SpineMap 3D Installation Instructions
Transcription
SpineMap 3D Installation Instructions
SpineMap™ 3D Navigation OrthoMap® 3D Navigation Installation Instructions Version 1.0 c 1275 File in your maintenance records Rev. A 2008-12-18 SpineMap 3D Navigation: TD6002650760 OrthoMap 3D Navigation: TD6005650760 Table of Contents Change Record Revision A Comment Initial revision Date 16. Dec 08 Author H. Rath Table of Contents 1 Introduction 1.1 1.2 How to use this document Representation of User Interface Elements 3 3 3 2 Glossary 3 3 Navigation System I 4 4 Navigation System II 5 4.1 4.2 4.3 4.4 4.5 4.6 4.7 4.8 4.9 4.10 4.11 4.12 4.13 5 Remote Planning System 5.1 5.2 5.3 5.4 5.5 5.6 6 Installation of the operating system 5 Install SpineMap™ 3D/OrthoMap® 3D 6 Optional ATI Driver Update on Navigation System with Matrox graphics card 7 Optional ATI Driver Update on Navigation System without Matrox graphics card 16 Application Manager Setup 21 Required Navigation System II-Camera Firmware 22 License Installation 23 User Settings 25 User Password Management 26 Application Settings 27 Image Import 28 Backup/Restore 31 Additional Settings 32 SpineMap™ 3D/OrthoMap® 3D Installation Put SpineMap™ 3D/OrthoMap® 3D into Service Import of images with GEYMS and Philips Hitachi formats Setup without Ziehm and Siemens C-arms Setup without Ziehm C-arms Setup without Siemens C-arms Calibrate C-arms 6.1 6.2 6.3 6.4 Ziehm Vision Vario 3D and Ziehm Vision FD Vario 3D calibration Troubleshooting Siemens ARCADIS® Orbic calibration Siemens Siremobil Iso-C calibration 33 33 33 34 35 37 38 39 39 61 62 81 Page 2 of 104 Introduction 1 Introduction This document is intended to guide through the installation of the SpineMap™ 3D/OrthoMap® 3D system. For the configuration of the present operating systems refer to the Installation Instructions of the corresponding operating system. 1.1 How to use this document Carefully read this document prior to installation. For informative background information, refer to the user documentation supplied with the product. For detailed instructional steps to install related components, refer to installation instructions posted to the Technical Corner of www.strykereurope.com/navigation (password protected). The words “CAUTION” and “NOTE” in this document carry special meanings and should be observed with care. CAUTION NOTE CAUTION indicates any measure, which is intended to avoid potential malfunction and/or product damage. This provides special information to make important instructions clearer. An exclamation mark within a triangle is intended to alert the user to the presence of important operating instructions. 1.2 Representation of User Interface Elements GUI elements are represented with cursive type style. Literals (to be input exactly by the technician) and variables (to be selected by the technician) are written in bold. Examples: Logon as NavigationAdmin [literal]. If message System Settings Change [GUI element]… appears enter Yes [variable]. 2 LMS DIU ENT CD DVD MOD UPS Glossary License Management System Device Identification Utility. A software tool for collecting data necessary for license generation for Stryker® Navigation Systems Ear Nose Throat Compact Disk Digital Video Disk Magneto Optical Disk Uniterruptable Power Supply Page 3 of 104 Navigation System I 3 Navigation System I Installation of SpineMap™ 3D/OrthoMap® 3D Software 1.0 on a Navigation System I platform is neither supported nor released! DO NOT try to install SpineMap™ 3D/OrthoMap® 3D Software 1.0 on a Navigation System I platform. Page 4 of 104 Navigation System II 4 Navigation System II 4.1 Installation of the operating system To install the operating system refer to the corresponding Installation Instructions. Page 5 of 104 SpineMap™ 3D/OrthoMap® 3D Installation 4.2 Install SpineMap™ 3D/OrthoMap® 3D Stryker® Navigation System II is delivered with pre-installed up-to-date software at the time of shipment. First, login as NavigationAdmin and check if the software package and version you expect is already installed. If you see the package name “SpineMap™ 3D/OrthoMap® 3D” or “SpineMap™ 3D/OrthoMap® 3D” grayed out in the Application Manager you can activate the package by licensing – refer to Chapter 4.7. Once licensed, start the package and check the package version using the “About” button. To install SpineMap™ 3D/OrthoMap® 3D, follow this procedure: Logon as NavigationAdmin Click Shutdown … Click Windows Desktop Insert the SpineMap™ 3D/OrthoMap® 3D CD in the DVD drive. Notice: The file c:\winnt\system32\autoexnt.bat for the service to start the DICOM receiver will be overwritten each time a new installation of an image-based Stryker® Navigation package is made. Backup the file if necessary and restore it after installation. Refer to Chapter 4.11. Image Import on how to configure the data import via DICOM network. 1,2 Execute install_all.bat from the CD drive Prior to the installation of the application the installation automatically checks whether the Stryker® Device Identification Utility (DIU) and Stryker® Application Manager requires an update and installs it automatically, if required. Just follow the steps of the installation workflow. On some systems the SpineMap™ 3D/OrthoMap® 3D installation will force you to update the ATI driver prior to the installation of the application: In this case you must follow the instructions given in chapter 4.3 and 4.4 and then repeat this chapter. After successful installation indicated by Installation complete press any key to reboot the computer. After reboot remove the iNtellect SpineMap - 3D/OrthoMap® -3D Navigation CD. 1 If the DICOM receiver “simple storage” is currently running, close it by either clicking on X in the top-right corner of the console of the DICOM receiver, or open the Task Manager, select start_dicom_receiver.bat, and click End Task. 2 If the message Cannot find the file ‘c:\programs\Stryker_Leibinger\spine3D\bin\start_dicom_receiver.bat’ appears, enter OK. The file will be installed during package installation. Page 6 of 104 ATI Driver Update with Matrox graphics card 4.3 Optional ATI Driver Update on Navigation System with Matrox graphics card Attention: Update of the ATI Driver is only required if installation requests it. Otherwise skip this chapter. This patch may only be installed on a Navigation System II W670 OS V1.0-4. If connected: detach any external DVI monitor (e.g. Plasma screen connected to the Systems external DVI output socket) before you start the system. Login as NavigationAdmin Click into Application Manager and close it using ALT-F4 Run 1_uninst_ati.bat on the installation CD (in directory ATI_Patch_2006_08_01) When the following message is displayed: select Yes When the following message is displayed: select No Page 7 of 104 ATI Driver Update with Matrox graphics card When the following message is displayed: select Remove, Next >, OK When the following message is displayed: select No, Finish Page 8 of 104 ATI Driver Update with Matrox graphics card When the following message is displayed: select OK When the following message is displayed: select No Press any key to close the command window. Uninstall the Matrox G450 graphics board: MyComputerManageDevice Manager select Display adapters - Matrox G400/G450 - Uninstall... Page 9 of 104 ATI Driver Update with Matrox graphics card and confirm removal by selecting OK When the following message is displayed: select No Shutdown the PC, and start it again. It starts up in VGA mode. Login as NavigationAdmin Click into Application Manager and close it using ALT-F4 The following message is displayed twice Each time select Cancel Page 10 of 104 ATI Driver Update with Matrox graphics card In C:\Dell\DRIVERS\R108753 execute Setup.exe Select Next, Yes, Custom When the following message is displayed: Select both ATI Display Driver and ATI Control Panel, then Next > When the following message is displayed: Select No, Finish Shutdown the PC, and start it again. Login as NavigationAdmin Click into Application Manager and close it using ALT-F4. Page 11 of 104 ATI Driver Update with Matrox graphics card When the following message is displayed: Select Next > When the following message is displayed: Select Search for a suitable driver for my device (...), and Next > Page 12 of 104 ATI Driver Update with Matrox graphics card When the following message is displayed: Remove the checkmark for Floppy disk drives, then select Next > When the following message is displayed: select Next > Page 13 of 104 ATI Driver Update with Matrox graphics card When the following message is displayed: Select Finish When the following message is displayed: Select No Run 2_apply_stryker_settings.bat on the installation CD (in directory ATI_Patch_2006_08_01) Page 14 of 104 ATI Driver Update with Matrox graphics card When the “ATI update finished” message appear in the command window Press any key to shutdown the system. Start it again. Login as NavigationAdmin To ensure that the display screen area is set correctly follow these steps: In the Application Manager select Shutdown–>Windows Desktop. Right-click into the desktop and select Properties–>Settings. Select screen area 1280 by 1024 pixels and select OK to close dialog. Congratulations, the ATI driver update is done. Page 15 of 104 ATI Driver Update without Matrox graphics card 4.4 Optional ATI Driver Update on Navigation System without Matrox graphics card Update of the ATI Driver is only required if installation requests it. Otherwise skip this chapter. This patch may only be installed on a NavSuite II W670 OS 1.0-4. If connected: detach any external DVI monitor (e.g. Plasma screen connected to the Systems external DVI output socket) before you start the system. Login as NavigationAdmin Click into Application Manager and close it using ALT-F4 Run 1_uninst_ati.bat on the installation CD (in directory ATI_Patch_2006_08_01) When the following message is displayed: select Yes When the following message is displayed: select No Page 16 of 104 ATI Driver Update without Matrox graphics card When the following message is displayed: select Remove, Next >, OK When the following message is displayed: select No, Finish Page 17 