Vitrea ®

version 4.1

Administration Guide

VPMC-12847A
Copyright © 1997 - 2013 Vital Images, Inc.
Protected by U.S. Patents 6,219,059; 6,662,918; 7,039,723; Other Patents Pending in the U.S. and other countries.

VPMC-12847A Vitrea 4.1 Administration Guide

No part of this work may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic
or mechanical, including photocopying and recording, or by any information storage or retrieval system without permission
in writing from Vital Images.

Trademarks
Vitrea is a trademark of Vital Images, Inc.
Microsoft, Microsoft Windows, and Microsoft Word are registered trademarks of Microsoft Corporation.

Restricted Rights Legend

If this software or documentation is delivered to the Department of Defense (DOD) of the U.S. Government, it is delivered
with Restricted Rights as follows:
Use, duplication or disclosure of the software by the U.S. Government is subject to restrictions as set forth in subparagraph
(c)(l)(ii) of the Rights in Technical Data and Computer Software clause at DFARS 252.227-7013.
If this software or documentation is delivered to any unit or agency of the U.S. Government other than DOD, it is delivered
with Restricted Rights and use. Duplication or disclosure by the U.S. Government is subject to the restrictions as set forth in
FAR 52.227-19 (c)(2). If the software or documentation is delivered to NASA, it is delivered with Restricted Rights subject to
the restrictions set forth in 18-52.227-86(d) of the NASA FAR Supplement.

Limits of Liability and Disclaimer of Warranty

VITAL IMAGES SHALL HAVE NO LIABILITY OF ANY KIND FOR ANY DIRECT, INCIDENTAL OR CONSEQUENTIAL DAMAGES BASED
ON ANY DEFECT, FAILURE OR MALFUNCTION OF THE SOFTWARE,OR USE OF ANY VITAL IMAGES DOCUMENTATION, WHETHER
THE CLAIM IS BASED UPON WARRANTY, CONTRACT, TORT OR OTHERWISE. VITAL IMAGES MAKES NO WARRANTY, EXPRESS OR
IMPLIED, INCLUDING BUT NOT LIMITED TO, ANY WARRANTY OF MERCHANTABILITY OR FITNESS FOR A PARTICULAR PURPOSE
WHETHER ARISING FROM STATUTE, COMMON LAW, CUSTOM OR OTHERWISE.

Notice of Confidentiality
This software and the information in this software including, but not limited to, the ideas, concepts and know-how are
proprietary, confidential and trade secret to Vital Images, and the information contained therein shall be maintained as
proprietary, confidential and trade secret to Vital Images and shall not be copied or reproduced in any form whatsoever. This
software and any information contained therein shall not be disclosed to anyone other than authorized representatives of
the user's employer who is contractually obligated not to disclose same, without the express written consent of Vital Images.
The user of this software and any information contained therein shall not attempt to discern Vital Images' confidential and
trade secret information and shall not reverse compile, disassemble, or otherwise reverse engineer this software or any
information contained therein.
Software License Notice
This software is a licensed product of and is distributed by Vital Images, and may only be used according to the terms of that license on the
system identified in the License Agreement. In the event of any conflict between these terms and the terms of any written agreement or
agreement assented to through electronic means with Vital Images, the terms of such written or assented agreement shall control.
European Representative: Australian Sponsor: Australian Sponsor:
MediMark® Europe CELEO Pty Ltd Toshiba Australia Pty Ltd
11 rue Emile ZOLA, BP 2332, 38033 15 Alvarado Court PO Box 350
GRENOBLE CEDEX 2, France Broadbeach Waters, QLD 4218 North Ryde, NSW 1670
Tel: +33 476 86 43 22 Australia Australia
Fax:+33 476 17 19 82
E-mail: info@medimark-europe.com

Manufactured by: Vital Images, Inc; 5850 Opus Parkway, Suite 300; Minnetonka, MN, US; 55343; Phone 866.433.4624
®
MediMark Europe is an authorized representative in the European Community and acts on behalf of Vital Images, Inc. in the
communication of safety-related incidents and regulatory matters with Competent Authorities in the European Community. CELEO Pty Ltd
and Toshiba Australia Pty Ltd are authorized sponsors in Australia and act on behalf of Vital Images, Inc. in the communication of safety-
related incidents and regulatory matters with Therapeutic Goods Administration in Australia. Distributors are still the first line of
communication with their customers regarding service and complaints.

VPMC-12847A
 Vitrea® version 4.1 Administration Guide

Table of Contents

Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-1

Product Overview . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-1

Safety and Regulatory Considerations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .1-2
Caution Statements . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .1-2
General Safety Considerations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-3
HIPAA Compliance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-3
Online Registration. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-3
Contact Us. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .1-4

Getting Started – Microsoft Windows® Preparation . . . . . . . . . . . . . . . . . . . . . 2-1

Understanding Hardware Specifications. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .2-1

Minimum & Recommended Hardware Specifications . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .2-1
Hard Drive Setup . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-2
Installing Windows 32bit . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-2
Overview. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-2
Windows Setup . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-2
Configuring Windows Settings. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-3
Overview. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-3
Windows Preferences . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-3
Installing Windows 64bit . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-11
Pagefile Settings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .2-12
BIOS Settings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .2-12
Configuring Antivirus and Disk Defragmentation Software . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .2-12
Adding Restore Points . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .2-13
Cleaning Up the Disk . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .2-13
Creating a Restore Point . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .2-13
Creating and Restoring Disk Images . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .2-15
Creating an Image . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .2-15
Applying an Image . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .2-15
Imaging New Systems . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-16
Imaging the C: Partition . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-16

Software Installation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-1

Setting Network Information and Partitions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .3-1

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Setting an IP Address. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .3-1

DNS Settings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .3-3
Changing Drive Letters. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-4
Licensing Vitrea . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-6
Overview. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-6
Entering a Static License . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-6
Understanding Concurrent (Floating) Licensing . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-6
Floating License Setup Instructions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-6
Query the Floating License Manager. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-8
Installing Vitrea Software . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .3-10
Registering and Authorizing Vitrea Software . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .3-10

DICOM Devices and Postscript Printers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4-1

Introducing DICOM . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .4-1

Overview. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .4-1
Common Terms . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4-2
Understanding VICommunicator . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4-3
Overview. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4-3
Testing the Functionality of VICommunicator . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4-3
Restarting VICommunicator. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4-4
Adding DICOM Devices. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4-5
Overview. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4-5
Testing DICOM Connectivity. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4-5
Sending Images to the Vitrea . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4-6
Extended Storage Classes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4-6
Configuring Vitrea’s DICOM Settings. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4-8
Turning on the Multi-frame Option in Vitrea . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4-8
Configuring PACS in Vitrea . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4-9
Setting Up Vitrea to Vitrea (V2V) Connectivity . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4-10
Adding ViTALConnect Entries . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .4-14
Configuring Printers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .4-17
Configuring DICOM Printers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .4-17
Installing Postscript Printers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .4-19
rUnderstanding SmartQuery . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .4-19
Using the SmartQuery Option . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .4-19
Importing and Exporting the DICOM Device List . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4-20
Reading the ECFConfiguration.xml Document . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4-20
Exporting the DICOM Device list into the ECFConfiguration.xml . . . . . . . . . . . . . . . . . . . . . . . . . 4-22

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Learning Basic Vitrea Operations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5-1

Learning Basic Vitrea Operations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5-1

Study Directory. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5-1
The Gallery window . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .5-2
The Viewer Window . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .5-3
The Report Window . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .5-4
The Review Window . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .5-5
The Help Window . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5-6

Vitrea Customization . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6-1

Customizing Vitrea Burned CDs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .6-1

Modifying the Apache Web Server Properties . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6-4
Enabling Password Protection. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6-4
Adding Multiple Vitrea Workstations to the Web Server . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6-5
Understanding Modified Presets and Protocols . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6-7
Saving Modified Presets . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6-8
Changing the Default Protocol. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6-9
Changing Compression Settings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6-12
Customizing Reports . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .6-13

System Maintenance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7-1

Disk Defragmentation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7-1

Software Upgrades . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .7-5
Configuring Autodelete . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .7-5
Configuring AutoDelete by Timeout . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .7-5
Configuring AutoDelete by Disk Space . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7-6
Configuring AutoDelete by Store Confirmation. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7-6

Troubleshooting . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8-1

Welcome to Vital Image’s Support Knowledge Base . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .8-1

Registering for Vital Images’ Support Knowledge Base . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .8-1
Using Vital Images Knowledge Base . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8-3
Adding Feedback . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8-6
Resolving Importing, Exporting, and Printing Issues . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8-6
Troubleshooting DICOM Export Issues . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8-7
Troubleshooting DICOM Printing Issues . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8-8
Troubleshooting CD/DVD Burning in Vitrea . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8-9

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General CD/DVD Troubleshooting Issues . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8-9

Archiving Data in Vitrea . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8-10
Archiving a Report to CD/DVD . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8-11
Troubleshooting a Slow System. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .8-13
Running Chkdsk to Fix Errors. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8-14
Verify Free Disk Space . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8-14
Checking Processes for high CPU usage. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .8-15
Running Disk Defragmentation Software . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .8-17
Optimizing Video Card Settings. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8-19
Vitrea Configuration . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8-19
Changing Video Management . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .8-21
Vitrea Software Upgrades . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8-22
Restoring Customized Report Templates and Graphics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8-23
Vitrea Saves Your Customized Templates and Graphics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8-24

Quick Reference . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9-1

Finding Commonly Used Files . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .9-1

C: Drive Folders . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .9-1
E: Drive Folders . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9-3
Creating a Backup for Vitrea . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9-4

VxNet Introduction (for PACS Integrated Systems) . . . . . . . . . . . . . . . . . . . . . . . A-1

Introducing VxNet . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .A-1

Understanding Stand-alone vs. Integrated Architecture . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .A-1
Reading VxNet Log Files . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . A-2
Introducing the Communication Channel . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . A-3
Reviewing Load Times of Integrated Systems. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . A-4

Licensing Form . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . B-1

Vital Images License Request Form . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . B-1

Index . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Index-1

iv of iv VPMC-12847A
 Vitrea® version 4.1 Administration Guide

Introduction

Product Overview
Vital Images’ Vitrea® medical imaging software, installed on a state-of-the art,
high performance Windows workstation, provides the most sophisticated vol-
ume-rendering software available anywhere in the world today.
Vitrea revolutionizes the world of clinical radiology by providing you with an easy-
to-use workstation that can make diagnoses easier, faster, and more reliable than
ever before. Vitrea provides both 2D and 3D environments, where you can create
and examine diagnostic quality images in less than five minutes. Vitrea gives you
the tools you need for your daily work: fast image rendering, an embedded clini-
cal workflow and protocols, image fine-tuning and navigation, and report author-
ing.
With Vitrea, you can quickly and easily accomplish the following tasks:
• Communicate with configured DICOM (Digital Imaging and Communica-
tions in Medicine) devices to retrieve and export patient data
• Preview images as acquired by the scanner, using the 2D Study Viewer
feature
• Load one or multiple CT or MR volumes for a patient
• Select from a gallery of predefined clinical viewing protocols
• Adjust visualization parameters to enhance images
• Review multiple image files in 2D, side-by-side views
• Measure regions of interest
• Locate and observe points of interest, using a mix of multi-planar refor-
matted (MPR) 2D and 3D images
• Trim with 3D and 2D segmentation to focus images on regions of interest
• Fly through or around anatomical images
• Save snapshots highlighting regions of interest to a printable, Intranet-
ready report
• Capture image sequences in batches to create printed reports or make
Intranet-ready digital movies

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Safety and Regulatory Considerations

For general Vitrea safety and regulatory considerations, refer to the Safety and
Regulatory Considerations section of Basic Vitrea User Guide.

Caution Statements
Hardware and Safety
• Some computer monitors (computer screen, CRT) are unshielded. Do not
place the monitor, whether in its shipping carton or unpacked, inside the 1.3
Gauss line of any Magnetic Resonance Imaging (MRI) magnet. Exposure to
this strength of magnetic field will permanently damage the monitor and may
void the manufacturer’s warranty. Assume all monitors, regardless of the
manufacturer or source, are unshielded unless the manufacturer specifically
states otherwise.
• The Vitrea workstation uses 24-bit color resolution or 8-bit grayscale resolu-
tion which is lower than that of radiologic film. The user must use profes-
sional judgment at all times when interpreting images that may be influenced
by resolution level.
• For best results, set the workstation monitor resolution to 1600 X 1200 pixels.
If you set the monitor to a lower resolution, for example 1280 x 1024, you may
not be able to see some buttons and controls. If you use a lower resolution,
set the Windows Taskbar to auto-hide. To do this, right-click the taskbar, then
select Properties. Check Auto-hide the taskbar box.
• You must have enough random access memory (RAM) on your workstation. If
you do not have sufficient memory, you may experience a significant
decrease in system performance or even a system crash. It is important to
provide enough memory to work with--more than the anticipated maximum
size for a volume. If you think you are experiencing low memory issues, con-
tact your System Administrator or Vital Images. For Vital Images contact infor-
mation, see Contact Us.
• Do not use the Vitrea workstation if any unsafe condition exists. If the hard-
ware fails, resulting in a hazardous condition such as smoke or fire, turn off
the power to the hardware and unplug the monitor and CPU. Do not use the
equipment if a malfunction takes place. Contact your System Administrator or
Vital Images to correct any malfunctions before proceeding. For Vital Images
contact information, see Contact Us.
• If the Vitrea screen goes blank or the system locks up at any time while you
are using it, it could disrupt the interpretation of an image. Should this occur,
be sure to restart Vitrea.
• Do not install the Vitrea workstation within six feet of a patient area. Patient
vicinity is defined in Medical Electrical Equipment - Safety Requirements for
Medical Electrical Systems (IEC 601-1-1), as ‘any volume in which intentional
or unintentional contact between the PATIENT and any parts of the SYSTEM or
some other persons touching parts of the SYSTEM can occur’. See the follow-
ing diagram for clarification:

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FIGURE 1. Patient Vicinity Diagram

General Safety The Vitrea software and its computer platform constitute the Vitrea workstation.
Considerations The Vitrea workstation is a sophisticated combination of software and hardware.
The Vitrea workstation is intended to be used by the following individuals:
• physicians
• radiologic technologists
• other medical personnel under a physician’s supervision
Keep the electronic copy of this manual on your workstation. Review the Vitrea
operating instructions on a regular basis, paying special attention to Caution
statements and Notes.
Refer to the instruction manuals for your specific computer hardware and for any
other system software for additional safety information.
Be sure to limit access to patient data to authorized individuals. Access control
can be achieved by physical security measures (locking systems), by software-
based password security systems, or both. If you have questions, contact your
System Administrator or Vital Images. For Vital Images contact information, see
Contact Us.

