of the Software for com-
pliance with the terms of this Agreement at any time, upon reasonable notice.
In the event that such audit reveals any use of the Software by you other than
in full compliance with the terms of this Agreement, you shall reimburse
Sorna for all reasonable expenses related to such audit in addition to any
other liabilities you may incur as a result of such non-compliance.

2.3 Documentation. Sorna shall deliver copies of any Documentation or

technical manuals, Sorna deems necessary in an electronic form. Customer’s
use of that documentation and technical manuals shall be subject to the terms
and conditions of this Agreement.

3. LICENSE RESTRICTIONS

3.1 Copies. Except as set forth in Section 5, you may not make or distribute
copies of the Software, or electronically transfer the Software from one com-
puter to another or over a network.

3.2 Reverse Engineering. You may not alter, merge, modify, adapt or trans-
late the Software, or decompile, reverse engineer, disassemble, or otherwise
reduce the Software to a human-perceivable form.

3.3 Distribution. Customer may not rent, lease, sublicense or otherwise

distribute the Software.

3.4 Derivative Works. Customer may not modify the Software or create
derivative works based upon the Software.

3.5 Export. Customer may not export the Software into any country pro-
hibited by the United States Export Administration Act and the regulations
thereunder.

3.6 Medium and Platform. Customer may receive the Software in more
than one medium but you shall only install or use one medium. Regardless
of the number of media you receive, you may use only the medium that is ap-
propriate for the server or computer on which the Software is to be installed.

32 Reviewer User Guide R

 You may also receive the Software in more than one platform but you shall
only install or use one platform.

3.7 Competitive Products. Customer agrees that Customer will not use the
Software to develop any product having the same primary function as the
Software.

3.8 Proprietary Notices. Customer that it will not remove or alter any
trademark, trade names, product names, logo, copyright or other proprietary
notices, legends, symbols or labels in the Software. Sorna does not authorize
Customer to use its name or its trademarks.

4. MODIFICATIONS.

4.1 Error Corrections and Updates. Provided Customer has contracted for
Sorna maintenance services, Sorna will provide Customer with error correc-
tions, bug fixes, patches or other updates to the Software licensed hereunder
in object code form to the extent available in accordance with Sorna’s release
schedule.

4.2 Other Modifications. Customer may, from time to time, request that
Sorna incorporate certain features, enhancements or modifications into the
Software. Sorna may, in its sole discretion, undertake to incorporate such
changes and distribute the Software so modified to all or any of Sorna’s
Customers.

4.3 Title to Modifications. All such error corrections, bug fixes, patches,
updates or other modifications shall be the sole property of Sorna, and shall
otherwise be subject to the terms and conditions of this License Agreement.

5. COPIES.

5.1 Printed Matter. Except as specifically set forth herein, no Software or

Documentation which is provided by Sorna pursuant to this Agreement in
human readable form, such as written or printed documents, shall be copied
in whole or in part by Customer without Sorna’s prior written agreement.
Additional copies of printed materials may be obtained from Sorna at the
charges then in effect.

5.2 Machine Readable Matter. Except as specifically set forth herein, any
Software provided in machine readable form may not be copied by Cus-
tomer in whole or in part, except for Customer’s backup or archive purposes.
Customer agrees to maintain appropriate records of the number and location
of all copies of the Software and make such records available upon Sorna’s

Reviewer User Guide 32 Reviewer User Guide 33

request. Customer further agrees to reproduce all copyright and other propri-
etary notices on all copies of the Software in the same form and manner that
such copyright and other proprietary notices are originally included on the
Software.

6. LICENSE FEES AND PAYMENT.

6.1 Consideration. In consideration of the license rights granted in Section 2

above, Customer shall pay all agreed upon fees. All amounts payable hereun-
der by Customer shall be payable in United States funds without deductions
for taxes, assessments, fees, or charges of any kind.
6.2 Taxes and Other Charges. Customer shall be responsible for paying all (i)
sales, use, excise, value-added, or other tax or governmental charges imposed
on the licensing or use of the Software or Documentation hereunder, (ii)
freight, insurance and installation charges, and (iii) import or export duties or
like charges.

7. PROTECTION OF SOFTWARE.

7.1 Proprietary Notices. Customer agrees to respect and not to remove,

obliterate, or cancel from view any copyright, trademark, confidentiality or
other proprietary notice, mark, or legend appearing on any of the Software or
output generated by the Software, and to reproduce and include same on each
copy of the Software.

7.2 No Reverse Engineering. Customer agrees not to modify, reverse engi-

neer, disassemble, or decompile the Software, or any portion thereof.

