GE Healthcare

Integrated IT Solutions, Dynamic Imaging Solutions

Centricity PACS-IW 3.7.3

Quick Start User’s Guide (Extended)

Launch and Login Launch from a CD

1. Open Internet Explorer to your Centricity® Website. Studies and reports saved to CDs can
2. Always answer “Yes” to security questions and click be read on any computer, even those
the ActiveX control bar if it pops up. without access to Centricity. All the
3. Type your username, then password. necessary utilities to read the study
4. Click Login (or use Enter key). are included on the CD; simply insert
If the login fails, check the Caps Lock key; usernames and the CD into the CD drive of the
passwords are case sensitive. Also check the pop-up bar to computer. A viewer for Centricity
allow ActiveX controls, or add the Dynamic Imaging demo PACS-IW opens automatically, and
server as a Trusted Site in the Security settings panel of the you can access images and reports
Internet Options dialog. using the features described in this
document.
Study List

Use the paging buttons on the toolbar above the tabs to navigate forward or backward through the
Study List.

Use the icons next to each study for a quick grasp of that study’s status:
Denotes that the study is selected.
Click here to view the study. (Note: That if this icon is yellow, the particular study is already
open. This feature is available to radiologists only, as recognized by their login, and is designed
to help radiologists make updates to only one copy of a study.)
Indicates the note/report status:
The gray notepad indicates that no note or report is attached to the study.
If the notepad icon is yellow, then a note has been attached to the study. (Pale yellow
indicates an internal note.)
If the notepad icon is green, then a final report has been attached to the study. (Pale
green indicates a preliminary report.)
Indicates the read status. A study may have a large checkmark (the study has been read and
dictated by a radiologist), a small checkmark (the study has been reviewed but not dictated, or it
has been read by a resident), both or neither.

Note: All examinations should be viewed using Lossless

Wavelet Compression; use the drop-down list.

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Open a Study

Click anywhere on the study’s row in the Study List to launch Image Viewer and load a patient’s
exam.
 Referring physician users, recognized by login, see a special viewing application that shows
only the study interpretations (reports, annotations, key images, etc.), instead of the entire
study. The full Image Viewer can be invoked at any time to see the entire study in the
standard way.
 Mammography studies load in a Mammography Viewer, if a licensed user selects the MG
study and if the layout specifies that the Mammography Viewer (Cedara) should be used.
Click Refresh Viewer from the menu to view any new images that were added while the study was
loaded.

Tip! Hover the mouse over an icon to see a tool tip that defines its function. Right-click to open
floating menus.

Search for and Organize Studies

 Click the appropriate tab to scroll through the list, or click the Search button to enter
search criteria.
 To save the search results as a permanent tab, right click the red Search Results tab. Click
Save Search as…to enter a name and save the tab.
 To move or delete tabs, make the tab active by clicking it, then right-click the tab to get an
options menu.
 To see STAT studies, click the red STAT button.

Tip! You can create tabs by study description, such as Neuro or Body tabs, or by any search criteria.

Page/Scroll

When the exam opens, Page/Scroll mode is enabled on

the main toolbar. Shortcuts
To page through images, click anywhere in a series window to  Right-click for a floating menu.
activate it, then page using any of these actions:  Right-click and drag to adjust the
 Drag the left mouse button. Window /Level.
 Scroll using the mouse wheel.  Hit the space bar to toggle preset
 Left- or middle-click. Window /Level settings.
 Use the up and down arrow keys or the page up and  Hold F2 for Triangulation mode.
page down keys.

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Tips! You can set additional keyboard shortcuts to jump to the middle slice of a series or to jump
forward/backward a page; you can also scroll directly from one series to the next or arrange images
from every series into a single window. See the Shortcut tab and the More Settings tab in Layout
Editor.

Swap a Window Position

To quickly swap a series from one window to another, click and drag the swap icon from the series to
move, and drop it inside the target window.

Window/Level Adjustment and Histogram Analysis

Click the Window/Level toolbar button.

 For manual manipulation, left click and drag to adjust the Window/Level. Right to left drag
adjusts the window; up and down drag adjusts the level.
 For histogram analysis (automatically sets the intensity of a defined region of interest), select
the ROI by clicking and dragging the right mouse button.

Tips! While in W/L mode, use the mouse wheel or keyboard to scroll images. To restore the original
setting, right-click and select from the Preset Window menu.

Zoom

Click the Zoom toolbar button.

 Left click and drag the mouse up to increase in size.
 Left click and drag the mouse down to decrease in size.