HIPAA Compliance Vital Images’ products comply with the Health Insurance Portability and
Accountability Act (HIPAA) of 1996.
It is the responsibility of users to comply with their institutions’ HIPAA policies.

Online Registration
All customers are required to register their Vitrea software and agree to the terms
of a Vital Images software license agreement. Upon installation and subsequent
upgrades, a dialog box will display every time you launch Vitrea, requesting you
register the software. After you register, the dialog box will not display.
You can also register your software through our web site, or by email.

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You should register within 30 days to ensure continuous operation of Vitrea. If you
have not registered within 30 days, you will no longer be able to start Vitrea.

NOTE To register the software on your workstation, you must log on as a

Vitrea administrator.

Contact Us
• For general, non-technical support questions, contact us through our Web
site: www.vitalimages.com.
• For customer technical support, contact us using one of the following meth-
ods:
• In the U.S., call the Customer Support line at 1.800.208.3005.
• Outside the U.S., contact your Vital Images distributor. For a list of inter-
national distributors, go to http://support.vitalimages.com/contact.asp.
• Email support@vitalimages.com.
• For licensing information or requests, contact us through
license@vitalimages.com.
To provide feedback about this document or other Vital Images product
documentation, email feedback@vitalimages.com.

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®
Getting Started – Microsoft Windows
Preparation
This chapter contains the following information:

• Understanding Hardware Specifications

• Installing Windows 32bit
• Configuring Windows Settings
• Installing Windows 64bit
• Configuring Antivirus and Disk Defragmentation Software
• Adding Restore Points
• Creating and Restoring Disk Images

Understanding Hardware Specifications

This section describes Vital Images’ recommendations for purchasing hardware.
We provide minimum hardware specifications so your facility can choose which
hardware vendor they prefer to run Vitrea software.

Recommended hardware is available for purchase through a variety of outlets,

including:

• Hardware vendors (Dell® and HP®)

• Insight® (www.insight.com) (Systems purchased through Insight are imaged
and pre-configured for Vitrea software.)
• Vital Images (Hardware purchased through Vital Images - HP only - is
supported by HP throughout the length of the maintenance contract with
Vital Images. Vital images will dispatch the vendor.)

CAUTION: Hardware purchased through Insight or directly from the hardware

vendors will not be supported by the Vital Images Support group.

Minimum & Current minimum and recommended system specifications is outlined by the
Recommended Vital Images Sales team or Technical Support. See Contact Us.
Hardware
Specifications

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Hard Drive Setup Vital Images recommends you set up a RAID configuration with redundancy. The
choice of RAID configuration (RAID 0,1, or 5)as well as the hard drive interface
(SCSI or SATA) is your decision. Vital Images will not be responsible for data loss
due to hard drive failure.

Installing Windows 32bit

Overview The Vitrea workstation runs on the Microsoft Windows Operating system. The
following Windows configurations optimize software performance and
standardize Vitrea workstations. Before installing Windows, configure the RAID.

The following directions are provided for customers who purchase hardware that
meets the software criteria but does not have Vital Images’ image disks.

NOTE: Vital Images provides image disks for some recommended systems. Image
Instructions are listed in the Imaging Section of this manual. (Systems purchased
through Insight or Vital Images will be loaded with Windows and ready for the
Vitrea software installation.)

CAUTION: This process will remove any present information on the hard disk.
The hard disk will be partitioned, and Windows XP will be installed.

Windows Setup Boot from the Windows XP Software CD into Windows XP Setup.

Install a default Windows XP installation except for the following:

1. Delete the Primary partition.
2. Create a new primary partition that is 10,000 MB.
3. Format the new partition with NTFS.
4. Create a second new partition:
• Primary Partition (drive E:) with the remaining space formatted with
NTFS. This partition is for the patient data storage.

NOTE: It is not necessary to create a separate E: partition if the

administrators prefer to store patient cases and reports on the C:
partition. Most PACS integrated Vitreas will use the C: partition for
storage.
5. During the registration process, enter Vitrea for the UserName. There is no
default password for the Vitrea user.
6. Set the Administrator password to vital$.

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FIGURE 2. Partition Sizes

Configuring Windows Settings

Overview The following steps set how Windows XP will look and feel. Some performance
enhancements are made.

NOTE: The default Administrator account is hidden while Welcome screen

displays. Press CTRL + ALT + DELETE twice to view the standard logon.

Windows Preferences To turn off System Restore:

1. Right-click My Computer and select Properties.
2. Select the System Restore tab.
3. Check theTurn off System Restore box.

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FIGURE 3. System Restore Settings

To create the Pagefile:

1. Right-click My Computer and select Properties.
2. Select the Advanced tab.
3. Click Settings in the Performance section.
4. Select the Advanced tab.
5. Click Change in the Virtual Memory section.
6. Set the C: drive pagefile to 20MB.
7. Set the E: drive pagefile to 4092MB.

NOTE: If the E: drive does not exist, place only one 4092MB pagefile on the largest
partition.
8. Reboot.

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FIGURE 4. Pagefile Settings

To edit the User Accounts:

1. From the Start menu, select Settings | Control Panel.

NOTE: The Control Panel displays in either Classic or Category view. The Figures in
this guide use the Classic view.
2. Double-click User Accounts.

FIGURE 5. Control Panel

3. Click Change the way the users log on or off.

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FIGURE 6. User Accounts Screen

4. Clear the Use Fast User Switching box.

5. Clear the Use Welcome Screen box. This is recommended for HIPAA
compliance.

FIGURE 7. Logon and Logoff Options

6. Click Apply Options and return to the Control Panel.

NOTE: If using a domain, make sure that domain users group is part of the Vitrea
users group.

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To disable offline files:

1. From the Start menu, select Settings | Control Panel.
2. Double-click Folder Options.
3. Select the Offline Files tab.
4. Clear the Enable Offline Files box and click Apply.

FIGURE 8. Disable Offline Files

To change Display Settings:

1. From the Start menu, select Settings | Control Panel.
2. Double-click Display.
3. Select the Settings tab.
4. In the Screen Resolution box, adjust the screen resolution to 1600 by 1200
pixels. Click Apply.
5. Select the Appearance tab and click Effects.
6. Select ClearType from the Use the following method to smooth edges of
screen fonts drop-down arrow.

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FIGURE 9. Effects Window

7. Clear the Use the following transition effect for menus and tooltip box.
8. Click OK.

To configure Network Settings:

1. From the Start menu, select Settings | Control Panel.
2. Double-click Network Connections.
3. Right-click Local Area Connection of the network card and select Properties.

FIGURE 10. Local Area Connection Properties

4. Double-click Internet Protocol TCP/IP.

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The Internet Protocol (TCP/IP) Properties window opens.

5. Click Advanced and select the DNS tab.
6. Change the DNS suffix to match your site or set it to default.com.
7. Check the Register this connection’s addresses in DNS box.
8. Check the Use this connection’s DNS suffix in DNS registration box.

FIGURE 11. DNS Settings Tab

9. Select the WINS tab.

10. Select Enable NetBIOS over TCP/IP.
11. Click OK to save.

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FIGURE 12. WINS Settings Tab

To Configure Network Card Power Settings:

1. From the Start menu, select Settings | Control Panel.
2. Double-click Network Connections.
3. Right-click Local Area Connection of the network card and select Properties.
4. Click Configure.
5. Click the Power Management tab if present.
6. Clear the Allow the computer to turn off this device to save power box.
7. Click OK.

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FIGURE 13. Network Card Power Management Tab

MSN (Windows) Messenger Policy

Vital Images policy is to disable Windows Messenger. It is uninstall Messenger

from Add/Remove Programs.

Windows Updates Policy

Vital Images policy is to verify all Windows updates to ensure any changes do not
interfere with the software. At this time, all service packs are added to Vitrea
workstation, but no other updates.

Installing Windows 64bit

The Windows 64 bit installation follows the same rules as the 32 bit installation
with a few exceptions. The pagefile changes in size due to the increased RAM. The
increased RAM must also be recognized by the BIOS.

CAUTION: Upgrading to the 64-bit OS could cause other programs installed

on the Vitrea workstation to stop functioning properly.

CAUTION: It is also possible that peripheral devices such as printers may no

longer function unless 64-bit versions of the device drivers are installed on
the workstation.

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CAUTION: The Fusion 7D application is not validated for use on the 64-bit OS.
If Fusion 7D is available on your workstation, discontinue using it after the
upgrade.

Pagefile Settings To create the Pagefile for Windows 64 bit:

1. Right-click My Computer and select Properties.
2. Select the Advanced tab.
3. Click Settings in the Performance section.
4. Select the Advanced tab.
5. Click Change in the Virtual Memory section.
6. Set E: drive pagefile to System managed size.

NOTE: If the E: Drive does not exist, place the pagefile on the largest partition.
7. Reboot.

BIOS Settings HP systems configured with more than 4GB of RAM may need to be adjusted for
Windows to recognize the additional RAM. If the System Properties do not display
the correct RAM amount, memory remapping may be disabled.

Ensure Memory Remapping is Enabled in the BIOS of some HP Systems

1. Enter BIOS as the computer is starting up.
2. Browse to the Processors/Memory Section.
3. Ensure Memory Remapping is enabled.

Configuring Antivirus and Disk Defragmentation Software

Vital Images Antivirus Policy

Vitrea software is compatible with the most major Antivirus software. Install
Antivirus software using the default settings. Then, disable any real time scanning
on the VitreaData folder.

CAUTION: Scanning this directory could result in data corruption/loss or slow

performance.

Vital Images Defragmentation Software Policy

Vital Images does not provide Defragmentation software. We recommend

®
PerfectDisk by Raxco. Vitrea software requires a defragmentation software for
optimal performance.

NOTE: For best results, perform disk defragmentations when Vitrea is not in use.

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Adding Restore Points

Cleaning Up the Disk Clear the system of unnecessary files to conserve disk space on the image CD.

To clear the system of unnecessary files before creating a Restore Point (or Ghost
Image):
1. Delete all the files that can be removed in C:\Windows\prefetch.
2. Delete all the files that can be removed in C:\Windows\Temp.
3. Delete all the files that can be removed in C:\ Documents and
Settings\Administrator\Cookies.
4. Delete all the files that can be removed in C:\ Documents and
Settings\Administrator\My Recent Documents.
5. Delete all the files that can be removed in C:\ Documents and Settings\
Administrator\Local Settings\Temp.
6. Delete all the files that can be removed in C:\ Documents and Settings\
Administrator\Local Settings\History.
7. Delete all the files that can be removed in C:\ Documents
andSettings\Administrator\Local Settings\Temporary Internet Files.
8. Empty the Recycle Bin.
9. Open Administrative Tools and clear all the entries in Event Viewer for
Application, Security, and System log files.
10. Run a deframentation software to defragment the C:\ and E:\ partitions.

Creating a Restore To create a Restore Point:

Point 1. Right-click My Computer and select Properties.
2. Select the System Restore tab.

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FIGURE 14. System Restore Turned On

3. Clear theTurn off System Restore box.

4. From the Start menu, select All Programs I Accessories I System Tools I System
Restore.
The System Restore screen displays.
5. Select Create a restore point and click Next.

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FIGURE 15. System Restore Welcome Screen

6. Name the Restore Point Base Install.

7. Turn off System Restore after the Restore Point is created.

Creating and Restoring Disk Images

® ®
Creating an Image If Symantec Ghost or PowerQuest imaging software is installed, you can take a
customized image of the Vitrea system after configuration settings have been set.
It is important to take the image before image data starts arriving on the system.
With a high compression setting, a Ghost Image of a system with Vitrea installed
will take approximately three blank CDs.

Applying an Image If you purchase your own hardware, Vital Images recommends that you use Ghost
to take an image of the system post-configuration. This section describes the
image process for Vital Images purchased hardware platforms.

Disk Imaging creates a system quick restore point and configurations that are
ideal for Vitrea software performance. Imaging or Windows Configurations needs
to take place before Vitrea Software is loaded. Imaging may also be used in
troubleshooting issues with Windows software.

NOTE: Systems purchased through Insight or Vital Images are imaged and pre-
configured for Vitrea software. No Imaging is necessary for these systems.

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Imaging New Systems CAUTION: Before imaging, be sure all image disks are present and labeled for
the hardware to be imaged. Imaging the entire drive will remove all patient
data and Vitrea settings. Be sure Vitrea configuration files, license files, and
templates are saved onto a removable drive before continuing. See the
System Maintenance chapter for backup instructions.