7.3 Ownership. Customer further acknowledges that all copies of the Soft-
ware in any form provided by Sorna or made by Customer are the sole prop-
erty of Sorna and/or its suppliers. Customer shall not have any right, title,
or interest to any such Software or copies thereof except as provided in this
Agreement, and further shall secure and protect all Software and Documenta-
tion consistent with maintenance of Sorna’s proprietary rights therein.

8. CONFIDENTIALITY.

8.1 Acknowledgement. Customer hereby acknowledges and agrees that the

Software and Documentation constitute and contain valuable proprietary
products and trade secrets of Sorna and/or its suppliers, embodying sub-
stantial creative efforts and confidential information, ideas, and expressions.
Accordingly, Customer agrees to treat (and take precautions to ensure that its
employees treat) the Software and Documentation as confidential in accor-
dance with the confidentiality requirements and conditions set forth below.

34 Reviewer User Guide R

 8.2 Maintenance of Confidential Information. Customer agrees to keep
confidential all confidential information disclosed to it by Sorna in accor-
dance herewith, and to protect the confidentiality thereof in the same manner
it protects the confidentiality of similar information and data of its own (at
all times exercising at least a reasonable degree of care in the protection of
confidential information).

8.3 Injunctive Relief. Customer acknowledges that the unauthorized use,

transfer or disclosure of the Software and Documentation or copies thereof
will (i) substantially diminish the value to Sorna of the trade secrets and other
proprietary interests that are the subject of this Agreement; (ii) render Sorna’s
remedy at law for such unauthorized use, disclosure or transfer inadequate;
and (iii) cause irreparable injury in a short period of time. If Customer
breaches any of its obligations with respect to the use or confidentiality of the
Software or Documentation, Customer agrees that Sorna shall be entitled to
equitable relief to protect its interests therein, including, but not limited to,
preliminary and permanent injunctive relief.

8.4 Medical Information. Customer will be solely responsible and liable to

maintain the confidentiality of any patient data and medical information, and
Customer will strictly comply with HIPAA and any other applicable confi-
dentiality and privacy standards.

8.5 Survival. Customer’s obligations under this Section 8 will survive the
termination of this Agreement or of any license granted under this Agreement
for whatever reason.

9. WARRANTIES; SUPERIOR RIGHTS.

9.1 Legal Authority. Sorna represents that it has legal rights sufficient to
allow Sorna to grant the license specified in this license agreement, and that
it has not knowingly granted licenses to any other entity that would restrict
rights granted hereunder except as specifically stated herein.

9.2 Limited Warranty. Sorna represents and warrants to Customer that the
Software, when properly installed by Customer and used with the Designated
Equipment, will perform substantially as described in Sorna’s then current
Documentation for such Software for a period of one year from the date of
shipment.

9.3 Limitations. Notwithstanding the warranty provisions set forth in Section

9.2 above, all of Sorna’s obligations with respect to such warranties shall be
contingent on Customer’s use of the Software in accordance with this Agree-
ment and in accordance with Sorna’s instructions as provided by Sorna in

Reviewer User Guide 34 Reviewer User Guide 35

the Documentation, as such instructions may be amended, supplemented, or
modified by Sorna from time to time. Sorna shall have no warranty obliga-
tions with respect to any failures of the Software which are the result of
accident, abuse, misapplication, extreme power surge or extreme electromag-
netic field.

9.4 Customer’s Sole Remedy. In the event of Sorna’s breach of this War-
ranty , Sorna’s entire liability, and Customer’s exclusive remedy shall be, at
Sorna’s option, either (a) return of the price paid or (b) repair or replacement
of the Software upon its return to Sorna; provided Sorna receives written
notice from Customer during the warranty period of a breach of warranty.
Any replacement Software will be warranted for the remainder of the original
warranty period or thirty (30) days, whichever is longer.

9.5 DISCLAIMER OF WARRANTIES. SORNA DOES NOT REPRE-

SENT OR WARRANT THAT ALL ERRORS IN THE SOFTWARE AND
DOCUMENTATION WILL BE CORRECTED. THE WARRANTIES STAT-
ED IN SECTION 9.2 ABOVE ARE THE SOLE AND THE EXCLUSIVE
WARRANTIES OFFERED BY SORNA. THERE ARE NO OTHER WAR-
RANTIES RESPECTING THE SOFTWARE AND DOCUMENTATION OR
SERVICES PROVIDED HEREUNDER, EITHER EXPRESS OR IMPLIED,
INCLUDING BUT NOT LIMITED TO ANY WARRANTY OF DESIGN,
MERCHANTABILITY, OR FITNESS FOR A PARTICULAR PURPOSE,
EVEN IF SORNA HAS BEEN INFORMED OF SUCH PURPOSE. NO
AGENT OF SORNA IS AUTHORIZED TO ALTER OR EXCEED THE
WARRANTY OBLIGATIONS OF SORNA AS SET FORTH HEREIN.