of 104 ATI Driver Update without Matrox graphics card When the following message is displayed: select OK When the following message is displayed: select No Press any key to close the command window Shutdown the PC, and start it again. It starts up in VGA mode. Login as NavigationAdmin Click into Application Manager and close it using ALT-F4 The following message is displayed: Select Cancel In C:\Dell\DRIVERS\R108753 execute Setup.exe Select Next >, Yes, Custom Page 18 of 104 ATI Driver Update without Matrox graphics card When the following message is displayed: Select both ATI Display Driver and ATI Control Panel, then Next > When the following message is displayed: Select No, Finish Shutdown the PC, and start it again. Login as NavigationAdmin Click into Application Manager and close it using ALT-F4 Run 2_apply_stryker_settings.bat on the installation CD (in directory ATI_Patch_2006_08_01) Page 19 of 104 ATI Driver Update without Matrox graphics card When the “ATI update finished” message appear in the command window Press any key to shutdown the system. Start it again. Login as NavigationAdmin To ensure that the display screen area is set correctly follow these steps: In the Application Manager select Shutdown–>Windows Desktop Right-click into the desktop and select Properties–>Settings Select screen area 1280 by 1024 pixels and select OK to close dialog. Congratulations, the ATI driver update is done. Page 20 of 104 Application Manager Setup 4.5 Application Manager Setup Logon as NavigationAdmin Click Tools button. Click Edit appman_user.def of NavigationAdmin User Edit the application list in section [main_group] so that the surgeons preferred applications are addressed which are supposed to be present on the application manager screen. The entry appman_spine3d.def refers to ‘SpineMap 3D’; the entry appman_oncology.def refers to ‘OrthoMap 3D’ entry. Example 3 : Application Manager Setup Admin user [main_group] entry30=c:\programs\stryker_leibinger\spine3D\system_settings\appman_spine3d.def ;entry02=c:\programs\stryker_leibinger\ieknee\system_settings\appman_oncology.def NOTE: The order of the entries has no influence on the order in which the applications are shown in the application manager. To change that order, renumber the entries but don’t create duplicate numbers. Save the file and close editor. Repeat the above steps for the Navigation User (Click Edit appman_user.def of Navigation User). For further details refer to the Installation Instructions of the operating system. Other Users 3 Please note: if there is only one application configured in the [main_group] list this application is started automatically when the “Navigation” user logs on. The application manager does not show up in that case. Page 21 of 104 Required Navigation System II-Camera Firmware 4.6 Required Navigation System II-Camera Firmware SpineMap™ 3D/OrthoMap® 3D requires a Navigation System II-Camera firmware revision 20 or higher. In case a Navigation System II-Camera firmware revision below 20 is installed, the message Wrong Navigation Device Revision will pop up when entering the Setup System dialog. The latest firmware revision is on the SpineMap™ 3D/OrthoMap® 3D installation CD. Refer to the corresponding Installation Instructions in the “FP6000 V1.0-21 Update Kit” folder for an update. NOTE: DO NOT downgrade a camera from firmware revision 21 to 20, since the camera will not work after downgrading. In this case you have to upgrade to 21 again. Page 22 of 104 License Installation 4.7 License Installation A license may be generated using the web-based Stryker® License Management System (LMS). If you do not have authorization to use the LMS, please contact Operations. The web application for license generation can be found at https://license.stryker.com. If the Stryker® Navigation System for which the license is to be generated is not in the LMS Database, perform the steps as described in 4.7.2, 4.7.3 and 4.7.4. If you are uncertain as to whether the Navigation System is in the LMS Database perform step 4.7.1. If the Stryker® Navigation System for which the license is to be generated is in the LMS Database, perform the steps as described in 4.7.3 and 4.7.4. 4.7.1 4.7.2 Verify Navigation System is recorded in LMS Database Go to https://license.stryker.com Login with username and password as provided by Operations. Click License Manager, Edit Devices, and verify that the serial number of the Navigation System for which a license is to be generated is listed. If not present, device identification data must be obtained from the Navigation System using the Device Identification Utility. See 4.7.2. Verify Navigation System is recorded in LMS Database Device Identification Utility (DIU) Login as NavigationAdmin Click Tools button. Click Device Identification Utility Enter the Serial Number 4 of the Navigation System and select the correct Model Number. Click Save to store the data on the Navigation System. Click Save to File to store all the displayed information to a file. It is recommended that the data is saved to a USB stick. This file along with the customer id/country can now be uploaded to the Stryker® LMS Database (next chapter). Retrieving Device Identification Data for LMS Database 4 The Serial Number of a Nav. Sys II – Cart is the serial number of the Cart. The Serial Number of a laptop based system is the serial number of the laptop itself as found on the underside. Page 23 of 104 License Installation 4.7.3 License Generation (LMS) Go to https://license.stryker.com Login with username and password as provided by Operations. Click License Manager Click Edit Customers, verify customer is in database. If not present, click Add New Customer to add your customer’s details. Click Edit Devices, verify that the Navigation System is in the database. If not present, device identification data must be obtained from the Navigation System using the DIU. See 4.7.2. To add a device click Edit Devices , click on link Add new Device and select Browse button to pick your DIU file from your memory stick stored with the DIU tool. Click the Upload button to upload the file to the LMS. Pick the correct distribution center, customer ID and enter a description as needed. Select Save Device Details for complete the task. Click Get License Based of what has been ordered select one package of the following SpineMap™ 3D configuration packages: SpineMap™ 3D Navigation SpineMap™ 3D Planning SpineMap™ 3D C-arm 3D Navigation License Generation (LMS) (REF 6002-650-000) (REF 6002-651-000) (REF 6002-650-010) OrthoMap® 3D configuration packages: OrthoMap® 3D Navigation OrthoMap® 3D Planning OrthoMap® 3D C-arm 3D Navigation 4.7.4 5 (REF 6005-650-000) (REF 6005-651-000) (REF 6005-650-010) Select License Validity Enter Order Number Select Serial Number Click Generate Licens. Download license to USB stick. Log off. 5 Installing the License Login as NavigationAdmin Click > adjacent to grayed out SpineMap™ 3D/OrthoMap® 3D Click License Manager Enter the license string: o Click Browse, open the license file created in 4.7.3 “License Generation (LMS)” and close the License Manager. o Enter the string manually. Click Accept to install the license. The license is now installed and the SpineMap™ 3D/OrthoMap® 3D Package can now be started. Further Information on license generation can be found on the web application’s help page. Installing the License Page 24 of 104 User Settings 4.8 User Settings If required, each user of SpineMap™ 3D/OrthoMap® 3D can store his/her own settings. To use this feature, each user must have his/her own user name: To create new users, the “Add user assistants” must be used. Logon as user NavigationAdmin Create New User Execute Tools…Add User Enter Username: UserName (Note: use characters, numbers and underscore “_“ only and must not be longer than 20 characters). Enter Password: Password. (Note: for the password only characters, numbers and underscore “_” is allowed, length should be between 5 and 14 characters). Confirm Password: Password Select Create File appman_user.def is opened automatically. Edit according to Chapter 4.5 “Application Manager Setup”, file appman_user.def Enter user’s real world name in line username= This name will be displayed on the application manager screen. Edit application list as described in Chapter 4.5 “Application Manager Setup”. Add another user or leave the Add User assistant Set the user password to never expires according to Chapter 4.9 “User Password Management”. Page 25 of 104 User Password Managements 4.9 User Password Management To switch off the expiration of a user password, follow this procedure: Logon as NavigationAdmin Press Shutdown… Press Windows Desktop… With right mouse button click My Computer 6 on the desktop and open Manage. Go to Local Users and GroupsUsers Open properties of the user and verify that the box Password never expires is checked. If not, check box. User Password Management or: StartSettingsControl PanelAdministrative ToolsComputer ManagementLocal Users and GroupsUsers 6 Page 26 of 104 Application Settings 4.10 Application Settings Logon as NavigationAdmin Click on Tools Click Edit appman_system.def Enter the hospital’s name under section ‘hospital_name’ Save file. Start SpineMap™ 3D[OrthoMap® 3D] Navigation application On the Home page open User settings … in the Administration section. Raise the “Stryker® Contact” tab and enter the appropriate contact settings for the site. This contact will be shown if Get Support is chosen from the Help section of the application’s Home page. Hospital Name Stryker® Contact Information Page 27 of 104 Image Import 4.11 Image Import Logon as NavigationAdmin Click Shutdown … Click Windows Desktop Open the Windows Disk Administrator by right clicking My ComputerManage and selection of Disk Management Device Settings Notify the numbers of the disks as indicated in the dark grey list of all connected disk drives, here: Disk 0 (hard disk), Disk 1(Sony Mo). If unsure which disk belongs to which physical drive you can right click the disk and open the Properties dialog to check the Hardware Vendor. Write down disk number and according physical drive type. Adjust drive