To Image a New System:

1. Insert the Disk 1 Image CD into CD-RW drive. This CD is bootable.
2. In the About Symantec Ghost screen, click OK.
3. Select Image/Tape I Image Disk.
4. Click Accept.
5. Select Local I Disk.
6. Click From Image.
7. Select CD-ROM drive from drop-down menu at the top of the window and
select the.GHO image file.
8. Click OK.
9. Select Local Destination Drive by Clicking on the Drive Number.
10. Click OK.
11. At Destination Drive Details, be sure the minimum partition size for the C
drive (first primary drive listed) is at least 10,000 MB.

NOTE: Change to 10,000 MB if necessary.

12. Click OK.

NOTE: The other two drives listed are the E: (patient storage), and F: (for
the pagefile) drives. The C: and E: drives are NTFS, and the F: drive is
FAT32.
13. At the Proceed with disk load? prompt, click Yes.
14. Insert the second media disk when prompted.
15. Click OK.
16. At the Clone Completed Successfully prompt, remove the second media disk
and select Reset Computer.

Imaging the C: CAUTION: Before imaging, be sure all image disks are present and labeled for
Partition the hardware to be imaged. Imaging the C drive will remove all settings and
files on the C: drive. Be sure Vitrea configuration files, license files, and
templates are saved onto a removable drive before continuing. See the
System Maintenance chapter for backup instructions.

To Image the C: Partition Only:

1. Insert the Disk 1 Image CD into CD-RW drive. This CD is bootable.
2. In the About Symantec Ghost screen, click OK.
3. Select Image/Tape.

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4. Select Image Disk.

5. Click Accept.
6. In the menu, select Local I Partition.
7. Click From Image.

CAUTION: Be sure the ‘Partition’ is selected; choosing ‘Disk’ at this step will
remove all patient data.
8. Select CD-ROM drive from the drop-down menu at the top of the window and
select the .GHO image file.
9. Click OK.
10. Be sure the first drive is highlighted at Select Source Partition from Image
File. This drive is the C drive and should be around 10GB in size.
11. Click OK.
12. Click OK from Select Local Destination Drive by Clicking on the Drive Number.
13. Be sure the minimum partition size for the C drive (the first primary drive
listed) is at least 10,000 MB at Destination Drive Details.

NOTE: Change to 10,000 MB if necessary.

14. Click OK.

NOTE: The other two drives listed are the E: (patient storage), and F: (for
the pagefile) drives. The C: and E: drives are NTFS, and the F: drive is
FAT32
15. Click Yes at the Proceed with disk load? prompt.
16. Insert second media disk when prompted.
17. Click OK to continue.
18. At the Clone Completed Successfully, remove the second media disk and
choose Reset Computer.

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Software Installation
This chapter contains the following information:

• Setting Network Information and Partitions

• Licensing Vitrea
• Installing Vitrea Software
• Registering and Authorizing Vitrea Software

Setting Network Information and Partitions

Setting an IP Address Vitrea software requires a static IP to run properly, and Windows XP requires a
subnet mask. Vital Images recommends entering gateway information as well as
either DNS or WINS fields.

NOTE: Vital Images Technical Support uses WebEx™ software for high speed
remote access. Internet access on the Vitrea is required for use of this service.

To Set a Static IP Address:

1. From the Start menu, select Settings | Control Panel.
2. Double-click Network Connections.
3. Right-click Local Area Connection of the network card and select Properties.

NOTE: There are multiple Local Area Connections entries. Be sure the Local Area
Connection selected is the entry associated with the network card.

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FIGURE 1. Local Area Connection Properties

4. Double-click Internet Protocol TCP/IP.

The Internet Protocol (TCP/IP) Properties window opens.
5. On the General tab, select Use the following IP address:.
6. Enter the IP address and Subnet Mask.
7. Click OK to close all remaining windows.
Optional. The Default Gateway, DNS server, and WINS Server can be filled in
at this time.

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FIGURE 2. Internet Protocol Properties for a Static IP

DNS Settings Vitrea Software requires certain DNS Settings, regardless of whether DNS entries
are in place.

To Set the DNS Settings:

1. Open TCP/IP Properties with the Setting an IP Address directions provided on
pages 3-1 and 3-2.
2. Click Advanced and select the DNS tab.
3. Change the DNS suffix to that of your site or leave as default.com.
4. Select the Register this connection’s addresses in DNS box.
5. Select the Use this connection’s DNS suffix in DNS registration box.

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6. DNS Settings Tab

Changing Drive Letters The default setting for partitions on the Vitrea system is three partitions. Systems
that use only one partition will not need these instructions.

The Drive Letters should be C:\ for the Windows XP OS, D:\ for the CD-Rom, and
E:\ for the Patients drive. After imaging, the drive letters may be out of sequence.

NOTE: A restart may need to take place during the following instructions.

To Change Drive Letters:

1. From the Start menu, select Settings | Control Panel.
2. Double-click Administrative Tools I Computer Management.
3. From Computer Management, click Disk Management from the right column.

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FIGURE 3. Computer Management Screen

4. Be sure the drive letters labeling is correct. If drive letters are correct, skip the
following steps, and continue preparation of the system.
5. Right-click on the D: drive and choose Change Drive Letter and Paths….

FIGURE 4. Change Drive Letter Options

6. Click Change and assign any new drive letter for the drive.
7. Click OK.

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FIGURE 5. Change Drive Letter Window

8. Continue to change drive letters until the CD-ROM drive is set to D:, the patient
storage drive is set to E:, and the pagefile drive is F:.

Licensing Vitrea

Overview Vital Images offers two main types of licenses:

• Static licenses that are designated for one workstation

• Floating licenses that can ‘float’ between workstations. Floating licenses also
have the ability to ‘float’ certain software options between workstations.

NOTE: All license files can be obtained through emailing or faxing the Vital Images
License Request Form to Vital Images Licensing Group. This form is located in
Appendix A of this guide. Please contact Vital Images Support with any questions
regarding the process. See Contact Us.

See the Licensing Group Contact Information and Request form.

Entering a Static 1. After you receive your license.dat file, copy the license.dat file onto the Vitrea
License workstation.
2. Copy the file into C:\flexlm folder. Create this folder if it does not exist.

NOTE: Examine the file to be sure it is correct. Open the file through
Wordpad. Check the options purchased and physical address are correct.

Understanding Vitrea’s concurrent license scheme allows Vitrea you float the software and its
Concurrent (Floating) options between Vitrea access points. In this scheme, a license server grants and
Licensing denies license requests from the access points. All access points must have
network connectivity to the server and the same license file for the process to
function.

Floating License Setup NOTE: Because of the nature of the floating license scheme, we recommend you
Instructions install the Floating License Service on a non-Vitrea machine such as a server that

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remains on at all times. If no suitable server exists, this service can be installed
on a Vitrea workstation.

CAUTION: If the License Server is shut down or taken off the network, Vitrea
workstations will be unable to obtain a license file until network connectivity
is restored.

To Setup a Floating License Server:

The following files were sent in the email containing the license file. The files also
can be requested through license@vitalimages.com or found in C:\Program
Files\Vital Images\Vitrea\bin on a workstation with Vitrea installed.

• InstallLicenseManager.exe
• Lmgrd.exe
• Vital.exe
• Lmtools.exe
1. Place the required floating license files and the license.dat into C:\flexlm
folder of the server where the floating license service will reside. Create this
folder if it does not exist.

FIGURE 6. FlexLM Folder

2. Click InstallLicenseManager.exe to launch the License Manager Utility and

check to ensure the first three fields have the correct extension and point to
the correct folder.
3. Click Install and then verify that the Status confirms that the service has been
installed successfully.

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FIGURE 7. License Manager Installation

4. Copy the same license.dat file from C:\flexlm to all the Vitrea workstations that
will use the license server. If the license file is adjusted to accommodate
additional license options, it needs to be adjusted on the Server.

NOTE: You may want to examine the file to ensure it is correct. Open the
file through the program Wordpad. Check to ensure the options
purchased and physical address and IP address of the server are correct.

Query the Floating You may want to query the License Manager to see what licenses are checked out
License Manager at any given time. The following steps may be performed on either the License
server or any Vitrea workstation that is part of the floating license configuration.

NOTE: At any time, you can click the Perform Status Enquiry to see what licenses
are checked out and how many licenses are available. If a discrepancy occurs,
use the Start/Stop/Reread tab to restart the service or re-read a recently adjusted
license file.

To Query the Floating License Manager:

1. Open the C:\FlexLM folder on the server or C:\Program Files\Vital
Images\Vitrea\bin on a Vitrea workstation.
2. Double-click lmtools.exe.
3. On the Service/License File tab, click Configuration using License File.

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FIGURE 8. LMTOOLS Service/License File WIndow

4. Browse to C:\FlexLM and open license.dat.

5. On the Server Status tab, click Perform Status Enquiry.
6. The total number of each licenses for each option will appear. Any checked out
licenses will be listed by the Computer name.

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FIGURE 9. LMTOOLS Server Status

FIGURE 10. LMTOOLS Server Status Total Options

Installing Vitrea Software

Vitrea Software Installation instructions are sent out as part of the new software
or software upgrade package.

NOTE: For more information on troubleshooting software installation, see the

Troubleshooting chapter.

Registering and Authorizing Vitrea Software

Installation of new Vitrea software requires registering the software.

To Register Vitrea Software:

1. From the Start menu, click All Programs I Start Vitrea to launch the software
program. The Welcome to the Vitrea Software registration window displays.

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FIGURE 11. Vitrea Software License Agreement

2. On the back of your Vitrea Software CD case, locate the serial number. Enter
the ten digit number into the Serial Number textbox in the registration
window.
3. Read the agreement and select ‘Accept’ to continue.
A Congratulations message is displayed.
4. Click OK.

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FIGURE 12. Completed Registration

The registration process is now complete

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DICOM Devices and Postscript Printers

This chapter contains the following information:

• Introducing DICOM
• Understanding VICommunicator
• Adding DICOM Devices
• Configuring PACS in Vitrea
• Setting Up Vitrea to Vitrea (V2V) Connectivity
• Adding ViTALConnect Entries
• Configuring Printers
• Understanding SmartQuery
• Importing and Exporting the DICOM Device List

Introducing DICOM

Overview The Radiology field and its vendors use a standard of communication between
their devices. This standard is Digital Imaging and Communication in Medicine
(DICOM). Common DICOM devices and some of the DICOM features are explained
in this section.

NOTE: The Vitrea Workstation can build 3D images with CT or MR modalities only.
Modalities like US, NM, PT, CR, DR, RF, VL, and RT can be viewed in 2D mode using
Vital Image’s Study Viewer tool.

Throughout the entire workflow of scanning a patient, reading and diagnosing the
scan, printing reports, and saving the patient data, large amounts of data get
transferred through the site’s network. The transfers between any DICOM devices
require the DICOM standard. The DICOM standard uses a set of functions that
allow permissions for one device to receive or send data.

When two DICOM devices transfer data, the connection is called an association.
The association is created when the two devices grant permission to share
information and with the other device. For an Association to take place, each
device will share three pieces of information with the other device. The following
pieces of information are needed for an association:

• IP Address
• Port Number
• Application Entity (AE Title)

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After the Association takes place, the two devices are able to send and receive
commands. Print, Store, Query and Move are some of the more common
commands used in DICOM. Before the command, the terms SCP or SCU are listed.
Each device can then determine whether it is the device doing the action or the
device asking for an action. The Service Class Provider (SCP) is the device doing
the action. The Service Class User (SCU) is the device asking for an action to take
place.

NOTE: The process of sending data and tasks within DICOM devices is a cause for
many Support Issues. A strong understanding of DICOM terms and procedures
will lead to successful setup and troubleshooting of DICOM devices.

Common Terms The DICOM standard is a difficult concept to comprehend. Brief descriptions of
these terms provide you with an understanding of the DICOM standard. The
following list contains common DICOM terms and a brief definition:

• Alias– The Alias field serves as a descriptor of the AE Title and how DICOM
entries in VICommunicator display in Vitrea. An alias is required to be unique.
• AE Title (Application Entity) – The DICOM term for defining a particular
software application which resides at a particular IP address. AE Titles are not
required to be unique, but it is highly desirable.
• Archive – a computer database for storing images and patient demographic
information.
• Association – A DICOM term for a communication context that is used by two
Application Entities to communicate with another.
• Association Negotiation – The handshaking of information that occurs
between two DICOM Application Entities.
• Called (Receiving) AE Title – The name used by the sender in DICOM protocol
to indicate which Application Entity it wants to transmit its data to. It is also
the AE that is receiving the transfer.
• Calling (Requesting) AE Title – The name used by the receiver in DICOM
protocol to indicate which Application Entity it received the data from. It is
also the AE that is initiating the transfer.
• Conformance Statement – A document whose organization and content are
mandated by the DICOM Standard, which allows vendors to communicate
how they have chosen to comply with the Standard in their implementations.

NOTE: Vital Image’s DICOM Conformance Statement is available for viewing at

http://www.vitalimages.com/products/DICOM-conformance.aspx
• Digital Imaging and Communication in Medicine (DICOM) – Medical Industry
Standard allows inter operation of different imaging modalities.
• Film Box – A normalized information object that is the DICOM name for the
equivalent of a printed “sheet”.
• Film session – A normalized information object that is the DICOM name for
the equivalent of a printed “study” or “series”.

