Lucion - 기능편 - Orangedental
Transcription
Lucion - 기능편 - Orangedental
EzImplant Manual (Version 2.0.0) E-WOO Technology Company Limited 2006 1 Copyright by © 2006 E-WOO Technology Company Limited The document contains only the EzImplant user guide manual. For additional information pertaining to either this manual or the EzImplant program, please contact E-WOO at: Tel 031-379-9595 Fax 031-377-1882 Email [email protected] Printed manual distributed with products may not include contents specific to the latest version. Please refer to the software disk or contact your supplier for latest version. 2 Contents CONTENTS EZIMPLANT 1 CONTENTS 1 I 9 EZIMPLANT INTRODUCTION 1. EZIMPLANT MAIN FUNCTIONS 2. COPYRIGHTS II 9 10 INSTALL, UNINSTALL AND OPERATION 11 1. SYSTEM REQUIREMENTS 11 2. SYSTEM OS UPDATE 11 3. HASP KEYLOCK INSTALL 13 4. EZIMPLANT CD INSTALL 18 5. EZIMPLANT INSTALL FOR MULTIPLE USERS 21 6. STRUCTURE OF SETUP FOLDER 22 7. EZIMPLANT UNINSTALL 23 8. FAQ 24 TOOL 25 III 9. MAIN TOOL 25 (1) 25 (2) VIEW ▪ Pan (Moving) 25 ▪ Rotate 25 ▪ Zoom (Zooming) 26 ▪ Windowing (Brightness/Contrast) 26 ▪ Invert 27 ▪ Text Overlay 27 ▪ VOI Overlay (VOI: Volume Of Interest) 27 MEASURE 27 ▪ Measure Distance 28 1 Contents (3) (4) ▪ Angle 29 ▪ Profile 30 ▪ Area 30 ▪ ROI (Region of Interest) 30 ▪ Arrow 31 ▪ Note 31 SEGMENTATION 31 ▪ Cutting (Draw Mask) 31 ▪ Extracting (3D Picker) 32 ▪ Mask Overlay 33 ▪ Reset Mask 34 ▪ Undo Mask 34 ▪ Redo Mask 34 OUTPUT 34 ▪ Capture 34 ▪ Print 37 ▪ Save 37 ▪ CINE Player 38 ① How to use CINE Player 39 ② Change Play Speed/Play Mode 39 - Play Speed 39 ③ Save as… 40 ④ Extra Features 41 ▪ Show Menu 10. IV 42 LOCAL TOOL 42 IMAGE PANE GUI 43 1. DEFINITION 43 2. IMAGE PANE TYPE 43 (1) 43 IMAGE PANE WITH TITLE BAR ▪ ① Title Bar 43 ▪ ② Image Pane Sub-Tool 44 ▪ ③ Image 44 ▪ ④ Image Information 44 ▪ ⑤ Grid 44 2 Contents ▪ ⑥ Direction Information (2) 3. 4. V IMAGE PANE WITHOUT TITLE BAR 44 45 IMAGE PANE SUB-TOOL 45 (1) QUICK-LIGHTBOX 45 (2) MAXIMIZE / MINIMIZE 45 (3) MENU 46 DEFAULT FUNCTIONS 46 (1) MOVE 46 (2) ROTATE 46 (3) WINDOWING 46 MAIN WINDOW 47 1. DEFINITION 47 2. WINDOW DESIGN 47 (1) MAIN TOOL 47 (2) MAIN WINDOW 48 (3) FINE TUNING 48 3. MPR (1) TITLE BAR 49 (2) MENU 49 (3) MOVE 49 (4) ADJUST RENDERING MODE / THICKNESS 49 (5) 4. VI 48 ▪ Adjust Rendering Mode 49 ▪ Adjust Thickness 50 ROTATE 50 3D 50 (1) ADJUST RENDERING MODE 50 (2) MPR OVERLAY SETTING 51 (3) ROTATE 51 (4) INITIALIZE THE DIRECTION 51 MPR 1. 53 MPR – ROTATING AXES 53 (1) 54 MOVE AXES 3 Contents 2. VII (2) ROTATE AXES 54 (3) ADJUST AXIS’ THICKNESS 55 (4) LOCAL TOOL 55 ▪ Rendering 55 ▪ Thickness 55 ▪ Reset 56 MPR – OBLIQUE SLICE 56 ▪ Setting 56 ▪ Adjusting 57 CURVE 58 1. DEFINITION 58 2. CURVE / CROSS-SECTIONAL 58 (1) 58 (2) HOW TO MAKE CROSS-SECTIONAL VIEW ▪ Partial Arch 59 ▪ Full Arch 61 HOW TO UNDERSTAND THE CROSS-SECTIONAL VIEW 62 ▪ Cross-Sectional View 62 ① Sub-Tool 63 ② Move image 64 ③ Measure Length 65 ④ Measure Profile 66 ▪ Panoramic View 67 ▪ Axial View 68 ▪ 3D View 68 3. CURVE - GENERAL CURVE 69 4. CURVE - SELECT LATEST ITEM 70 5. LOCAL TOOL 71 6. PRINT 71 (1) PRINT CROSS-SECTIONAL VIEW 71 (2) PRINT PANORAMIC VIEW 72 (3) PRINT AXIAL VIEW 74 VIII 3D ZOOM 76 4 Contents 1. DEFINITION 76 2. 3D ZOOM – ENDOSCOPY 76 (1) ADJUST SURVEY RANGE OF CAMERA 77 (2) CAMERA MOVING 77 3. 4. IX ▪ Target Point Moving 77 (3) OBLIQUE CAMERA MOVING 80 (4) ROTATE 80 ▪ Rotate centering on the observation part 80 ▪ Rotate centering on the View 81 (5) ADJUST OBSERVING ANGLE 81 (6) LOCAL TOOL 82 3D ZOOM - CUBE 82 (1) 82 MOVE ▪ Centerpiece Moving 83 ▪ Free Moving 83 (2) ROTATE 83 (3) SIZE ADJUSTING 83 (4) INITIALIZE DIRECTION 84 (5) SET RENDERING MODE 84 3D ZOOM - PLANE 85 CANAL (DRAW CANAL) (1) (2) 88 DRAW CANAL IN CORONAL VIEW ▪ Calibrate axis 88 ▪ Canal Draw 89 DRAW CANAL IN CROSS-SECTIONAL VIEW 90 ▪ Make Cross-Sectional View 90 ▪ Canal Draw 90 2. CANAL MANAGER X 88 92 ▪ Set Diameter 92 ▪ Delete 92 IMPLANT (IMPLANT SIMULATION) 1. IMPLANT SIMULATION 93 93 5 Contents (1) INSERT (3) 93 ▪ Inset Implant 94 ▪ Multiple Insert 95 EDIT IMPLANT 95 ▪ Move/Rotate Implant 95 ▪ Implant Menu (popup) 96 2. IMPLANT MANAGER 97 3. IMPLANT LIBRARY 98 (4) ADD USER DEFINED IMPLANT (NEW) (5) MODIFY USER DEFINED IMPLANT 100 (6) DELETE USER DEFINED IMPLANT 100 4. SHOW BONE DENSITY XI 99 100 UTILITIES 102 1. FREE DRAW 102 2. REPORT 103 XII (7) TOOL MENU 104 (8) DATA REGISTER 105 ▪ Insert Image 105 ▪ Register Patient Information 106 ▪ Register Treatment Record 106 SETTINGS 107 1. CONFIGURE DEFAULT SETTINGS 107 ▪ Cross-Sectional Images 107 ▪ Panoramic Images 107 ▪ MPR Images 107 ▪ Initial Zoom Factor (MPR) 107 ▪ Default Windowing 108 ▪ Implant Overlay 108 XIII FINE TUNING, OBJECT 1. 109 DEFINITION 109 6 Contents 2. FINE TUNING GUI 109 (1) OBJECT LIST 109 (2) COLOR BAR 110 (3) OPACITY GRAPH REGION 110 (4) WINDOWING BAR 110 (5) SCROLL BAR 110 (6) LOCAL TOOL 110 ▪ AutoFit 110 ▪ Load Preset 110 ▪ Object Tool 110 ▪ Expand 110 ▪ Shrink 110 3. OBJECT MANAGING 111 4. ADJUST OPACITY GRAPH 111 (1) ADD/SELECT NEW OPACITY GRAPH 111 (2) DELETE OPACITY GRAPH 111 (3) ADJUST / DELETE OPACITY GRAPH 112 ▪ Move Graph 112 ▪ Adjust Graph by dot 112 5. ADJUST WINDOWING 112 6. ADJUST SCROLL BAR 113 7. PRESET 113 (1) LOAD PRESET 113 (2) SAVE TO PRESET 113 ▪ Save To Preset (3) (4) 8. 114 SET THE PRESET AS DEFAULT 115 ▪ Set as Default 115 CATEGORY SETTING 116 COLOR BAR 116 (1) LOAD COLOR-MAP 117 (2) SAVE COLOR-MAP 117 (3) COLOR ANCHOR 118 ▪ Add Anchor 118 ▪ Edit Color 119 XIV APPENDIX 121 7 Contents 1. UNDERSTANDING & APPLICATION FOR MPR IMAGE 121 2. APPLICATION FOR 3D IMAGE 122 (1) MPR PLANE IMAGE 122 (2) STATE OF BONES 122 (3) REVIEW TREATMENT RESULT 123 3. 4. 3D IMAGE AND CT NO. 123 (1) THE RELATION BETWEEN 3D IMAGE AND CT NO. 123 (2) THE RELATION BETWEEN 3D IMAGE AND COLOR BAR 124 MAKING MOVIE… 124 ▪ Quick LightBox XV 124 KEYBOARD MAP 128 1. COMMON 128 2. GENERAL 128 8 Tools I EzImplant Introduction EzImplant is a DICOM format Medical Dental CT Image Viewer program for prompt and accurate diagnosis with a host of useful functions including MPR, 2-dimensional analysis and 3-dimensional image reformation. For Professional Version, it serves more advanced simulation function such as Implant Simulation, Drawing Canal, Show Implant Environ Bone Density, etc. 1. EzImplant Main Functions EzImplant helps easier diagnosis and analysis by serving 3D image with simple and convenient user interface. EzImplant’s main function are as follows; ◊ Effortless image adaptation through various rendering methods such as VR(Volume Rendering) / MIP / minIP / X-ray. ◊ High accuracy 3D images by MPR Rotating, Curve, 3D Zoom rendering mode. ◊ Cross-Sectional View function for fast analysis. ◊ Easy setting of “Default Gap” and “Default Thickness” for Cross-Sectional Images, and “Default Windowing” in “Settings” menu. ◊ “Segmentation” function for hiding/deleting unnecessary part or for extracting specific valued data. ◊ Convenient grouping system for Objects, Color-map, Opacity Graph, Preset files and more. ◊ DICOM format for reconstructed images, easy file saving and compact interface. ◊ Implant Simulation function for more accuracy medical treatment planning and more effective consultation with patient. (Professional only) ◊ Canal Draw function for easy explaining the relationship between teeth and canal. (Professional only) ◊ “Show Bone Density” function to teach relative bone density of Implant environ bones. (Professional only) ◊ Various utilities such as Free Draw, Report. (Professional only) 9 Tools 2. Copyrights All software programs, data files, data, manual and other documents included in EzImplant product are legally protected by Copyright law and Korean Computer Program Protection law. The related content is provided in the program CD or in ‘End User License Agreement’ which appears on installing program so that the user can read and check for agreement. Windows 2000 and Windows XP are products of Microsoft. INFO. DICOM is the standard for medical images that has been issued by the ACR/NEMA. 10 Tools II Install, Uninstall and Operation 1. System Requirements Intel Pentium 4 or compatible. CPU (P4 2.4GHz or above is recommended) Memory 512MB RAM (1GB or above is recommended) HDD 100MB free space (10GB or above is recommended ) Video-card (1280x1024, 32bpp or above is recommended) OS Microsoft Windows 2000 (SP4) / Windows XP (SP1) Explorer Microsoft Internet Explorer 6.0 or above Etc. 2. 1024x768, 24bpp USB port, Mouse, Keyboard, Network card, CD-R/RW drive System OS Update For stable use of EzImplant, updated files of Windows Service Pack, Internet Explorer must be installed as follows. Also, for smooth use, Microsoft MDAC 2.7 or above is recommended to be installed. Windows Service Packs Windows 2000: Service Pack 3 or above Windows XP: Service Pack 1 or above Internet Explorer: Version 6.0 or above Microsoft MDAC 2.7 or above To check Windows version installed in the system, you can go to Properties of “My Computer” and see the images as follows: 11 Tools Internet Explorer version installed in the system, you can check on Internet Explorer Window ‘Help’ ⇒ ‘About Internet Explorer’ as the image follows; When the version of Windows or Internet Explorer is under our recommended specification, please firstly install the appropriate update files from the EzImplant Install CD. The file for Microsoft MDAC is also included in the CD. 12 Tools The language of Windows Service Pack and Internet Explorer in EzImplant Install CD may not agree with that of user system. In this case, the user can visit Microsoft Homepage and install the WARNING! appropriate update install file. If the user wants to update to the latest version of Windows Service Pack or Internet Explorer, please visit Microsoft Homepage and download the update install file. 3. HASP Keylock Install To operate EzImplant program you have to install HASP Keylock onto your computer. ‘HASP License Manager’ should be installed onto the PC which the HASP Keylock will be installed. And ‘HASP Driver’ should be installed onto the PC which will be used by Network connection without Keylock. Utilizing a USB port, the HASP Keylock install process is as follows: If you connect USB type Keylock to the computer before installing WARNING! the driver, malfunction can be caused. Inevitably, install the driver first, then connect USB Keylock. ¾ How to install HASP License Manager: - After booting the system, log in as Administrator Group - Operate Imsetup.exe in HASP License Manager and select ‘U.S.English’ then click ‘OK’ 13 Tools - Check the version and click ‘Next’ to continue. - Read carefully ‘End User License Agreement’ and if you agree, select ‘I accept the license agreement’ then click ‘Install’ to continue. - Select ‘Service[nhsrvice.exe]’ in Installation Type and click ‘Next’ 14 Tools - Select the install path and then click ‘Next’ - Select the name to register in start menu. Then click ‘Next’. - Click ‘Next’ to install the driver. - The driver successfully installed. Click ‘Next’ to continue. 