letters: MaxOptics/Sony M: Close Computer Management dialog and click Back to Navigation button. Page 28 of 104 Image Import To receive DICOM files via network first contact the Hospital’s network administrator to integrate the Stryker® Navigation PC into the network. Login as user NavigationAdmin Click “>” next to SpineMap™ 3D/OrthoMap® 3D The DICOM receiver simple_storage.exe is called by start_dicom_receiver.bat. The start_dicom_receiver.bat is started by the AutoExNt service Click ImportEdit start_dicom_receiver.bat Set the DICOM_PORT number according to your actual configuration. The other configurable variables are set to useful default values during installation, so there is no need to change them. DICOM Network EXE_DIR must be set to the name of the directory where simple_storage.exe is located. DICOM_DEST specifies the directory where the received images shall be stored. This directory must be the same as STP_DATAIN (defined in SPINE3D[ONCOLOGY].bat), because the DICOM import plug-in reads the images from STP_DATAIN. Set LOG_NAME to the name of the log file. Set LOG_SIZE to the max. size of the log file. (It is deleted and rewritten when it reaches this limit.) Click Shutdown… Click Windows Desktop… Ensure that the port is open in the firewall: - Open the firewall: Start Menu\Programs\McAfee Desktop Firewall\McAfee Desktop Firewall - Right-click "Allow DICOM receiver - port 4711" and select "duplicate". - Right-click "Allow DICOM receiver - port 4711" and select "properties". - Change "4711" to the DICOM_PORT number specified above in the "description" field and in "Local Service". - Close the Firewall window. Activate the AutoExNt service by right-clicking on the My Computer icon. Select Manage, Services and Applications, Services. Right-click on AutoexNT. Select Properties, General and change Startup type to automatic. Confirm your changes with OK, shut down and restart the system. After the system has rebooted, the receiver starts automatically even if you are not logged in. The application entity title of simple_storage is ‘DICOM_STORAGE’, but it will accept any other name with 1 to 16 characters. Notice: The file c:\winnt\system32\autoexnt.bat for the service to start the DICOM receiver will be overwritten each time a new installation of an image-based Stryker® Navigation package is made. Backup the file if necessary and restore it after installation. Refer to the Installation Instructions of the operating system for further details on how to configure the data import via DICOM network. Page 29 of 104 Image Import Ensure to write protect media before inserting in drives for image import. Under certain circumstances (when starting the disk administrator) WINDOWS will write some kind of signature to the media that will make it unreadable by the import modules. DICOM MOs: Can be accessed directly by the corresponding drive letter. Other MOs: Make sure that the PHYSICALDRIVE server is started: My ComputerManageServices and Magneto Optical Disk (MO) ApplicationsServicesPHYSICALDRIVE server Due to the new DICOM plug-in a revalidation of established navigation imaging protocols is mandatory after installation. DICOM Imaging Protocol Check Follow the functional testing instructions of the Installation Protocol. Make sure to cover the customer’s scanners and revise established imaging protocols. Page 30 of 104 Backup/Restore 4.12 Backup/Restore Logon as NavigationAdmin Click “>” next to SpineMap™ 3D/OrthoMap® 3D Click Devices patient_backup_setup.def Set the drive letter for the backup drive to the correct CD/DVD writer’s drive letter 7 (e.g. E or F): backup_drive=E CDRW/DVD Settings for Patient Backup 7 You can check for the appropriate drive letter in the Windows File Explorer or in the Windows Disk Management dialog as shown in chapter 4.11. Page 31 of 104 Additional Settings 4.13 Additional Settings 4.13.1 File appman_user.def In order to adapt the appearance of the Application Manager to meet every single user’s specific needs, e.g. to show the users name and a specific list of applications, the file appman_user.def of each system user can be changed: Logon as NavigationAdmin Click “Tools” Edit appman_user.def of … <User Name> in order to edit the settings for the application manager for different users. Individual Application Manager Settings The following settings can be made: Section Entry Description [general] use_system_username User name from the current users Windows profile is used. Default: no [general] Username Username to show on the Application Manager's screen. Ignored if “use_system_username” is set to “yes”. Default: “” (No user name) [main_group] entryXX Applications visible in Application Manager. To make an application invisible comment out 8 the line “entryXX”. For each user the applications displayed in the Application Manager can be customized. Add a ‘;’ at the beginning of a line to hide an application of the corresponding entry. Please note: if there is only one application configured in the [main_group] list this application is started automatically when the “Navigation” user logs on. The application manager does not show up in that case. 8 To comment out a line add a ‘;’ at the beginning of that line. Page 32 of 104 Remote Planning Systems 5 Remote Planning System 5.1 SpineMap™ 3D/OrthoMap® 3D Installation The Remote Planning System comes with pre-installed software packages, the latest packages available at the time of shipment. First, login as NavigationAdmin and check, if the software package and version you want is already installed. If you see the package name “SpineMap™ 3D/OrthoMap® 3D” or “SpineMap™ 3D/OrthoMap® 3D” grayed out in the Application Manager you can activate the package by licensing – refer to Chapter 4.7 . Once licensed, start the package and check the package version using the “About” button. The Installation of the Remote Planning Software works according to the Installation of SpineMap™ 3D/OrthoMap® 3D on Navigation System II with some minor differences explained in the following paragraph. Please refer to the previous chapter for: Installation of the operating system Software Installation Application Manager Setup License Installation User Settings User Password Management Application Settings Image Import Backup/Import Additional Settings 5.2 Put SpineMap™ 3D/OrthoMap® 3D into Service Resulting planning data and patient backups from SpineMap™ 3D/OrthoMap® 3D must only be used and restored with navigation systems running the same version of SpineMap™ 3D/OrthoMap® 3D as well. It is part of the installation procedure to verify whether the remote planning system is compatible to the associated navigation system. The system must not be installed, handed over to the hospital and released for patient treatment if the 2 systems are not compatible. Page 33 of 104 GEYMS and Philips Hitachi formats 5.3 Import of images with GEYMS and Philips Hitachi formats Login as Navigationadmin Click on SpineMap 3D/OrthoMap 3DImportLegacy Import Enable Send an E-mail to [email protected] which describes the scanner type which was connected. Page 34 of 104 Setup without Ziehm and Siemens C-armss 5.4 Setup without Ziehm and Siemens C-arms When no C-arm is licensed the Dicom receivers for the C-arms have to be disabled: SpineMap™ 3D Remove Read Only attribute of file C:\Programs\Stryker_Leibinger\spine3d\system_settings\watchdog.def Open file C:\Programs\Stryker_Leibinger\spine3d\system_settings\watchdog.def OrthoMap® 3D Remove Read Only attribute of file C:\Programs\Stryker_Leibinger\oncology\system_settings\watchdog.def Open file C:\Programs\Stryker_Leibinger\oncology\system_settings\watchdog.def Go to section [GENERIC] Change the line required = COORDENGINE DICOM_SIEMENS DICOM_ZIEHM3D into required = COORDENGINE Comment the following sections by adding a semicolon to each line: ;[DICOM_SIEMENS] ;start_command = start_dicom_receiver_siemens.bat ;stop_command = kill_process.exe ;keywords = storescp.exe ;required = ;optional = ;init_time = 500 ;init_restarts = 2 ;restarts = -1 ;WINDOW_TYPE = 1 ;TITLE = DICOM Siemens 3D ;[DICOM_ZIEHM3D] ;start_command = start_dicom_receiver_ziehm.bat ;stop_command = kill_process.exe ;keywords = storescp.exe ;required = ;optional = Page 35 of 104 Setup without Ziehm and Siemens C-armss ;init_time = 500 ;init_restarts = 2 ;restarts = -1 ;WINDOW_TYPE = 1 ;TITLE = DICOM Ziehm 3D Save the file and exit the editor. Set file attribute to Read Only Page 36 of 104 Setup without Ziehm C-arms 5.5 Setup without Ziehm C-arms SpineMap™ 3D Remove Read Only attribute of file C:\Programs\Stryker_Leibinger\spine3d\system_settings\watchdog.def Open file C:\Programs\Stryker_Leibinger\spine3d\system_settings\watchdog.def OrthoMap® 3D Remove Read Only attribute of file C:\Programs\Stryker_Leibinger\oncology\system_settings\watchdog.def Open file C:\Programs\Stryker_Leibinger\oncology\system_settings\watchdog.def Go to section [GENERIC] Change the line required = COORDENGINE DICOM_SIEMENS DICOM_ZIEHM3D into required = COORDENGINE DICOM_SIEMENS Comment the following section by adding a semicolon to each line: ;[DICOM_ZIEHM3D] ;start_command = start_dicom_receiver_ziehm.bat ;stop_command = kill_process.exe ;keywords = storescp.exe ;required = ;optional = ;init_time = 500 ;init_restarts = 2 ;restarts = -1 ;WINDOW_TYPE = 1 ;TITLE = DICOM Ziehm 3D Save the file and exit the editor. Set file attribute to Read Only Page 37 of 104 Setup without Siemens C-arms 5.6 Setup without Siemens C-arms SpineMap™ 3D Remove Read Only attribute of file C:\Programs\Stryker_Leibinger\spine3d\system_settings\watchdog.def Open file C:\Programs\Stryker_Leibinger\spine3d\system_settings\watchdog.def OrthoMap® 3D Remove Read Only attribute of file C:\Programs\Stryker_Leibinger\oncology\system_settings\watchdog.def Open file C:\Programs\Stryker_Leibinger\oncology\system_settings\watchdog.def Go to section [GENERIC] Change the line required = COORDENGINE DICOM_SIEMENS DICOM_ZIEHM3D into required = COORDENGINE DICOM_ZIEHM3D Comment the following section by adding a semicolon to each line: ;[DICOM_SIEMENS] ;start_command = start_dicom_receiver_siemens.bat ;stop_command = kill_process.exe ;keywords = storescp.exe ;required = ;optional = ;init_time = 500 ;init_restarts = 2 ;restarts = -1 ;WINDOW_TYPE = 1 ;TITLE = DICOM Siemens 3D Save the file and exit the editor. Set file attribute to Read Only Page 38 of 104 Ziehm C-arm calibration 6 Calibrate C-arms 6.1 Ziehm Vision Vario 3D and Ziehm Vision FD Vario 3D calibration 6.1.1 Prerequisites To calibrate a Ziehm C-arm the following equipment is required 1. Navigation System II. 2. Ziehm C-arm with intraoperative 3D imaging technology. 