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• Picture Archiving and Communications Systems (PACS) – The medical

industry standard for transferal of radiological images and other medical
information between computers.
• Print Job – A request to perform a print service containing all the necessary
information.
• Protocol Data Unit (PDU) – A data object that is exchanged by protocol
machines (entities) within a given layer of the protocol stack. Its size is
usually negotiated between the sender and receiver of the data object.
• Service Class – A structure description of an activity performed, e.g., storage,
printing, etc.
• Service Class Provider (SCP, Provider, Server) – A device that provides
services used by another device. A supplier of services. A server of clients.
• Service Class User (SCU, User, Client) – A device that uses services provided
by another device. A customer of services. A client of a server.
• Service Object Pair (SOP) – SOP class is a set of services that can be
performed on a specific information object.
• Transfer Syntax – The way that the Value Representation (VR) of data
elements is presented and the encoding is performed.
• Worklist – A Worklist is the structure to present information related to a
particular set of tasks. It specifies particular details for each task. The
information supports the selection of the task to be performed first, and
supports the performance of that task.
• Value Representation (VR) – The attribute value.

Understanding VICommunicator

Overview VICommunicator is a Windows service that Vitrea software uses for DICOM
communications. VICommunicator is accessible through an interface that allows
you to manage DICOM entries, customize the autodelete function, and rebuild the
patient database.

Testing the The VICommunicator service has a Graphical User Interface (GUI) that is installed
Functionality of with the software. The service can be stopped and started through either the GUI
VICommunicator or Windows Services.

To test the VICommunicator service:

1. Double-click on the small blue “V” icon on the toolbar (in the bottom right
corner of the screen) to launch the VICommunicator window.

OR

Run ecfadmin from the Run window.

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FIGURE 1. ECFAdmin Command Box

The VI Communicator window opens.

2. Click Test.

FIGURE 2. VI Communicator Test

Restarting Verify that the VICommunicator test response indicates “Running”. If the test bar
VICommunicator indicates “Not running”, restart the ViCommunicator.

To restart the VICommunicator:

1. From the Start menu, select Control Panel I Administrative tools I Services.
2. Restart VIServices.
VIServices starts VICommunicator.
3. Make sure the blue “V” is on the task bar, and verify that VICommunicator is
now running.

NOTE: If the service fails to start, see the Troubleshooting chapter in this manual.

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Adding DICOM Devices

Overview DICOM Printers, PACS, and other Vitrea workstations can be configured for
communication. VICommunicator uses wizards to set up these devices. It is also
possible to make customizations and change printer settings in VICommunicator.

Testing DICOM DICOM devices connect through a connection known as an association. The
Connectivity association can only take place after three pieces of information are exchanged.
The DICOM device’s IP Address, Port Number, and AE title are needed for an
association to occur. Often times one of these three pieces of information are
incorrect. Vitrea software includes commands to test the validity of the
information.

To test a DICOM association:

1. Double-click the small blue “V” icon on the toolbar (in the bottom right corner
of the screen) to launch VICommunicator window.

OR

Enter ecfadmin in the Run window.

2. Click DICOM.
3. On the Diagnostics tab, select the device to be queried from the Device:
dropdown list.
4. Double-click ECHO from the Services: window.
When the information is correct, the message Response: OK displays in the
Messages window. If the information is incorrect, the message Unable to
create association displays.
If the Operation is not successful, ping the device you are trying to reach and
check the validity of the AE title and Port Number you entered.

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FIGURE 3. ViCommunicator Diagnostics tab

Sending Images to the Vital Image’s DICOM Conformance statement outlines the image types the Vitrea
Vitrea workstation has the ability to store. Vitrea Software will receive DICOM images
without the sending device being added to the software. There is no entry needed
for any Scanners or PACS that are sending to Vitrea. By default, Vitrea software is
configured to receive only the following Storage Classes: CT, MR, and Secondary
Capture (SC). Other Storage Classes need to be manually added in
VICommunicator.

Extended Storage To add extended Storage Classes:

Classes 1. Double-click the small blue “V” icon on the toolbar (in the bottom right corner
of the screen) to launch VICommunicator window.

OR

Enter ecfadmin in the Run window.

2. Click DICOM.
3. On the Config tab, select the Local entry.

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4. Click Edit to edit Vitrea’s local AETitle information.

5. Click Storage Options to select Storage Classes.
6. Select the Storage Classes boxes for local Vitrea. If no checkboxes are
selected, Vitrea will only receive images of Standard Storage Classes (CT, MR,
SC). Check all four Standard Storage Classes before any Extended Storage
Classes. Vital Images does not limit the number of Extended Storage Classes
selected.

NOTE: The Presentation State (PR) option is unavailable on the Local, QRServer,
and Store Commit entries.

FIGURE 4. VICommunicator Storage Options Selections

7. Click OK.
8. Close the DICOM Server Edit window and VICommunicator.

NOTE: Each Storage Class entry lists its number of items. VICommunicator limits
the total number of combinations (multiply the total number of items by number
of syntaxes) of storage classes and transfer syntaxes to 127. If this combination
number is exceeded, an error message is displayed. Uncheck either a transfer
syntax option or limit the number storage classes to continue. The Transfer Syntax
can be configured through clicking the Transfer Options button next to Storage
Options on the DICOM Server Edit screen in Vitrea.

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FIGURE 5. Storage and Transfer Options Error

Configuring Vitrea’s The Vitrea default DICOM settings are VITREA1 for the AETitle and Port 3002. Both
DICOM Settings of these settings are customizable, but we recommend you set the Port at 3002.

To change the local Vitrea AETitle:

1. Close Vitrea if it is open.
2. Double-click the small blue “V” icon on the toolbar (in the bottom right corner
of the screen) to launch VICommunicator window.

OR

Enter ecfadmin in the Run window.

3. Click DICOM.
4. On the Config tab, select the Local entry.
5. Click Edit to edit Vitrea’s local AETitle information.
6. Edit the AETitle or Port text boxes.
7. Click OK.
8. Close the DICOM Server Edit window and VICommunicator.

Turning on the Multi- You can configure Vitrea to accept multi-frame CT or MR images.
frame Option in Vitrea
To turn on the multi-frame option:
1. Close Vitrea if it is open.
2. Double-click the small blue “V” icon on the toolbar (in the bottom right corner
of the screen) to launch VICommunicator window.

OR

Enter ecfadmin in the Run window.

3. Click DICOM.
4. On the Config tab, select the Local entry.
5. Click Edit to edit Vitrea’s local AETitle information.
6. Click Storage Options to select Storage Classes.

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7. Check the Multi-frame Computed Tomography (CTMF) and Multi-frame

Magnetic Resonance (MRMF) boxes.
8. Click OK.
9. Close the DICOM Server Edit window and VICommunicator.

Configuring PACS in Vitrea

Vitrea sends to and queries/retrieves from PACS (Picture Archiving
Communication System). Set up the Vitrea configuration information as a DICOM
entry on the PACS so that query/retrieve functions properly.

Be sure you have the following information before you begin:

• AE Title
• IP address
• Port number of the PACS

To add a PACS entry:

1. Close Vitrea if it is open.
2. Double-click the small blue “V” icon on the toolbar (in the bottom right corner
of the screen) to launch VICommunicator window.

OR

Enter ecfadmin in the Run window.

3. Click DICOM.
4. On the Config tab, select the Local entry.
5. Click New to add the New PACS entry.
The DICOM Wizard displays.

FIGURE 6. DICOMWizard Archive Server Entry

6. Select Archive Server.

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7. Click Next.
8. On the Archive Configuration screen, click Yes to setup query and retrieve of
the PACS.
9. Enter the information in the Alias, Host, AE Title, and Port fields.
The Alias field is how the entry will display in the software.
10. Click Finish to continue.
11. Close VICommunicator.
The setup of the PACS is complete.
12. Start Vitrea software to test.

Setting Up Vitrea to Vitrea (V2V) Connectivity

Vitrea to Vitrea (V2V) allows two (or more) Vitrea workstations to share patient
studies, workflows, and reports. The process can be used for more than two
Vitrea workstations if none of the Vitrea workstations share the same AE title.
Network communication between the Vitrea workstations needs to take place for
Vitrea to Vitrea to function. Vitrea to Vitrea connections are composed of a query
request, a move request, and finally an export. The query function operates on
port 3003 and the storage and move functions operate on port 3002. There will be
two entries per Vitrea connection on each Vitrea workstation.

NOTE: This example uses the AE titles of VITREA1 and VITREA2 and 192.168.1.1
and 192.168.1.2 for the IP addresses.

To set up a Vitrea to Vitrea Connection:

1. Close Vitrea if it is open.
2. Double-click the small blue “V” icon on the toolbar (in the bottom right corner
of the screen) to launch VICommunicator window.

OR

Enter ecfadmin in the Run window.

3. Click DICOM.
4. On the Config tab, verify there is an entry with an alias of Local and one with
QRServer.

NOTE: Vital Images recommends you edit the AETitle of QRServer to include the
Local AETitle + SERVER. (Example: If the Local AETitle is VITREA1, the AETitle for
the QRServer would be changed to VITREA1SERVER)
5. Click New to add the first Vitrea entry.
The DICOM Wizard displays.

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FIGURE 7. DICOMWizard Another Vitrea Entry

6. Select Another Vitrea.

7. Click Next to continue.
The V2V Setup window displays.
8. Select Archive Server.
9. Click Next.
The DICOM Node Entry Window displays. The value 3002 will display in the
port field (the default port of Vitrea).

FIGURE 8. DICOMWizard Node Entry Window

10. Enter Vitrea2Export in the Alias field, and then enter the AE Title and IP
address of Vitrea2.
11. Click Finish.
12. Click New to add the first Vitrea Query entry.
The DICOM Wizard displays.
13. Select Another Vitrea.
14. Click Next to continue.
The V2V Setup window displays.
15. Select Query Server.

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16. Click Next.

The DICOM Node Entry Window displays. The value 3003 will display in the
port field (the default querying port of Vitrea).

FIGURE 9. DICOMWizard Node Entry Window

17. Enter in Vitrea2Query in the Alias window and VITREA2SERVER for the
AE Title textbox.
18. Enter the IP Address of Vitrea2.
19. Click Finish.

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FIGURE 10. VICommunicator Config Tab of Vitrea1 Setup for Vitrea to Vitrea

20. Repeat steps 6 through 19 on Vitrea2 while reversing the necessary

information (AE Titles, Alias, and IP Titles).

NOTE: Remember that two entries (One Archive and one Query Server)
need to be added on each Vitrea for each additional Vitrea node. These
steps can be repeated to add as many Vitrea entries as desired.
21. Once completed, test the query function.
22. Start the Vitrea software.
23. Select the Vitrea2 Server tab on the Vitrea1 Study Directory tab to access the
patient list of Vitrea2.

FIGURE 11. Vitrea2Query tab shown on the Study Directory tab

24. Select the desired patient case and click Retrieve to test.

If the cases import into the local study directory, the retrieve function is
working properly.

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Adding VitreaWeb Entries

VitreaWeb connections are set up in VICommunicator in a similar process to
setting up Vitrea to Vitrea. Two entries will need to be added into VICommunicator
for the VitreaWeb; one entry used to export to and one entry for query/retrieve.
Similar to Vitrea, the query function operates on port 3003 and the storage and
move functions operate on port 3002.

To add the VitreaWeb Entries:

1. Close Vitrea if it is open.
2. Double-click the small blue “V” icon on the toolbar (in the bottom right corner
of the screen) to launch VICommunicator window.

OR

Enter ecfadmin in the Run window.

3. Click DICOM.
4. On the Config tab, verify there is an entry with an alias of Local and one with
QRServer.
5. Click New to add the first Vitrea entry.
The DICOM Wizard displays.
6. Select Another Vitrea.

FIGURE 12. DICOMWizard Another Vitrea Entry

7. Click Next to continue.

The V2V Setup window displays.
8. Select Archive Server.
9. Click Next.

The DICOM Node Entry Window displays. The value 3002 will display in the
port field (the default port of Vitrea).

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FIGURE 13. DICOMWizard Node Entry Window

10. Enter ViTALConnect in the Alias field, and then enter the AE Title and IP
address of ViTALConnect.
11. Click Finish.
12. Highlight the newly created ViTALConnect entry and click Edit.

The DICOM Server Edit Window displays.

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FIGURE 14. DICOM Server Edit Window

13. Select ViTALConnect from the Type dropdown list.

14. Click Save.
15. Click New to add the ViTALConnectQuery entry.
The DICOM Wizard displays.
16. Select Another Vitrea.
17. Click Next to continue.
The V2V Setup window displays.
18. Select Query Server.
19. Click Next.
The DICOM Node Entry Window displays. The value 3003 will display in the
port field (the default querying port of Vitrea).

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FIGURE 15. DICOMWizard Node Entry Window

20. Enter the IP address and AETitle of the ViTALConnect Query. Enter
ViTALConnectQuery in the Alias window.
21. Click Finish.
22. Highlight the newly created ViTALConnect entry and click Edit.

The DICOM Server Edit Window displays.

23. Select ViTALConnect_QR from the Type dropdown list.
24. Click Save.
25. Once complete, test the export function.
26. Start the Vitrea software.
a Take a snapshot.
b Navigate to the Report tab.
c Export using the ViTALConnect button instead of the Export button.
27. A DICOM Export complete message displays if the Export takes place
successfully.

Configuring Printers

Configuring DICOM To add a DICOM Printer entry:

Printers 1. Close Vitrea if it is open.
2. Double-click the small blue “V” icon on the toolbar (in the bottom right corner
of the screen) to launch VICommunicator window.

OR

Enter ecfadmin in the Run window.

3. Click DICOM.
4. On the Config tab, select the Local entry.

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5. Click New to add the new DICOM Printer entry.

The DICOM Wizard displays.

