Ambra Viewer

Guide
Ambra Viewer is a zero-footprint diagnostic
HTML 5 medical image viewer that can be
accessed through the web or integrated into any
PACS. Easy to use viewing tools are available for
annotating and collaboration: hanging protocols,
window, cine, measurements, and more.

1
Table of Contents
Indications for Use 3
Browser Requirements 4
Measuring Systems and Standards 5
Getting Started 6-8
Importing Studies 9-15
User Interface Overview 16-17
Study Page 18
Main Toolbar 19
Sub-Toolbars 20-23
Multiple Frames 24
Stack Series 25
Related Studies 26
Meetings 27-28
Local Study Viewing 29
Settings 30
Printing 31
Keyboard Shortcuts 31
Mobile Browser Requirements 32
Viewer Features Comparison 32
Mobile Phone Viewer 33
Mobile Tablet Viewer 34

Feedback & Support

support@ambrahealth.com
(888) 315-0790 ( anytime ) or
(321) 608-9723 ( anytime )

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Indications for Use
510(k) Number: K152977
Device Name: Ambra PACS
Ambra PACS software is intended for use as a primary diag-
nostic and analysis tool for diagnostic images for hospitals,
imaging centers, radiologists, reading practices and any user
who requires and is granted access to patient image, demo-
graphic and report information.
Ambra Viewer, a component of Ambra PACS, displays and
manages diagnostic quality DICOM images.
Lossy compressed mammographic images and digitized film
screen images must not be reviewed for primary image inter-
pretations. Mammographic images may only be interpreted
using cleared monitors intended for mammography display.
Not intended for diagnostic use on mobile devices.
Caution: Federal law restricts this device to sale by or on the
order of a physician.

Name and Place of Business

DICOM Grid (dba Ambra Health)
4530 E. Muirwood Drive, Suite 113
Phoenix, AZ 85048

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Browser Requirements
All supported browsers are listed.
Other browsers, and older versions of
browsers listed, are not supported.
Supported Java versions: Java 7, Java 8.
Download Java at:
java.com/en/download/ manual.jsp

Windows OS
Internet Explorer 9
Upload Images: Requires Java installation or
Google Chrome Frame plug-in installation.
View Images: Native, no cine tooling support.

Internet Explorer 10
Upload Images: Requires Java installation.
View Images: Native

Internet Explorer 11
Upload Images: Requires Java installation.
View Images: Native

Google Chrome ( version 28.0 and later )

Upload Images: Native.
View Images: Native.

Firefox ( version 23.0 and later )

Upload Images: Requires Java installation.
View Images: Native.

Mac OS
Safari ( version 6.0 and later )
Upload Images: Requires Java installation.
View Images: Native.

Google Chrome ( version 28.0 and later )

Upload Images: Native.
View Images: Native.

Firefox ( version 23.0 and later )

Upload Images: Requires Java installation.
View Images: Native.

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Measuring Systems and Standards
For diagnostic use, users must use base monitor standards or better
per modality below.
Not intended for diagnostic use on mobile devices.

Recommended Monitor Standards

Modality Capture Modality Matrix Screen Size Pixel Matrix Color Required Comments
Ultrasound IVUS 512, 768 & 1024 18 to 19 in ≥1280 x 1024 Doppler IVUS, avoid screen sizes above
126 lines 15 to 18 in ≤ 1280 x 1024 18” diagonal

NUC/PET PET/CT Variable 18 to 19 in ≥1280 x 1024 Encoding Not recommended on 5 MP

19 to 20.1 in ≥1600 x 1200 Pixel size: ≥ 0.206mm

MRI/CT 256 & 512 19 to 20.8 in ≤ 1536 x 2048 Enhanced 3d Not recommended on 5MP
~ 1mm/Slice Typical Re-construction Large studies on 4 MP 30” di-
agonal color. Pixel ≥ 0.206mm

fMRI 256 & 512 19 to 20.8 in ≤ 1536 x 2048 Contrast ≤ 3 MP color or mono- chrome
Enhancement or 6MP @ ≥ 0.206mm

Fluoro/R&F 1024 x 1024 18 to 20.1 in ≤ 1600 x 1200 N/A 1280 x 1024 minimum for 1:1
CT-Fluoro aspect image w/in 5:4 screen.
Gray-to-Gray cycle response
time ≤ 13ms