3. External USB keyboard for the C-arm. 4. 10Base-T Crossover Cable (REF 6004-400-100). 5. 3 Batteries. 6. Universal Tracker. 7. Scanned pointer (use OrthoGrip Pointer 6003-012-100) 8. C-arm Digitizer (use Short Pointer 6000-012-000 or Knee Pointer 6003-011-000) 9. Styrofoam/plastics block or X-ray translucent fixation for scanned pointer. 10. X-ray translucent table or tripod to position the Styrofoam/plastic block with the scanned pointer in the isocenter. 11. Passwords and service commands: a. Administrator password for the Stryker Navigation System _______________________ b. Service mode password for the C-arm _______________________ Procedural Steps 6.1.2 Step Device Instructions 1. C-arm & Define the following configuration settings: Navigation a. TCP/IP address of the Navigation System System ___.___.___.___ b. TCP/IP address of the C-arm ___.___.___.___ Task TCP/IP Network settings for Navigation System and C-arm c. Subnet mask of the TCP/IP connection ___.___.___.___ d. DICOM port number where the Navigation System receives the images from the C-arm (default is 4721) _______________________ 2. Navigation System a. Logon as NavigationAdmin Login b. Press Shutdown… c. Press Windows Desktop… Page 39 of 104 Ziehm C-arm calibration Step Device 3. Navigation System Instructions Check (or set) the TCP/IP address of the Navigation System. This TCP/IP address must correspond to the setting on the C-arm. a. Press MyNetworkPlaces (with right mouse button)Properties Task Setting the TCP/IP Address of the Computer b. Select Loacal Area Connection (with right mouse button)Properties c. Select Internet Protocol (TCP/IP) d. Select Properties e. Select Use the following TCP/IP address f. Enter the required TCP/IP address as supplied by the hospital’s network administrator. Attention: the C-arm uses 2 TCP/IP addresses. In the standard configuration the client address of the Carm is used (e.g. 172.16.10.40) and the same address with the last number plus 1 (e.g. 172.16.10.41). DO NOT set the TCP/IP address of the Navigation System to one of these 2 C-arm TCP/IP addresses. g. Enter the required subnet mask as supplied by the hospital’s network administrator. h. Enter the required default gateway as supplied by the hospital’s network administrator. i. Click OK to save your changes. 4. Navigation System a. Logon as NavigationAdmin b. Press Shutdown… c. Press Windows Desktop… d. Click StartProgramsMcAfee Desktop FirewallMcAfee Desktop Firewall e. Right-click in the white area and select AddNew Rule… Firewall Settings C-arm 3D Installation Tool Application Page 40 of 104 Ziehm C-arm calibration Step Device > 4 Navigation System Instructions Task f. Set the filter for the TCP/IP protocol: 1. Set Description to Allow Ziehm C-arm TCP/IP communication 2. Select Action to Permit 3. Select Address to Single 4. Set the TCP/IP address of the C-arm (same as in #1). 5. Check the Active flag. 6. Click OK Page 41 of 104 Ziehm C-arm calibration Step Device > 4 Navigation System Instructions g. Set filter for Ziehm DICOM port (default 4721) 1. Right-click in the white area and select Task AddNew Rule… 2. Set Description to Allow Ziehm DICOM port. 3. Select Action to Permit 4. Select Local Service to Single 5. Type in DICOM port number (default is 4721). 6. Check the Active flag. 7. Click OK h. Set filter for Ziehm C-arm PING 1. Right-click in the white area and select AddNew Rule… 2. Set Description to Allow Ziehm C-arm PING 3. Select Action to Permit 4. Select Protocol ICMP 5. Set Address to Single 6. Set the TCP/IP address of the C-arm (same as in #1) 7. Check the Active flag 8. Click OK i. Click OK to save the rules. j. Exit Desktop Firewall. Page 42 of 104 Ziehm C-arm calibration Step Device Instructions 5. Navigation a. Open file System C:\Programs\Stryker_Leibinger\spine3d\bin\ SpineMap™ spine3d.bat 3D b. Set DICOM_PORT_ZIEHM_3D (default is 4721). Application c. Safe file and exit the editor. 6. Navigation System OrthoMap® 3D Application a. Open file 7. Navigation System & C-arm Connect the C-arm and the Navigation System with the Cross-over Network Cable. 8. C-arm Connect the USB keyboard to the C-arm. 9. C-arm Switch on the C-arm. 10. C-arm Type in service password ___________ and press Enter to get into the service mode. C:\Programs\Stryker_Leibinger\oncology\bin\oncol ogy.bat b. Set DICOM_PORT_ZIEHM _3D (default is 4721). c. Safe file and exit the editor. The C-arm gives acoustical feedback (beep tone). 11. C-arm Set the pointer tip diameter in file RoboC2.ini. a. Type in service command qqqq and press Enter to close the controller software of the C-arm. Task TCP/IP and DICOM Port Numbers for SpineMap 3D Application TCP/IP and DICOM Port Mumbers for OrthoMap® 3D Application C-arm Service Password Set Pointer Tip Diameter b. Open file C:\RoboC_V5_4\config\RoboC2.ini (with notepad editor). c. Set CASPOINTER to 1. d. Safe file and exit the editor. e. Click on shortcut to auto.bat icon on the C-arm touch screen to restart C-arm software. 12. C-arm Type in service password ___________ and press Enter to get into the service mode. The C-arm gives acoustical feedback (beep tone). Page 43 of 104 Ziehm C-arm calibration Step Device 13. C-arm Instructions Click on Config. 14. Click on Service Settings Enter the Service Password _____________ Click on DICOM. C-arm Task Page 44 of 104 Ziehm C-arm calibration Step Device 15. C-arm Instructions Select ServersStoragenet_navigation=2 Task 16. a. Set the DICOM Port (default is 4721). DICOM port Hostname TCP/IP Address AE-Title of the Navigation System C-arm b. Set the Hostname to STRYKER-IGS c. Set the TCP/IP address to the TCP/IP address of the Navigation System (same as in #1). d. Set the AE-Title to StrykerReceiver e. Select Class Modality CR 17. Navigation System and C-arm Test the DICOM and network connection between Carm and Navigation System a. Start SpineMap™ 3D or OrthoMap® 3D application. Test the Network and DICOM Connection b. Click on Test button on the C-arm DICOM settings page. c. Check if C-arm displays the message box Verification successful d. Click OK e. Switch off the C-arm f. Switch on the C-arm g. Close SpineMap™3D or OrthoMap® 3D application. Page 45 of 104 Ziehm C-arm calibration Step Device 18. Navigation System Instructions Start the C-arm 3D Installation Tool on the Navigation System. Task Start Calibration SpineMap™ 3D: Start the C-arm 3D Installation Tool from Application Manager entry SpineMap 3DRun C-arm 3D Installation or OrthoMap® 3D: Start C-arm 3D Installation Tool from Application Manager entry OrthoMap 3DRun C-arm 3D Installation 19. 20. 21. 22. 23. Navigation System Navigation System Navigation System Navigation System C-arm (C-arm calibration for Ziehm has only to be performed either for SpineMap 3D or OrthoMap 3D.) Click Start Installation. Select the C-arm type Ziehm. Switch on the Universal Tracker. Switch on the scanned pointer and validate it. Switch on the C-arm Digitizer and validate it. Click on tab 3D. Start new scan on the C-arm by clicking New Scan. Page 46 of 104 Ziehm C-arm calibration Step Device 24. C-arm Instructions Select the patient orientation (for calibration scans any patient orientation can be selected). Task Select body region (extremities). Page 47 of 104 Ziehm C-arm calibration Step Device 25. C-arm Instructions a. Place the C-arm that the scanned pointer’s tip is in the isocenter (with laser) in AP position. Task b. Place the Universal Tracker that it is close to the scanned pointer tip (~5 cm). c. Follow the instructions on the C-arm console. Press AP button. Page 48 of 104 Ziehm C-arm calibration Step Device 26. C-arm Instructions Position the C-arm that the pointer tip is in the isocenter when C-arm is in lateral position. Task Press LAT button on the screen. 27. C-arm Perform the collision check with the C-arm and put the C-arm into lateral position. 28. C-arm Lock all brakes except for the horizontal carriage brake. 29. C-arm Press the With Navigation button on the C-arm. 30. Navigation System Align the camera that the scanned pointer and the Universal Tracker is visible and that the C-arm Digitizer is visible when touching the registration points on the Carm. Page 49 of 104 Ziehm C-arm calibration Step Device C-arm 31. Instructions Start the registration procedure. Task DO NOT move the scanned pointer and the Universal Tracker during registration and before scan has been completed! Align the Navigation System II-Camera and digitize the 3 markers points on the image intensifier with the Carm Digitizer. Page 50 of 104 Ziehm C-arm calibration Step Device 32. Navigation System Instructions Send the digitized points to the C-arm by clicking on Send Registration button (if an error message appears, press the With Navigation button on the C-arm again). The C-arm gives acoustical feedback when receiving the points (6 beep tones). Navigation System confirms successful transfer of the registration points. Task Transfer Position 33. Check the accuracy information on the C-arm and confirm if distance is acceptable. If registration value is higher than 0.5 mm the digitization of the points should be repeated. Registration Check on Carm C-arm 34. C-arm 35. C-arm DO NOT move the scanned pointer and the Universal Tracker during registration and before scan has been completed. Unlock the orbital and the horizontal carriage break of the C-arm. Perform the 3D scan while pressing the left footswitch until the scan has been finished. Perform 3D Scan Page 51 of 104 Ziehm C-arm calibration Step Device 36. Navigation System Instructions Send the scanned pointer position to the C-arm (the scanned pointer needs not be visible while its position is sent) by clicking on Send Position button. 