9.6 LIMITATION OF LIABILITY. CUSTOMER ACKNOWLEDGES

AND AGREES THAT THE CONSIDERATION WHICH SORNA IS
CHARGING HEREUNDER DOES NOT INCLUDE ANY CONSID-
ERATION FOR ASSUMPTION BY SORNA OF THE RISK OF CUS-
TOMER’S CONSEQUENTIAL OR INCIDENTAL DAMAGES WHICH
MAY ARISE IN CONNECTION WITH CUSTOMER’S USE OF THE
SOFTWARE AND DOCUMENTATION. ACCORDINGLY, CUSTOMER
AGREES THAT SORNA SHALL NOT BE RESPONSIBLE TO CUSTOM-
ER FOR ANY LOSS-OF-PROFIT, INDIRECT, INCIDENTAL, SPECIAL,
OR CONSEQUENTIAL DAMAGES ARISING OUT OF THE LICENSING
OR USE OF THE SOFTWARE OR DOCUMENTATION. ANY PRO-
VISION HEREIN TO THE CONTRARY NOTWITHSTANDING, THE
MAXIMUM LIABILITY OF SORNA TO ANY PERSON, FIRM OR COR-
PORATION WHATSOEVER ARISING OUT OF OR IN THE CONNEC-
TION WITH ANY LICENSE, USE OR OTHER EMPLOYMENT OF ANY
SOFTWARE DELIVERED TO CUSTOMER HEREUNDER, WHETHER
SUCH LIABILITY ARISES FROM ANY CLAIM BASED ON BREACH
OR REPUDIATION OF CONTRACT, WARRANTY, TORT OR OTHER-

36 Reviewer User Guide R

 WISE, SHALL IN NO CASE EXCEED THE ACTUAL PRICE PAID TO
SORNA BY CUSTOMER FOR THE SOFTWARE WHOSE LICENSE,
USE, OR OTHER EMPLOYMENT GIVES RISE TO THE LIABILITY.
THE ESSENTIAL PURPOSE OF THIS PROVISION IS TO LIMIT THE
POTENTIAL LIABILITY OF SORNA ARISING OUT OF THIS AGREE-
MENT. THE PARTIES ACKNOWLEDGE THAT THE LIMITATIONS SET
FORTH IN THIS SECTION 9 ARE INTEGRAL TO THE AMOUNT OF
CONSIDERATION LEVIED IN CONNECTION WITH THE LICENSE OF
THE SOFTWARE AND DOCUMENTATION AND ANY SERVICES REN-
DERED HEREUNDER AND THAT, WERE SORNA TO ASSUME ANY
FURTHER LIABILITY OTHER THAN AS SET FORTH HEREIN, SUCH
CONSIDERATION WOULD OF NECESSITY BE SET SUBSTANTIALLY
HIGHER.

10. INDEMNIFICATION

10.1 SORNA WILL NOT BE LIABLE TO CUSTOMER FOR ANY

CLAIM THAT THE SOFTWARE INFRINGES A UNITED STATES
PATENT, COPYRIGHT TRADEMARK OR ANY OTHER TYPE OF
PROPRIETARY OR INTELLECTUAL PROPERTY RIGHT. THE
FOREGOING STATES THE ENTIRE LIABILITY OF SORNA AND
THE EXCLUSIVE REMEDY FOR CUSTOMER RELATING TO IN-
FRINGEMENT OR CLAIMS OF INFRINGEMENT OF ANY COPY-
RIGHT OR OTHER PROPRIETARY RIGHT BY THE SOFTWARE.

10.2 Customer shall indemnify and hold harmless Sorna, its officers, agents
and employees from and against any claims, demands, or causes of action
whatsoever, including without limitation those arising on account of Custom-
er’s modification or enhancement of the Software or otherwise caused by, or
arising out of, or resulting from, the exercise or practice of the license granted
hereunder by Customer, its sublicensees, if any, its subsidiaries or their of-
ficers, employees, agents or representatives.

11. INSURANCE.

Customer shall carry and maintain paid up policies for adequate medical mal-
practice insurance, and Customer shall provide Sorna with proof of all such
insurance, copies of all such policies, and any renewals thereof at Sorna’s
request.