CR/DR 4 MP 20.8 to 21.3 in ≥ 1536 x 2048 N/A Ideal t to 3 MP, color or

(100-150) microns monochrome ≥ 400 cd./m2

Digitized Film 8 MP 20.8 to 21.3 in ≥ 1536 x 2048 N/A 3 MP color or monochrome 5

(50-150) ~ 8-10 lp/mm MP monochrome

Mammography 20MP+ 21.3 in 2048 x 2560 N/A Lossy compressed mammo-

(50-100) ~ 18-20 lp/mm graphic images and digitized
lm screen images must not
be reviewed for primary
image interpretations. Mam-
mographic images may only
be interpreted using cleared
monitors intended for mam-
mography display.

SMPTE is the Society of Motion Picture & Television Engineers. This organization has developed
several test patterns to ensure image quality viewing standards. This 1024 x 1024 test image is used
to calibrate the monitor on any viewing station running DICOM software. Once the SMPTE pattern is
loaded and displayed, the user should ensure the 5% and 95% grey scales are clearly visible. If not,
adjust the monitor’s contrast and brightness.
The American Association of Physicists in Medicine (AAPM) Task Group 18 (TG-18) is a national task
force consisting of medical imaging experts and organizational af liates dealing with per- formance
evaluation of electronic display devices. Used correctly, the AAPM QC test patterns will indicate im-
mediately if there are any potential issues with the calibration and/or monitor.
The pixel spacing test images for DICOM developed by David Clunie allows the user to appropri-
ately calibrate and con rm display resolution. Test image data with physical pixel spacing bars are
rendered allowing the user to quanti ably check spacing.

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Getting Started

Ambra
Point your web browser to:
https://access.ambrahealth.com
Click ‘Register here’.

Register
Complete all fields.
Read and accept:
‘Terms of Use’,
‘Privacy Policy’,
‘Indications for Use’.

Click ‘Register’.

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Studies Page
After clicking ‘Register’ you will be taken to the
‘Studies’ page. To search for studies, click ‘advanced’
to display all searchable study fields.

Search for a Study

Enter parameters, and click ‘Search’.

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View a Study
Click the ‘Eye’ icon to view a study’s images.

View Related Studies

Click checkboxes in the left column to select multiple studies.
Then click the ‘Actions’ button, and select ‘View as Related’.

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Importing Studies
There are four methods of importing studies:

Web Upload
Email Request
DICOM Send
DICOM Query/Retrieve

Web Upload
Click the ‘Add Study’ dropdown and select ‘Upload Studies’.

Click ‘Choose File’.

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Navigate to your study or studies.
Click ‘Upload’.

After a scan, a list of studies found will appear.

‘Check’ studies to upload, and click ‘Upload Selected Studies’.

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Uploading will begin, with a progress indicator. Uploaded studies are
marked ‘Uploaded’ with a green box. Click ‘Back to Studies’ to return
to the Studies list. To upload click ‘Upload More’.

The Studies list displays the study just uploaded.

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Email Request
To request a study be uploaded by another party,
click ‘Add Study’ and select ‘Request Study’.

Enter the email address of the person from whom you are requesting
the study, your email address, to receive notification when the study
has been uploaded, and a message requesting the study. The party
will receive an email with a link to log on (or register) and upload the
study. From here the workflow is identical to ‘Web Upload’.

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About DICOM communications
If your user account belongs to a larger Ambra account your ac-
count administrator may have set up a Ambra Gateway.
Ambra Gateway is a DICOM router used to acquire studies
from devices within your network such as modalities,
viewers, and PACS.

DICOM Send
In the event that your administrator has set up a Ambra
Gateway it is likely that some devices are already configured
to automatically send studies to the application. In this event
studies will show up on the Studies list as they are acquired.

DICOM Query/Retrieve
If your administrator has set up a Ambra Gateway you may
be able to query downstream destinations for studies and
retrieve them. Click ‘Add Study’ and select ‘Query Retrieve’.

