SECTION B

Basic Operations

This section provides basic information about using the DROC to acquire images and
send them to output devices. It also includes procedures for system start up and shut
down.

CONTENTS

SECTION B BASIC OPERATIONS ....................................................................................................... 1

STARTING UP AND LOGGING IN TO THE SYSTEM ....................................................................................... 2

WARMING UP THE X-RAY TUBE ................................................................................................................ 5
CAPTURING IMAGES ................................................................................................................................. 7
LOGGING OFF THE DROC APPLICATION ................................................................................................ 33
POWERING DOWN THE SYSTEM .............................................................................................................. 35

B1
Basic Operations

Starting Up and Logging in to the System

NOTE: Below steps only for reference. Steps maybe changes according to your system
configuration.

To start up the system and prepare for acquiring patient images,

Steps：

1. Before power up the host system, power up the X-ray generator, detector and all
the other x-ray system components are needed.

2. Check that the other X-ray system components are on and working properly.

3. Power up the DROC Host PC.

4. Log in to the PC’s operating system

5. Log in to the DROC application.

The DROC HOST PC should be powered down once a day to ensure

a complete system reset. If this is not done, system performance
deteriorates.

The Detector should be powered up at least half an hour before

intended use. If it is used sooner than half an hour after being
powered up, image quality can be affected. For more information
about powering up the Detector, see the next subsection, "Step 1:
Starting Up the UPS.”

The following subsections provide instructions for each of these steps:

Step 1: Powering up the X-ray generator, detector, etc

Please refer to the related instructions from their corresponding manufacturers.

Step2: Checking the System

Once the X-ray generator is powered on, perform the following checks:

B2 2010 V4 DROC User Manual

 Basic Operations

 Remove any patient supports or other objects so they do not interfere with the movement
of the X-ray tube's suspension arm.

Press the light switch on the collimator to ensure that the area exposed to the beam is
illuminated.

 Check the releases, if applicable, on the X-ray tube's suspension arm, the Bucky, and the
table to ensure that the controls are operating properly.

You can now power up the DROC.

Step3: Powering Up the DROC Host PC

Power up the DROC HOST PC; if the monitor is not on, press the power button on the
monitor.

NOTE: Before you power on the DROC HOST PC, make sure the Detector have completed their
startup sequence (wait at least several minutes after you power on the UPS).

Step 4: Logging In to the PC's Operating System

Log in to the PC's operating system; start up the DROC Application, the Status window will
show the initialization status of the DROC, shown as below:

Figure 1：Initialization window

There are some initialization tasks for DROC functions, the result of each task (successful

DROC User Manual 2010 V4 B3

Basic Operations

or failed) is displayed, after the initialization is completed successfully, the application

Login window is displayed. Go to the next subsection to log on to the DROC application.

NOTE: Consult your System Administrator if you do not know your login password. Passwords
are case sensitive, please ensure you enter the correct password, if you enter false
password continually for three times, the application will exit.

Step5: Logging in to the DROC Application

To sign into the DROC application, choose your name from the User Name drop-down list,
enter your password, and click OK button.

Figure 2: Login to DROC window

NOTE: The default password for users is the same with their user name.

The DROC application window for Worklist displays:

B4 2010 V4 DROC User Manual

 Basic Operations

Figure 3: Worklist window

NOTE: Your site’s settings might be different. For example, if you added the Stitching module,
there will appear a “Stitch” menu in the Menu list.

If the X-ray tube has been inactive for a period of time, such as
over 3 hours, you must warm it up to prolong the life of the tube,
as explained in the next section.

Warming Up the X-ray Tube

To perform the tube warm-up,

Steps：

1. Ensure everyone is out of the X-ray room.

2. Close the Collimator shutter, using the shutter controls.

DROC User Manual 2010 V4 B5

Basic Operations

3. Cover the Collimator or the Bucky with a lead apron or position the X-ray tube so it
will not emit the x-ray to the Detector.

4. In the DROC main window, with no patient chosen, click the Conventional Mode
button. The Conventional X-ray Mode window displays.

Figure 4: Conventional mode

5. Set the technique settings, as instructed in the Tube Warm-Up panel.

6. Take exposures until the heat unit count reaches 7% to 9%.

7. When you have completed the exposures, click the Close button and remove the
lead apron from the tube.

B6 2010 V4 DROC User Manual

 Basic Operations

Capturing Images

Overview for Capturing Images

The general workflow for using the DROC to acquire and send images to the output
devices involves the following steps.