FIGURE 16. DICOMWizard DICOM Printer Entry

6. Select DICOM Printer, then click Next.

7. Click Yes to accept the default printer settings, then click Next to continue.
8. Enter information in the Alias, Host, AE Title, and Port fields.
9. Click Finish.

FIGURE 17. DICOMWizard Node Entry Window

After saving the new entry, the VI Communicator Admin screen displays.
10. Select the Printer Config tab to verify the printer’s properties.

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FIGURE 18. ViCommunicator DICOM Printer Config Tab

11. Select the appropriate printer under the Printer: drop-down arrow.
12. Click OK.

NOTE: The default settings will work for most printers, you may need to make
changes in some cases. DICOM Printer’s configuration settings will be listed in
the DICOM Conformance statement of the printer.
13. Close VICommunicator.
The setup of the PACS is complete.
14. Start Vitrea to test.

Installing Postscript Vitrea Software versions 4.0 and higher support all Windows printers. The
Printers printing is done through Internet Explorer and printers do not require postscript
drivers.

rUnderstanding SmartQuery

Using the SmartQuery The SmartQuery option does not require any configuration from an administrator.
Option The tool allows a user to SmartQuery by right-clicking on the patient name and
choosing Find Similar Studies or click the SmartQuery tab from the Vitrea Study
Directory tab. The software will then query the selected server through the Patient
ID field and/or the Patient Last name and Date of Birth.

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NOTE: If a server does not appear as an option for the user to query, the
administrator may need to add query rights (SCP CFind) to an existing PACS entry
in VICommunicator for this function to work.

To add query rights to a PACS entry:

1. Close Vitrea if it is open.
2. Double-click the small blue “V” icon on the toolbar (in the bottom right corner
of the screen) to launch VICommunicator window.

OR

Enter ecfadmin in the Run window.

3. Click DICOM.
4. On the Config tab, double-click the entry for PACS.
The DICOM Server Edit window opens for the PACS entry.
5. Under Possible Services, highlight the SCP CFind option and move it to the
Selected Services.
6. Click Save.
7. Close VICommunicator and open Vitrea.

Importing and Exporting the DICOM Device List

In software versions 3.9 and higher, the DICOM Device list and Printer
Configurations are located in tables in the MYSQL database. In previous versions
of the software, these lists were located in the ECFConfiguration.xml and
PrintDefaults.xml files administrators backed up and restored. The following
steps allow the administrator to restore this function and save the DICOM and
printer configurations information entered in VICommunicator into the
ECFConfiguration.xml file.

Reading the To Read the ECFConfiguration.xml:

ECFConfiguration.xml 1. Browse to C:\Program Files\Vital Images\Components\config folder.
Document
Windows x64 users will browse to C:\Program Files (x86)\Vital
Images\Components\config folder.
2. Right-click the ECFConfiguration.xml file and select Edit.

NOTE: An XML Notepad software will open. If the Edit option is unavailable, the
administrator will need to install an XML Notepad viewing program.

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FIGURE 19. Config Folder

3. Expand the DICOM folder if it is present The entries in the DICOM folder align
with the folders in the DICOM section of VICommunicator. If DICOM entries
are not listed, export the entries from the VICommunicator into the ECF
Configuration file using the steps below.

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FIGURE 20. ECFConfiguration.xml File with DICOM Entries

Exporting the DICOM To Export (Save) DICOM Devices and Printer Configurations into ECFConfigura-
Device list into the tion.xml:
ECFConfiguration.xml
If the ECFConfiguration.xml file does not include a DICOM entries, it is possible to
export this information into the document.
1. Close Vitrea if it is open.
2. Double-click the small blue “V” icon on the toolbar (in the bottom right corner
of the screen) to launch VICommunicator window.

OR

Enter ecfadmin in the Run window.

3. Click DICOM.
4. On the Config tab, click the Export button.

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FIGURE 21. VICommunicator DICOM Config Tab

An Open Window displays.

5. Browse to C:\Program Files\Vital Images\Components\config folder.
Windows x64 users will browse to C:\Program Files (x86)\Vital
Images\Components\config folder.
6. Highlight the ECFConfiguration.xml document and click Open.
The DICOM devices and printer configurations will now be listed in the
ECFConfiguration file.

To Import (Restore) DICOM Devices from a ECFConfiguration.xml:

The DICOM device list can be restored from any ECFConfiguration.xml file that
contains the DICOM devices. This includes ECFConfiguration.xml files from 3.9
software that has been exported or any ECFConfiguration.xml files from 3.8.x
software or earlier.

CAUTION: The Import Tool will clear what is existing in VICommunicator and
replace those entries with the entries from the ECFConifiguration.xml file that

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is selected. Ensure the ECF Configuration document that you use contains the
appropriate entries. To view the contents of a ECF Configuration, see Reading
the ECFConfiguration.xml section in this chapter.
1. Close Vitrea if it is open.
2. Double-click the small blue “V” icon on the toolbar (in the bottom right corner
of the screen) to launch VICommunicator window.

OR

Enter ecfadmin in the Run window.

3. Click DICOM.
4. On the Config tab, click the Import button.
The Configuration Import Warning displays.

FIGURE 22. Configuration Import Warning

5. If you select Cancel or close the warning box, no changes will take and you will
return to VICommunicator.
If you choose OK, the existing DICOM entries in VICommunicator will be
deleted from the database.
An Open file window displays.
6. Browse to the location of the ECFConfiguration.xml that contains the desired
DICOM settings. Select the file and click Open to restore these settings.

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Learning Basic Vitrea Operations

This chapter contains information on basic Vitrea operations.

Learning Basic Vitrea Operations

This guide provides the basic functions and how to access the system, which is
convenient for the administrator. A basic understanding of operating Vitrea
software is necessary for the customization of Vitrea functions and reports.

CAUTION: This tutorial should be used for administrator’s use only.

Individuals who will be using Vitrea clinically should use the Basic Vitrea User
Guide. A Vitrea Quick Reference Guide card was sent from Vital Images with
Vitrea software. The Quick Reference Guide card serves as an excellent
teaching tool for learning Vitrea. Both these guides, plus all other Vitrea User
Guides, are available on the Help tab.

To start Vitrea:
1. If the Welcome to Windows dialog box displays, press and hold CTRL-ALT-
DELETE.
The Log On to Windows dialog box displays.
2. Enter administrator for the user name. The default password is vital$.
3. Press ENTER.
4. Perform the steps below to manually start Vitrea software:
From the Start menu, select Programs I Vital Images I Start Vitrea.
Vitrea’s Study Directory Displays.

Vitrea’s workflow uses the Study Directory, Gallery, Viewer (visual, analysis and
batch), Report, Review, and Help tabs at the bottom of the Vitrea Software
window. The workflow moves left to right.

Study Directory Vitrea initially opens to the Study Directory. The Study Directory shows the list of
patients that have been sent to Vitrea. From here, you can query and retrieve
studies, archive studies, export studies, lock cases, and delete studies from the
Patient List. Right-click on a study to display the options of deleting, archiving
(cd/dvd burning), locking, and exporting. The query and retrieve function will
display in the bottom portion of the window if this option has been set up.

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FIGURE 23. Study Directory showing Vitrea Workflow Tabs

To load a patient study:

1. In the patient list, click the study to select it.

NOTE: You can expand the study listing to display the individual volumes
to load.
2. Click Load Volume(s).
OR

Right-click the study and select Load in Vitrea.

A message in the status bar indicates Vitrea is loading the volume(s). When
the volume(s) are loaded, the Gallery window displays.

The Gallery window The Gallery window displays up to six preset viewing settings. The settings will
vary depending on the options purchased for the system and on the type of study.

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FIGURE 24. Gallery Window

To select a protocol and preset:

1. Select a protocol name from the Protocol list.
The preset vies change to reflect the protocol selected.
2. Click Pick for the desired preset.
The Viewer window displays.

The Viewer Window The Viewer window is the main working area in Vitrea. After you select a preset in
the Gallery window, it displays images based on the specified protocol and
preset.

Different sets of tools are available on the Visual, Analysis, and Batch tabs.

For administrative purposes, the snapshot button is a helpful function. The

snapshot button takes an image of a 2D or 3D image that can be placed into a
report or than can be used to restore a workflow.

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FIGURE 25. Viewer Window and Snapshot Button

To save an image:
1. Click Snap, or press S.
The cursor changes to look like a camera.
2. Click the image you want to save.
The image is saved to the Choose Images area on the Report window.
The snapshot also serves as a save point that can be restored from the Study
Directory.

The Report Window The Report window allows you to export reports to a CD, PACS, Word Report,
another Vitrea, or ViTALConnect.

The Choose Images area thumbnails representing snapshots, batch images, and
digital movies that were created in the Viewer window.

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FIGURE 26. Report Window

To create a report to print or post:

1. Drag and drop a thumbnail from the Choose Images area into one of the image
frames in the report.
2. Do any of the following:
• To print images, click Print.
• To create a Word report, click Word Report.
• To archive a report to CD or DVD, insert a blank CD or DVD in the drive,
then click Burn CD/DVD.
• To export the report to a DICOM server, click DICOM Export.
• To export the report to a ViTALConnect server, click ViTALConnect.

The Review Window The Review window is a web server that runs on the Vitrea workstation. Any
images that are Intranet Posted from the Report tab can be accessed through the
web server. Computers on the same network can read this page when you enter IP
address of the Vitrea in an Internet Explorer window. You can password-protect
the web server.

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FIGURE 27. Review Window

The Help Window The Help window lists links to all Vitrea User Guides in .pdf format.

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FIGURE 28. Help Tab

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Vitrea Customization
This chapter contains the following information:

• Customizing Vitrea Burned CDs

• Modifying the Apache Web Server Properties
• Understanding Modified Presets and Protocols
• Changing Compression Settings
• Customizing Reports

Customizing Vitrea Burned CDs

Vital Images allows administrators access to the HTML documents that are used
in a burned Vitrea report CD.

NOTE: Vital Images Support will provide assistance in locating the necessary files,
but will not be responsible for writing or customizing the HTML pages.

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FIGURE 29. Default Report CD Screen

CAUTION: Vital Images recommends you save a backup of the files that are
altered.

To change the default CD report:

NOTE: It is possible to burn CDs from two locations in Vitrea software: the Study
Directory and Report windows. The following changes will only be applied to CDs
burned from the Report window.
1. Browse to C:\Program Files\Vital Images\Vitrea\config\ReportCD.

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FIGURE 30. Vitrea\config\ReportCD Folder

2. Copy any necessary images, such as logo graphics, into the images folder and
any flash files into the flash folder.

NOTE: Vital Images recommends you only make text and logo changes. It
is possible to make other changes to the HTML documents, however,
these changes will not be supported by Vital Images Support.
3. Resize the images you copied to 249 by 45 pixels.
4. Open bottom.html in Wordpad or Notepad.
5. Change the following line to reference the image you copied:
<TD WIDTH="252" ALIGN="right"><img src="images/
vitallogo.gif" width="249" height="45"></TD>
Optional. If 249 X 45 pixels are not satisfactory dimensions for your logo,
change the “width” and “height” appropriately.

NOTE: We recommend that you set the height of your image to a value of
less than 50 pixels.
6. Open top.html in Wordpad or Notepad.
7. Change the following line to reference the image you copied:
<TD VALIGN="top" WIDTH=140><IMG SRC="images/logo.gif"
WIDTH=60 HEIGHT=52 BORDER=0 VSPACE=4 HSPACE=36></TD>
Optional. Change the “width” and “height” appropriately.
8. Open body.html in Wordpad or Notepad.
9. Enter changes to the following line to reference your facility’s website URL and
name:

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<font face="arial, verdana, sans-serif" size="2"

class="copy" color="#9d2524"><b><a href="http://
www.vitalimages.com">link to your website</a></b></
font>
10. Open index.html to view the changes.

Modifying the Apache Web Server Properties

Vital Images runs an Apache Web server to display reports throughout the site’s
intranet.

Select the Review tab in Vitrea software to access the Web Server.

Enabling Password By default, the Web server is not password protected, but you can enable
Protection password protection. The Web server’s default username is vitrea and the
password is vitrea.

To enable password protection:

1. From the Start menu, select Run.
2. Enter cmd in the textbox to open a Command Prompt Window.
3. Browse to C:\Program Files\Apache Group\Apache\cgi-bin.

FIGURE 31. Apache cgi-bin folder.

4. Enter rename.htaccess.default.htaccess to
rename.htaccess.default to.htaccess.

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FIGURE 32. htaccess Command Line Change.TIF

The user is prompted to enter a username and password in order to access

the Web server.

FIGURE 33. Review Tab Authorization Window

Adding Multiple Vitrea The Apache Web Server displays any intranet posted reports on the local server.
Workstations to the The Web server also displays the reports of other Vitrea workstations on the
Web Server intranet.

To add multiple Vitrea workstations to the Web server:

1. Browse to C:\Program Files\Apache Group\Apache\cgi-lib.

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FIGURE 34. Apache\cgi-lib folder

2. Open VitreaStations.xml in Wordpad or Notepad.

FIGURE 35. Default VitreaStations.xml

3. Change the field localhost to the IP address of the Vitrea you are working on.
4. Copy and paste the third line of the text (<station name="VITREA1"
ip="localhost" />) on the subsequent line.
5. In the newly copied line, change the station name and IP fields with
information from another workstation.
6. Repeat step 5 until all Vitrea workstations are added.

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FIGURE 36. Modified Vitrea Stations xml

7. Test changes by querying the newly added Vitrea on the Review page of the
local system.

FIGURE 37. Review Tab with Multiple Vitreas

Understanding Modified Presets and Protocols

On the Gallery tab, Vitrea displays up to six viewer settings called presets. These
preset files can be altered to create modified presets. Vitrea software allows
users to toggle between the original presets and a set of modified presets. Users
may want to copy these modified presets to other Vitrea workstations or have the
files saved as backup.