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You will be presented with a search form to indicate any criteria to be
used when searching downstream destinations for studies. You must
select a Destination and fill in at least one criteria field.
The fields are:

• Destination – The device you want to search for the study on

• Study UID
• Patient Name – The name of the Patient in DICOM format (e.g.
LAST^FIRST^MIDDLE)
• Patient ID – The patient MRN
• Accession #
• Referring Physician – The name of the Referring Physician in
DICOM format (e.g. LAST^FIRST^MIDDLE)
• Modality – A dropdown of Modality types, or ‘All’ if unknown
• Start Date and End Date – Must be set together, these are
bounding dates for the date of the study.

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After the query is conducted the Activities queue You can ‘Retrieve’ or ‘Reject’ the study.
is updated with one result per match, indicated by If you select Retrieve, the study will be
a change in the number next to the Activities link acquired from the downstream device.
in the main menu. Clicking this link presents the If you select ‘Reject’ the record will be
query results. deleted from the queue.

If you clicked ‘Retrieve’ the study is available in the Studies list.

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User Interface Overview

Main Toolbar Study Page Closes Viewer

See page 6. Opens a new tab with study details. See page 5.

Study Series Thumbnails The first series thumbnail displays: Subsequent thumbnails display:
Studies are grouped by “Series”. Patient name Series name
Series contain one or more images. Patient date of birth (DOB) Number of instances in series
Study description
Click or drag a series thumbnail to
Accession number
load its images in the main image
frame. Date of study
Number of series

Study Demographic
If using Ambra Accelerator, a white
lightning bolt icon will display next to
the study description for accelerated
studies. If the study is not accelerated,
the icon will be red.

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User Interface Overview

Protected Health Information (PHI) Patient orientation

Patient: Name, and gender: (F) female, (M) male Indicators appear at top, sides, and bottom:
DOB: Date of birth, MM/DD/YYYY A: Anterior, S: Superior. P: Posterior, I: Inferior
Date: Study date, MM/DD/YYYY; time of day, HH24MMSS L: Left, R: Right
Primary, Current: Load order, study location in patient history
Instance: 1/x: Instance number in study
Ruler
Adjusts to scale on zoom in or out.

Protected Health Information (PHI) Zoom: Magnification level

Ref. Phys.: Referring physician Quality: Image quality:
Study: Description SD: Standard Definition: 256 pixels max defintion, JPEG compressed
HD: High Definition: 8 bit max definition; JPEG compressed
Series: Modality in parentheses concat-
Diagnostic: Full pixel-depth (8, 10, 12, or16 bit max definition) pre-
enated with the study series number. sented as PNG
Image type: Modality dependent DICOM
tag that identifies the type of image dis- Center/Width: Window level
played. Indicates window level
These items display only if the
DICOM tags contain data:
Context Menu
Slice Thickness: The slice thickness, in mm
Displays with right-click, Windows;
Machine name: Radiation machine used to acquire image
Control-click, Mac.
kVp: Peak kilo voltage output of the device used

mA: The total exposure expressed in mAs

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Study Page
The Study Page opens a new tab when the ‘Study Page’ link
in the Viewer is clicked. It is divided into four sections.

Overview: information and functionalities shown below.

Series: a list of series in the study. Series can be downloaded individually, if
the ‘Download Study’ permission is enabled.
Attachments: a list of items attached to the study – reports, etc.
Meetings: displays a meeting name and host when a meeting is in progress.

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Main Toolbar
The toolbar has been divided here for legibility.
It is a continuous horizontal bar in the user interface.

View Export
Toggles the View sub-toolbar visible/hidden. See sub-tool- Exports main image or displays editable metadata. See
bar descriptions on a subsequent page. Export Sub-Toolbar below.
Scroll Cine
Scrolls through a study’s images. Use mouse wheel to View images as a movie. US ( multi-frame ) studies are
scroll. displayed with HTML5 video in actual frames per second.
See sub-toolbar on a subsequent page.
Window width/level
Sets image’s window width (contrast) and window level Key Image
(the number at the center of the window).Mouse: Window Makes the visible study image ( highlighted with a blue
width: hold left click, move mouse left-right. Window level: bounding box ), a Key image. A study’s key images can be
hold left click, scroll up-down. Touch pad: Window width: viewed by selecting ‘View Key Images’ in the view options
one finger tap, drag left-right. Window level: one finger tap, menu in the studies list.
drag up-down. See window width/level description on a Key Images Only
subsequent page. Toggle to show/hide key images. When enabled, only im-
ages marked as key will display.
Annotate
Toggles Annotation sub-toolbar visible/hidden. See an- Meet
notation sub-toolbar button descriptions on a subsequent Start a live collaborative meeting with other Ambra users.
page. See a subequent page for meeting instructions.