Steps:

1. Identifying the patient and Study;

2. Taking an exposure;

3. Viewing and accepting the image; Optionally, you can reject the image and
re-capture one;

4. Closing the patient/Study;

5. After all images being captured, the data will be transmitted to the default node.
alternatively, users can send the images to other node or print the images;

The following subsections provide instructions for each of these steps.

Step 1: Identifying the Patient and Study

Before capturing images, you must identify with which patient they are to be associated.
Proper identification ensures that the image data are associated with the correct patient
information.

Depending on the system configuration at your site, there are three ways for you to
identify the patient which you want to acquire images, as described below.

DROC User Manual 2010 V4 B7

Basic Operations

Menu Bar

Worklist page History page

Patient panel

Query panel

Figure 5: Worklist window

All systems allow you to identify patients manually. Whether you are acquiring images for
a new or existing patient, you can identify a patient manually by:

 Creating a new patient record in the local database.

 Selecting a patient from those previously entered and currently stored in the Worklist
database. For more information about how to manually specify the patient, refer to the
following topic “Creating a New Patient Locally”.

If your system supports Worklist queries, you can retrieve patient information from a
Radiology Information System (RIS). Refer to the following topic “Query and Refresh”.

If your system supports bar code scanning, you can use the bar code scanner to read in
the patient ID or some other unique identifying number. If the ID is found in the Worklist (if
this feature is available) or in the local DROC patient database, the corresponding patient,
and Study is opened. If the ID is not found, you must enter that patient manually.

B8 2010 V4 DROC User Manual

 Basic Operations

The patient/Study list in the Worklist page is shown as below:

Figure 6: Worklist Status bar

There are three status of the patient/study:

 SCHEDULED: A new patient/Study with no image being captured;

 IN PROGRESS: An existing patient/Study not having all the images being captured;
 COMPLETED: An existing patient/Study with all the images being captured.

You can capture images for the patient/Study with SCHEDULED or IN PROGRESS
status, even can superadd images to a COMPLETED status patient/Study as long as it
still existing in the Worklist database.

NOTE: As long as the patient/Study has been accomplished, it will be stored as history data.
Meanwhile, the completed studies will still being stored in Worklist database for a certain
period after exposures, it dependent on the Space Reclamation Strategy and individual
configuration. Users can pick up the patient still in the Worklist table and proceed on
capturing images. A Study existing in the History database could not being superadded
images any more.

Creating a New Patient Locally

NOTE: Make sure you enter patient names and IDs correctly. Incorrect entries can cause
duplicate patient records for the same patient, or make it more difficult to find the patient
in future search operations.

To add a new patient when not using a barcode, click the New Patient button in the
Patient panel in the Worklist page.

DROC User Manual 2010 V4 B9

Basic Operations

Figure 7: Patient panel

The New Patient Entry window is displayed below. Note that, for your site, the fields in
this window may be different.

Figure 8: New Patient Information Window

Complete the fields in the window. Fields labeled with an asterisk (*) are required to be
filled in. You can switch to different fields by pressing Tab key. After birthday inputted, age
is calculated and showed by the system automatically. The name is displayed in the
format LAST ^FIRST^MIDDLE. If you don’t want ^ character to appear in name, you can
input all content of name in First Name field or Last Name field.

B10 2010 V4 DROC User Manual

 Basic Operations

When specifying the procedure, you can select multiple procedures. First of all, choose
the checkbox to determine whether use the Often Used procedures list.

Figure 9: Procedures Specifying

 If the checkbox is not selected, all procedures display in two drop-down lists. You
need to select from left list first. The left one contains the group of body part. When
one item is selected in the left drop-down list, the right one displays procedures
belonging to that body part. You can choose one from the right drop-down list and
click “Add” button. You can repeat the selection to achieve multiple procedures.
Looking up procedures in two levels facilitates the user’s operation, avoiding all
procedure items displaying in only one drop-down list and difficult to look up from
them.
 If the checkbox is selected, only procedures marked as often used display in
drop-down list (The often used procedure list is predefined by DROC configuration).
Because the quantity of such procedure is small, they display only in right drop-down
list with left one disabled. You can select one item and click Add button. You can
repeat the selection to have multiple procedures chosen.