37. C-arm Set the cursor of the Multi Planar View of the C-arm on the scanned pointer tip (use the zoom function to zoom into the images for higher accuracy). 38. C-arm Type in service command nex2 and press Enter on the C-arm. 39. C-arm a. Confirm Perform Calibration by clicking on Yes b. Write down the calibration values. Task Perform Carm Calibration Save Calibration c. Click OK 40. Navigation System Stop the transfer of the scanned pointer tip position by clicking on Stop Sending button. Page 52 of 104 Ziehm C-arm calibration Step Device 41. Navigation System 42. C-arm Instructions Close the C-arm 3D Installation Tool. Task Set the pointer tip diameter plus the drape thickness in file RoboC2.ini. a. Type in service command qqqq and press Enter to close the RoboC2 software on the C-arm. b. Open file C:\RoboC_V5_4\config\RoboC2.ini c. Set CASPOINTER value dependent on tip diameter of the C-arm Digitizer and 2x of drape thickness. (if pointer tip is 1mm and drape has a thickness of 0.045mm the value has to be set to 1mm + 2x0,045mm = 1,09mm). d. Switch off the C-arm. e. Switch on the C-arm. 43. C-arm 44. 49. Navigation System Navigation System Navigation System Navigation System Navigation System C-arm 50. C-arm 51. C-arm Perform the collision check with the C-arm and put the C-arm into lateral position. 52. 53. C-arm C-arm Lock all brakes except for the horizontal carriage brake. Press the With Navigation button on the C-arm. 54. C-arm Align the Navigation System II-Camera and digitize the 3 markers points on the image intensifier with the Carm Digitizer. 45. 46. 47. 48. Put a drape over the image intensifier of the C-arm that the registration points are covered. Start the C-arm 3D Installation Tool. Repeat Procedure Select the C-arm type Ziehm Switch on the Universal Tracker. Switch on the scanned pointer and validate it. Switch on the C-arm Digitizer and validate it. Click New Scan Click New Scan Center Follow the instructions on the C-arm console. Place the C-arm that the scanned pointer’s tip is in the isocenter (using laser of C-arm) in AP position. e. Press the AP button. a. Position the C-arm that the pointer tip is in the isocenter when C-arm is in lateral position. b. Press LAT button on the screen. a. b. c. d. Page 53 of 104 Ziehm C-arm calibration Step Device 55. Navigation System Instructions Send the digitized points to the C-arm by clicking on Confirm Registration button (if an error message appears, press the Navigation button on the C-arm again). The C-arm gives acoustical feedback when receiving the points (6 beep tones). Navigation System confirms successful transfer of the registration points. Task 56. Check the accuracy information on the C-arm and confirm if distance is acceptable. If registration value is higher than 0.5mm the digitization of the points should be repeated. Registration Check on CArm C-arm 57. C-arm 58. 59. C-arm Navigation System 60. C-arm 61. C-arm DO NOT move the scanned pointer and the Universal Tracker during registration and before scan has been completed! Unlock the orbital and the horizontal carriage break of the C-arm. Perform a (2nd) 3D scan from the scanned pointer. Send the scanned pointer position to the c-arm (the scanned pointer needs not be visible while its position is sent) by clicking on Send Position button. Set the cursor of the Multi Planar View of the c-arm to the scanned pointer tip (use the zoom function to zoom into the images for higher accuracy). Type in service command nex2 and press Enter on the C-arm. Compare Carm Calibration Page 54 of 104 Ziehm C-arm calibration Step Device 62. C-arm Instructions DO NOT confirm Perform Calibration. Click on No. Note down the calibration values for x, y, and z. The values contain the distance between the scanned pointer tip and the center of the scanned volume. Task Write down difference values compared to previous calibration Each value for x, y and z must not exceed the range of ±1.0mm. 63. 64. 65. C-arm C-arm Navigation System If one of the values exceeds ±1.0mm calibration procedure has to be repeated (From step 18 on). Click OK. Click button Stop Sending Close the C-arm 3D Installation Tool. Logoff from Navigation System. Page 55 of 104 Ziehm C-arm scan procedure 6.1.3 Perform scan procedure Step Device Instructions 1. Navigation Logon as Navigation System 2. Navigation a. Click on SpineMap™ 3D or OrthoMap® 3D and System start the application. Item Login Start Application b. Click on Start C-arm 3D scan c. Click on Ziehm C-arm d. Click on Scan Intra-Operative e. Switch on the Universal Tracker. f. Switch on the C-arm Digitizer (Short Pointer) and validate it. 3. OR table Mount the Universal Tracker onto a scan phantom and place it on the OR table. 4. C-arm a. Switch on the C-arm. Start C-arm b. Connect the C-arm and the Navigation System with a crossover network cable. 5. OR Table 6. Navigation System 7. C-arm Place the scan phantom using the laser pointer of the Carm that it is located near to the isocenter of the C-arm. Align the camera that the Universal Tracker is visible and that the C-arm Digitizer is visible when touching the registration points on the C-arm. Start new scan on the C-arm by clicking New Scan Page 56 of 104 Ziehm C-arm scan procedure Step Device 8. C-arm Instructions Select the patient orientation Item Select body region (extremities). Page 57 of 104 Ziehm C-arm scan procedure Step Device 9. C-arm Instructions Place the C-arm that the scan phantom is in the isocenter (with laser) in AP position and follow the instructions on the C-arm console. Item Press AP button. 10. C-arm Position the C-arm that the scan phantom is in the isocenter when C-arm is in lateral position. Press LAT button on the screen. 11. C-arm Perform the collision check with the C-arm and put the C-arm into lateral position. 12. 13. C-arm C-arm Lock all brakes except of the horizontal carriage brake. Press the With Navigation button on the C-arm. Page 58 of 104 Ziehm C-arm scan procedure Step Device 14. C-arm Instructions Start the registration procedure. Item DO NOT move the scan phantom during registration and before scan has been completed! Align the Navigation System II-Camera and digitize the 3 markers points on the image intensifier with the Carm Digitizer. 15. Navigation System Send the digitized points to the C-arm by clicking on Transfer Position button (if an error message appears, press the With Navigation button on the C-arm again). The C-arm gives acoustical feedback when receiving the points (6 beep tones). Navigation System confirms successful transfer of the registration points. Transfer Position Page 59 of 104 Ziehm C-arm scan procedure Step Device 16. C-arm Instructions Check the accuracy information on the C-arm and confirm if distance is acceptable. If registration value is higher than 0.5mm the digitization of the points should be repeated. Item Registration Check on Carm Perform 3D Scan Landmark Check 17. C-arm 18. C-arm 19. Navigation System DO NOT move the scan phantom until the scan has been completed. Unlock the orbital and the horizontal carriage break of the C-arm. Perform the 3D scan while pressing the left footswitch until the scan has been finished. After the scan the images are transferred automatically to the Navigation System (this can take ~1 minute). The Navigation System shows the landmark confirmation page after receiving the images. 20. Navigation System a. Check the registration by performing a landmark check. b. The landmark check passes when accuracy is better than 2 mm. c. The C-arm calibration has to be repeated when landmark check fails. 21. Navigation System Exit the application and shut down the Navigation System. Page 60 of 104 Ziehm C-arm troubleshooting 6.2 Troubleshooting Scan does not start when pressing left footswitch If scan does not start when pressing the left footswitch, unlock orbital break and move C for approximately 5 degrees in ORBITAL direction. DO NOT move the Universal Tracker. Then press the left footswitch and perform the 3D scan. Page 61 of 104 Siemens ARCADIS® Orbic calibration 6.3 Siemens ARCADIS® Orbic calibration 6.3.1 Prerequisites To calibrate a Siemens C-arm the following equipment is required 1. Navigation System II 2. Siemens C-arm with intraoperative 3D imaging technology 3. 10Base-T Crossover Cable (REF 6004-400-100) 4. 3 Batteries 5. Universal Tracker 6. Pointer 7. C-arm Tracker 9” 8. C-arm Tracker Adapter 9” for Siemens C-arms or Universal Tracker Adapter for 9” Carms 9. Siemens Calibration Phantom for Stryker Navigation System 10. Stand for Siemens Calibration Phantom 11. Passwords and service commands: a. Administrator password for Navigation System _______________________ b. Administrator password for C-arm (known by Siemens service technician) _______________________ Page 62 of 104 Siemens ARCADIS® Orbic calibration 6.3.2 System Configuration Step Device Instructions 1. C-arm & Define the following configuration settings: Navigation a. TCP/IP address of the Navigation System System ___.___.___.___ b. TCP/IP address of the C-arm ___.___.___.___ c. Subnet mask of the TCP/IP connection ___.___.___.___ Task These settings have to be the same for Navigation System and C-arm d. Hostname of the Navigation System (default is STRYKER-IGS) e. DICOM port number where the Navigation System receives the images from the C-arm (default is 4722) _______________________ 2. Navigation System a. Logon as NavigationAdmin Login b. Press Shutdown… c. Press Windows Desktop… 3. Navigation System Check (or set) the TCP/IP address of the Navigation System. This TCP/IP address must correspond to the setting on the C-arm. a. Press MyNetworkPlaces (with right mouse button)Properties Setting the TCP/IP address of the Computer b. Select Loacal Area connection (with right mouse button) Properties c. Select Internet Protocol (TCP/IP). d. Select Properties e. Select Use the following TCP/IP address f. Enter the required TCP/IP address as supplied by the hospital’s network administrator. g. Enter the required subnet mask as supplied by the hospital’s network administrator. h. Enter the required default gateway as supplied by the hospital’s network administrator. i. Click OK to save your changes. Page 63 of 104 Siemens ARCADIS® Orbic calibration Step Device 4. Navigation System Instructions a. Logon as NavigationAdmin b. Press Shutdown… c. Press Windows Desktop… d. Click StartProgramsMcAfee Desktop FirewallMcAfee Desktop Firewall e. Right-click in the white area and select AddNew Rule… Task Firewall settings C-arm 3D Installation Tool Application f. Set the filter for the C-arm’s TCP/IP address 1. Set Description to Allow Siemens C-arm3D TCP/IP communication. 