15 Tools - Run HASP License Manager. Now install HSAP Keylock driver. 16 Tools ¾ How to install HASP Driver: - Operate HASP driver setup.exe and select ‘U.S.English’ then click ‘OK’. - Install HASP Keylock driver software as ‘Typical’ condition. - Read carefully ‘End User License Agreement’ and if you agree, select ‘I accept the license agreement’ then click ‘Install’ to continue. 17 Tools - When you finish installing the driver software, insert the ‘EzImplant Keylock’ served with install CD into an available USB port. The red lamp of the Keylock will turn on if the driver software is successfully installed. If not, remove the Keylock from the computer, reboot the system and repeat all above processes. 4. EzImplant CD Install The process of EzImplant CD installation is the same with both Windows 2000 and Windows XP. ¾ EzImplant CD Install - Insert EzImplant Install CD and click ‘Next’ button to follow the instruction when the dialogue box appears. 18 Tools - Read carefully ‘End User License Agreement’ and if you agree, select ‘I agree’ then click ‘Next’ to continue. - Decide the product type. Install ‘EzImplant-3D for CT Console’ type onto the PC which is connected with the equipment and ‘EzImplant Keylock’. And install ‘EzImplant-3D for Normal Workstations’ type for other PCs which are connected by Network. Click ‘Next’. 19 Tools - Check on ‘Everyone’ as follows then click ‘Next’ button without changing the path. If you select ‘Just me’, other users connected by Network cannot use the program. - Click ‘Next’ button to confirm installation. 20 Tools - 5. Click ‘Close’ button to finish. EzImplant Install for multiple users Once EzImplant is installed in the system multiple users can be allowed access to the program without needing Administrator ID. Multiple user access is determined at installation according the system’s OS version. ¾ Windows 2000 / Windows XP Professional / Windows .NET 2003 Server - After Logging in as Administrator Group, in MDAC 2.7 or above, install HASP keylock driver. - ‘Install for Everyone’ must be checked during EzImplant installing so that all system users can use the program. - When you install the driver on above process, all users logged in as Poweruser Group or Limited account can use EzImplant. ¾ Windows XP Home - After Logging in as Administrator Group, in MDAC 2.7 or above, install HASP keylock driver. - ‘Install for Everyone’ must be checked during EzImplant installing so that all system users can use the program. - Go to EzImplant Setup Folder using Windows Explorer and delete ‘Read-Only’ option then Share the folder on the network. When sharing the folder, check ‘Allow network users to change my files’ option. 21 Tools - After this process the users logged in the system by ‘Limited account’ can also use EzImplant program. As Windows XP Home version is not an OS for various users, inevitably you need to share the folder in which EzImplant is WARNING! installed. However in this case, security problems can be incurred on the system. Therefore, we do not recommend that the EzImplant is used by various users in Windows XP Home version. 6. Structure of Setup Folder Normally, EzImplant Setup folder is set as “C:\Ezimplant”. This basic folder can be changed in the Installation process. When EzImplant is normally installed, you can see the following sub-folders: \Bin Execution files folder \ColorDir Colormap files folder \ImplantLib Implant Library files folder \Log Log files save folder that is produced when EzImplant is running \Preset Opacity Graph/Color Preset files folder used in VR \Report Report form files folder \Shared Shared files folder \Temp Temporary files folder \User DICOM image files folder \WLPreset Windowing preset data folder Be careful not to change or modify the files saved in each folder as there can be a problem in stability of the program. 22 Tools 7. EzImplant Uninstall You can uninstall EzImplant Program on the process as follows: ¾ Ezimplant Uninstall - Windows ‘Start’ → ‘Control Panel’ (In case of Windows 2000, ‘Start’ – ‘Setup’ – ‘Control Panel’) -Go to ‘Add or Remove Programs’ - In the list of all installed programs, select ‘EzImplant’ and ‘Remove’ - When ‘Uninstall EzImplant’ dialog appears as follows, click [OK] (Do not check any item) - EzImplant is removed automatically Although you can remove EzImplant program automatically as above, DICOM image data and User’s WARNING! Preset files as saved on Hard Disk cannot be deleted automatically. To delete all files you have to do it manually in Window Explorer. This requirement is to protect the data in the case of accidental program removal. 23 Tools 8. FAQ EzImplant does not run with message “HASP not Found” Displays when the anti-piracy Hardware key-lock is not connected, or when Network key is using the permitted number of Licenses. Please check the connection of key-lock and if other user is using the program. EzImplant is running but the program window is not displayed. At Desktop → click mouse right button → go to ‘Properties’ → Settings. Check if the Screen resolution is set as 1024x768 or more, and if not, make it 1024x768 or more. EzImplant is running but the color is not displayed correctly. At Desktop → click mouse right button → go to ‘Properties’ → Settings. Check if the Color quality is set as 16bit or more, and if not, make it 16bit or more. (24bit or more is recommended) In anti-piracy key-lock Setup, Error message “User has no access to the Database Registry” is displayed. At My Computer → Click mouse right button → go to ‘Properties’ → Check if you are logged on as “Administrator”. If not, log off then log in again as “Administrator” and run the Setup program to install device driver for keylock. Saved the work by “Project Save,” however only original image is showing up when EzImplant runs. EzImplant “Project Save” function is operated through EasyDent program. Check whether EasyDent was properly running on Project Saving. When you still fail to save the project, contact to your technical support agency and do upgrade EasyDent program to the latest version. 24 Tools Tool III 9. Main Tool These are the common tools used in across all EzImplant menus. Normally the Main Tools are situated on the left side of the window. In the case of a vertical monitor the Main Tools are usually situated across the top. ★ Note: the icon becomes colored and ‘tool-tip’ appears when you hold the cursor over the icon. ★ Note: Some icons include options and they appear on ‘Tool Option’ at the bottom of Main Tool. ★ Note: Normally ‘mouse click’ means mouse left button, unless right mouse button is referred to. (1) View The basic functions are provided in [View] menu on Main Tool’s upper side. ▪ Pan (Moving) Move image within the window pane. Select the Pan icon then click-drag with the hand cursor icon. ▪ Rotate Rotate images 3-dimensionaly. Select the icon then click-drag the mouse with rotating cursor icon. ★ Note: In the 3D Pane, you can rotate the 3D image using the mouse right bu tton without selecting ‘Rotate’ icon. When you select ‘Rotate’ icon, ‘Tool Option’ menu appears as below. On MPR* Pane, <3D Rotation> means rotating in 3D Pane and <2D Rotation> means rotating in one of the 2D Panes (Coronal-Sagittal-Axial). * MPR: Multi Planar Reconstruction 25 Tools ▪ Zoom (Zooming) Zoom in/out on the image (view area). Select the icon then click-drag mouse on the Pane. The entire Pane is zoomed in/out together. ▪ Windowing (Brightness/Contrast) Adjust Image Brightness (Width) and Contrast (Level). Select the icon → click-drag mouse; ① left↔right: Adjust Contrast (Windowing Level) ② up↔down: Adjust Image Brightness (Windowing Width) Select ‘Windowing’ Menu then ‘Tool Options’ to view <Preset> button in dialog box. In this dialog box you can save the Windowing value as a preset for regular use. 26 Tools * <Preset> dialog function: Modality Tab Setting Add/Delete Tab New Add new Preset value Remove Delete Selected Preset value Edit Edit Selected Preset Value OK Apply Selected Preset Value to the image Cancel Cancel the work and go back to Main Window ▪ Invert Invert Image Brightness and Color. Select the icon then all the Images remain inverted until you re-select the icon to release the function. ▪ Text Overlay Display Image Information-ID, Patient Name, Gender, Age, Setting Value (mA, kVp), etc. The information is displayed in all MPR windows when the icon is selected. ▪ VOI Overlay (VOI: Volume Of Interest) Select VOI icon then FOV* border line is shown as dotted line. Move the dotted line to the specific area (VOI) you want to see in MPR Pane, then 3D Pane shows only VOI area selected. * FOV: Field Of View, (2) Measure Measure menu comprises tools for Image Analysis and includes Ruler, Tapeline, Angle, Profile, Area, ROI, Note, and Delete All. These tools help you to analyze the image easily and precisely. 