12. DEFAULT AND TERMINATION.

12.1 Events of Default. This Agreement may be terminated by the nonde-

faulting party if any of the following events of default occur: (1) if a party

Reviewer User Guide 36 Reviewer User Guide 37

materially fails to perform or comply with this Agreement or any provi-
sion hereof; (2) if either party fails to strictly comply with the provisions of
Section 9 (Confidentiality) or makes an assignment in violation of Section
13 (Nonassignability); (3) if a party becomes insolvent or admits in writing
its inability to pay its debts as they mature, or makes an assignment for the
benefit of creditors; (4) if a petition under any foreign, state, or United States
bankruptcy act, receivership statute, or the like, as they now exist, or as they
may be amended, is filed by a party; or (5) if such a petition is filed by any
third party, or an application for a receiver is made by anyone and such peti-
tion or application is not resolved favorably within ninety (90) days.

12.2 Effective Date of Termination. Termination due to a material breach

of Sections 2 (Grant of Rights), 5 (Copies), 7 (Protection of Software), or 8
(Confidentiality) shall be effective on notice. In all other cases, termination
shall be effective thirty (30) days after notice of termination to the defaulting
party if the defaults have not been cured within such thirty (30) day period.

12.3 Obligations on Termination. Within ten (10) days after termination of

this Agreement, Customer shall cease and desist all use of the Software and
Documentation and shall return to Sorna all full or partial copies of the Soft-
ware and Documentation in Customer’s possession or under its control.

13. BASIS OF THE BARGAIN. The Limited Warranty and Disclaimer,

Exclusive Remedies and Limited Liability set forth above are fundamental
elements of the basis of the agreement between Sorna and Customer. Sorna
would not be able to provide the Software on an economic basis without such
limitations. Such Limited Warranty and Disclaimer, Exclusive Remedies
and Limited Liability inure to the benefit of Sorna’s resellers and distributors.

14. THIRD PARTY SOFTWARE. The Software may contain third party
software which requires notices and/or additional terms and conditions.
Such required third party software notices and/or additional terms and condi-
tions are located at www.sorna.com and are made a part of and incorporated
by reference into this Agreement. By accepting this Agreement, you are also
accepting the additional terms and conditions, if any, set forth therein.

15. NOTICES. All notices, authorizations, and requests in connection with

this Agreement shall be deemed given (i) five days after being deposited in
the U.S. mail, postage prepaid, certified or registered, return receipt re-
quested; or (ii) one day after being sent by overnight courier, charges prepaid,
with a confirming fax; and addressed as first set forth above or to such other
address as the party to receive the notice or request so designates by written
notice to the other.

38 Reviewer User Guide R

 16. NONASSIGNABILITY. Customer shall not assign this Agreement or its
rights hereunder without the prior written consent of Sorna.

17. GOVERNING LAW; JURISDICTION AND VENUE. The valid-

ity, interpretation, construction and performance of this Agreement shall be
governed by the laws of the State of Minnesota, and the federal laws of the
United States of America without regard to its conflicts of law rules. The
Minnesota state courts of Dakota County, Minnesota (or, if there is exclusive
federal jurisdiction, the United States District Court for the District of Min-
nesota) shall have exclusive jurisdiction and venue over any dispute arising
out of this Agreement, and Customer hereby consents to the jurisdiction of
such courts.

18. GOVERNMENT CONTRACTS. If the Software or Documentation to

be furnished hereunder are to be used in the performance of a government
contract or subcontract, the software shall be provided on a “restricted rights”
basis only and Customer shall place a legend, in addition to applicable copy-
right notices, in the form provided under the governmental regulations. Sorna
shall not be subject to any flowdown provisions required by the governmental
customer unless agreed to by Sorna in writing.

19. SEVERABILITY. If any provision of this Agreement shall be held by

a court of competent jurisdiction to be illegal, invalid or unenforceable, the
remaining provisions shall remain in full force and effect.

20. MISCELLANEOUS. This Agreement and its exhibits contain the entire
understanding and agreement between the parties respecting the subject mat-
ter hereof. This Agreement may not be supplemented, modified, amended,
released or discharged except by an instrument in writing signed by each
party’s duly authorized representative. All captions and headings in this
Agreement are for purposes of convenience only and shall not affect the
construction or interpretation of any of its provisions. Any waiver by either
party of any default or breach hereunder shall not constitute a waiver of any
provision of this Agreement or of any subsequent default or breach of the
same or a different kind.

PLEASE NOTE THAT YOU HAVE ACCEPTED THE TERMS AND

CONDITIONS OF THIS SOFWARE LICENSE BY INSTALLING AND/
OR USING THE SOFTWARE.

Reviewer User Guide 38 Reviewer User Guide 39