2. Select Action to Permit 3. Select Address to Single 4. Set the TCP/IP address of the C-arm (same as in #1). 5. Check the Active flag. 6. Click OK Page 64 of 104 Siemens ARCADIS® Orbic calibration Step Device > 4. Navigation System Instructions Task g. Set the filter for the C-arm PING: 1. Right-click in the white area and select AddNew Rule… 2. Set Description to Allow Siemens C-arm3D PING 3. Select Action to Permit 4. Set Protocol to ICMP 5. Select Address to Single 6. Set the TCP/IP address of the C-arm (same as in #1). 7. Check the Active flag. 8. Click OK Page 65 of 104 Siemens ARCADIS® Orbic calibration Step Device > 4. Navigation System Instructions Task h. Set filter for Siemens DICOM port (default 4722) 1. Right-click in the white area and select AddNew Rule… 2. Set Description to Allow Siemens DICOM port 4722 3. Select Action to Permit 4. Set Protocol to TCP/IP 5. Select Local Service to Single and type in the port number (default is 4722). 6. Check the Active flag. 7. Click OK Page 66 of 104 Siemens ARCADIS® Orbic calibration Step Device > 4. Navigation System Instructions Task i. Click OK to save the rules. j. Exit Desktop Firewall 5. Navigation a. Open file System C:\Programs\Stryker_Leibinger\spine3d\bin\ SpineMap™ spine3d.bat 3D b. Set DICOM_PORT_SIEMENS_3D (default is 4722). Application 6. Navigation System OrthoMap® 3D Application 7. Navigation System & C-arm 8. C-arm TCP/IP and DICOM Port Numbers for SpineMap ™ 3D Application a. Open file TCP/IP and C:\Programs\Stryker_Leibinger\oncology\bin\oncolog DICOM y.bat Port Numbers b. Set DICOM_PORT_SIEMENS_3D (default is 4722) for OrthoMap ® 3D Application Connect the C-arm and the Navigation System with the cross-over Network Cable Switch on the C-arm. Page 67 of 104 Siemens ARCADIS® Orbic calibration Step Device 9. C-arm Instructions Select ServiceLocal Service from the Options menu. 10. C-arm Enter the Service Password and click OK 11. C-arm Click on Configuration Task C-arm Service Mode Page 68 of 104 Siemens ARCADIS® Orbic calibration Step Device 12. C-arm Instructions a. Select System Options (on the right). b. Select the system type and check the following lines: Task Attached to Network DICOM Offline Devices DICOM Networking Image Import/Export c. Click on Next 13. C-arm a. Click in theDICOM section on Network Nodes Set TCP/IP Address and Hostname b. Enter the Host Name of the Navigation System. c. Enter the TCP/IP address of the Navigation System. It is the same TCP/IP address as set in step #1. d. Click on Save e. Click on “>” Page 69 of 104 Siemens ARCADIS® Orbic calibration Step Device 14. C-arm 15. C-arm 16. Navigation System and C-arm 17. C-arm Instructions a. Enter the Logical Name NAV3D_StrykerNavigation (Starting with NAV3D_ is madatory) b. Enter the AE Title StrykerReceiver (ensure that the all small and capital letters are typed in correctly and that there are no additional blanks are entered) c. Enter the Port Number This is the DICOM port number where the Navigation System receives the images from the Siemens C-arm. d. Check that Port Number is set to the same value as the DICOM_PORT_SIEMENS_3D in #5 and #6 (default is 4722). e. Set Storage on checked. f. Click on Add g. Click on Save Check the order of all listed nodes in the Logical Name selection box. NAV3D_StrykerNavigation must be the first node listed. If NAV3D_StrykerNavigation is not the first node listed the images will not transfer properly. If other nodes are already installed they need to be uninstalled, then reinstalled later after the NAV3D_StrykerNavigation node. a. Start the SpineMap™ 3D/OrthoMap® 3D application on the Navigation System. b. Check the DICOM connection by clicking on the VERIFICATION button. a. Click on Finish b. Click on Home Task Set Node Settings Check Node Settings Verify Node Settings Complete Node Settings Never close any page by clicking on the cross (except of the home page). Otherwise setting may not be saved reliably. Page 70 of 104 Siemens ARCADIS® Orbic calibration Step Device 18. C-arm Instructions Restart the C-arm software by clicking OK 6.3.3 C-arm Calibration Step Device Instructions 19. C-arm a. Mount the 3D-Adapter Siemens Iso-C (REF 6004400-020) to the image intensifier b. C-arm Tracker 9" (REF 6004-007-005) to the adapter. c. Make sure the Fluoroscopy Phantom is not attached to the tracker. C-arm a. Switch on the C-arm 20. b. Mount the Siemens Calibration Phantom c. Attach the 3D Installation Adapter. (REF 6004-400210) to the Siemens Calibration Phantom. d. Position the Siemens Calibration Phantom in the isocenter of the C-arm using the laser pointer of the C-arm. e. Verify the correct positioning of the phantom with 2 orthogonal x-rays (one from AP and one from lateral direction). Task Restart Carm Software Task Mount Carm Tracker and remove Fluoroscopy Phantom Position Siemens Calibration Phantom Example X-ray image of a bad phantom position: The phantom is not centered. The edge of the phantom is here visible on the top and it is shifted to the left (see red arrows). Page 71 of 104 Siemens ARCADIS® Orbic calibration Step Device > 20. C-arm Instructions Example X-ray image of a well aligned calibration phantom: 21. Start the C-arm 3D Installation Tool on the Navigation System. Navigation System Task SpineMap™ 3D: Start the C-arm 3D Installation Tool from Application Manager entry SpineMap 3DRun C- arm 3D Installation OrthoMap® 3D: Start the C-arm 3D Installation Tool from Application Manager entry OrthoMap -3DRun C-arm 3D Installation Navigation System Navigation System NOTE: If both applications are used for Siemens 3D Carms, the calibration procedure has to be performed only once. After calibration of e.g. SpineMap™ 3D the calibration data can be copied and used for OrthoMap 3D (and vice versa). See section 1.1.1. Select the C-arm type Siemens Click on Start Installation a. Switch on the Universal Tracker b. Mount it onto the Siemens Calibration Phantom 24. Navigation System Switch on the C-arm Tracker (ensure that the Fluoroscopy Phantom is removed) 25. Navigation System Align the camera that the Universal Tracker and the Carm Tracker are visible when C-arm is in start position for the calibration scan. 22. 23. Page 72 of 104 Siemens ARCADIS® Orbic calibration Step 26. Device C-arm Instructions Select OptionsServiceLocal Service from the menu. 27. C-arm Enter the Service Password 28. Task Click on Main System Page 73 of 104 Siemens ARCADIS® Orbic calibration Step 29. Device C-arm Instructions Select ARCADIS Orbic 3D Task Click NEXT Click 3D Calibration - Stryker Navigation 30. C-arm Perform the following 8 calibration scans (4 start Positions and 2 resolutions). Step 1 2 3 4 check 5 6 7 8 Angulation, Orbital Angulation =180 ° Orbital = +95° Angulation = 180° Orbital = -95° Angulation = 180° Orbital = +95° Angulation = 180° Orbital = -95° Verify the positioning of the Siemens Calibration Phantom. Make sure it is still positioned in the isocenter by making orthogonal x-rays. Angulation = 0° Orbital = +95° Angulation = 0° Orbital = -95° Angulation = 0° Orbital = +95° Angulation = 0° Orbital = -95° Mode fast fast slow slow N/A fast fast slow slow Page 74 of 104 Siemens ARCADIS® Orbic calibration Step 31. Device C-arm Instructions Task Position the Siemens calibration phantom in the isocenter from the C-arm, adjust it with fluoroscopy. 32. C-arm 33. Navigation System 34. C-arm 35. C-arm 36. Calibration Phantom C-arm 37. If the contrast of the phantom is poor and the calibration fails the scan quality can be increased by increasing manually the mA values. Check the 2D images before repeating the complete 3D calibration. Move the C-arm into the position shown in the figure (Angulation 180°-, Orbital +95°). a. Align the camera that the C-arm tracker and the Universal Tracker are visible. Important: the trackers need to be visible only at the beginning of the scans. It does not matter, if the visibility gets lost during the scan. b. Click on Go a. Press the left footswitch and hold it pressed (the first 4 calibration steps are performed) b. When Success is displayed, move the C-arm into the position displayed on the C-arm monitor. Move the C-arm into the position shown in the figure (angulation = 0°, orbital = ±95) Position the Calibration Phantom into the isocenter of the C-arm. a. Align the camera that the C-arm Tracker and the Universal Tracker are visible. Important: the trackers need to be visible only at the beginning of the scans. It does not matter, if the visibility gets lost during the scan. Click on Go Start Calibration Start Calibration Scan Ensure that the C-arm is not swinging when starting the scan. Page 75 of 104 Siemens ARCADIS® Orbic calibration Step 38. 39. Device C-arm Instructions a. Press the left footswitch and hold it pressed (the last 4 calibration steps are performed) b. When Success is displayed, move the C-arm into the position displayed on the C-arm monitor. c. Click on Finish d. Click on Home to complete the calibration e. Close the Service Mode by clicking on f. Close the C-arm 3D Installation Tool on the Navigation System. If an Error is displayed the following options have to be checked: a. Check the position of the Calibration Phantom. b. Repeat the scan for the position the error was raised. Select suitable angulation & orbital angle and scan mode. Repeat the calibration scan for this position. c. If recalibration is required, restart the C-arm and repeat the calibration procedure. d. If the contrast of the phantom is poor and the calibration fails the scan quality can be increased by increasing manually the mA values. Check the 2D images before repeating the complete 3D calibration. Task Continue Calibration Scan Error during Calibration Page 76 of 104 Siemens ARCADIS® Orbic 3D scan 6.3.4 Perform a 3D scan with the Siemens ARCADIS® Orbic 3D Step Device Description 1. C-arm a. Connect the Navigation system and the ARCADIS® Orbic 3D with the 10Base-T Crossover Cable (REF 6004-400-100). Comment Start 3D Scan b. Mount the 3D-Adapter Siemens Iso-C (REF 6004-400020) to the image intensifier. c. Attach the C-arm Tracker 9" (REF 6004-007-005) to the adapter. 