27 Tools ▪ Measure Distance Ruler Measure the distance between 2 points [mm]. Select the icon, click mouse for measurement start and again for measurement finish, then an arrow appears with 3 little squares. With the square in the middle you can move the arrow, and with squares at both ends you can enlarge/reduce the arrow. Tapeline Measure various contiguous points as straight line/curve line [mm]. Select the icon, click-move-click…with mouse along the line you want to measure and double click (or mouse right button click) to finish. ★ Note: You can also move the result box away from the viewing area. Selecting ‘Ruler’ icon, you can choose <2-D Ruler> or <3D-Ruler> on ‘Tool Options’ ★ Note: to Measure the distance on 3D Pane, select <3D-Ruler> 28 Tools Selecting ‘Tapeline’ icon, you can choose <Line Type> (straight line) or <Curve Type> on ‘Tool Options’. To Measure on 3D Pane, first adjust the image by [Fine WARNING! Tuning] then measure when the area you want to measure is optimally visualized. Selecting of points must be completed on the 3D pane without further ability to adjust the image. ▪ Angle Measure angle between 2 lines by [degree] unit. Select the icon and Measure the angle by clicking 3 points or for Cobb Angle by clicking 4 points between 2 lines (see below) You can select measuring option on ‘Tool Options’ as above. ① 3-Points Click: firstly click the vertex then the ends of 2 lines in order ② 4-Points Click: click 2 end points of 2 lines in order ③ 3-D Angle: measure angle on 3D Pane WARNING! You cannot measure the area you cannot see in the window pane! 29 Tools ▪ Profile Show relative density of selected section like the graph below. Click 2 points (beginning and end points). You can move the arrow and enlarge/reduce by click-drag on the square. Also you can move both ends points on the graph. Y axis means HU value. * HU: Hounsfield unit (=CT Number), e.g. air(-1000HU), H2O(0HU), dentin(1000HU) ▪ Area Measure the area by tracing your area of interest. Select the icon and draw the area you want to measure by clicking successive points. You can choose drawing line type on ‘Tool Options’. ① Line pen: draw straight line ② Curve pen: draw curved line ③ Smart pen: click-move the mouse then the line draws related region automatically ▪ ROI (Region of Interest) Determine pixel values for region of interest. Select the icon and draw Box/Circle by click-drag to define region and determine the characteristics for the average value, the minimum/maximum value, etc for pixels within the defined region. You can choose ROI type as <Box> or <Circle> on ‘Tool Options’ 30 Tools ▪ Arrow Drawing arrow to indicate specific part to emphasize. Click-move-click the mouse. ▪ Note You can write a memo on the Pane. Select the icon → click on the Pane → double click the box → ‘Edit Note’ dialogue appears. The Note disappears when you close EzImplant program so the image should be captured with the Note. (3) Segmentation ‘Segmentation’ serves the function such as Cut (Draw Mask), Extract (3D Picker), Mask Overlay, Reset Mask, Undo Mask, Redo Mask, etc. ▪ Cutting (Draw Mask) Select parts you want to adjust by Poly-lines or Closed polygon (‘Tool Option’). You can Remove/Keep/Restore the selected area. 31 Tools Select Poly-lines or Closed polygon on [Drawing Type]. Then select Remove/Keep/Restore on [Action] to operate the work. Mark the area as below image. To finish marking area, double click the mouse and draw the mouse cursor on selected area then click mouse left button. ▪ Extracting (3D Picker) Possible to delete non-connected area and remain connected area by using Opacity. And by using ‘Threshold Value’ you can extract only the area of specific density value. ¾ Using opacity Click the point where you want to extract with mouse left button. When you point on 3D image, the menu appears as follows. Select appropriate menu according the area. 32 Tools Click ‘Start’ to operate image extracting on ‘Object Mask Tool’ dialog. ¾ Using threshold values Select ‘Using threshold values’ item and insert the minimum/maximum value. Click ‘Start’ to operate image extracting. ▪ Mask Overlay MPR image option on ‘Segmentation’. When you operate Segmentation function with ‘Mask Overlay’ checked (defaulted), MPR image changes simultaneously. If you don’t select ‘Mask Overlay’, only 3D image changes and MPR image remains unchanged. 33 Tools ▪ Reset Mask Initialize the Segmentation work. ▪ Undo Mask Cancel the last Segmentation work. ▪ Redo Mask Restore the canceled Segmentation work lately. (4) Output ▪ Capture Capture selected Pane/Region or Full Screen. Selected image is saved in EasyDent Database automatically. Select the patient again in EasyDent viewer then you can see the captured image in Thumbnail Window. Select the icon then click the Pane/Region you want to capture. The selected Pane is captured as shown by an inverting flash. ¾ To Capture & Save a Single Pane Select ‘Capture’ icon on [Output] Menu Click ‘Tool Options’ box then choose <Pane> option. Also choose <with overlay> or <original data> ① with overlay: capture the image with measurement data on it ② original data: capture only image data 34 Tools When the mouse cursor is converted to the Hand icon, click the Pane you want to capture ¾ To Capture & Save a Region of the Image Select ‘Capture’ icon on [Output] Menu. Click ‘Tool Options’ box, then choose <Region> option. When the mouse cursor is converted to Hand icon, click-drag the mouse on the region you want to capture 35 Tools After drawing the rectangle around the region, click the rectangle and then with inverting flash indicator, the region is captured. ¾ To Capture the Full Screen as a Single Image Select ‘Capture’ icon on [Output] Menu. Click <Full Screen> button then whole view is captured with inverting flash. 36 Tools ▪ Print Print * As Print mode is different in each module, it is explained in each chapter. ▪ Save Save the work as Project When Project Save dialogue displays, complete User information including project description and click [OK]. When you select the image with Project Save, Loading Project dialog appears as follows. Select the Project data you want to analyze and click [OK] button. 37 Tools If you want to see the original image, select [Normal] tab on the left upper side and click [OK] button. ▪ CINE Player Run CINE Player CINE Player function serves to make a short movie from the serial images in 38 Tools LightBox Pane. CINE Player is very useful to make a movie with 3D View Rotating (multi-directional) for various applications such as seminars, meetings, symposiums, exhibitions etc. WARNING! ① To run CINE Player, the images should be serial images of the same type and size. How to use CINE Player CINE Player provides all the basic functions that all movie players have. CINE Player’s interface is as below; ¾ Function of the buttons: Backward Play, Pause, Forward Play Backward and Forward Play by one image Move to the start/end of the movie Stop and move to the beginning Save the movie as AVI Files (*.avi) Menu for Options and Extra features is as below; ② Change Play Speed/Play Mode - Play Speed CINE Player can control the play speed, selectable at 3 steps (Fast, Normal, and Slow) on the Tool Bar. The Play Speed is also saved when saving the movie as an AVI File. 39 Tools - Play Mode You can also set the Play Mode on Tool Bar. There are 3 options being Normal, Loop, YoYo. + Normal: Plays from the beginning → the end, 1 time (To play again you have to move the playing cursor to the start) + Loop: Plays from the beginning → the end, continuously + YoYo: Plays from the beginning ↔ the end and back again, continuously ③ Click Save as… icon, then you can save the movie on your computer as an AVI File. If you insert the proper File name and click Save button, Video Compression dialog appears. Generally, if you compress the AVI Files, the image quality doesn’t decrease much but the playback delay can be greatly lowered. We recommend you to compress the file. 40 Tools We further recommend you to select Microsoft’s ‘Microsoft MPEG-4 Video Codec V2’, a universal method used in Window OS as compression program. If you have any other compression program related to AVI file, you can go ahead. EzImplant assumes that the Codec is installed in the WARNING! computer OS. If you encounter any error related to the movie saving, you should contact Codec development company. ④ Extra Features - View Mode Click ‘Invert’ icon for image inverting and click ‘Text’ icon to show/hide the image information. - Repeated section setting function Drag the slide bars on the edge to the section you want to play repeatedly. Selected section is indicated as bright grey color and the movie plays only within the selection. 41 Tools ▪ Show Menu Click button on the sub-tool bar and you can see ‘Flip’ Menu. Flip Vertically: turns the image vertically. Flip Horizontally: turns the image horizontally. ★ Note: this function is helpful when consulting a patient with wrong image orie ntation from another clinic. 10. Local Tool Description about Local Tool is explained in each Chapter as it is different in each module. 42 Image Pane GUI IV Image Pane GUI 1. Definition Image Pane is little window where each image is shown. Here can be shown various image types as MPR, 3D, Endo and others. Image Panes, including Title Bar, can exchange the image type. 2. Image Pane Type (1) Image Pane with Title Bar This is the standard Image Pane. It is used in General 3D. ② ① ④ ③ ⑤ ▪ ① Title Bar Click Text ⇒ Context Menu ⇒ You can choose the Image type to be displayed in the Pane 43 Image Pane GUI ▪ ② Image Pane Sub-Tool Includes Sub-Menus: Quick-LightBox, Maximize-Minimize, and Show Menu. ▪ ③ Image Display area for Image. ▪ ④ Image Information Indicates the information relating to the displayed image. Click the information and you can change the mode/setting. ★ Note: details will be explained further. ▪ ⑤ Grid Applies the scale to the Field of View. ▪ ⑥ Direction Information At the lower right corner of the Pane there is a cube to indicate the direction of the image. The definition of Initials are as below; (H) Head, (F) Foot, (A) Anterior, (P) Posterior, (L) Left, (R) Right e.g. this cube explains that the image now you are seeing is taken displayed from the anterior viewing position. 44 Image Pane GUI Generally, the cube only shows the direction from where we are INFO. seeing the image. However you can also rotate the image with the cube according to the features of each module. (2) Image Pane without Title Bar Mainly is using on Quick-LightBox and Cross-Sectional View. This image Pane doesn’t include functions you can do with Title Bar. You can Maximize/Minimize by double clicking the image. 3. Image Pane Sub-Tool (1) Quick-LightBox Click icon on Sub-Menu. ‘Option for Quick- LightBox’ dialog appears. This is to slice MPR image in any gap and thickness. QuickLB Within the 3D module, it is used to control the specific rotating degree Vertically or Horizontally. Please go to Chapter “V. MainWindow – MPR – Menu” for more detailed explanation. * This button may not be viewed in all Pane types. (2) Maximize / Minimize Click Maximize icon on Sub-Menu then Image Pane enlarges to Full Screen. * This button may not be viewed in all Pane types. In Maximized Image Pane window, the button is converted as Minimize Minimize icon . Click the icon then the window reduces to little Pane size. 45 Image Pane GUI (3) Menu If the Image Pane has the icon , click and operate special sub-menus specific to each Pane. Menu Please go to Chapter “V. Main Window – MPR – Menu” for a more detailed example & explanation. 