Probe Actions
This button appears only when viewing CTs. Click and drag ‘Share’ shortcuts. See sub-toolbar description on a subse-
on an image to read Hounsfield values. quent page.

Reset Delete
Returns series to original state while remaining on current Delete images or series. See sub-toolbar description on a
image. Resets window level, invert tone, rotation, zoom, subsequent page.
free draw and line measure annotations. Settings
3D Opens the viewer settings editor whichs allows you to set
Toggles 3D sub-toolbar visible/hidden. See sub-toolbar a default layout, default mouse tool, thumbnails position,
button descriptions on a subsequent page. toolbar buttons by modality, default cine speed by modal-
ity, Window Level presets by modality, text display by
Layout
modality, and hanging protocols by modality. See a subse-
Choose number of images to display from the grid. ‘Maxi-
quent page for viewer settings editor use instructions.
mize’ opens the selected series in a one-up full screen
view. ‘New’ opens the study in a new browser tab. Enhance
Locally enhance the contrast of an image. This filter pro-
Print
vides an alternative to the window/level filter for global
Opens a page in a new browser window with a hyperlinked
contrast enhancement.
list of all available images in the study(s) being viewed. See
a subsequent page for how-to-use instructions. Record ( Audio )
Opens the audio recorder in a new window. Audio record-
Hide/Show Buttons
ings are saved to the study as WAV file attachments.
Thumbs
Toggle to Hide//Show study thumbnails. Record ( Script )
Info Captures screen activity in the viewer ( video ), and micro-
Toggle to show/hide study information. phone input ( audio ). Movie files are automatically saved
as study attachments, and available for replay from the
Annotations
attachments list at the bottom of the study thumbnails
Toggle to show/hide annotations.
column.
Invert
Mouse
Inverts image colors.
Set functions of left button, right button, and scroll wheel.

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Sub-Toolbars

View

Fit Flip V
Fits image to screen. Flips image vertically.

Zoom Flip H
Zooms in and out. Mouse scroll wheel: Scroll Flips image horizontally.
up-down. Touch pad: Swipe up/down. When
you zoom in, the system zooms to the location Rotate
of your mouse pointer. Rotates image in 90 degree increments.

Move Magnify
Pans image. Touch pad: Swipe up/down. Click and drag magnify an area.

Window Level
Up to nine window level presets can be saved per modality. They can be ac-
cessed from the window level menu or by using the numeric keys 1-9 on the
keyboard. CT supports default window level presets for Bone, Head and Neck,
Soft Tissue, and Lung.

Reset Presets
Resets window level to level when viewer Three examples of as many as nine
was opened. saved presets.

Save
Saves currently adjusted window
level to a preset.

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Sub-Toolbars

Annotations
Annotation mark-up is not saved in the original DICOM file.
However, you can use the GSPS export button to save a copy of the annotations as a sec-
ondary DICOM file, or use the secondary capture button (on the Export menu, see previous
page ) to save a copy of the image with burned-in annotations.

Select Rectangle
Selects an existing annotation. Once an annota- Click to create a rectangle. The dimensions will be
tion is selected, you can adjust it by clicking on the calculated automatically.
points that appear.
Ellipse
Delete Click to create an ellipse. The dimensions will be
Click to delete a selected annotation. calculated automatically.

Fill Text
Click to fill a rectangle or ellipse. Click to create text annotations.

GSPS Export Radius

Click to export annotations as a Grayscale Softcopy Draw a circle and the radius measurement will be
Presentation State file. calculated automatically..