Tips! Look for the zoom factor in the lower left corner of the image. To undo zoom, right click and
select Zoom Factor-to fit, or choose Set Zoom from the Main Menu. Hold the middle mouse button to
pan while in Zoom mode.
Use the Zoom to ROI (Scissors) button to zoom only one part of the image.

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Special Note for CR and DR modalities

Right click for True Size, Calibrate Image and

Calibrate Monitor. (Shown in the figure at right.)

Pan

Click the Pan toolbar button.

 Left click and drag to re-center or scroll image.

Tip! Hold the middle mouse button to zoom when in pan mode.

Select an Image

Click the Select toolbar button. Left-click an image to select it, i.e., mark it as a key image.
 To select nonadjacent images, hold CTRL while clicking each image.
 To select adjacent images, click on the first image, then hold SHIFT while clicking on the last
image.

Tip! To deselect an image, hold CTRL and click on the image again. For more options, click on Select
from the Main Menu.

Key Images

There are several ways to save key images: printed to paper or film, or by saving to a file.
 Method 1: Click Key Images on the main menu and select the desired format, a blank page
will appear. Return to viewing mode by clicking the Page/Scroll icon on the main toolbar, or
from the right click pop-up menu. While paging through the study, type the letter i on the
keyboard to insert the current image to the print preview.
 Method 2: Click Key Images on the main menu and select the desired format, a blank page

will appear. This will activate the “add to key images” icon on the main toolbar. Click
an image to send it to print preview. To continue viewing, make the series active by clicking

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 on the title bar, then use the up/down arrow key to page. Click inside the image to add it to
the print page.
 Method 3: Use the Select tool to mark images within the same series as selected. From the
Key Images drop down menu (on the main menu bar), click “add selected images to print
preview.”
 Method 4: Click Key Images on the main menu and select “activate print preview.” Use the
key images toolbar on the right to select a format (L on the keyboard), or click the New icon
(D) and make selections.

Click the Save button (G) in the Key Images toolbar to save the Shortcut
selected images to the desired output.  Type the letter i to insert
the current image onto
Tips! The print page can be moved to any location on the the print page.
monitors by dragging the title bar.

The print page can be resized by dragging the double arrows on any corner.

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The Done Option can be set to prompt you to save your work at exit by checking “save unsaved key
images.”
To delete an image from the print page, double click on it with the “add to key images” tool; to
replace, click and drag any image over another to swap places.

Navigator

Click the Navigator toolbar button. A thumbnail image representing each series is displayed.
The active series is outlined in blue. Displayed series are outlined in white. Undisplayed series have
no outline. If in compare mode (as shown below), different studies are separated by a line and
header information.
 Double click an undisplayed series to open the window.
 Hover the mouse over a thumbnail to display the series description.
 Click and hold a thumbnail to locate its position, which will flash on the monitor.
 Re-arrange series by clicking and dragging a series to a new position.

Tips! When an exam is displayed that has additional series not provided for in the layout, Navigator
opens automatically. Right-click in the Navigator to define its default behavior, such as what overlay
data displays.

Film View

This icon toggles between Film View and Single Series View.
When enabled, paging icons will appear on the toolbar, and images will be displayed in a row &
column format.

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Click Page Format on the Main Menu to select a different matrix display. Use the paging icons on the
right end of the Main Toolbar to page through images.

First Page Page Forward

Fast Back Fast Forward

Page Back Last Page

Tip! Page/Scroll options (as described above) also page while in Film View.
Open the Navigator, click and drag thumbnails to re-sort the order.
Click the Film View icon again to return to Stack View.

Cine Mode

Click the Cine button on the toolbar; a control bar opens at the bottom of the series, as shown
below. Use the arrows to set the frames per second (FPS). Use the arrows to control the direction
forward, backward, or bounce back and forth mode.

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Tip! Point the mouse at a control button to see a tool tip that defines its function.
Click the slider to advance to that section of the cine.

Magnifying Glass

Click the magnifying glass, then click on the area of interest. The area changes to full 100%
resolution (1.0 magnification). Use this tool for x-rays (CR,DR,etc.),
especially chest x-rays. Shortcut
 Hold the shift key to
Tip! Click the toolbar button to toggle between off and on. Click and drag the zoom area.
drag the corner of the ROI to resize it.

Synchronize

Click the toolbar button to toggle the feature off and on.

Tips! For more linking options, go to “Synchronize” in the main menu bar.
Absolute Position is the bed position from the scanner.
Absolute Number is the image number from the scanner.
Use Inter-Studies Sync to page in concert when in comparison mode (e.g., current and prior studies).