4. Default functions (1) Move With mouse scroll wheel or using the scroll bar on the right in 2D image, you can see the image moving to vertical direction. (2) Rotate Click-Drag the right mouse button on 3D image, the image rotates as the mouse is draged. (3) Windowing Click-Drag the right mouse button (Brightness/Contrast) is adjusted. 46 on a 2D image, and the windowing Main Window V Main Window 1. Definition EzImplant is a dedicated program for assisting users to achieve clear diagnosis and precise analysis by providing DICOM format CT images able to be reconstructed in 3D and conventional 2D planes. Main Window includes VR (Volume Rendering) function, reconstructing MRP function using Curve, 3D Zoom and additional convenient functions so that the user can easily generate CT images on a highly efficient interface. 2. Window Design This is the general window design of EzImplant; (1) Main Tool With Main Tool you can use EzImplant’s main functions. INFO. For detailed information please go to Chapter “III. Tool” 47 Main Window (2) Main Window You can view images by MPR, VR etc. TIP. Anywhere on the main window, you can click right mouse button to view Context Menu which includes all Main Tool function. ★ Note: release ‘Cascaded Menu’ then you can see all menus at once. (3) Fine Tuning Adjust 3D image’s opacity to obtain clear image of specific anatomy that you want to observe. INFO. 3. For detailed information please go to Chapter “XIII. Fine Tuning and Object” MPR 48 Main Window (1) Title Bar Title Bar above each pane indicates direction of displayed cross-section image. Vertical Cross-Sectional images are provided as Axial/Sagittal/Coronal. REMARK. Above image is shown in Coronal cross section. Click ‘Coronal’ Text and you can see the Context Menu as below; Select the new scan plane you want to display. (2) Menu Click button to call popup as below. Flip Vertically: Flip the image over vertical direction Flip Horizontally: Flip the image over Horizontal direction ★ Use when external image is incorrectly saved, etc…… (3) Move Allow easy review of a previous slice (image) or of the next slice by using either the mouse wheel or the scroll bar on the right. (4) Adjust Rendering Mode / Thickness For a variety of analysis method, there are Rendering Mode and Thickness adjusting function on MPR. ▪ Adjust Rendering Mode The text on the right upper side of the Pane in Rendering Mode is expressed as MPR / MIP / minIP / VR and describes the rendering mode of the image you are seeing. If you want to change to another Rendering Mode, click the text and select the Mode you want to observe on the Context Menu. 49 Main Window REMARK. Above image is on MPR Rendering Mode. To change to other Mode move the mouse cursor over the text then the letters convert into orange color. ▪ Adjust Thickness You can adjust the Thickness of MPR’s sliced image on the right upper side of the Pane. Click the text then the Context Menu appears. The set value is applied to all MPR’s. (5) Rotate You can rotate the image by mouse key on direction cubic (right below) or by ‘Rotate’ menu on Main Tool. 4. (1) 3D Adjust Rendering Mode Click ‘VR’ text on the right upper side of 3D Pane, and the Context Menu below is shown. You can select VR, MIP, minIP, X-ray Rendering Mode at your option. VR Show 3-dimensional image MIP (Maximum Intensity Projection) Show the image as angiography minIP Show air filling area in the body such as (Minimum Intensity Projection) Sinus X-ray Reset to posterior view (as X-ray image) 50 Main Window (2) MPR Overlay Setting Click ‘Text Overlay’ on Main Tool to remove all the Text in the Window. Click ‘Plane Overlay’ on 3D Pane and you can select ‘MPR Overlay’ or ‘Overlay Off’. (3) Outline Overlay Indicate selected MPR as plane outline overlay Plane Overlay Indication selected MPR as plane overlay MPR Overlay Indication its own MPR Overlay on selected MPR Overlay Off No overlay Rotate Rotate 3D image by click-drag on the Direction Cube icon in the bottom right corner of the Pane. You can also use the ‘Rotate’ Tool on Main Tool or the right mouse button when the cursor is over the image. ★ Note: with mouse scroll function you can apply a fine adjustment to the twisted image to achieve proper position. (4) Initialize the Direction Click the Text on the right upper side of 3D Pane to reset the direction (position) of 3D image. 51 Main Window * The Text Initial definition is as below; H (Head) Reset To Head View F (Foot) Reset To Foot View A (Anterior) Reset To Anterior View P (Posterior) Reset To Posterior View L (Left) Reset to Left View R (Right) Reset To Right View 52 VI MPR Rotating Axes helps the user to check the image’s current position by providing convenient functions in operating Coronal, Sagittal, Axial and 3D image. Also, Rotating Axes is the pane for accessing the Curve and 3D Zoom functions of EzImplant. MPR serves the main window ‘Rotating Axis’ and ‘Oblique Slice’ which make possible to see any cross section image. 1. MPR – Rotating Axes General View of MPR is composed by Coronal, Sagittal, Axial and 3D pane view. MPR-Rotating Axes make possible to view cross-section images in various direction by adjusting the axes and through this general view the user can use other functions such as Cross-Sectional View, etc. You can return to this general view anytime easily from other view mode like Cross-Sectional View, Oblique Slice View, etc. Go to main menu ‘MPR-Rotating Axes’ General View of Rotating 53 (1) Move Axes You can Move/Rotate the blue cross bars on MPR window by mouse dragging. Mouse click the blue cross bar near to the circle, you can move the axis according the plane of the near line. If you click the inside the circle you can move both axes together in any direction. Each cross bar indicates cross section of the image in other Pane. Therefore if you move one axis on a specific Pane, corresponding axes in the other Panes also move. (2) Rotate Axes Click the outer part of the blue axis and drag to the direction you want to rotate. By rotating the axis you can monitor the position of the image by the changes on other MPR Panes. The translucent Pink arrow on the window indicates both the direction of the sight and the image slice thickness. 54 (3) Adjust Axis’ Thickness To adjust Image Thickness, click the bold line in the middle of blue cross bar and drag up (gets thicker) or drag down (gets thinner). You can also adjust the image thickness by Local Tool. REMARK: If you adjust the Thickness of the Axial Pane as above, you can view the resultant modified image on Coronal and Sagitttal Panes. ★ Note: Default slice size is set as 2mm and Thickness as 1mm on EzImplant. If you set the Thickness too thin you can miss the structure, and if you set too thick the image can be blurred. (4) Local Tool ▪ Rendering You can change Rendering mode of all Panes as MPR, VR, MIP, minIP. ▪ Thickness 55 You can set the Thickness on Local Tool and also with the Axes. When you set the Thickness in Local Tool all Axes in all Panes change together. ▪ Reset When you select Reset button on Local Tool the Menu appears as below and each function is explained on the table below. 2. Reset Initialize MPR, Curve, AutoFit, VOI Auto Fit Initialize to proper size to observe Reset MPR Initialize MPR window Reset Mask Initialize the object parameters Reset VOI Initialize VOI state Reset All Initialize all - MPR, Curve, AutoFit, etc. MPR – Oblique Slice Oblique Slice is the function to see simple cross section image in any part briefly. When you set the area and range to see the cross section image, Oblique Slice View and pane to set oblique degree appears in the left side above/below. You can check current setting of oblique slice in Sagital View and 3D View in the right side. Go to main menu ‘MPR → Oblique Slice’ ▪ Setting Click mouse on the image you want to see the cross section and drag as required to adjust the axis then click again. You can see the ‘Oblique Slice’ Window as follows. Oblique slice is orange in color. 56 Main Window of Oblique Slice ▪ Adjusting As with MPR Axes, you can control and adjust the viewing plane by clicking on the orange Oblique Slice line in close to the circle, click within the circle to move all planes together, you can adjust the Thickness by clicking the bar within the line and you can also rotate it by clicking the outer part of the line. With little squares in both end of the Oblique Slice line you can Zoom in/out. 57 If you draw the mouse cursor on the circle in the center, 4 squares in each corner become activated. Click and drag these squares to adjust the view area. IF you click and drag the circle in the center, you can move the view point on the image. ★ Note: to go back to MPR Window (Main Window), Click [Task] → ‘MPR’ → ‘Rotating Axes’ Curve VII 1. Definition Curve is a 3-dimensional user defined curved or straight line in 3D Pane and MPR Pane. In EzImplant, the user sets the path along which is generated continual 2D cross section according to the selected start/finish points and view direction. Also, with [Select Latest Item] function, the user can easily find all Curves made previously. 2. (1) Curve / Cross-Sectional How to make Cross-Sectional View In dental image, the direction of each tooth changes according which part you see the arch. Therefore in dental area, generally analyzes teeth by making Cross-Sectional View. To make Cross-Sectional View of arch is divided into 2 type; Full arch and partial arch. 58 ▪ Partial Arch It is important firstly to determine the correct orientation of the Occlusal Plane and teeth and to adjust the axes to match the desired planes. Firstly, adjust the X-axis (Coronal) to run parallel with arch in [Axial] Pane. In [Axial] Pane, the X-axis (Coronal) is rotated parallel to the arch. Move the X-axis over to the arch by dragging the interior part of the axis. The image in [Coronal] Pane is converted into Panoramic image. To analyze the entire arch, Rotate X-axis (Axial) parallel to Occlusal plane and to analyze a single tooth Rotate X-axis (Axial) as parallel to the tooth. 59 For precise arch settings, move X-axis (Axial) to the roots on [Coronal] Pane. Having defined the planes accurately, on the Main Tool, click [Task] → ‘Curve’ → ‘Cross-Sectional’ then go to [Axial] Pane and click the middle of the arch to set the line. Finish drawing line by Double-clicking the mouse. ★ Note: It is recommend not to click numerous points when drawing the line. As you will notice by practicing, fewer points generates a more natural curve line. 60 ▪ Full Arch Rotate X-axis (Axial) on [Coronal] Pane so as to parallel the Occlusal Plane. Rotate X-axis (Axial) on [Sagittal] Pane so as to parallel the Occlusal Plane. Then move X-axis (Axial) to the plane of the roots. The 3D image helps to define the Occlusal Plane and this can be easily adjusted. 