Line Measure Anonymize Series

Hold left click and move mouse from point to point to Anonymize PHI in the pixel data for all images within
measure. Measurements display in millmeters to 100, a series by drawing a rectangle over the area to be
then in centimeters. anonymized, then clicking this button.
A new anonymized series will be created.
Arrow
Hold the left mouse button and drag from the Anonymize Study
source point to the target point. An arrow will be Anonymize PHI in the pixel data for all images within
drawn from the source to the target. a study by drawing a rectangle over the area to be
anonymized, then clicking this button.
Angle A new anonymized study will be created.
Select three points using the left mouse button.
The angle at the middle point will be measured
GSPS Layer Toggle Visible/Hidden
and displayed.
Click to toggle saved Grayscale Softcopy Presentation
State.
Cobb Angles
Locate the most tilted vertebra at the top of the
curve and draw a parallel line to the superior ver-
tebral end plate. Locate the most tilted vertebra
at the bottom of the curve and draw a parallel
line to the inferior vertebral end plate. The angle
formed between the two lines is the Cobb angle.

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Sub-Toolbars

3D
3D tools are for interacting with 3D DICOM data such as CT and MR studies.

R/L: Reference Lines Local: Plane Localization

Toggles the reference lines’ visibility for all series. Refer- Click/drag with the left mouse button to localize all
ence lines show the intersection of the selected image’s visible series to the point under the cursor. A red
plane with all orthogonal series. cursor will display the corresponding location on
each series, and the series will scroll to display the
Link nearest image.
When selected and either the mouse wheel or Scroll tool is
used to scroll a series, all parallel series will scroll in such
a way as to display the nearest image. The loading bar ( a
blue horizontal incremental bar at the base of the image
frames ), shows the amount of DICOM information that
needs to be loaded to enable the linked series and plane
localization features. Those features will work when the
bar reaches the right hand side of the linked image frames.

Layout

Maximize
Fills the screen with current study image.

+ New
Loads a duplicate view of study in a new tab.

Grid
Selects the number of series to display
simultaneously.

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Sub-Toolbars

Export Actions

Export Actions
Click ‘PNG’ to export main image as a PNG file. The ‘Actions’ button displays for users with the ‘Rout-
ing Rules: Create and run manual rules’ role permis-
Click ‘DICOM’ to export main image as a DICOM sion checked. Any routing rule with the ‘Apply rule
file. when a study is manually routed’ setting enabled will
be available from the new ‘Actions’ button, shown as
Click ‘Meta’ to display study’s editable metadata
‘Test’ in this example.
in a new tab – any non-red DICOM tags. Metada-
ta editor supports study level changes to DICOM
tags, not series or image level changes. Editable
study list fields are not editable in the metadata
editor.

Cine Delete

Delete Image
Cine
Click to delete the currently highlighted image.
The cine sub-toolbar controls video playback.
Click ‘Play’, or ‘Pause’. ( ‘Pause’ shown here. )
Delete Series
Click ‘Faster’ to increase playback speed.
Click to delete the currently highlighted series.
Click ‘Slower’ to decrease playback speed.
Frames-per-second ( FPS ) is displayed next
to the primary ‘Cine’ button when video is playing.

Keyboard shortcuts:
P Play/Pause all visible cine loops
N Next set of series
B Back to the previous set of series
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 Multiple Frames

Layout
Click ‘Layout’ to choose
from one-up to sixteen-up
layouts. One-up is shown
here.

Layout
Two-up is shown here.

Active series
The active series is high-
lighted with a blue bound-
ing box. Clicking another
frame will make that frame
active.

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Stack Series
When enabled, the Stack feature allows users to scroll continuously
through all images in a study. Stack functionality is activated in Viewer
Settings. It can be set as the default per modality, and/or can be enabled
on a study-by-study basis by clicking on the Stack Series thumbnail.

Stack Series Thumbnail

The Stack Series thumbnail can be
configured to display first or last in the
series thumbnails. Click the thumbnail
to enable Stack functionality.

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 Related Studies
Related studies have the same MRN in the active folder
(organization, group or location). If the MRN is blank, no
studies will display in the related study’s thumbnails. The
active folder is the folder in which the viewed study resides.

Find related studies

If related studies for a
patient exist in the Ambra
system, they can be found
on the right hand side of the
thumbnails panel. Scroll to
the right if necessary, and
click the related study’s icon
to load its series. The related
study’s thumbnails will load
alongside the existing study
in the thumbnails panel.

View a related study

Scroll to the related study’s
heading in the thumbnails
panel, and click a series im-
age to load the series. This
screenshot shows two stud-
ies for the same patient: the
‘Primary/Current’ study
and a ‘Related/Prior #1’.

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 Meetings
Collaborate live with other Ambra users and guests.