NOTE: You need to re-assign an Accession Number whenever you adding a new procedure.

DROC User Manual 2010 V4 B11

Basic Operations

To save the patient information, click the Accept button. The Creating/Editing Patient
information window closes and the patient information is loaded on the Exam window for
technicians to capture images.

NOTE: Your site’s settings might be different from those described above.

Figure 10: The Exam window opens after accepting the new patient

To clear the entire patient information and input again, click the Clear button.

To cancel creating/editing the patient information, click the Cancel button.

Emergency Patient Registration (Optional)

To add a patient for emergency, register the patient rapidly and need not fill in the
detailed information, clicking the Emergency button. The system will register a patient
automatically with the name composed of prefix, current date and sequence number. The
sequence number increases in 1 step by each patient. The prefix of the name and default
procedure and other factors can be modified in Setting window(Refer to Section E：

B12 2010 V4 DROC User Manual

 Basic Operations

Emergency Setting Part).Then DROC loads the Exam window directly for technicians to
capture images of this emergency patient.

Figure 11: Emergency patient register button

Figure 12: Exam window for the emergency patient

DROC User Manual 2010 V4 B13

Basic Operations

Editing Patient Demographic Information before Exposure (Optional)

You can edit an emergency patient or locally registered patient demographic information
before exposure.

Figure 13: Edit button

1. From the Worklist page in the Worklist window, select the patient/Study with
whose demographic information you want to correct.

Figure 14: Patient selecting

B14 2010 V4 DROC User Manual

 Basic Operations

2. Click Edit button, patient demographic information editing page displays with the original
information:

Figure 15: Edit Patient dialog

3. Input the corrected information;

Figure 16: Demographic information correction

4. Click Accept button to save the correction, the updated information will shown

DROC User Manual 2010 V4 B15

Basic Operations

in the Worklist page as:

Figure 17: After demographic information correction

NOTE: As to a fresh completed Study, the images will be transmitted to a default PACS node.
In case you edited an item with images being captured, the new information, for example,
the new name, will be written into the DICOM info. Whenever you re-open the patient in
DROC, it will appear the new name. If the item also exists in the History list, you can find
the related item shows the new name, too. This Editing operation is only effective for local
database data. It DOES NOT make any changes for the images already transmitted to
the PACS node. We extremely recommend you to resend the Study you just edited to
your desired destination.

Query and Refresh (Optional)

To search an exact patient

From the Query Panel in the Worklist page, you can query a patient/Study by various
searching criteria such as Patient ID, Patient Name, Accession Number and Date. The
Query panel is shown as below:

B16 2010 V4 DROC User Manual

 Basic Operations

Figure 18: Query and Refresh panel

Input the key information associated to the desired patient/Study, and then click Query
button. The DROC application will search the local database, then the result list displays
in the Worklist page.

DROC User Manual 2010 V4 B17

Basic Operations

Figure 19: Searching result list

If multiple patients/studies match the criteria, they will be listed in the Worklist page. You
can choose the exact Study or patient to perform the exposures.

If only one result matches, the Study or patient will be loaded into the Exam window
automatically.

To manually refresh the Worklist from Radiology Information System (RIS)

If your site is connecting with RIS, the DROC can retrieve the worklist in background and
automatically refresh the Worklist page. You can override this operation manually by
clicking the Refresh button.

Deleting an item from the Worklist page (Optional)

To delete a Worklist item, choose the item from the worklist;

B18 2010 V4 DROC User Manual

 Basic Operations

Figure 20: Choosing the item

Then by clicking Delete button, the wordlist item will be prepared to delete.

Figure 21: Delete button

To delete the item, click OK.

Figure 22: Confirm information

NOTE: Only the local cached worklist item can been removed by this Deleting operation. If the
item retrieved from RIS, it may appear again.
Remove the completed item from the Worklist will not inflect the corresponding item’s
existing in History page.

DROC User Manual 2010 V4 B19

Basic Operations

Step 2: Capturing Images

This X-ray unit may be dangerous to the patient and operator unless
safe exposure factors and operating instructions are observed.