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FIGURE 38. Gallery Tab Screen

Saving Modified Saving modified presets allows administrators to backup configuration settings
Presets for users as well as for faster configuration of new settings.

To save a modified preset’s settings:

1. Log onto the system with administrative rights.
2. Browse to C:\Program Files\Vital Images\Vitrea\config.
3. Backup any preset files that contain an underscore character.

NOTE: Modified presets can also be deleted from this location.

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FIGURE 39. Modified Preset File Example

Changing the Default Vitrea will automatically select specific protocols through a process that matches
Protocol the Study Description field to standard Vitrea protocols.

NOTE: Protocols are default views that are provided on the Gallery tab in Vitrea.
Certain protocols are a purchased option.

FIGURE 40. Protocols on the Gallery Tab

The software code provides a document named “base.selector” that correlates

study descriptions to protocols in Vitrea. You can create an additional file named
“custom.selector” that supersedes the base.selector. Custom.selector are
created in two ways.

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To create a user-defined custom.selector:

• At the Always select (user selected protocol) for (Study Description field)?
prompt, click Yes.

NOTE: This prompt displays when a user chooses a protocol that is not
the default selection for the study description.

FIGURE 41. Custom Protocol Selection Screen

To create an administrator-defined custom.selector:

1. Log onto the system with administrative rights.
2. Browse to C:\Program Files\Vital Images\Vitrea\config.
3. Open custom.selector with Wordpad or Notepad.
4. To remove any settings the users do not want, delete the brackets,
protocol_selector_table, selector, and protocol lines from the document.

NOTE: If the users do not want any of the automatic selections listed,
delete the entire custom.selector file.

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FIGURE 42. Custom.Selector File

CAUTION: Do not modify the base.selector file. Alterations should be made

only in custom.selector

FIGURE 43. Base.Selector File

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Changing Compression Settings

Vitrea supports Lossless Image Compression. This compression setting allows for
more images to be stored on the hard drive or burned to CD. It is important to
verify that JPEG 2000 Image Compression (Lossless Only) is compatible with
other DICOM devices in your workflow. Review the DICOM Conformance statement
of devices in the workflow to check the compatibility of compression before
proceeding.

CAUTION: The R2 ImageChecker CT and Fusion 7D options will not return

results of compressed images. If the Vitrea system uses these options, turn
off all compression settings.

To change compression settings:

1. Close Vitrea if it is open.
2. Browse to the C:\Program Files\Vital Images\Components\Config folder.

FIGURE 44. Vital Images\Components\Config Folder

3. Right-click ECFConfiguration.xml and select Edit.

The file opens in XML Notepad.
The ECFConfiguration.xml file is divided into two columns: Structure and
Values. The Structure column is located on the left side of the editor and has
a folder tree.
4. Expand the DICOM folder and the Options folder.
There are four values of compression in the Options folder. The settings
include:
• Two settings for image storage for Vitrea
• One setting for CD/DVD burning
• One setting for DICOM export.

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FIGURE 45. ECFConfiguration Compression Settings

5. Change the CDRCompression attribute value to Yes.

This turns on compression for images burned to CD.
6. Change the CompressOutgoingImages attribute value to Yes.
This turns on compression for exported images.
7. Change the CompressIncomingImages attribute value to Yes.
This turns on compression for images that are sent to the Vitrea
uncompressed.
8. Change the DecompressIncomingImages attribute value to No.
This keeps compression for images that are sent to the Vitrea compressed.

Customizing Reports
Vital Images’ Report Page has been changed in Vitrea version 4.0. The new
Reports Tab allows users to add in their own icons.

CAUTION: Word Reports cannot be customized in Vitrea version 4.0 and

higher.

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To Add New Logos to the Report Tab

1. Open Vitrea if the software is not open.
2. Navigate to the Report Tab. It may be necessary to load a case and protocol to
activate the Report Tab.
3. Double click the Vital Images logo.
4. Browse to the desired logo file.
5. Click the Import button.

FIGURE 46. Report Import Icon

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System Maintenance
This chapter contains the following information and instructions:

• Disk Defragmentation
• Software Upgrades
• Configuring Autodelete

Disk Defragmentation
Vital Images Support recommends daily disk defragmentation for optimum
system performance. Vital Images has qualified Raxco’s Perfectdisk for Vitrea
workstations. Vital Images chose the Perfectdisk software for Vitrea Workstations
because it can handle large drives, requires small free disk space, and
defragments in a single pass. The following directions outline the installation and
scheduling of Perfect Disk software.

NOTE: Other defragmentation software programs can be used on the Vitrea

system, but they have not been qualified by Vital Images. Vital Images Support
will not provide support for the setup, scheduling, or maintenance of these
programs.

CAUTION: It is important to schedule defragmentation while Vitrea software is

not in use.
1. From the Start menu, select All Programs I PerfectDisk.
The PerfectDisk software opens.
2. From the Schedule menu, select Create Local Schedule

OR

click to start the Schedule wizard.

3. Click Next.
4. At Schedule Name, enter a name for the schedule.
5. At the Drives to Defragment, keep the default options All drives and
Defragment drives one after another (in series).

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FIGURE 47. PerfectDisk Drives to Defragment Screen

6. Click Next.
7. From Defragmentation methods, keep the defaults of Defragment files online
and Place file using Smartplacement and click Next.
8. From Schedule Frequency, select Daily and click Next.
9. At Daily Schedule, choose the time of day the defragmentation schedule
should run and click Next.

NOTE: It is best to run it at a time when the Vitrea is the least used. Most systems
in the field are configured to run every night at midnight for no more then five
hours. This gives the software plenty of time to clean-up a heavily fragmented
system.

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FIGURE 48. PerfectDisk Daily Schedule Screen

10. Click Close to complete your scheduling configuration.

NOTE: Vital Images recommends the Vitrea workstation runs overnight during the
week.

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FIGURE 49. PerfectDisk Main Screen with Schedule

11. Double-click next to the newly created Schedule to open the Schedule
Wizard.
The Schedule Wizard opens.

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FIGURE 50. PerfectDisk Schedule Wizard Summary

12. Click Edit Schedule if you want to edit the newly created Wizard.

Software Upgrades
Vitrea customers under a current maintenance contract will receive periodic
software upgrades. These software upgrades will be sent in CD format. The
software upgrade package will include all necessary directions for installation as
well as release notes for the software version.

Configuring Autodelete
Vitrea’s AutoDelete feature is a method to delete patient studies or volumes as a
way to save disk space. AutoDelete will run automatically when conditions are
met.

NOTE: Autodelete will not delete any locked studies or volumes under any
parameters.

Configuring AutoDelete AutoDelete can be configured to delete volumes older than a specified time
by Timeout period.

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To enable AutoDelete based on timeout:

1. Double-click the small blue “V” icon on the toolbar (in the bottom right corner
of the screen) to launch VICommunicator window.

OR

Enter ecfadmin in the Run window.

2. Click Patient Management.
3. Select the AutoDelete tab.
4. Check the Enable AutoDelete based on timeout box.

NOTE: Select a time parameter.

Configuring AutoDelete AutoDelete can be configured to run once a predefined disk space amount is
by Disk Space reached. If Vitrea determines that performing AutoDelete will free enough disk
space to continue receiving data, a dialog box displays. If Vitrea determines that
performing AutoDelete will not free enough disk space to continue receiving data
(due to its settings or because it is not enabled), you will need to manually delete
studies or volumes.

To enable AutoDelete based on disk space limit:

1. Double-click the small blue “V” icon on the toolbar (in the bottom right corner
of the screen) to launch VICommunicator window.

OR

Enter ecfadmin in the Run window.

2. Click Patient Management.
3. Select the AutoDelete tab.
4. Check the Enable AutoDelete based on disk space limit box.
5. Enter the desired free space amount in the Delete non-required volumes when
disk space is less than text box.

NOTE: The amount is in Megabytes. Vital Images recommends free space of 10 to

20% of the patient storage partition.

Configuring AutoDelete If Store Commit is enabled, AutoDelete can be configured to run after a set
by Store Confirmation number of volumes have been stored.

NOTE: If your site views large datasets (1600+ images), choose a lower number of
volumes. If the datasets are smaller, choose more volumes.

To enable AutoDelete based on successful Store Confirmation:

1. Double-click the small blue “V” icon on the toolbar (in the bottom right corner
of the screen) to launch VICommunicator window.

OR

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Enter ecfadmin in the Run window.

2. Click Patient Management.
3. Select the AutoDelete tab.
4. Check the Enable AutoDelete based on successful Store Confirmation box.
5. Select a parameter for number of Volumes that have successful Storage
Confirmation.
Vitrea will delete this number of volumes once they have been successfully
stored.

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Troubleshooting
This chapter contains the following information:

• Welcome to Vital Image’s Support Knowledge Base

• Resolving Importing, Exporting, and Printing Issues
• Troubleshooting CD/DVD Burning in Vitrea
• Troubleshooting a Slow System
• Optimizing Video Card Settings
• Vitrea Software Upgrades
• Restoring Customized Report Templates and Graphics

Welcome to Vital Image’s Support Knowledge Base

Registering for Vital Vital Images Support Web site is a great first resource for troubleshooting Vitrea
Images’ Support software. The Knowledge Base portion of the site is password protected and
Knowledge Base users need to register to enter.

CAUTION: Only customers who are current with their maintenance program as
well as Vital Image’s partner companies’ employees are able to register.

To register for the Vital Images Support site and Knowledge Base:
1. Go to http://support.vitalimages.com to enter the Vital Images Customer
Support homepage.
OR

Click the Customer Services link from the Vital Images homepage
(www.vitalimages.com).
2. Click the Knowledge Base link from the menu on the right side of the screen.
A logon screen displays requesting an Email address and Password.

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FIGURE 51. Vital Images Support Web site

3. Select the If you are a new user click here to register link.

NOTE: If you have registered in the past, you will not need to reregister.

NOTE: Users who have registered before August 2005, primarily for software
registration, will need to register again.

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FIGURE 52. Vital Images Knowledge Base Login Screen

4. If you do not have your Customer ID, call ViTAL Images Customer Support (1-
800-208-3005) to get your Customer ID and to verify that your name exists in
the Vital Images database file.

FIGURE 53. Vital Images Support New User Registration Screen

5. Fill out the form and click Sign In.

Vital Images will then check its customer database for a match. Your
information will be displayed if there is a match.
6. Click Select to continue registering.
The first name, last name, and email fields will automatically be filled in.
7. Choose a password and enter it in the Password textbox.
8. Click Save to complete the process.
A congratulations message will appear once you have successfully registered.
9. If any errors in this process, call ViTAL Images Customer Support (1-800-208-
3005) for help.

Using Vital Images Vital Images Knowledge Base is an excellent tool for troubleshooting Vitrea
Knowledge Base related issues. The web site provides hundreds of help documents as well as user
manuals.

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To use the Vital Images Knowledge Base

1. Go to http://support.vitalimages.com to enter the Vital Images Customer
Support homepage.
OR

Click the Customer Services link from the Vital Images homepage
(www.vitalimages.com).
2. Click the Knowledge Base link from the menu on the right side of the screen.
3. Log into the Knowledge Base using your email address and password.

NOTE: If you have not registered online, follow the directions in the Registering
Users for Vital Images’ Knowledge Base section of this manual.

FIGURE 54. Vital Images Knowledge Base Home Page

NOTE: Currently, only the Contents tab of the web page is functional.
4. Enter the keyword of the topic that you would like more information about and
click Search.
OR

Navigate through the Hot Topics section located in the left hand column and
click Support Knowledge Base.

NOTE: Hot Topics uses an explorer format. To locate an article, expand

the relative folders into the drill down to the final topic you wish to learn
more about.
5. Once you locate an article using either Hot Topics or the Search textbox, click
the article name to open the article.

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FIGURE 55. Knowledge Base Tools and Feedback

6. Once an article is displayed, print, email, bookmark, or download the article.

To download a Knowledge Base attachment:

Some Knowledge Base Documents contain a file attachment that are used in
problem resolution. Examples of attachments are user guides, patches and driver
files.
1. Under the Attachments section, click the file name of the attachment.
2. In the File Download window, click Save to save the file locally.

FIGURE 56. Knowledge Base File Download Window

A Save As window displays.

3. Browse to the directory where the file is to be stored.
4. Click Save to finish downloading the file.

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Adding Feedback After viewing an article, please fill out the feedback fields in the right side
column. User feedback improves the effectiveness of the knowledge base.

FIGURE 57. Knowledge Base Feedback Section

To provide feedback for the Knowledge Base:

1. Select Yes or No to decide whether the article solved the problem.
2. In the dropdown menu, select how helpful the article was in solving your
issue.
3. Fill in any suggestions in the Suggestions textbox.

Resolving Importing, Exporting, and Printing Issues

The following checklist is to be used in situations where the Vitrea workstation is
unable to accept images from another DICOM device.

NOTE: DICOM Abbreviations are used in the following text. Go to the Common
DICOM terms and definitions section of this manual for more information.
• Verify that VICommunicator is running.
• Vitrea will accept images from sending devices without an entry for the
sending device in Vitrea’s configuration. Therefore it is important to recheck
the settings for the Vitrea’s AETitle, IP Address, and Port number.
• If the DICOM data sent to the Vitrea is not CT or MR, the Extended Storage
Class Options may need to be changed.
• Select the ECF.log file located in the E:\VitreaData\Temp folder to ensure the
association takes place.
• If an association takes place between the sending device and Vitrea, the
slices are sent to the E:\VitreaData\Patients folder. The DICOM slices build

into a Volume (stored as an .AVOL file), and they are also stored in
the Patients folder.