61 Click [Task] → ‘Curve’ → Cross-Sectional on Main Tool and go to [Axial] Pane. Click points on the middle of the arch to set curved line. Finish drawing line by Double clicking the mouse. (2) How to understand the Cross-Sectional View Cross-Sectional Pane is composed of [Cross-Sectional View], [Axial View], [Panoramic View] and [3D View]. You can confirm the exact location of points located in [Cross-Sectional View] and [Panoramic View] via [Axial View]. And with [3D View] you can find out the location more intuitively. ▪ Cross-Sectional View Cross-Sectional View displays the perpendicular section of the arch continuously. The structure of Cross-Sectional View is as shown below. In each frame in the Pane the ruler indicates the real size. In [Cross-Sectional View], as the image’s right-left orientation is subject to change according the part of the arch displayed, the direction is inmdicated as L(Lingual) and B(Buccal). 62 ① Sub-Tool In [Cross-Sectional View], there are 3 buttons as below; Change the Layout of Cross-Sectional View Print Cross-Sectional View image View the Cross-Sectional View in full screen ¾ Change Layout Click [Layout] button on the right upper side. Select the region by mouse moving on the layout design. 63 4 x 4 View Mode 3 x 3 View Mode ¾ Print Print whole Cross-Sectional View. ¾ Maximize (↔ Restore) After checking the location, you can view and analyze the image easily in extended window by clicking [Maximize] button. ★ N o t e : t o go back to main window, click ‘Restore’ button in extended window. ② Move image There are 3 ways to move the image on Cross-Sectional View. i) Select an image on [Cross-Sectional View] layout. The image moves to the center of layout with orange color frame and the indication line also changes in [Axial View], [Panoramic View] and [3D View]. ii) Scroll the mouse over [Cross-Sectional View]. The image moves one by one through the frames. iii) Move the orange vertical line (the indication bar) on [Panoramic View]. 64 For ease of work and analysis, the selected image is always located in the middle of the [Cross-Sectional View]. Information! You can distinguish each image by the number on the right upper side. And you can see the extended image by Double clicking the image and with [Maximize] button you can see whole [Cross-Sectional View] in full screen. ③ Measure Length Select [Measure→Ruler] in Main Tool. Measure the length by clicking start and end points. 65 ④ Measure Profile Use the [Profile] tool to measure relative density within the selected area to improve the rate of success of surgical Implant. Select [Measure]→ ‘Profile’ then click start and end points to measure the density. In Profile, X-axis indicates the length of selected area and Y-axis indicates CT No.(HU). Move the blue vertical bar so that you can measure the density of specific area more precisely. 66 ▪ Panoramic View Shows a Panoramic image according to the Cross-Sectional line you set. Using mouse to scroll on the Panoramic image, you can analyze the image moving over the whole arch (blue line in Axial image) and see the relations between structures and teeth. EzImplant provides 7 Panoramic Slices in total. Short orange lines in Cross-Sectional View indicate each slice location and red lines are shown on every 10 orange lines. Click-drag the mouse on the bold orange line to move the location on Cross-Sectional View (you can see the image change in Cross-Sectional View’s orange pane). 67 Using Quick-Light Box in Panoramic View, you can easily check the relationship of structures and teeth in one viewing. ▪ Axial View With Axial Window you can check the location on Cross-Sectional View and Panoramic View. Also by mouse scroll, you can see cross-section image of Axial View. ▪ 3D View Using 3D View, you can check the location of Cross-Sectional View and Panoramic View. As in MPR Window, with the mouse right button you can rotate image 3dimensionally. This viewing mode can be changed to 3D Zoom or Endoscope. 68 3. Curve - General Curve Users can set the path to trace a specific area as needed. General Curve can also be set in MPR view and 3D windows. Solid Center In CT, on a pipe like structure such as a blood vessel which is filled with regular value, select the pipe’s center . Surface In 3D Pane window, select on the surface of the object. Airway Center In CT, on air filled pipe like structure such as colon or bronchus, select the pipe’s center . Double click after selecting the Path. 69 Select General Curve, you will see the Panoramic, 3D and Perpendicular Views as the shown above. Click-drag the vertical orange line on Panoramic View then you can easily find the desired Perpendicular View image. In Perpendicular View, you can adjust the view area by click-drag at each corner, and move the view center by click-drag the circle in the middle. 4. Curve - Select Latest Item You can check the selected Curves in [Main Tool] → ‘Curve’ → ‘Select Latest Item’ and in Local Tool (see below) you can view other Curves or delete a selected Curve. ★ Note: the Curves are saved until you run EzImplant program. 70 5. Local Tool Select Curve number and click delete button then the Curve is deleted. Choose the X mark to delete a selected Curve and * mark to delete all. The items on the right allow for checking the information of the Path by each function. Curve number Curve Delete Show Cross-Sectional, Axial, Panoramic, and 3D View Show the basic CPR, 3D, Perpendicular View Show Endoscope View 1. Vessel – Vascular Endoscope : use to see the blood vessel by virtual Endoscope 2. Normal – Airway, Vertebra, Colon : use to see other areas besides blood vessel by virtual Endoscope The same function with Endo1 but has different Layout. Endo 1 shows the basic CPR View but Endo2 also shows MPR 6. Print EzImplant provides a Print function for easy printing of each Slice. (1) Print Cross-Sectional View To print within Cross-Sectional View, after drawing Cross-Sectional Curve click [Print] button on the right upper side then the Print Dialog window appears as below. Select ‘Layout setting’ function on Cross-Sectional View Print Dialog. You can select Print options like ‘Show Images’, ‘Overlay’, ‘Invert’ and more. 71 (2) Print Panoramic View To print Panoramic View, after drawing the Cross-Sectional Curve click QuickLightBox button on the right upper side of Panoramic View pane. The Quick-LightBox dialog window appears as below. The three Slices left indicate first, middle, end panoramic images and the Slice on the right is guide image for Slices. Select Spacing, Thickness, and Extent and Click [OK] button. To obtain 7 panoramic slices, choose Extent value 12. 72 When Panoramic Slice images appear, click the print button on the left lower side. When Print Dialog appears, choose print options like ‘Show Images’, ‘Overlay’, ‘Invert’. Choose the selected Layout before click [Print] button is applied. 73 (3) Print Axial View To print Axial View, click Quick-LightBox button on the right upper side of Axial View pane. The Quick-LightBox dialog window appears as below. The three Slices left indicate first, middle, end image and the Slice on the right is a guide image for Slices. Click [OK] button after selecting Spacing, Thickness, and Extent. To obtain 7 Panoramic Slice, choose Extent value 12. 74 When Print Dialog appears, choose the options like ‘Show Images’, ‘Overlay’, ‘Invert’. Choose the Layout before clicking [Print] button. 75 3D Zoom VIII 1. 3D ZOOM Definition There are Endoscopy, Cube and Plane functions within the 3D Zoom Menu. With 3D Zoom functions, more intuitive image surveys are possible and it makes it easier to obtain the patient’s consent for medical treatment. 2. 3D zoom – Endoscopy From Virtual Endoscope click the region you want to observe and rotate the camera’s angle to select the exact part. Set the range with mouse click to see the Virtual Endoscope. 76 3D Zoom You can see the selected region on Oblique View, Virtual Endoscope View and the camera location on 3D Pane. The Endoscope can be adjusted for location and angle via the Endoscopy image and Oblique image. (1) Adjust Survey Range of Camera with the circle surrounding the Endoscope camera, you can adjust radius distance that the camera can show. (2) Camera Moving ▪ Target Point Moving 77 3D Zoom When you move mouse cursor to X mark, it enlarges as above feature. Click the X mark as appears below and drag the mouse to mark the new camera target location (marked with an arrow). When you release the mouse the camera target moves to new location. You can view X-ray image on Oblique View and you can move the Target Point more precisely by referring to the X-ray image. Below shows Endoscope window after moving to the new Target Point. 78 3D Zoom ▪ View Moving When you move the mouse cursor near to circle in the middle of Endoscope Window, 4 arrows that allow moving appear as the feature below. Click and drag the mouse then the view changes. With Oblique Slice image you can easily orientate your location in view moving (see the feature as below). If you click-drag X mark, the view is changed and if you click-drag the rotation mark, the direction of camera moves. 79 3D Zoom (3) Oblique Camera Moving Oblique 1. Click-drag to rotate the Camera View Point and change the View direction within the radius of the circle. Oblique 2. Unlike Oblique 1, the camera doesn’t rotate in 2-dimensions but in 3-dimensions and changes the view area accordingly. (4) Rotate ▪ Rotate centering on the observation part Click- drag the feature on the left lower side of Endoscope Window as below, the view rotates centering on the observation part. You will observe on 3D Pane that the Target Point (X mark) doesn’t move at all although you rotate the feature vertically or horizontally. 80 3D Zoom ▪ Rotate centering on the View Click – drag mouse right button anywhere in the Endoscope Window then the view moves centering on the field of view of camera. Also using the Rotate Tool or rotating the rotating point on Oblique image performs this action. (5) Adjust Observing Angle In Degree indicating feature on the left lower side of Endoscope Window, click right button of the mouse to see the Context Menu as below. → Click “Degree” then <Setting Degree> dialog appears. Input desired degree → click ‘OK’. Then the changed degree is applied directly on the window. 