2. Navigation System d. Make sure the Fluoroscopy Phantom is not attached to the C-arm Tracker. a. Logon as Navigation Start 3D Scan b. Start the SpineMap 3D or OrthoMap 3D application from Application Manager c. Click on Start C-arm 3D scan d. Select C-arm type Siemens e. Select Scan Intra-Operative f. Switch on Universal Tracker and mount it onto the scanned phantom. g. Switch on C-arm Tracker. h. Switch on Pointer and validate it. 3. 4. C-arm a. Switch on C-arm b. Position the C-arm so that the phantom to be imaged is in the isocenter of the C-arm. c. Verify the correct positioning of the C-arm with 2 orthogonal x-rays (AP and lateral). a. Select in menu PatientRegistration b. Enter the required patient data. c. Click on 3D scan button. d. Select the body part to be scanned. Page 77 of 104 Siemens ARCADIS® Orbic 3D scan Step Device > 4. Description e. Select the patient’s position on the OR table by clicking on the arrows. Comment f. Select the position of the C-arm relative to the patient by clicking on one of the C-arm symbols. Page 78 of 104 Siemens ARCADIS® Orbic 3D scan Step Device 5. Description a. Select the Scan protocol (Slow = 100 pictures, Fast = 50 pictures per scan). b. Select StrykerNavigation as navigation system c. Select 3D Navigation d. Select Start 3D Scan Comment 6. a. Perform the collision check by following the instruction on the C-arm monitor. b. Lock all breaks of the C-arm. Collision check C-arm Page 79 of 104 Siemens ARCADIS® Orbic 3D scan Step Device 7. Navigation System 8. C-arm & Navigation System 9. C-arm & Navigation System Description a. Align the camera that the Universal Tracker and the C-arm Tracker are visible. NOTE: The trackers need to be visible only at the beginning of the 3D scan. It does not matter, if the visibility gets lost during the scan. b. Start the 3D scan with the left footswitch. Keep the footswitch pressed until the 3D scan has finished. a. The images will be transferred to the Navigation System. b. A visual landmark check has to be performed before the images can be used for navigation. Follow the instructions on the Navigation System. c. The visual landmark check passes when accuracy is better than 2 mm. d. If the landmark check fails the calibration procedure has to be repeated. Perform the phantom scan for all other start positions and resolution (slow/fast). All in all 4 start positions and 2 resolutions i.e. 8 scans and landmark checks have to be performed. Comment Perform 3D scan Image Transfer and Registratio n Check Perform landmark check for all start positions and scan resolutions Page 80 of 104 Siemens Siremobil Iso-C calibration 6.4 Siemens Siremobil Iso-C calibration 6.4.1 Prerequisites To calibrate a Siemens Iso-C C-arm the following equipment is required 1. Navigation System II 2. Siemens C-arm with intraoperative 3D imaging technology 3. 10Base-T Crossover Cable (REF 6004-400-100) 4. 3 Batteries 5. Universal Tracker 6. Pointer 7. C-arm Tracker 9” 8. C-arm Tracker Adapter 9” for Siemens C-arms or Universal Tracker Adapter for 9” Carms 9. Siemens Calibration Phantom for Stryker Navigation System 10. Stand for Siemens Calibration Phantom 11. Passwords and service commands: Administrator password for Navigation System _______________________ Administrator password for C-arm (known by Siemens service technician) _______________________ Page 81 of 104 Siemens Siremobil Iso-C calibration 6.4.2 System Configuration Step Device Instructions 1. C-arm & Define the following configuration settings: Navigation a. TCP/IP address of the Navigation System System ___.___.___.___ b. TCP/IP address of the C-arm ___.___.___.___ Task Settings for Navigation System and C-arm c. Subnet mask of the TCP/IP connection ___.___.___.___ d. Hostname of the Navigation System (default is STRYKER-IGS) e. DICOM port number where the Navigation System receives the images from the C-arm (default is 4722) _______________________ 2. Navigation System a. Logon as NavigationAdmin Login b. Press Shutdown… c. Press Windows Desktop… 3. Navigation System Check (or set) the TCP/IP address of the Navigation System. This TCP/IP address must correspond to the setting on the C-arm. a. Press MyNetworkPlaces (with right mouse button)Properties Setting the TCP/IP Address of the Computer b. Select Loacal Area connection (with right mouse button) Properties c. Select Internet Protocol (TCP/IP). d. Select Properties e. Select Use the following TCP/IP address f. Enter the required TCP/IP address as supplied by the hospital’s network administrator. g. Enter the required subnet mask as supplied by the hospital’s network administrator. h. Enter the required default gateway as supplied by the hospital’s network administrator. i. Click OK to save your changes. Page 82 of 104 Siemens Siremobil Iso-C calibration Step Device 4. Navigation System Instructions a. Logon as NavigationAdmin b. Press Shutdown… c. Press Windows Desktop…. d. Click StartProgramsMcAfee Desktop FirewallMcAfee Desktop Firewall e. Right-click in the white area and select AddNew Rule… Task Firewall settings C-arm 3D Installation Tool Application Page 83 of 104 Siemens Siremobil Iso-C calibration Step Device > 4. Navigation System Instructions f. Set the filter for the C-arm’s TCP/IP address Task 7. Set Description to Allow Siemens C-arm3D TCP/IP communication 8. Select Action to Permit 9. Select Address to Single 10. Set the TCP/IP address of the C-arm (same as in #1). 11. Check the Active flag. 12. Click OK Page 84 of 104 Siemens Siremobil Iso-C calibration Step Device > 4. Navigation System Instructions g. Set the filter for the C-arm PING: Task 1. Right-click in the white area and select AddNew Rule… 2. Set Description to Allow Siemens C-arm3D PING 3. Select Action to Permit 4. Set Protocol to ICMP 5. Select Address to Single 6. Set the TCP/IP address of the C-arm (same as in #1). 7. Check the Active flag. 8. Click OK Page 85 of 104 Siemens Siremobil Iso-C calibration Step Device > 4. Navigation System Instructions h. Set filter for Siemens DICOM port (default 4722) Task 1. Right-click in the white area and select AddNew Rule… 2. Set Description to Allow Siemens DICOM port 4722 3. Select Action to Permit 4. Set Protocol to TCP/IP 5. Select Local Service to Single and type in the port number (default is 4722). 6. Check the Active flag. 7. Click OK i. Click OK to save the rules. j. 5. Exit Desktop Firewall. Navigation a. Open file System C:\Programs\Stryker_Leibinger\spine3d\bin\ SpineMap™ spine3d.bat 3D b. Set DICOM_PORT_SIEMENS_3D (default is 4722). application TCP/IP and DICOM Port Numbers for SpineMap™ 3D Application Page 86 of 104 Siemens Siremobil Iso-C calibration Step Device 6. Navigation System OrthoMap® 3D application Instructions a. Open file 7. Navigation System & C-arm Connect the C-arm and the Navigation System with the Cross-over Network Cable. 8. C-arm Switch on the C-arm. 9. C-arm Press Crtl-D to switch to the 3D mode. 10. C-arm Select OptionsLocal Service from the menu 11. C-arm Enter the Service Password and click OK C:\Programs\Stryker_Leibinger\oncology\bin\oncolo gy.bat b. Set DICOM_PORT_SIEMENS_3D (default is 4722) Task TCP/IP and DICOM Port Numbers for OrthoMap® 3D application C-arm Service Mode Page 87 of 104 Siemens Siremobil Iso-C calibration Step Device 12. C-arm Instructions Click on Configuration 13. a. Select System Options (on the right). b. Select the following settings: C-arm Task Attached to Network DICOM Offline Devices DICOM Networking Image Import/Export. c. Click on Next Page 88 of 104 Siemens Siremobil Iso-C calibration Step Device 14. C-arm Instructions a. Click in the DICOM section on Network Nodes. Task Set TCP/IP Address and Hostname b. Enter the Host Name of the Navigation System. c. Enter the TCP/IP address of the Navigation System. It is the same TCP/IP address as set in step #1. d. Click on Save e. Click on “>” 15. C-arm Set Node Settings Attention: Default Node must be set to Set first node a. In Logical Name select Define New b. Enter the Logical Name N_StrykerNavigation (Starting with N_ is madatory) Page 89 of 104 Siemens Siremobil Iso-C calibration Step Device > 15 C-arm 16. C-arm 17. Navigation System and C-arm 18. C-arm Instructions c. Enter the AE Title StrykerReceiver (ensure that the all small and capital letters are typed in correctly and that there are no additional blanks entered) d. Enter the Port Number. It is the DICOM port number where the Navigation System receives the images from the Siemens C-arm. e. Check that Port Number is set to the same value as the DICOM_PORT_SIEMENS_3D in #5 and #6 (default is 4722). f. Set Storage on checked. g. Click on Add h. Click on Save Check the order of all listed nodes in the Logical Name selection box. N_StrykerNavigation must be the first node listed. If N_StrykerNavigation is not the first node listed the images will not transfer properly. If other nodes are already installed they need to be uninstalled, and then reinstalled later after the N_StrykerNavigation node. a. Start the SpineMap™ 3D/OrthoMap® 3D application on the Navigation System. b. Check the DICOM connection by clicking on the VERIFICATION button. Restart the C-arm software by clicking OK. The restart can take approximately 5 min. 6.4.3 C-arm Calibration Step Device Instructions 1. C-arm a. Mount the 3D-Adapter Siemens Iso-C (REF 6004400-020) to the image intensifier. b. C-arm Tracker 9" (REF 6004-007-005) to the adapter. c. Make sure the Fluoroscopy Phantom is not attached to the tracker. 