Start a meeting
Click the ‘Meet’ button.
Name the meeting,
then click ‘OK’.

Attendees
The meeting is started.
All attendees are shown in
the ‘Attendees’ list.
Registered Ambra users al-
ready viewing the study can
join the meeting by clicking
the Meeting thumbnail.
Actions performed by the
host ( Move, Scroll, Anno-
tate, Probe, 3D, Window/
Level, for example ) are
synced live with attendees.
( Continues on next page. )

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Meetings

Invite Guests
Click ‘Create Public Link’
to create a hyperlink,
that can be emailed to
guests ( anyone not
already a registered
Ambra user ).

Change Presenter
Click an attendee to make
that person the presenter.
( Registered Ambra users
with appropriate permis-
sions can be presenters.
Guests do not have permis-
sion to be presenters. )

End a Meeting
Click ‘End Meeting’.

Attendee View
Attendees will see the
presenter’s view, minus
the toolbar.

Leave a Meeting
Click ‘Leave Meeting’.

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Local Study Viewing
We provide two options for downloading and viewing studies locally.

‘Download Viewer’
‘Download Viewer’ enables local viewing of a study using the full
Ambra Viewer, which includes window level and performs at PACS
viewer speeds. Clicking the down arrow to the right of the ‘Download’
button and selecting the ‘Download Viewer’, will download a Zip file to
your machine. Un-zip it and double click the ‘index’ file. The study will
open in Ambra Viewer. You do not need access to the Internet to view
the study.

‘Download ISO’
‘Download ISO’ downloads a study package that includes any attached
reports and Ambra Simple Viewer software to make it easy to copy the
study package to a CD. Simple Viewer does not include the window level
function, but it performs at PACS viewer speeds. Clicking the down ar-
row to the right of the ‘Download’ button and selecting the ‘Download
ISO” will download a Zip file. Un-zip the file, and a folder will appear
which can be burned to CD. Double clicking the ‘index’ file within the
folder will open the study in Ambra Simple Viewer. You do not need ac-
cess to the Internet to view the study.

View Unrelated Studies as

Related Studies
Select all studies to view as related by clicking the checkbox next to
each study on the left side of the Studies list. Next, select the ‘View re-
lated’ option in the Actions menu on the top left side of the Studies list.
The selected studies will open in a new tab. The most recent study will
display as the primary study by default. The other selected studies will
be available to view as related studies. To compare a related study to
the primary study, click on the related study thumbnail in the viewer.

29
Settings
All settings are per-user. Account-level settings must be edited by contacting support.
Open the settings editor by clicking the ‘Settings’ button on the main viewer toolbar.
Save changes at any time by clicking the blue ‘Save’ button, or undo all changes by clicking the
gray ‘Reset’ button.
Use the menu on the left to navigate. Expand or collapse a section by clicking on it. Edit a page
by clicking on a blue link.
Clicking on a ‘New Page’ icon on the right hand side of the menu will add a new page to that sec-
tion. A page can be removed by clicking the ‘x’ icon on the right side.

Sections
General
Choose: Default Layout, Default Left Click Hold Mouse tool, Default Right Click Hold Mouse
Tool, Default Mouse Scroll Tool, Reverse Vertical Window/Level Behavior, Reverse Horizontal
Window/Level Behavior, Thumbnails Position, Number of Images to Preload, Print Size, Print
Margin, Display Key Image Series First, Combine Key Image Series, Show Related Studies, Show
PDFs,Display Reports First, and Disable Mobile Image/Series Scroll Arrow.
Toolbar
Select and arrange toolbar buttons.
Context Menu
Select and order context menu buttons.
Key Shortcuts
Customize keyboard shortcuts for viewer tools.
Modalities
• General - Simple settings like the modality name, default cine speed, show stack series.
• Window level presets - Add and remove window level presets, which appear on the win-
dow. level menu in the application when a series of the right modality is selected.
• Toolbar Buttons - Add or remove buttons from the toolbar for this modality.
• Text Annotations - Add or remove text annotations for this modality.
Hanging Protocols
A hanging protocol specifies how studies of a particular type should be displayed on the screen.
• General - The hanging protocol name and layout.
• Study Filters - Specify which studies this hanging protocol applies to. At least one filter in
every “filter group” must be matched, so for example, to match only CT studies of the head,
create two filter groups, one with a “modality CT” filter, and one with a “study description
head” filter. Filter types:
• Modality - The Modality DICOM tag must match the specified text.
• Study Description - The study description must contain the specified text.
• Image Sets - Specifies how series are selected for display. Filters are applied in the same
way as study filters, but there are more options:
• Series Description - The series description must contain the specified text.
• Image Type - The Image Type DICOM tag must contain the specified text.
• View Position - The View Position DICOM tag must contain the specified text.
• Laterality - The Laterality DICOM tag must contain the specified text.
• Multiframe - If checked, this filter only matches multiframe series.
• Ultrasound Image Type - Extra filter options for ultrasound images.
• Display Sets - Display sets describe how to display the selected series on the screen:
• Which image set to use.
• How to transform the image (flips, rotations).
• Window level and inversion settings.
• Which overlays to display (text, measurements).
• Cine Settings - Specify cine settings such as frame rate and automatic playback.