81 3D Zoom (6) Local Tool 1.Normal – observe area besides blood vessel 2.Vessels – observe the inside of blood vessel with Endoscope camera Convert into Endoscope Window Convert into Cube Window Convert into Plane(=Oblique Slice) Window 1.Reset – Initialize MPR, Curve, AutoFit, VOI 2.Auto fit – Initialize to optimal size to review 3.Reset MPR – Initialize MPR Window 4.Reset VOI – Initialize VOI state 5.Reset All – Initialize MPR, Curve, AutoFit all 3. 3D Zoom - Cube Zooming in with ‘Zoom’ menu on [Main Tool] has restricted effectiveness in surveying as the resolution of the image gets lower. 3D Zoom function enlarges specific area centered on specific point without lowering the resolution. (1) Move To move the image (view) in 3D Zoom, you can use ‘Centerpiece Moving’ and ‘Free Moving’. 82 3D Zoom ▪ Centerpiece Moving In Sagittal/Axial/3D Zoom Pane, click-drag the X mark in the middle of the circle to the new location. Centering moves to new site (as indicated by an arrow). ▪ Free Moving In 3D Zoom Pane, click-drag within the circle then the View is moving freely. (2) Rotate It’s the same with general rotating method. (3) Size Adjusting 83 3D Zoom In 3D Zoom Pane you can see little orange box icons in each corner of the Cube. Click – drag this box icon to adjust the Cube size. If you drag the mouse away from the centerpiece, the Cube is enlarged and the image reduced. And if you drag the mouse toward the centerpiece the Cube is reduced and the image enlarged. (4) Initialize Direction Initialize the Direction of image by click the text on the right upper side. The meaning of the text is; (5) H Reset To Head View F Reset To Foot View A Reset To Anterior View P Reset To Posterior View L Reset to Left View R Reset To Right View Set Rendering Mode 84 3D Zoom When you click “VR” text on the right upper side of the image as the shown above, Context Menu appears with Rendering options as below. Select Rendering type then it is applied to the image immediately. 4. 3D Zoom - Plane You can view 3D image’s enlarged cross section in any direction like Oblique Slice. Select ‘3D Zoom→Plane’ on Main Tool. Click ( ( ) the center of area you want to see the cross section, then move and click ) again where you want to adjust the plane. 85 3D Zoom Click ( ) ‘MPR’ in the right above of Oblique View Window to see the menu as below. Select ‘VR’ and change the image to 3D View mode. Click ( ) ‘Thickness’ in the right above of Oblique View to see the menu as below. And change the thickness of cross section you want to see. Then Oblique View is viewed as 3D volume mode. You can view the successive cross section image with mouse scroll. 86 3D Zoom 87 Canal IX Canal (Draw Canal) Draw Canal is the function to color Mandible Canal to make user easy to explain about the relationship between tooth and canal to the patient. EzImplant serves the function as Canal Draw, Canal Manager. These functions are only to users of EzImplant Professional version. 1. Draw In EzImplant, you can draw the canal path very handy with Coronal View and CrossSectional View. (1) Draw Canal in Coronal View To draw canal in Coronal View, firstly you have to calibrate the axis so that the canal can be seen clearly. On Coronal View click ( and when you finish to draw double click ( ) the canal path by mouse scrolling ) the last point. ▪ Calibrate axis Rotate Coronal axis to be parallel with occlusal plane as the figure below to see the canal path on Axial pane. To see more accurate location of canal, make Axial axis to be parallel to occlusal plane on Coronal pane then also calibrate Coronal axis on Axial View. 88 Canal ▪ Canal Draw Go to main menu ‘Canal→Draw’ Scroll the Mouse on Coronal view and click ( Double click ( ) the canal as the figure below. ) the last point to finish drawing the path. ① ② ③ ④ ⑤ ⑥ You can check the colored canal path on MPR, 3D, Cross-Sectional View, etc. 89 Canal (2) Draw Canal in Cross-Sectional View Firstly make Cross-Sectional View to draw canal on Cross-Sectional View. In CrossSectional View you can draw the canal by moving the image (mouse scroll). You can draw by click ( ) on the canal. Double click the last point to finish drawing. ▪ Make Cross-Sectional View Make Cross-Sectional View as below following “VII. Curve – Cross-Sectional – How to Make Cross-Sectional View” ▪ Canal Draw In Cross-Sectional View select the image you want to draw the canal. Go to main menu ‘Canal→Draw’ As the figure below, in Cross-Sectional View draw the canal path by moving the image (mouse scroll). Click ( click the last point to finish. 90 ) on the canal path to draw and double Canal ① ② ③ ④ When you finish drawing canal you can check as below. ★ It’s clearer to find the canal path in Cross-Sectional View, but in Coronal View you can draw neater. 91 Canal 2. Canal Manager With Canal Manager you can adjust thickness of canal drawing line and also delete the drawing canal. Go to main menu Canal → Canal Manager When the dialog appears as below, select ( ) the item on the list then ‘Set Diameter’ or ‘Delete’. ▪ Set Diameter Select the item to change the thickness of drawing line then click ‘Set Diameter’ to call ‘Input box’ dialog as follows. Insert the number as mm unit then click ‘OK’ to apply new value. ▪ Delete Select the item to delete and click ‘Delete’ button. 92 Implant X Implant (Implant Simulation) ‘Implant’ is the function that serves Inserting Implant (Insert, Multi Insert) for implant simulation, Implant Manager to manage implants, Implant Library to manage implant library and Show Bone Density function to view implant environ density. This implant simulation function makes possible planning more accurate diagnosis and getting prompt agreement of the patient. 1. Implant Simulation By implant simulation on CT image you can get fast agreement of the patient and expect high rate of success on implant surgery. EzImplant serves ‘User Defined Implant’ and ‘Real Implant’ made as STL file. You can Insert/Modify/Delete implants. (1) Insert To insert implant, firstly calibrate the axes to plant implant parallel to occlusal plane as the figure below. Rotate the Coronal axis on Axial View and when Coronal View is seen as Panorama image, rotate Axial axis on Coronal View to be parallel on occlusal plane. Then move Sagittal axis to the area you will plant the implant. 93 Implant ▪ Inset Implant Go to main menu ‘Implant→Insert’ When you go to main menu ‘Implant→Insert’ to add new implant, the list for selecting implant type saved in Library appears as the figure below. Select the implant type. After selecting implant type, locate it where you want to plant implant by mouse click ( ). You can see the implant on MPR pane and VR image. 94 Implant ▪ Multiple Insert Go to main menu ‘Implant → Multiple Insert’ As the same method with ‘Insert’, select implant type and locate it where you want to plant by mouse click ( ). If you continue to click ( ), the same implant will be planted continuously and you can finish by double click ( ) the last one. (3) Edit Implant Implant Simulation serves various functions like Move/Rotate Implant and more functions by popup menu. ▪ Move/Rotate Implant When you move the mouse cursor on the implant, the axis on the middle is activated as the figure below. 95 Implant If you click and drag the orange colored line the implant moves. And if you click and drag the mouse the yellow colored line (both ends) the implant rotates. ▪ Implant Menu (popup) When you click ( ) mouse right button on the implant, popup menu appears as follows. The first menu serves the function to select the implant product range that you selected lately. The other itmes are as follows. MegaZen Real Change the implant type to the same product range Find Similar Implant Show implants list from the most similar one in length and diameter Replace Replace to other implant in Library Hide Hide implant Remove Remove implant Go to Center Move MPR axes to the center of implant Show Bone Density Show bone density of implant’s environ Properties Set Properties ★ With ‘Properties’ function, you can change color and length of the implant Also, you can click ‘Abutment’ button to set properties of abutment. 96 Implant 2. Implant Manager You can Show/Hide/Remove/Edit the implant already planted by Implant Manager function. Go to main meny ‘Implant→Implant Manager’ When you click the menu ‘Implant Manager’ dialog appears as the figure below. 97 Implant Select the implant on the list and choose menu on the bottom. Each function of the is as follow table. Select all implants planted Show selected implant Hide selected implant Remove selected implant Show the Properties dialog of selected implant 3. Implant Library Implant Library serves ‘User Defined Implant’ and STL file’s ‘Real Implant’. ‘Real Implant’ is served on installing EzImplant or on Upgrading the program further. With ‘User Defined Implant’ you can add implants besides the served ones in Library on installing EzImplant. In Implant Library you can Add/Modify/Delete user defined implants. Go to main menu ‘Implant → Implant Library’ When you click the menu ‘Implant Library’ dialog appears as follows. 98 Implant (4) Add User Defined Implant (New) Click ‘New’ button on ‘Implant Library’ dialog. Then the dialog to add new implant will appear. Register information such as Company, Product Line, Model Name and Fixture information (Occlusal, Apical width, Length, Color). When you click ( ) Color button you can select the color. The dialog to add new implant is as the figure below. When you click ( ) ‘Add Abutment’, you can set Abutment on the dialog above. 99 Implant STL file for ‘Real Implant’ can be added with ‘Load Detail 3D Model’ INFO. button. If any problem shows up on program operation after adding ‘Real Implant’ please contact to your technical support agency. (5) Modify User Defined Implant Click ( ) Modify on ‘Implant Library’ dialog to call implant properties dialog. Modify properties then click ( ) ‘OK’ button to apply. If you click ( ) ‘Restore’ button on modifying, properties remains in initial value. (6) Delete User Defined Implant Select the implant to be deleted and click ( ) Delete on ‘Implant Library’ dialog. Confirmation message for deleting appears as ‘Do you want to remove this item, really?’ Click ( ) ‘Yes’ to remove the implant. 