Loading the desired patient/Study to the Exam window

To load SINGLE Study:

1. Double-click the item in the Worklist page,

Figure 23: Double-click the desired Study

2. The Study is loaded in the Exam Window.

B20 2010 V4 DROC User Manual

 Basic Operations

Figure 24: Study loaded

To load MULTIPLE studies:

1. From the Worklist page, select a Study belong to the desired patient ,

Figure 25: Select a Study related to the desired patient

2. Click the Select button in the Patient panel,

DROC User Manual 2010 V4 B21

Basic Operations

Figure 26: Select button

3. Studies associated with the desired patient are loaded in the Exam Window:

Study control area

Message display area

Figure 27: studies loaded

NOTE: The UI in your site may not show the some buttons after its installation due to the
customization. Please refer to your support engineer for more details.

You can switch the studies by choosing the related item shown in the Study Control
Area:

B22 2010 V4 DROC User Manual

 Basic Operations

Figure 28: The Study Control Area in the Exam window

Adjusting Exposure Settings and Capturing Sequence (Optional)

At the time the system is installed, default exposure settings and capturing sequences are
configured according to every specific view. You can use manual techniques or phototiming
techniques to adjust the default exposure settings.

Figure 29: Exposure Control panel

Typically, you will simply use the default parameters. They should only be changed for
special circumstances, such as a very small person or a missing lung.

DROC User Manual 2010 V4 B23

Basic Operations

If you need to adjust the exposure parameters or capturing sequence, refer to Section C
Adjusting exposure parameters for detailed instructions.

Checking the Grid

Figure 30: Gird indication

Please check whether you are using a correct grid, otherwise, error message will appear
in the Message display area.

Adding an Additional Procedure (Optional)

For a patient, you may want to open additional procedures, to include their images in the
same Study. For more information, refer to Section C “Working with Multiple Open
Procedures”.

Adding a View to a Procedure (Optional)

Figure 31 : Procedure editing

If you need to capture extra view image, you could add views to current procedure. For
more information, refer to Section C “Adding a View to a Procedure”.

Taking an Exposure

While behind the leaded wall when taking an exposure, you must
maintain verbal communication with the patient and keep the
patient within your sight at all times.

If the X-ray tube heat units exceed the maximum allowable limit, the
X-ray tube and generator will be disabled until the heat units drop to
a safe level. If this condition occurs, a message will be displayed
and an audible beep will sound.

B24 2010 V4 DROC User Manual

 Basic Operations

Steps:

1. Check the detector state. There is a detector state indicator at the bottom of
Exposure Control panel. There are three colors to show the detector state: green
indicates “ready to exposure”, yellow indicates “preparing for exposure”, red indicates
“on exposure”. If the indicator turns into yellow, please wait until it turns to green.

Figure 32: Detector Status—Ready to exposure

Figure 33: Detector Status— Preparing for exposure

Figure 34: Detector Status—On exposure

2. Optionally, give the patient instruction, such as breathing or do not move.

3. Press the Prep/Expose button to the second position and hold till the generator is
ready. After the generator ready tone sounds, press the button to the end.
Approximately a half to several seconds (the time interval is decided by the
characteristic of the detector) after pressing the exposure button to the end, the
exposure occurs. When the exposure occurs, a tone sounds.

4. After the tone stops, release the button.

5. Optionally, give the patient the appropriate instructions.

When the exposure is complete, the Preview window pop up and displays captured image.
It will be closed automatically after several seconds.

For more details of the other buttons on the EXAM window, please refer to “Section C
Additional Operations”

NOTES:
Releasing the Prep/Expose button on the hand-switch before exposure will cancel the
exposure without any error occurs.
If there is any error occurs during the exposure, the Message Field below the “Reset”
button will display the warning or error message.

DROC User Manual 2010 V4 B25

Basic Operations

If it is just a warning, the message disappears automatically after several seconds.

If it is not an auto recoverable error, the message will remain. Click the “reset” button
before performing subsequent exposure.

Figure 35: Reset button & Warning Area

NOTE: The UI in your site may not show the “Reset” button after its installation. Please refer to
your support engineer on how to show the button.

Taking an Exposure on dual-detector system

NOTE: If you are not using dual detector system, the UI may not show the selection of
WorkStation (WS). It is depends on different UI version.

Firstly, please select the proper detector that you need to capture image with.