Cross Reference

Click the toolbar button to toggle the feature off and on.

Image Overlay

Click the toolbar button repeatedly to toggle through the available overlays. Click the down
arrow to open the menu to display all the overlay templates.

Tip! For more slice information, right click an image and choose Image Info.

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Create Copy

Click the toolbar button to create a duplicate of the active series.

Tip! This is very useful for CT Abdomen and for creating duplicates for Lung, Liver and Bone
windows.

Triangulation

Click the toolbar button to activate this feature. Click an area Shortcut
of interest; all other series (of unlike axes) will advance to that level  While in paging mode, hold
and be marked by a green circle. F2 to activate Triangulation.

Tips! A red circle indicates that there are no corresponding slices at that level.
Click and drag over an area of interest to display the corresponding images.
Click and drag along a sagittal spine to move the axial series.

Measurements

Click this toolbar button to open a sub-toolbar menu for measurements.

You can measure from point to point, angles, ROI (elliptical, central-elliptical, rectangular or single
point, known as “probe”) or freehand. The trash can button deletes all measurements at once.

Tips: Click and drag to define a region of interest.

Move the measurement label by clicking and dragging it.
Click and drag the Point ROI tool to obtain a roving Hounsfield measurement.
Right click on an angle measurement’s label and choose “Ortho Angle” for orthopedic
measurements.
Right click on the measurement to edit font and color.
To delete a single object, double click on the highlighted annotation.
Use elliptical to drag around the ROI; use central-elliptical to drag from the center outward.

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Use the Color Well to select any color for measurements, or a different color for each.
Use the OB Measurements button to measure the gestational age of a fetus.

Special Note for US and X-ray distance measurements

Some images must be calibrated to the ruler before an accurate measurement can be made.
Calibrate Image is used to make measurements on Ultrasound images and other images that are
considered screen-captured.
1. For X-rays, right click and select a true size format.
2. Click Calibrate Image on the main menu or from the right-click floating menu.

3. Draw a known measurement using the scale on the side of an image.

4. Enter the length and the calibration method.
5. Click Apply to Image.
6. Click and drag on the image to calculate a point-to-point measurement.

Labels

Click this toolbar button to display a sub-toolbar menu.

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Tip! To make a text label, click the A button, then click the image. Type text and click the green
checkmark to accept the text.
Drag text to any desired location.
Right click the label to edit the font and color.

Save Image

Click the save image button to open the options dialogue. Select the file type and the folder in
which to save the image.

Tip! This action saves images to a file; to upload new (i.e., reformatted images) to the server, click
Upload Series from the Image Viewer menu.

Notepad

Click the toolbar button. Always answer “yes” to security questions. Click on Add Note, Add
Internal Note or Add Preliminary Report; type a message and click the Done button. Click the red X in
upper right corner to close.

Tips!
Notes and Reports are accessible from the patient folder. They are color-coded and have five levels.
If a notepad contains both notes and reports, the icon will be the color of the highest level.
Gray notepad is empty.
Light Yellow notepad indicates an Internal Note (viewable by all radiology personnel).
Dark yellow notepad indicates a Note (viewable by all users).
Light green notepad indicates a Preliminary Report.
Dark Green notepad indicates a Final Report.

Preset Window

Right-click in an image to see functions in the

floating menu. Any of these actions will be applied
to the active image or series.

Select Preset Window from the menu. Make a

selection from the predefined list of Window/Level
settings or choose to Invert black/white.

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Tip!
You can load a pre-set by default when a study is opened; go to the More Settings tab in the Layout
Editor.

Spine Labels

Click Spine Labels from the floating menu. Select the level at which to start labeling; then select the
label type, labeling step, direction and appearance settings.
Click the image to deposit labels at the desired levels.

Tip!
To remove labels or start over, click on Remove All.

Main Menu

Nearly any function can be added to the main toolbar via the Layout Editor; the following is an
example only:

Layout
Use this item to open the Layout Editor or access other load options. Referring physician users
cannot invoke the Layout Editor.

Load by Location
This item loads a specific presentation based on series attributes.

3D and MPR
These items opens the image in a different viewing mode, either three-dimensional or multi-planar
reformatting.

Presentation State
The user can save presentation states—such as measurements, annotations, zoom, pan, etc.—and
reload previous states.

Select
This item enables the user to select specific images that will receive changes (e.g., windowing or flip).

Set Zoom
Click on Set Zoom and select the desired window size. Use the “to fit” option to resize the window to
the original unzoomed size.