4. Show Bone Density This function is to check the density of implant’s environs. You can check Outside/Inside density by implant’s length and density in Axial cross-section to raise success rate of implant surgery. 100 Implant ① ④ ② ③ ⑤ ⑥ ▪ Outside ① View average density (Mean Value) from implant’s surface to outside as the distance set in Thickness(⑥) ▪ Inside ② View average density (Mean Value) from implant’s surface to inside as the distance set in Thickness(⑥) ▪ Axial ③ View average density (Mean Value) as Axial cross-section ▪ Implant ID ④ Select the Implant ID (number) to see the environ density ▪ Mean Value ⑤ View Mean Value and Standard Deviation of density ▪ Thickness ⑥ Set the distance you want to know the density from implant’s surface. 101 Utilities XI Utilities Only users of Anypen (Electronic pen) can use ‘Free Draw’ function in EzImplant Professional Version. This can help users give presentation and effective treatment consultation with patient. And you can make report of treatment record and plan with captured images in ‘Report’ function. 1. Free Draw You can only use the function when Anypen is activated. Go to main tool ‘Utilities → Free Draw’ When you draw the mouse cursor upside the window after selecting ‘Free Draw’ menu, you can find the detailed menu. Free Draw functions are as the table below; Color Set color by RGB value Pen Width Set drawing line thickness Image Select image quality Undo Cancel the last work Redo Restore the canceled work lately Clear Clear all free draw work Save to bitmap Save current window as bitmap image Save Env. Save configuration information Exit Exit Free Draw When you are using ‘Free Draw’ function you cannot use other WARNING! programs as EzImplant becomes top layer program. If you want to use other program, exit ‘Free Draw’. 102 Utilities After selecting Free Draw function, draw with Anypen (Electronic pen). 2. Report This function is to help the user make brief Report for simple analysis and treatment planning. You can analyze and capture image in EzImplant then insert in the Report. 103 Utilities (7) Tool Menu When Report module is operated, you can use edit tools like Word Processor. Save the report in HTML format Undo Redo Refresh (Initialize) Print… Select Print Paper Type Select Layout Select Font Size Bold Italic Underline Left justify Center align Right justify 104 Utilities (8) Data Register In Report menu you can register captured image, patient information, and treatment record. Click ( ) mouse right button on Thumbnail image to view popup menu. The functions are as follows; Delete Selected images Delete selected image Delete all images Delete all images Save as … Save selected image as other name. Insert to report Insert selected image on report Put patient info to report Register patient information on report Select All Select all images Deselect All Deselect (release) all images selected ▪ Insert Image Click ( ) the image to insert and drag to report on proper location. In other way, click ( ) mouse right button on the image to view popup menu and select ‘Insert to report’. WARNING! When you change Layout all the registered image shall be disappeared. Select the Layout firstly then insert images. 105 Utilities ▪ Register Patient Information Click ( ) mouse right button on Thumbnail image and select ‘Put patient info to report’ on popup menu. ▪ Register Treatment Record Register treatment record on below blank. You can edit the contents with editing tool menu. 106 3D Zoom XII Settings EzImplant serves function to set default value of Cross-Sectional Image, Panoramic Images, MPR Images, MPR Zoom, Default Windowing, and Implant transparency. If you change the configuration it is automatically applied in next operation. 1. Configure Default Settings Settings menu is as follows; ▪ Cross-Sectional Images Set main properties of Cross-Sectional View. Default Gap Gap between cross-sectional images Default Thickness Thickness of each cross-sectional image Image Size Height of cross-sectional image ★ The Height in Image Size is registered in mm unit. (Ex. for 8x7cm image, register 70) ▪ Panoramic Images Set main properties of Panoramic View. Default Gap Gap between cross-sectional images on Panoramic View Default Thickness Thickness of each cross-sectional image ▪ MPR Images On program operating, default thickness of MPR images (pane). ▪ Initial Zoom Factor (MPR) EzImplant shows images as automatically Fit-on type. Magnification on the image of under 8x7cm size can make image to be blurred. In this case release ‘Use Auto-Fit’ function and adjust magnification. 107 3D Zoom INFO. With the image of 5x5cm, magnification of 130% is suitable. With images over 8x7cm do not need to change. ▪ Default Windowing To apply ‘Default Windowing’ function, firstly check on ‘Use Default Windowing and register proper value in Width and Level. If you don’t use ‘Use Default Windowing’ function, the image shall be expressed as its own windowing record on DICOM file. INFO. You can check current value of Width and Level on Fine Tuning (Right below). ▪ Implant Overlay This function is to decide the transparency of ‘Real Implant’. You can register value as percentage from 0~100(%). 0% means it is completely transparent and 100% is totally opaque. WARNING! When you change any value in ‘Settings’ you should re-operate the program. New value will be applied after reset. 108 Fine Tuning, Object XIII Fine Tuning, Object 1. Definition Fine Tuning provides an Opacity Adjusting function for optimizing the 3D image in Volume Rendering View. In EzImplant’s Fine Tuning, the user can set the menu in various ways and can also make and save particular Preset views for fast recall. Fine Tuning comprises the Object button, Opacity Graph (Transition Function) demonstrated area, Windowing/Scroll bar to adjust/show Windowing, and the Local Tool on the left. Opacity Graph is composed of lines and dots which indicate the range of opacity. When the Opacity Graph is changed the images is also updated. ★ Note: 1. Firstly, to review this chapter click ‘Auto-Fit’ menu to see the graph better. 2. Opacity Transition Function will be referred to as ‘Opacity Graph’. 2. Fine Tuning GUI Fine Tuning generally is showed in compressed bar in the bottom of each module. When you click “Fine Tuning” bar Fine Tuning View appears as shown below. To minimize it double click “Fine Tuning” bar. Object List / Color bar, Opacity Graph, Windowing/Scroll bar, Local Tool (1) Object List Show objects. 109 Fine Tuning, Object (2) Color Bar By mouse dragging the dots you can change the Opacity Graph. The dots have limits in moving according each position and when you move the mouse over the dots the mouse cursor converts into the indication of direction. For functions related to Opacity Graph, see Context Menus as shown below. (3) Opacity Graph Region Adjust opacity. (4) Windowing bar Shows windowing (=Brightness) value of current image and makes it possible to adjust it. Windowing range is adjusted by mouse drag the border line (bar at the bottom, Gray colored). And the Windowing position is adjusted by dragging in the middle of Windowing range. ★ Note: this function only applies on MPR image. (5) Scroll bar (6) Local Tool ▪ AutoFit Automatically fit Opacity Graph in proper location for best viewing. ▪ Load Preset Load Preset ▪ Object Tool Provides operating tool related to Objects ▪ Expand Expand selected object as shown in 3- dimensional space ▪ Shrink Shrink selected object as shown in 3-dimensional space 110 Fine Tuning, Object 3. Object Managing Select the Object to be applied on Image Pane or change Object’s properties. 4. Adjust Opacity Graph Click mouse right button on Opacity Graph to see the Context Menu as below. <Fine Tuning View Context Menu> (1) <Opacity Context Menu> Add/Select New Opacity Graph When you select ‘Add Opacity’ new Opacity Graph is created centering the mouse cursor. (2) The added Opacity Graph basically uses only one White anchor. Delete Opacity Graph Select the Opacity Graph you want to delete. Click mouse right button over it to call Context Menu. Then click ‘Delete Opacity’ and delete completed. 111 Fine Tuning, Object Selected Opacity Graph is activated in bright color. WARNING! Opacity Context Menu is possible only when the mouse is over it and is applied only to the selected Opacity Graph. (3) Adjust / Delete Opacity Graph To move Opacity Graph follow the steps below: ▪ Move Graph Move the mouse so that the Opacity Graph to be activated to bright color. When the mouse cursor converts into hand icon, click and drag the Opacity Graph to move as a whole. ▪ Adjust Graph by dot The Graph has 4 dots to change the slot which decides the range of color on 3D image. 4 dots are 4 corner points in the ladder from the Graph. Moving these points you can see changes of the depth of color on 3D image. And between the 2 points which decide the slot, there is 1 point in the middle, and this is for moving the Graph. By moving the Graph you can adjust the standard of opacity. By these points you optimize the color and opacity to obtain an optimal 3D image. 5. Adjust Windowing You can adjust Windowing (=Brightness) by dragging Windowing bar in the bottom. Click and drag this part. 112 Fine Tuning, Object 6. Adjust Scroll Bar Display which part of the Opacity Graph we are seeing. You can see the whole Graph by mouse drag (left ↔ right). If you want the whole Graph showing on the view, click “Auto-Fit” in Local Tool. 7. (1) Preset Load Preset This function helps you to save various fine tuning settings and to memorize it for next use. With “Preset” button in Local Tool, you can change to previous Preset or add new Preset. If ‘Replace Existing Settings’ option in the bottom is checked, only selected Preset will be applied removing all Opacity Graphs previously used. Otherwise, if you release this option and select one Preset, then the selected Preset will be applied with all other Opacity Graphs already used. (2) Save to Preset To save current setting of Color-map and Opacity Graph, click right button of the mouse on the Graph to see the Context Menu as below. 113 Fine Tuning, Object When you click ‘Save to Preset’ on Context Menu, the dialog appears. ▪ Save To Preset Select / Add category you want to save new Preset in ‘Category’. In ‘Screenshot’, use Zoom/Move icon to make proper image icon for new Preset. When you click “Load Preset” you can see the Preset saved with the image icon and name you made. Click ‘OK’ button. 