1. Select correct WS to use the proper Bucky to capture image. Usually the DROC will
choose the correct WS according to procedure setting and you do not need to change
it. When the WS change, system needs preparation. This usually takes several
seconds.

Figure 36: Stand Bucky and Table Bucky for dual-detector system

2. Please refer to previous section “Taking an Exposure” to capture an image.

Step 3: Image Viewing

After the exposure, the image is shown in the View window. From the image View window,
you can:

 Verify the exposure information.

 Select ESA or IT (if available).
 Adjusting the ESA/IT Setting.

B26 2010 V4 DROC User Manual

 Basic Operations

 Crop the image.

 Enter a comment that accompanies the image if sent to a DICOM workstation or
printer.
 Add markers.
 Rotate or flip image, if required.
 View the image in full size.
 Accept the image or reject it.

Exposure Parameter area

Image working panel

Image Optimization panel

Figure 37: View window

The following topics explain how to perform these functions.

DROC User Manual 2010 V4 B27

Basic Operations

Adjusting the ESA/IT Setting (Optional)

Figure 38: Image optimization panel—ESA and IT

From the ESA/IT panel, you can change the current ESA/IT setting by:

 Clicking on the drop down list in the ESA panel and choosing a different setting.
 Pressing and holding the right mouse button, and moving the mouse on image
preview area, the LUT is changed. Vertical movement changes window width of LUT,
and horizontal movement changes window level of LUT.
 Adjusting the image’s LUT settings by placing the cursor on the three rectangle
handles of the curve, pressing and holding the left mouse button, and dragging the
handle.
 ESA setting changes or LUT adjustments are not typically needed. For more
information about making LUT adjustments, refer to the topic “Changing the ESA
Setting or Adjusting the LUT” in Section C.

Cropping an Image (Optional)

You can crop an image in order to cut the background and only save the area with useful
information. The cropping applies only to the image when it is sent to a DICOM print or
storage device. In DROC Configure page, the default crop size is set for each procedure.
When preview image, the initial crop rectangular is positioned according to the size. If
DROC is capable of controlling the collimator’s movement, the collimator receives the
position parameters from DROC and sets its field to the specified size before image taken.

B28 2010 V4 DROC User Manual

 Basic Operations

Furthermore, if DROC could be notified the new position of collimator when collimator is
adjusted manually, when preview image, the crop rectangle’s size will be changed
according to the new collimator field.

For more information, refer to the topic "Cropping an Image" in section C.

Adding Comments to an Image (Optional)

You can add text comments to an image at the time of acquisition; the comment is sent to
any DICOM devices chosen as an output destination for the image. There are only four
comments can be added to an image.

For more information, refer to the topic “Adding Comments to an Image” under the topic
“Working with Acquired Images” in Section C.

Selecting ESA or IT (Optional)

For more information, refer to the topic “Selecting ESA or IT” under the topic “Working with
Acquired Images” in Section C.

Adding Markers to the Image (Optional)

You can add markers to an image that allow you to give further information about the
image (for example, supine, upright, and so on), and the markers are sent to any DICOM
devices chosen as an output destination for the image. In DROC Configure page, you
can configure the default maker added to preview image and its position on the image for
each view. For more information, refer to the topic “Adding Markers to an Image” under
the topic “Working with Acquired Images” in Section C.

Rotating or Mirroring the Image (Optional)

You may wish to rotate or mirror the image. For more information, refer to the topic
“Rotating or Mirroring the Image” under the topic “Working with Acquired Images” in

DROC User Manual 2010 V4 B29

Basic Operations

section C.

View the Image in Full Size (Optional)

You can view the image in full size. For more information, refer to the topic “View the
Image in Full Size” under the topic “Working with Acquired Images” in Section C.

Accepting the Image

To accept the image, click the Accept button. The View window closes and a thumbnail
(minimized view) of the image is displayed in Exam window, as shown below. The
exposure parameters used to acquire the image are displayed under its thumbnail.

Figure 39 Exam window with image accepted

Once accepted the image, that image is stored in the DROC and is queued to be sent to

B30 2010 V4 DROC User Manual

 Basic Operations

the selected output devices.Now the image is acquired successfully.

By default, the next view to be exposed is selected in the image panel. If needed, you can
select a different view and adjust the exposure settings before acquiring the next image.
For more information about these procedures, refer to Section C.