2. C-arm a. Switch on the C-arm. b. Mount the Siemens Calibration Phantom. c. Attach the 3D Installation Adapter. (REF 6004-400210) to the Siemens Calibration Phantom. d. Position the Siemens Calibration Phantom in the isocenter of the C-arm using the laser pointer of the C-arm. e. Verify the correct positioning of the phantom with 2 orthogonal x-rays (one from AP and one from lateral direction). Task Check Node Settings Verify Node Settings Restart Carm Software Task Mount Carm Tracker and remove Fluoroscopy Phantom Position Siemens Calibration Phantom Page 90 of 104 Siemens Siremobil Iso-C calibration Step > 2. Device C-arm Instructions Example X-ray image of a bad phantom position: Task The phantom is not centered. The edge of the phantom is here visible on the top and it is shifted to the left (see the red arrows). Example X-ray image of a well aligned calibration phantom: 3. Navigation System Start the C-arm 3D Installation Tool on the Navigation System. SpineMap™ 3D: Start the C-arm 3D Installation Tool from Application Manager entry SpineMap 3DRun Start Carm 3D Installtion Tool C-arm 3D Installation OrthoMap® 3D: Start the C-arm 3D Installation Tool from Application Manager entry OrthoMap -3DRun C-arm 3D Installation Page 91 of 104 Siemens Siremobil Iso-C calibration Step > 3. Device Navigation System 4. Navigation System Navigation System Instructions Note: If both applications are used for Siemens 3D Carms the calibration procedure has to be performed only once. After calibration of e.g. SpineMap™ 3D the calibration data can be copied and used for OrthoMap® 3D (and vice versa). See section 1.1.1. Select the C-arm type Siemens Click on Start Installation a. Switch on the Universal Tracker b. Mount it onto the Siemens Calibration Phantom 6. Navigation System Switch on the C-arm Tracker (ensure that the Fluoroscopy Phantom is removed) 7. Navigation System 8. C-arm Align the camera that the Universal Tracker and the Carm Tracker are visible when C-arm is in start position for the calibration scan. Select ServiceLocal Service from the Options menu. 9. C-arm Enter the Service Password 5. Task Page 92 of 104 Siemens Siremobil Iso-C calibration Step 10. Device Instructions Click on Calibration Iso-C 3D Task Page 93 of 104 Siemens Siremobil Iso-C calibration Step 11. Device C-arm Instructions Depending on the Iso-C version 2 different selections are offered. DO NOT chose the wrong option, otherwise all existing previous calibrations would be deleted: Task Select removable or not mounted when the following screen appears. Select No when the question Registration Unit Fix Mounted? is asked. Click on “>”. 12. C-arm Perform the following 8 calibration scans (4 start Positions described by Angulation and Orbital and 2 resolutions with 50 and 100 pictures). The scans have to be performed in the following order: Page 94 of 104 Siemens Siremobil Iso-C calibration Step Device > 12. C-arm Instructions No. of Step 1 2 3 4 check 5 6 7 8 Task Angulation, Orbital Angulation =0 ° Orbital = -95° Angulation = 0° Orbital = +95° Angulation = 0° Orbital = -95° Angulation = 0° Orbital = +95° Verify the positioning of the Siemens Calibration Phantom. Make sure it is still positioned in the isocenter by making orthogonal x-rays. Angulation = 180° Orbital = +95° Angulation = 180° Orbital = -95° Angulation = 180° Orbital = +95° Angulation = 180° Orbital = -95° No. of Pictures 50 50 100 100 N/A 50 50 100 100 Page 95 of 104 Siemens Siremobil Iso-C calibration Step 13. Device C-arm Instructions Task a. Select the parameters according to the table. Start b. Select StrykerNavigation calibration c. Move the C-arm into the selected position. d. Select the number of pictures. e. Position the Siemens calibration phantom in the isocenter from the C-arm, adjust it with fluoroscopy. If the contrast of the phantom is poor and the calibration fails the scan quality can be increased by increasing manually the mA values. Check the 2D images before repeating the complete 3D calibration. 14. Navigation System a. Align the camera that the C-arm tracker and the Universal Tracker are visible. NOTE: The trackers need to be visible only at the beginning of the scans. It does not matter, if the visibility gets lost during the scan. b. Click on Go. Page 96 of 104 Siemens Siremobil Iso-C calibration Step 15. Device C-arm Instructions Press the left footswitch and hold it pressed until the dialog box Calibration successful appears. Task Start Calibration Scan Move the C-arm into the start position for the next calibration scan. 16. 17. C-arm Repeat the procedure for all remaining steps (2 -8) to complete all 8 calibration scans. a. After completion of all calibration scans click on Finish b. Click on Home to complete the calibration. c. Close the Service Mode by clicking on . d. Close the C-arm 3D Installation Tool on the Navigation System. If an Error is displayed the following options have to be checked: Continue Calibration Scan Error during Calibration a. Check the position of the Calibration Phantom. b. Repeat the scan for the position the error was raised. Select suitable angulation & orbital angle and scan mode. Repeat the calibration scan for this position. c. If recalibration is required, restart the C-arm and repeat the calibration procedure. d. If the contrast of the phantom is poor and the calibration fails the scan quality can be increased by increasing manually the mA values. Check the 2D images before repeating the complete 3D calibration. Page 97 of 104 Siemens Siremobil Iso-C scan 6.4.4 Perform a 3D scan with the Siemens Iso-C 3D Step Device Instructions 1. C-arm a. Connect the Navigation system and the Siremobil Iso-C with the 10Base-T Crossover Cable (REF 6004-400-100). Task Start 3D scan b. Mount the 3D-Adapter Siemens Iso-C (REF 6004400-020) to the image intensifier. c. Attach the C-arm Tracker 9" (REF 6004-007-005) to the adapter. 2. Navigation System d. Make sure the Fluoroscopy Phantom is not attached to the C-arm Tracker. a. Logon as Navigation Start 3D scan b. Start the SpineMap 3D or OrthoMap 3D application from Application Manager c. Click on Start C-arm 3D scan d. Select C-arm type Siemens e. Select Scan Intra-Operative f. Switch on Universal Tracker and mount it onto the scanned phantom. g. Switch on C-arm Tracker. h. Switch on Pointer and validate it. 3. C-arm a. Switch on the C-arm. b. Press Ctrl-D to switch to 3D mode. c. Position the C-arm so that the phantom to be imaged is in the isocenter of the C-arm. 4. d. Verify the correct positioning of the C-arm with 2 orthogonal X-ray images (AP and lateral). a. Select in menu PatientAcquisition ISO-C 3D b. Select the body part to be scanned. c. Select C-arm position. Page 98 of 104 Siemens Siremobil Iso-C scan Step Device 5. Instructions a. Select the Scan protocol (Slow = 100 pictures, Fast = 50 pictures per scan). b. Select StrykerNavigation as navigation system c. Select 3D Navigation d. Click on Start 3D Scan Task 6. a. Perform the collision check by following the instruction on the C-arm monitor. b. Lock all breaks of the C-arm. Collision Check a. Align the camera that the Universal Tracker and the C-arm Tracker are visible. Perform 3D Scan 7. 8. Navigation System C-arm & Navigation System b. NOTE: The trackers need to be visible only at the beginning of the 3D scan. It does not matter, if the visibility gets lost during the scan. c. Start the 3D scan with the left footswitch. Keep the footswitch pressed until the 3D scan has finished. a. Select in the menu PatientBrowser. b. Select Local Database <Current patient name>3D Images. c. Select N_StrykerNavigation and press Send. d. The images will be transferred to the Navigation System. e. A visual landmark check has to be performed before the images can be used for navigation. Follow the instructions on the Navigation System. f. The visual landmark check passes when accuracy is better than 2 mm. g. If the landmark check fails the calibration procedure has to be repeated. Image Transfer and Registration Check Page 99 of 104 Siemens Siremobil Iso-C scan Step Device 9. C-arm & Navigation System Instructions Perform the phantom scan for all other start positions and resolution (slow/fast). All in all 4 start positions and 2 resolutions i.e. 8 scans and landmark checks have to be performed. Task Perform Landmark Check for all Start Positions and Scan Resolutions Page 100 of 104 Siemens C-arm calibration of SpineMap™ 3D and OrthoMap® 3D on the same cart 6.4.5 C-arm calibration of SpineMap™ 3D and OrthoMap® 3D on the same Navigation System When a Siemens ARCADIS® Orbic or Siremobil Iso-C C-arm has to be used for SpineMap™ and OrthoMap® on the same Navigation System the following instructions have to be performed: 1. Calibrate the C-arm for SpineMap™ as described in chapter 6.3 for the ARCADIS® Orbic or chapter 6.4 for the Siremobil Iso-C. 2. Copy file C:\Programs\Stryker_Leibinger\spine3d\system_settings\siemens_carm3D_calibration.dat into directory C:\Programs\Stryker_Leibinger\oncology\system_settings CAUTION: DO NOT calibrate the Siemens C-arm twice when it should be used for SpineMap™ and OrthoMap®. Each new calibration of the C-arm overwrites the previous one. Therefore the calibration file siemens_carm3D_calibration.dat has to be copied as described above. Page 101 of 104 Siemens C-arm troubleshooting 6.4.6 Troubleshooting Poor contrast of the Siemens calibration phantom If the contrast of the phantom is poor and the calibration fails the scan quality can be increased when the mA values are set manually to a higher value. Check the 2D images before repeating the complete 3D calibration. Page 102 of 104 Siemens C-arm troubleshooting Page 103 of 104 Stryker Corporation or its divisions or other corporate affiliated entities own, use or have applied for the following trademarks or service marks: OrthoMap, SpineMap. All other trademarks are trademarks of their respective owners or holders. Always refer to the package insert, product label and/or user instructions before using any Stryker product. Products may not be available in all markets. Product availability is subject to the regulatory or medical practices that govern individual markets. Copyright © 2008 Stryker Printed in Germany Manufactured and Distributed by: Stryker Leibinger GmbH & Co. KG Bötzinger Straße 41 D-79111 Freiburg / Germany t: +49 (0)761 4512-0 f: +49 (0)761 4512-120 Distributed by: Stryker Navigation 4100 East Milham Avenue Kalamazoo, MI 49001 USA t: 1 269 323 7700 t: (for U.S. only) 800 253 3210