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Page Format
Click on Page Format and choose the desired matrix display.

Synchronize
The Synchronize feature allows you to link parallel series so that they page in concert.

Play Cine
This feature allows you to see all images in the study in a cinematic "loop."

True Size
True Size is used for viewing X-Ray images from CR or DR modalities. Click True Size and select the
desired true size factor for viewing.

Flip/Mirror/Rotate
Flip for top to bottom; Mirror for left to right. Rotate turns the image 90º.

Calibrate Monitor
Calibrate Monitor is used to adjust the monitor for viewing X-Ray images from CR or DR modalities.
Click Calibrate Monitor. Follow the step by step instructions in the pop-up.

Done

All users other than referring physician users can set the Done button to execute user-defined
actions by default:

1. Click the down arrow  to open the drop-down menu.

2. Select Done Options and then check the actions that

should be performed by default when you close a study;
click OK.

3. Once these defaults are set, click once on the Done button to execute these actions and
close the study.

Save Presentation State

Before closing a study, you have the option to save your

work (windowing, measurements, annotations, key
images—known as the presentation state) as part of the
permanent record. The Done button can be configured to
save the presentation state automatically on exit, or the
option can be selected at any time from the Done button’s
drop down menu.

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To view another user’s work, click Presentation State on the main menu, and select a date/user from
the list.

Layouts

To select from the layout list, click Layout on the main menu, then click Load. Referring physician
users cannot access the layout list.

If no layouts appear in your Personal list, check the “All Screen Sizes” option. If the list still appears
empty, click the “Common” option.

Click the desired layout from the list, and then click Apply.

To create a custom layout, first arrange the study. Click Layout | Edit, enter the appropriate settings
and click the Save As button to enter a name for the new layout.

Tips!
It is important to keep the naming convention consistent with the exam displayed on the screen, as
follows:
Body Part- Modality- # of Series- Monitor Configuration
When creating comparison layouts, add Comp to the end of the layout name.
To save a comparison layout, the images MUST be on the LEFT side of the display.

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Comparing Studies

To compare a prior study, select two or more studies to

Note: You can set the
compare from the Study List (check the boxes in the first column).
system to automatically
Click the Compare button above the Study List. open anatomically-related
The most current study will open on the left. The older study will display priors in Compare mode.
on the right. You can also set the system
to automatically fetch and
If more than two studies were originally selected, click the Compare load anatomically-related
priors.
button in the Image Viewer to display the list of studies. Click the
Left (L) and Right (R) monitor position for the respective exams, then click Display.

Tip! Centricity PACS-IW can load a patient’s prior studies in comparison mode by default when a
study is opened. Go to Preferences in the Configuration dialog.

Logout

Click the logout button to end the session.

Tips! This will free the license for another user to login, if your facility has a limited number of
licenses.
The system administrator may set the auto logout for a predetermined inactivity timeout.

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Index

Mirror.................................................................................13
A
Anatomically-related priors................................... 15
N
Naming Convention .................................................14
C Navigator ...........................................................................6
Notes ................................................................................11
Calibrate..................................................................... 4, 13
CD..........................................................................................1
Cine.......................................................................................7
O
Comparing Studies................................................... 15 OB Measurements ......................................................10
Copy .....................................................................................9 Organizing Studies ........................................................2
Cross-Reference.............................................................8
P
D Page Format............................................................. 7, 13
Done.................................................................................. 13 Page/Scroll ........................................................................2
Pan ........................................................................................4
F Presentation State....................................................13
Preset W/L Settings..................................................11
Film View............................................................................6
Flip...................................................................................... 13
R
I Refresh ................................................................................2
Reports ............................................................................11
Image Overlay.................................................................8
Rotate ...............................................................................13
Inter-Studies Sync .........................................................8

K S
Save Image....................................................................11
Key Images .......................................................................4
Search for a Study .........................................................2
Select an Image ..............................................................4
L
Spine Labels..................................................................12
Labels ........................................................................10, 12 Study List............................................................................1
Launch ................................................................................1 Swap.....................................................................................3
Layout.............................................................................. 14 Synchronize ......................................................................8
Load prior studies by default ................................ 15
Login ....................................................................................1 T
Logout.............................................................................. 15
Triangulation ....................................................................9
True Size ..................................................................... 4, 13
M
Magnifying Glass............................................................8 W
Measurements ................................................................9
Window/Level ..................................................................3
middle slice .......................................................................3

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Z Zoom ....................................................................................3
Zoom to ROI ......................................................................3

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