Rejecting the Image (Optional)

You may want to reject an image (for example, if the patient moved during the exposure).

To reject the image

Steps:

1. In the View window, click the “Reject” button.

The Image Rejection Reason window displays, as shown below. In this window,
you enter a reason of the rejection.

Figure 38: Reject Reason Window

2. Check the corresponding checkboxes to choose one or more reasons from the

DROC User Manual 2010 V4 B31

Basic Operations

displayed list of default comments. If you check the Other Reason checkbox, you
need to type the reason in field under the Other Reason checkbox.

3. Click the “Reject” button to save the rejection reason and reject the image.

Then the Rejection Reason Window and View window close and you can recapture
the image.

To dismiss the window and return to the View window without rejecting the image,
click the “Cancel” button.

Rejected images are stored in a designated reject bin storage area in the DROC, and can
be discarded or resent to an output device. .

NOTE: Rejected images can be manually deleted by the system administrator. And the
system will delete rejected images when it reclaims disk space.

Step 4: Outputting Images manually (optional)

After the images being captured, they will be output to default destinations or printers
automatically. But you can still send the images to different destinations or resend images
from Output window.

There are two types of output destinations: archive server for storage and printer for
printing. These two destinations which can contain zero or multiple nodes can be
configured for all images belong to the same procedure. Furthermore, the film orientation,
size and format can be configured for each different procedure. When an exam is opened,
these configurations are loaded automatically. You can also change them manually for
current Study.

For detailed information, please refer to Section D: Working with Worklist Studies.

Step 5: Closing the Study/Patient

You can quit the Exam window by closing the current Study to perform other operations,
no matter whether all the images being captured or not.

B32 2010 V4 DROC User Manual

 Basic Operations

To close a Study, from the bottom of the operation panel located in the Exam window,
click the Close button.

Figure 40: Close button

 If all of the images in the current study has being acquired, the status of this Study will
become Completed in Worklist window;
 Otherwise, the status will become In Progress in Worklist window.

You can pick up the incomplete Study from the Worklist page to proceed on the
exposures whenever you like.

NOTES:
The fact that a Study is incomplete does not prevent the patient record and associated
images from being deleted as part of the system's storage space reclamation process.
For more information about the reclamation, and how to protect a patient record and
associated images from being deleted, refer to Section E.
When the Study is closed and no new patient selected, the detector will perform offset
calibration; if no Study is opened for a period of time, the detector enters “sleep” mode
to save energy. To ensure detector could enter “sleep” mode when system is idle, don’t
leave a Study opened for a long time without taking exposure.

Logging Off the DROC Application

To logging off the DROC application, from the Menu Bar click the Exit button. The
DROC Exit dialog displays.

DROC User Manual 2010 V4 B33

Basic Operations

Figure 41: DROC Exit dialog

Three options are available:

 Close the DROC

 Logoff DROC
 Close Computer

You can choose the “Logoff DROC” option to switch to another user, shown as below.

Figure 42: Selecting user at Login window

B34 2010 V4 DROC User Manual

 Basic Operations

Powering Down the System

Typically, you should leave the system components on. The DROC HOST PC, monitor,
and Detector enter an energy-saving "sleep" mode1 when they are not used for a period
of time.

If you have to power down the system, perform the steps outlined in the following
sections.

Recommended Power Down Procedure Overview

To power down the system, it is recommended that you perform the power down tasks in
the following sequence,

Steps:

1. Power down the DROC HOST PC.

2. Power down the X-ray generator. This also typically powers down the other X-ray
system components.

Refer to the following topics for instructions on how to perform each of these steps.

The DROC HOST PC should be powered down once a day to ensure a

complete system reset. If this is not done, system performance
deteriorates.

Step 1: Powering Down the DROC HOST PC

To power down the DROC HOST PC,

Steps:

1. Close all the applications running in the PC;

1
The “Sleep” mode is available for Trixell Detector.

DROC User Manual 2010 V4 B35

Basic Operations

2. From the Start, choose power off the PC.

Step 2: Powering Down the X-ray Generator

Powering down the X-ray generator also typically does power down the other X-ray
system components, such as X-ray tube, tube suspension arm, collimator, Bucky, and
table (if applicable).

B36 2010 V4 DROC User Manual