114 Fine Tuning, Object (3) Set the Preset as Default The user can appoint one Preset as ‘Default Preset’ for 3D image. Then, when you run EzImplant, 3D image always is shown as Default Preset automatically. ▪ Set as Default Click [Load Preset] in Local Tool to run ‘Choose Opacity Preset’ dialog. Select Category. To set as Default Preset, click mouse right button on the image you selected to see the Context Menu. Click ‘Set as Default’ → ‘CT’ to appoint the image as Default Preset. If there is already appointed Preset, a warning dialog appears for the final confirmation. If you want to change, click ‘Yes’. If you want to check previously Defaulted Preset, see WARNING! the Root Category (“Default” in Category). In Preset Preview, the image with exclamation mark on the left side is Defaulted Preset in appropriate category. 115 Fine Tuning, Object (4) Category Setting You can manage Preset files on Context Menu of Category Tree on the left side. Click mouse right button on Category Tree and you can add/delete/modify Categories. When you want to classify Preset according to Categories, click Preset item on the right side and Drag&Drop to appropriate Category. ‘Unfiled’ Category is to keep Preset of deleted or WARNING! unclassified Categories. The user cannot change the name or delete it. 8. Color Bar You can save the color-map you have set or load color-map previously saved to apply on the Opacity Graph. Context Menu for color bar is shown below. Color bar’s Context Menu – click mouse right button on color bar (≠ color anchor). Color anchor’s Context Menu – click mouse right button on color anchor (little squares). 116 Fine Tuning, Object Add Color Here Add color anchor Delete All Colors Delete all color anchor Load Color-map Load saved color-map Save Color-map Save the color-map you have currently set Edit Color Edit the color of color anchor Delete Color Delete selected color anchor (1) Load Color-map Select ‘Load ColorMap’ on Context Menu then the dialog appears. (2) Delete Delete the color-map selected on the list left side OK Apply selected color-map Cancel Close the dialog without any change. Save Color-map Select ‘Save Color-map’ on Context Menu then ‘Save Color-Map’ dialog appears as below. 117 Fine Tuning, Object In ‘Save Color-Map’ dialog, new color-map you want to save is showed on the right lower side (RedWhite on above feature). And the color-map above (GreenWhite in the feature) is selected color-map on the list left side. When you save new color-map, be careful with ‘Color WARNING! Map Name’. If you insert the same name as already exists on the list, warning message doesn’t appear and overwrites new color-map on the name. (3) Color Anchor Color anchors indicate the reference point of colors in Opacity Graph. Each color anchor indicates one color and Color-map contains neutral color between one anchor and another. ▪ Add Anchor Click mouse right button on exact location of Color bar to see the Context Menu and select ‘Add Color Here’. Then ‘Color’ dialog appears. ★ Note: you can double click on exact location of Color bar to call the dialog directly. 118 Fine Tuning, Object Select the color on the dialog and click ‘OK’ button. Then the color is added as below. ▪ Edit Color Double click or click mouse right button on the anchor you want to change the color and select ‘Edit Color’ to call the dialog again. 119 Fine Tuning, Object Select the color and click ‘OK’ button. The anchor will be changed on the color bar. 120 Appendix XIV Appendix 1. Understanding & Application for MPR image MPR (Multi Planar Reconstruction) provides the function that makes possible to see selected sectional images by Anterior, Lateral and Horizontal planes as crosssectional images which are reconstructed from captured Z-axis data. In the diagram above, Yellow is vertical section in the Anterior plane and describes the “Coronal View”, Red is vertical section in the Lateral plane and describes the “Sagittal View” and Blue is vertical section in the Horizontal plane and describes the “Axial View”. By moving the 3 axes which correlate to the 3 vertical sections, you can view structures in any position. In Dental diagnosis, as the Dental Arch is the object to observe, correlation to ‘Front’ and ‘Lateral’ is subjected to change according the position along the arch. Therefore CT (Computerized Tomography) in Dental uses Cross-Sectional Views and multi planar econstructed images (MPR) as a practical tool to analyze the continually varying plane of the arch. Application for Dental CT image is generally divided into Maxillary and Mandible use. For Maxillary, distance to Sinus and the existence of Sinus outer wall are the important factor to reduce failure in Bone Graft surgery. And for Mandible, CT imaging is applied to check the distance to neural tube and to confirm where the neural tube is sited. 121 Appendix 2. Application for 3D image 3D image is a reconstructed image using Volume Rendering techniques. (1) MPR Plane Image When you click an axis in MPR, the vertical section of the selected axis is also marked in 3D image in overlay form so that you can easily confirm the position. (2) State of Bones Adjustment of the Opacity Graph with “Fine Tuning” function allows checking of the state of bones, especially bones of teeth. This is very useful to obtain the patient’s agreement in medical treatment. 122 Appendix (3) Review Treatment Result With 3D Zoom function more confident and efficient surgery or treatment is possible as the user can view the state of bones in great detail inside. Also, when a patient complains of unknown pain after implant surgery or neural treatment, Cube Zoom function makes it possible to find a subtle cause for post treatment faster. The image below shows bone absorption because of wrong neural treatment. 3. 3D image and CT No. (1) The relation between 3D image and CT No.(Hounsfield Unit, HU) When you click “Fine Tuning” on the bottom, the Fine Tuning window appears. In above image, values shown equate to CT numbers. CT number, also called as Hounsfield Unit(HU), has the range of density from -1000 to +1000 and it is set relatively according the standard value of AIR(-1,000), WATER(0) and hard bone as CROWN(+1,000). For example, in above Fine Tuning window, only data with more than -19.3 values will be reconstructed as D image and if you want to change the value click and drag the ladder like Graph. When you click and drag the Graph’s outer region with mouse right button, the range of “Fine Tuning” is extended or reduced. 123 Appendix ★ Note: when you click and drag the Graph’s outer region with mouse left button, you can see the Graph is moving on range extended view. (2) The relation between 3D image and Color bar The Color bar is for changing the 3D image’s color and it’s helpful to give different color on each image and as a rough indication of density. The Blue outline above indicates the Color bar with anchors inside you can adjust colors. For example, less than -19.3 value is showed in Red color and more than 162 is showed in White color. The middle value is subjected to show a middle color between Red and White. And if you click and drag the dots valued 162 right to left, you can see the change on color bar and 3D image. 4. Making Movie… ▪ Quick LightBox ‘Quick LightBox’ allows you to view a re-process of image with rotation by degrees you select. It also initiates ‘CINE Player’ mode with user selected parameters. A. How to make MPR movie Click button on the sub-tool bar and you can see ‘Option for Quick LightBox (tm) ’ dialog. 124 Appendix 3 images from the left are the first, middle and the end image of Slice and the 4th image is a guide image for Slice identification. With slide bar on the bottom, you can preview an image from a specific location. Select Direction (Vertical or Horizontal rotating) and Rotation Degree. Then ‘Quick LightBox’ shows up. ★ Note: to make smooth movie Rotating Degree ‘2’ is recommended. At least ‘5’ degree is recommended to make CINE Player. To initiate the rotating movie file, click [Rotation] button on the right side, set the rotating direction and rotating degree and click ‘OK’. “Quick LightBox” generates the individual slice components of the Cine loop, and when generation is completed, click commence Cine Playback function. 125 (CINE Player) button on the left to Appendix ★ Note: On ‘Quick LightBox’ Window you can use general tools like Panning (Move), Zooming, Windowing, Invert, Text Overlay, Measure, Capture, Print, etc. When CINE Player runs, control playback via the button. For detail information please go to Chapter “V. Main Window – MPR – Menu - Cine Player” B. How to make 3D movie Click button to operate “Quick LightBox” then the dialog as below appears. 126 Appendix Select the Direction and Rotation Degree then click ‘OK’. When “Quick LightBox” has generated all of the cine image components, click (CINE Player) button on the left of the window. When CINE Player runs, control playback via the 127 button. Key Map XV Keyboard Map 1. Common Keyboard Operations on Image Pane Key Operation Enter Overlay On / Off ESC Cancel or Stop Delete Delete a selected annotation. 2. General Keyboard Operation On “MPR” Image Pane Key Operation SPACE Next Slice Arrow ↓ Next Slice Arrow ↑ Previous Slice Arrow ← Previous Slice Arrow → Next Slice Page Up Previous Slice( Moving 1/10 of the whole) Page Down Next Slice( Moving 1/10 of the whole ) Home First Slice End Last Slice Keyboard Operation On “3D-Zoom” Image Pane Key Operation SPACE Toggle Status for Pre Integration Keyboard Operation On “Endoscopy” Image Pane Key Operation SPACE Toggle Status for Pre Integration Keyboard Operation On “Fine Tuning” Key Operation Delete Delete Current Opacity 128 Key Map Mouse “LButton” Operation On Image Pane Mouse LButton Standard +Shift +Ctrl +Alt MPR - Zoom In Pan Windowing 3D/3D-Zoom - Zoom In Pan VR : MIP/minIP/X-Ray –Windowing Endoscopy - Zoom In Pan Mouse “RButton” Operation On Image Pane Mouse RButton Standard +Shift +Ctrl +Alt MPR Windowing Zoom Out Zoom Auto Windowing 3D/3D-Zoom Object Rotation Zoom Out Zoom VR : MIP/minIP/X-Ray – Auto Windowing Endoscopy Rotation Zoom Out Zoom Mouse “Wheel” Operation On Image Pane Mouse Wheel MPR 3D/3D-Zoom Standard +Shift Next / Previous Next Slice Slice( each 1/10 ) Rotation Around / Previous Rotation Around View View Vector(each Vector(Rotating 30 degree) +Ctrl +Alt Same as Shift - Same as Shift - Same as Shift - each 3 degree) Endoscopy Backward and Backward and Forward Forward movement(Moving movement(Moving Each 3 times of Each 3 times of minimum minimum Resolution value) Resolution value) 129