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• If cases are present in the Patients folder but not in the Study Directory, it is
necessary to rebuild the database files.
• If these changes do not fix the issue, contact Vital Images Support.

Troubleshooting Vitrea’s ability to export both primary and secondary DICOM files often creates
DICOM Export Issues configuration issues with the receiving DICOM device. The following steps fix the
most common DICOM exporting issues.

• Verify that the VICommunicator is running.

• Check the entry for the receiving device in Vitrea’s configuration. It is
important to recheck the settings for the receiving device’s AETitle, IP
Address, and Port number.
• Check the ECF.log file located in the E:\VitreaData\Temp folder to ensure the
association takes place.
• If an association takes place between the sending device and Vitrea, check
for DICOM slices in the E:\VitreaData\ECF\Export folder as an association
takes place.
• Once you verify that a DICOM association takes place, it is necessary to check
if the receiving device accepts compression. If the receiving device does not
accept compression, change the value of the CompressOutgoingImages field
in ECFConfiguration.xml to No.

FIGURE 58. CompressOutgoingImages Field set to no

• If these changes do not fix the issue, contact Vital Images Support.

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Troubleshooting For DICOM Printing, Vitrea creates an association with a printer and a film box,
DICOM Printing Issues and then sends the film box in a film session with the printer. Most issues with
DICOM printer deal with the configuration of the printer’s settings in Vitrea.

• Verify that the VICommunicator is running.

• Check the entry for the receiving device in Vitrea’s configuration. It is
important to recheck the settings for the receiving device’s AETitle, IP
Address, and Port number.
• Check the ECF.log file located in the E:\VitreaData\Temp folder to ensure the
association takes place.
• Once the printer’s information has been verified and an association takes
place, it may be necessary to adjust Film Box settings. Check the film box
settings outlined in the DICOM Conformance statement from the printer’s
vendor web site.

To adjust Film Box settings:

1. Close Vitrea if it is open.
2. Double-click the small blue “V” icon on the toolbar (in the bottom right corner
of the screen) to launch VICommunicator window.

OR

Enter ecfadmin in the Run window.

3. Click DICOM.
4. Select the Printer Config tab.
5. Select the appropriate printer under the Printer: dropdown menu.
6. Change the printer’s properties if necessary.
7. Click OK to save changes.

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FIGURE 59. ViCommunicator DICOM Printer Config Tab

8. View the ECF.log file located in the E:\VitreaData\Temp folder to view the
creation of the print film box.
• If these changes do not fix the issue, contact Vital Images Support.

Troubleshooting CD/DVD Burning in Vitrea

Vitrea allows users to burn CDs/DVDs from two different points in the software
workflow. Understanding the difference between the two processes is essential in
troubleshooting. The following list describes general troubleshooting issues as
well as defining the difference between the two burn methods.

NOTE: Vitrea software is unable to perform other functions while writing one or
more volumes to a CD/DVD. However, the CD/DVD burning process will usually
take less than five minutes.

General CD/DVD • Ensure the CD/DVD is a blank CD-R/DVD-R disk. Vitrea does not have the
Troubleshooting Issues ability to burn to CD-RW/DVD-RW disks or CD-R/DVD-R that is not blank.
• Ensure there is enough free space on the drive where Windows stores an
“image” of the CD/DVD to be written. This image file may use up to 1 GB of
disk space.

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NOTE: The drive where Windows stores the image can be changed on the
Recording tab in the CD Drive Properties.
• If CD/DVD burning fails, attempt to burn a CD through Windows Explorer.
• If this fails, verify the Enable CD Recording box is selected.

To Enable CD Recording on the CD Drive:

1. From the Start menu, select My Computer.
2. Right-click on the CD Drive and select Properties to open the CD Drive
Properties window.
3. Select the Recording tab.
4. Check the Enable CD recording on this drive box.

FIGURE 60. CD Drive Properties Window

Archiving Data in Vitrea The first method to burn CDs/DVDs in Vitrea is the Archive to CD/DVD via the
Study Directory. Archive to CD/DVD via the Study Directory has the following
features and limitations:

• Only available on the Study Directory.

• Ability to archive multiple patients from the Study Directory tab in Vitrea.
Users can highlight multiple patients by holding the CTRL button and clicking
on the desired patients.
• Once the selected patient(s) are highlighted on the Study Directory, right-
click on the selected patient(s) and select Archive to CD/DVD

OR

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Click Archive to CD/DVD.

• Archiving to a CD/DVD does not include a 2D viewer.
• The following types of files from the Vitrea Workstation can be saved to CD/
DVD:
• Patient DICOM files (.dcm files)
• Patient volume files (.avol)
• Patient report files (.html files posted to the intranet)
• Patient media files (such as .png, .avi, and .preset files)

FIGURE 61. Archive to CD/DVD Dialog Box

NOTE: Most users will not want to include Volume files when burning from CD/
DVD as all Vitrea workstations can recreate the same 3D volume file.

Archiving a Report to The first method to burn CDs/DVDs in Vitrea is the Archive to CD/DVD via the
CD/DVD Report window. Archive to CD/DVD via the Report window has the following
features and limitations:

• Only available on the Report window.

• Only one patient per CD/DVD.
• Includes the Vital Images Study Viewer, a 2D viewer.
• Includes the HTML Report, and all of the Word Reports generated for the
study

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NOTE: Only images that have been added to the report will be burned to CD/DVD

FIGURE 62. Images Added to the Report

• Includes the Report, Media Files, and the option of DICOM files. DICOM files
must be checked for end users to open the Study Viewer.
• Does not include Volumes files.

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FIGURE 63. Report CD/DVD Dialog Box

NOTE: The Vitrea software is installed with a standard CD/DVD report template,
which can be customized with a customer’s address, header, footer, logo, and
any other boilerplate text or graphics.

To view a report saved to CD/DVD:

Insert the burned CD/DVD into the drive.

The report restores automatically in the default browser for the PC workstation.

NOTE: If the report does not restore automatically (such as when autoplay is
turned off), open the CD/DVD and run the autorun.exe file.

Troubleshooting a Slow System

Vitrea users describe the workstation as running slow. It is important to define
what slow means to the user. Slow may be receiving cases, building 3D volumes,
sculpting or rotating cases or general system slowness.

NOTE: If the DICOM transfer to Vitrea is slow, there may be a network issue.

For general slowness on the system, the following methods solve general disk
errors that are possible causes for slowness.

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Running Chkdsk to Fix Checkdisk is a command in Microsoft Windows systems that verifies a hard disk
Errors for file system integrity.

To run Checkdisk:
1. From the Start menu, select Run.
2. Enter cmd in the textbox to open a Command Prompt window.
3. Type chkdsk c: and press Enter.
This checks the C:\ drive for errors in read-only mode.
4. If errors are found, type chkdsk c” /f and press Enter.

NOTE: When used under Windows with the /f parameter, CHKDSK suggests it is
run on the next restart. If the user agrees, it will automatically run the next time
the computer is restarted.

FIGURE 64. Checkdisk Command Prompt Window

5. Type chkdsk e: and press Enter.

This checks the E:\ drive for errors in read-only mode.
6. If errors are found, type chkdsk e” /f and press Enter.

Verify Free Disk Space To check free disk space:

1. From the Start menu, select My Computer.
2. Right-click the C: drive and select Properties.

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FIGURE 65. C: Drive Properties Window

3. Verify that each drive (also referred to as a partition) has enough free space.

NOTE: Most partitions will need approximately 20% free space to run
effectively.
4. Close the Properties window.
5. Repeat these steps for any additional partitions on the system.

Checking Processes for To check hyperthreading and windows processes:

high CPU usage 6. Right-click an empty space on the taskbar and select Task Manager.
7. Select the Performance tab.

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FIGURE 66. Task Manager’s Performance Tab

#1 #2

8. Ensure there are only two CPU listed under CPU Usage History.
Vitrea hardware requires dual processors, but with hyperthreading disabled.

NOTE: If four processors are shown, hyperthreading will need to be

disabled from the system BIOS.
9. Select the Processes tab.

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FIGURE 67. Task Manager’s Processes Tab

10. Look for any process using high memory or high CPU usage at regular
intervals.
11. VICommunicator and Vitrea should be the only programs that consistently
use a large amount of system memory.
rd
12. This is also an opportunity to verify that no 3 party programs are running on
the system. Vital Images has only qualified Microsoft applications and most
major antivirus software.

Running Disk Raxco’s Perfectdisk is a optional disk defragmentation program that Vital Images
Defragmentation recommends for Vitrea workstation. There are multiple disk defragmentation
Software softwares that will also successfully perform this function.

CAUTION: All disk defragmentation softwares slow down the system when
performing functions. It is not recommended to perform a disk
defragmentation while Vitrea software is in use.

To perform disk defragmentation with PerfectDisk:

1. From the Start menu, select All Programs I Perfect Disk 6.0 .

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FIGURE 68. PerfectDisk Software Main Screen

2. Highlight the C: drive and click to analyze the drive. Repeat the
process for the E: drive.
Perfectdisk will make a recommendation for action.

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FIGURE 69. Perfectdisk Recommendation Screen

3. Click OK to close the Statistics window.

4. If a defragmentation is needed, click to defragment the drive.

5. If PerfectDisk has not been configured to run on a daily schedule, create a
schedule at this time.

Optimizing Video Card Settings

Vitrea Configuration The ATI FireGL series of Video Cards has a profile setting to optimize performance
in Vitrea.
1. Log in as Administrator.
2. Right-click anywhere on the Desktop and select Properties.
This opens Display Properties.

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FIGURE 70. Display Properties

3. Click Advanced.
The ATI FireGl Video Card Properties opens.
4. Click the Configuration tab.
5. Verify the Vitrea Configuration Profile is selected.

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FIGURE 71. Vitrea Profile

Changing Video 1. Right-click on My Computer and select Properties.

Management 2. Select the Advanced tab.
3. Click Settings in the Performance section.
4. On the Visual Effects tab, select Adjust for best performance.
5. Click OK to save.

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FIGURE 72. Adjust for best performance

Vitrea Software Upgrades

Information for upgrading to the newest version of Vitrea software is located in
the Vitrea Installation Guide, which is sent with the upgrade CD.

To request a printed copy of Vitrea Installation Guide:

• Fill out the Printed Manual Request Form that came in the Vitrea software box
and fax it to the number on the form.

OR

Send an email to request@vitalimages.com.

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To upgrade your Video Driver:

NOTE If you do not receive a message about your video driver, skip this sec-
tion.
• If you receive the video driver message, The installed video driver is not
the recommended version. Do you want to update the driver now?, per-
form one of the following steps:
a Click Yes.
b If you receive the Hardware Installation message, The software you
are installing has not passed Windows logo testing to verify its
compatibility with Windows XP and click Continue Anyway.

NOTE During the video driver installation, the screen may turn black.
If this happens, follow the instructions below, but use the keyboard
equivalents whenever you are instructed to click a button on the
screen. The installation will continue.
c When you receive a second Hardware Installation message, The
software you are installing has not passed Windows logo testing
to verify its compatibility with Windows XP, click Continue Any-
way.
OR

If the screen is black, press C.

After approximately 30 seconds, the video driver is installed.
• If you upgraded the video driver, the monitor resolution resets to 800 x 600
when you reboot the workstation. Reset it to the recommended resolution to
run Vitrea: 1600 x 1200.

NOTE You can use 1280 x 1024 resolution, but if you choose the lower resolu-
tion, set the Windows taskbar to auto-hide. To do this, right-click the taskbar
and select Properties. Check the Auto-hide the taskbar box. If the taskbar is
not set to auto-hide, you may not see some buttons and controls.

Restoring Customized Report Templates and Graphics

CAUTION If you did NOT upgrade to version 3.7 or 3.7.1, this version of soft-
ware contains new Vital Images logo graphics and report templates. When
you install this version, the new report templates and graphics are saved as
the default versions used by Vitrea.
If you customized the Vitrea report templates to contain site-specific information
and logos, you can restore them. Alternatively, you can update the new default
templates with your custom graphics and text.

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Vitrea Saves Your The Vitrea installer renames and saves your customized templates and logos as
Customized Templates described in the following table. It saves the files with their original file exten-
and Graphics sions (.dot, .html, .gif), so you can easily open, view, or edit them.

TABLE 1. Paths and File Extensions for Report Templates and Graphics

File Path Original New Ext.

Ext.
Custom Word Report E:\ProgramFiles\Vital Images\ .dot *.save.dot
templates vitrea\bin

Custom HTML Report E:\Program Files\Vital Images\ .html *.save.html

template (opens when Vitrea\config\ReportCD
you display reports
archived to CD)

Custom logo and E:\Program Files\Vital Images\ .gif *.save.gif

graphic files vitrea\config\
ReportCD\images

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Quick Reference
This chapter contains the following information:

• Finding Commonly Used Files

• Creating a Backup for Vitrea

Finding Commonly Used Files

The following is a list of folders and files that are commonly used through the
manual

C: Drive Folders • C:\Flexlm

This folder contains the license files for Vitrea.

For a standalone unit, Vitrea will have a license.dat file only.

Vitrea workstations that use Concurrent Licensing contain

InstallLicenseManager.exe, a log file, and lmtools.

• InstallLicenseManager.exe initiates the installation of the program that

manages license distribution in a concurrent license environment.
• lmtools is a program that shows which Vitreas are using license files at
any time.