30
Printing
Clicking the ‘Print’ icon in the Viewer opens a
new browser window with two columns, dis-
played here.

The left column contains links to each image

in the study, ‘Fit to Page’, ‘Full Size’ ( one screen
pixel for every image pixel ), and ‘True Size’
( 1” on the screen or paper equals 1” in the
geometry of the patient. ) Full Size should be
used when a specific DPI is required for print-
ing.

The right column displays images after their

respective links in the left column are clicked.
All images displayed in the right column will be
printed when the ‘Print’ link at the top of the
left column is clicked.

( Studies with less than 20 images display two

additional functioning hyperlinks at the top of
the left column: ‘Show All Full Size’ and ‘Show All
True Size’. )

Keyboard Shortcuts
Keyboard shortcuts can be customized by clicking the
‘Settings’ button, in the main Viewer toolbar, and then
the ‘Key Shortcuts’ link on the Settings page.

General
N Next set of series
B Back to the previous set of series
Arrow up/down Previous/next images
Page up/down moves 10 images at a time

Annotations
Control + C Copies a selected annotation to the clipboard
Control + V Pastes a copied annotation
Control + D Duplicates a selected annotation
Delete Deletes a selected annotation

Window Level
Number keys 1-9 Applies window level presets

Cine
P Play/Pause all visible cine loops
N Next set of series
B Back to the previous set of series

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Mobile Browser Requirements
Apple iOS
Safari iOS ( version 7.0 and later )
Upload Images: Native View Images: Native
Android
( Version 4.4 KitKat and later )
Google Chrome ( version 28.0 and later )
Upload Images: Native View Images: Native
Firefox ( version 23.0 and later )
Upload Images: Native View Images: Native

Viewer Features Comparison

Description Desktop Mobile Phone Mobile Tablet
Cybersecurity controls - login √ √ √
Search √ √ √
Import a study - web upload √ √ √
Import a Study - Email Request √ √
Import a Study - DICOM Send √ √ √
Import a Study - Query/Retrieve √ √
View images (zoom, move, rotate) √ √ √
PHI overlay √ √ √
Series thumbnails √ √
Study metadata √ √
Window/Level √ √
Annotations (text, distance, area, angle, density) √ √
3D (linked series, planar localization, and reference lines) √ √
Layout √ √
Cine √ √
Delete √ √
Related studies √ √
Meetings √
Local viewing √
Settings √ √
Printing √ √

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 Mobile Phone Viewer
View images on your iPhone
or Android phone using any of the
browsers supported on the Mobile
Browser Requirements page.
Not intended for diagnostic use on
mobile devices.

Mobile Viewer Gestures

Move Image
Swipe with one finger.

Zoom In or Out
Make a pinching or expanding gesture.

Rotate Image
Place two fingers on the image and move them in a
rotating motion.

Navigate Between Images or Series

Single tap with one finger in one of four quadrants.

Toggle Patient Information On/Off

Double-tap with one finger.

Not intended for diagnostic use

on mobile devices.

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Mobile Tablet Viewer
View images on your tablet using
any of the browsers supported on
Mobile Browsers Requirements page.
Not intended for diagnostic use
on mobile devices.
All tools in the Viewer’s desktop
version less the meetings feature and
the local viewing feature are available
in the tablet viewer.

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LBL0018 v8.0 May 2017

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