FIGURE 73. FlexLm Folder with Concurrent License Files

The C:\Program Files\Vital Images folder contains three folders that run Vitrea:

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• 3rd Party – This folder contains the installation folders for the database
programs that Vitrea uses. C:\Program Files\Vital
Images\3rdParty\Install\MySql contains install_sql,bat and remove_sql.bat
files. These files remove the database and then reload it. This is often a
necessary step to correcting a corrupt database.
• Components – Contains the Bin and Config folder.
• The Config folder contains the ECFConfiguration.xml and
PrintDefaults.xml.
• The ECFConfiguration.xml file holds the information stored in VI
Communicator.
• The PrintDefaults.xml file holds the information about the settings
for all DICOM printers.
• Vitrea – Holds multiple folders including Manuals, Learning, Bin, and Config.
• The Bin folder contains many of the executable files necessary to start
Vitrea and other Vitrea related programs such as Study Viewer and
Softread.

FIGURE 74. Program Files\Vital Images\Vitrea Folder

• The Manuals folder holds the Vitrea user guides in PDF format.
• The Learning folder holds all of the Learning Center tools and documents.
• The Bin folder holds the CACSTemplate.dot as well as other Microsoft
word templates that are used on the Report Page in Vitrea.
• The Config folder holds the preset files. These files show which views will
be displayed on the Gallery tab in Vitrea. If a customer saves a custom
preset, it will go into this folder. This folder also includes base.selector
and possibly a custom.selector file.
• Base.selector is the file that chooses what Protocol to load in Vitrea
by reading the Exam Description DICOM tag.

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• Custom.Selector will be created if a customer chooses a different

protocol than Vitrea recommends. If the customers chooses to make
this a permanent choice, an entry in custom.selector will take place.

E: Drive Folders E:\VitreaData contains the following important folders: Patients, temp, ECF,
Dropbox, Reports, and AuditLog and possibly a Users folder.

FIGURE 75. VitreaData Folder

• The Patients folder holds the DICOM slices, the avol (3D volume files), and an
xml for every patient. Snapshots and batches also are held in this folder.
• The Reports folder holds .jpg images, xml files, and web page information for
every patient that was Intranet Posted.
• The AuditLog folder contains a record of who logged onto the system and
what cases the person opened, exported, or printed.
• The Temp folder contains the ECF and Error log files.
• The ECF.log shows all DICOM communication and the building process of
each case.

NOTE: This is our most important logging file

• The Dropbox folder serves as a location for .dcm files to be copied to when
doing a manual push. Often DICOM files from network drives or external hard
drives are dropped into this folder.
• A shortcut to the Dropbox folder will appear on the desktop after each
software installation.
• The ECF folder contains the Export and Database folders.
• Export – When an export is done in Vitrea, files go here temporarily
before moving on to the intended recipient. This folder should always be
empty.

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• Import – files sent from the scanner are received here. This folder should
be empty unless images are currently arriving from the scanner.
• Database – This is where the database files are located. The contents of
this folder can be removed when reinstalling the database.

Creating a Backup for Vitrea

Hardware and operating system errors can lead to a complete reinstallation of the
Vitrea system. It is important to create a quick backup that will allow the
administrator to restore the Vitrea settings quickly. The files listed for backup do
not include any patient data or report data. These files are relatively small in size
and can be backed up onto CD, floppy disk, a network drive, or any external
storage device. Multiple Vitrea workstations can be backed up onto the same
storage device.

NOTE: Another method of backup is creating a custom image of the C: partition

using third party software like Symantec’s Ghost.
1. Backup license.dat (or possibly license.lic) from C:\FLEXlm. The license file
should be restored before reloading the software.
2. Backup ecfconfiguration.xml from C:\Program Files\Vital
Images\Components\Config. This file will be restored after reinstallation of
Vitrea software.
3. Backup any modified preset files from C:\Program Files\Vital
Images\Vitrea\config. Modified presets will contain an underscore “_” before
the extension. Restore this file after reinstallation of Vitrea software.
4. Backup any modified Microsoft Word templates from C:\Program Files\Vital
Images\Vitrea\bin.

NOTE: Modified Microsoft Word Templates only need to be backed up

once for multiple Vitrea workstations
Restore this file after reinstallation of Vitrea software.
5. Create a text file on the desktop of the Vitrea workstation and record the
following information:
• Any relevant network information
• Postscript Printer’s IP addresses and model number
• The serial number, registration, and authorization code from the registry
editor. (This is found under HKEY_LOCAL_MACHINE – SOFTWARE – Vital
Images – Vitrea)

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FIGURE 76. Backup Files

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VxNet Introduction (for PACS Integrated

Systems)
This chapter contains the following information:

• Introducing VxNet
• Understanding Stand-alone vs. Integrated Architecture
• Reading VxNet Log Files
• Introducing the Communication Channel
• Reviewing Load Times of Integrated Systems

Introducing VxNet
VxNet is Vitrea’s COM (Component Object Model) based API (Application
Programming Interface) used for providing Vitrea with data and information to
load data “on-the-fly”.

The COM protocol is the method of communication between Vitrea and the PACS.
In most cases, the DICOM protocol is used for the transfer of snapshots from
Vitrea to PACS.

NOTE: Some PACS systems use other mechanisms to transfer snapshots, such as
placing them in a specific location (with a message listing the location) or copying
snapshots into a Dropbox decided by the PACS. These are options that you can
configure in VitreaConfiguration.xml.

Understanding Stand-alone vs. Integrated Architecture

There are two types of Vitrea systems; integrated (with the PACS client software)
and stand-alone. This section explains the communication methods used
between the PACS and the Vitrea. The DICOM data does not reside on the local
disk of Vitrea. Therefore the Siemens Fusion7D option is not supported on
integrated systems.

NOTE: Vitrea integrates with multiple PACS systems and the following information
is a generalization of the architecture of several systems.

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FIGURE 77. Sample PACS Integration Architecture

PACS
PACS Client Bridge (not
used by all COM Vitrea
vendors)

CORBA
PACS WS /
Vitrea WS Files through
Shared Drive
ECF

DICOM
PACS
Server

FIGURE 78. Figure: Vendor Integration with Vitrea

PACS PACS
Client API VxNet Vitrea
Bridge API

Reading VxNet Log Files

Both the Vitrea software and the PACS client software create multiple log files.
The following log files show the interactions between the PACS and Vitrea through
COM and the VxNet API. The default locations of the files are listed for some of the
PACS systems. By default, the log files are located in VitreaData\temp, but
this location is configurable after install.

NOTE: Please contact your PACS vendor or Vital Images Support if your PACS
system is not listed below.

Make sure you view the most recent log files because many log files are created
daily.

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The vxnet.log file is found in VitreaData\temp on all PACS integrated

platforms. The corresponding VxNetConfiguration.xml file is in the
Program Files\Vital Images\vitrea\config folder.

For iSite Integrated Systems:

The isiteplugin.log file is found in VitreaData\temp. The

corresponding iSitePluginConfiguration.xml file is in the Program
Files\Vital Images\components\config folder. Additional log files
that will help support are located in C:\iSiteLogs and have the names
SystemLog<number>.txt.

For McKesson Integrated Systems:

The MckPlugin.log file is found in VitreaData\temp. The corresponding

MckPluginConfiguration.xml file is in the Program Files\Vital
Images\components\config folder. Additional log files that will aid
support are located in C:\ali\site\log. While many files are listed, the
AliSal.log, McKBE4ThirdParty.log, AliOAF.log and AliHRS.log
are the most valuable in troubleshooting.

For Sectra Integrated Systems:

The Sectraplugin.log file is found in VitreaData\temp. The

corresponding SectraPluginConfiguration.xml file is in the Program
Files\Vital Images\components\config folder. Additional log files
that will help support are located in C:\Program Files\Sectra\IDS5\log
and have the names workstation.<date>.txt.

Introducing the Communication Channel

The COM communication protocol is used between the PACS client bridge
component and Vitrea for loading the data. COM is a Microsoft-based standard
for inter-process communication. The DICOM images that Vitrea builds into
volume files are not sent through a DICOM association but through a COM
transmission.

The DICOM data loaded into Vitrea is not sent through a DICOM association in
PACS integrated systems. Vitrea pulls the data from a location on a shared drive
on the PACS server. In some cases, the PACS bridge, and not the PACS server,
feeds the data to Vitrea.

Vitrea sends snapshots back to the PACS through one of the following methods:

• The user can manually export snapshots and batches (through DICOM
protocol) from the Report tab in Vitrea.
• Vitrea auto-exports snapshots only (if enabled upon installation) when the
user selects the Back to PACS tab. Only Secondary Capture DICOM is
supported in this auto-export.

Introducing the Communication Channel VPMC-12847A 3 of 4

Vitrea® version 4.1 Administration Guide

Reviewing Load Times of Integrated Systems

Because variances in local network connections to PACS archives can affect
loading time, the volume load times for integrated Vitrea may be longer than
stand-alone Vitrea. The load time is the process of transferring the DICOM data to
the Vitrea and the loading the data into a 3D volume.

If data is cached on the local disk, load times are less.

NOTE: The performance at your site may vary due to network conditions.

4 of 4 VPMC-12847A Reviewing Load Times of Integrated Systems

 Vitrea® version 4.1 Administration Guide

Licensing Form
This appendix contains the Vital Images License Request Form.

Vital Images License Request Form

The Vital Images License Request Form is located on the next page. Complete this
form and email it to Vital Images to receive your license file. All fields are required
in order to generate the license.

Vital Images License Request Form VPMC-12847A 1 of 2

Vitrea® version 4.1 Administration Guide

2 of 2 VPMC-12847A Vital Images License Request Form

 Vitrea® version 4.1 Administration Guide

Index
A Filmbox 4–2
Access Point. See Licenses FlexLM Folder 3–6
Administrator Account 5–1 G
Alias 4–2 Gallery Tab 5–2
Antivirus Software 2–12 H
Apache 5–5 Hardware
modifying 6–4 minimum specifications 2–1
API A–1 Help Tab 5–6
Application (AE) Title 4–2 htaccess.default 6–4
Application Entity (AE) Title 4–1 hyperthreading 8–15
Archive Server 4–11, 4–14 I
Archive. See PACS Imaging
ATI FireGL Video Cards 8–19 creating an image 2–15
Autodelete 7–5 newsystems 2–16
B restoring an image 2–15
base.selector 6–9 Import DICOM Devices 4–23
body.html 6–3 index.html 6–4
bottom.html 6–3 Insight Corporation 2–1
C InstallLicenseManager 9–1
CD 6–1 integrated Vitrea A–1
burning 6–1 Integration A–2
customizing 6–1 Integration Architecture A–2
troubleshooting 8–9 iSite Integrated Systems A–3
Checkdisk 8–14 K
COM A–1 Knowledge Base 8–1
Compression 6–12 adding feedback 8–6
CD burning 6–13 downloading 8–5
troubleshooting 8–7 registering 8–1
Computer Management 3–4 using 8–3
Concurrent Licenses.See Licenses L
D License Manager 3–7
Defragmentation 7–1 Licenses 3–6
maintenance 8–17 Concurrent Licenses 3–6
DICOM 4–1, 4–2 Licensing
association 4–1, 4–2, 4–5 License Requests 3–6
Conformance Statement 4–2, 4–6 Lmgrd 3–7
DICOM Standard 4–1 LMTools 3–7
Vitrea default settings 4–8 LMTools.exe 3–8
Disk Management 3–4 Local Area Connection 3–1
Display Settings 2–7 Lossless Image Compression 6–12
Drive Letters 3–4 M
E McKesson Integrated Systems A–3
ECF.log 8–6 Multi-frame 4–8
Ecfadmin 4–3 N
Export DICOM Devices 4–22 Network Settings 2–8
F adding DNS entries 3–3
Fast User Switching 2–6 configuring DNS settings 3–3
Film session 4–2 static IP address 3–1

VPMC-12847A Index
Vitrea® version 4.1 Administration Guide

P V
PACS 4–3, A–1 Value Representation (VR) 4–3
adding entries 4–9, 4–20 VICommunicator 4–3
Pagefile testing 4–3
creating 2–12 Video Cards 8–19
Paging file Video Driver 8–23
creating 2–4 Video Settings 2–7
Partitions 2–2 Viewer Tab 5–3
Perfectdisk 7–1 Vital.exe 3–7
Port Number 4–1 Vitrea Software
Postscript Printers 4–19 basic operations 5–1
Power Management 2–10 Installing 3–10
Powerquest Imaging Software 2–15 registering 3–10
Presets 6–7 starting 3–10
Print Job 4–3 Vitrea to Vitrea Connection (V2V) 4–10
Printing adding entries 4–10, 4–14
adding DICOM printers 4–17, 4–22 VitreaStations.xml 6–6
adding Postscript Printers 4–19 W
Printer Config tab 4–18 Windows Setup 2–2
troubleshooting 8–8 automatic updates 2–11
Protocol Data Unit (PDU) 4–3 Installation 2–2
Q installing 2–2
QRServer 4–11, 4–16 Worklist 4–3
R
RAID Configuration 2–2
Report Tab 5–4
Review Tab 5–5
S
SATA 2–2
Screen Resolution 2–7
SCSI 2–2
Sectra Integrated Systems A–3
Serial Number 3–11
Service Class Provider (SCP) 4–2
Service Class User (SCU) 4–2
Service Object Pair (SOP) 4–3
SmartQuery 4–19
Snapshot tool 5–3
Storage Class 4–6
adding 4–5, 4–6
Study Directory Tab 5–1
Symantec Ghost 2–15
System Restore 2–3
adding points 2–13
T
TCP/IP 2–8
top.html 6–3
Transfer Syntax 4–3
U
User Accounts 2–5

Index VPMC-12847A