Flat E Operator'S Manual
Flat E Operator'S Manual
Flat E Operator'S Manual
(MOFLATE-U08)
FLAT E
(dd/mm/yy)
METALTRONICA II
FLAT E OPERATOR’S MANUAL
WARNING
Using and keeping X-Ray equipment and device must conform the local Regulations
and national laws concerning Medical X-Ray handling.
Note
According to CE 93/42 Directive for Medical Devices concerning product traceability, Metaltronica
as manufacturer, must be informed of any owner or installation address change.
Medical Devices traceability is prerequisite to assure their safety and reliability over the time.
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INDEX
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TYPICAL CONFIGURATIONS........................................................ 61
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MAINTENANCE .............................................................................. 70
ERROR MESSAGES............................................................................... 71
MAINTENANCE ...................................................................................... 74
A.E.C. TEST ............................................................................................ 75
SELF-DIAGNOSIS .................................................................................. 76
CLEANING .............................................................................................. 77
MOVING THE UNIT TO ANOTHER PLACE............................................. 77
ACCESSORIES............................................................................... 78
LIST OF ACCESSORIES ........................................................................ 79
FLAT-E: STANDARD AND OPTIONAL DEVICES ................................... 82
COMPRESSION PLATES ....................................................................... 83
COLLIMATION PLATES, MAGNIFICATION PLATFORM, LEXAN SCREEN
................................................................................................................ 84
CASSETTE HOLDER AND POTTER BUCKY ......................................... 85
24X30 CM POTTER BUCKY WITH 18X24 CASSETTE ADAPTOR ......... 86
X1.8 MAGNIFICATION DEVICE .............................................................. 87
ANTI-X RUBBER APRONS ..................................................................... 88
WALL ACCESSORIES BEARING AND WALL POTTER BUCKY BEARING
................................................................................................................ 89
STEREOTASSIC BIOPSY DEVICE BYM-3D ........................................... 90
DIGITAL IMAGING SYSTEM ................................................................... 91
ANTI X SHIELD (MODEL 2SPDES-T) ........................................................ 92
ANTI X SHIELD (MODEL 2SPDES-F) ........................................................ 93
AUTOMATIC FILTER MO/RH ................................................................... 94
AUTOMATIC COLLIMATOR ................................................................... 95
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UNIT DESCRIPTION
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H.V.GENERATOR
Line voltage compensation AUTOMATIC
H.V. generator with kV closed loop and line
Feed forward compensation
Inverter Technology Current fed, Mosfet bridge with output
current limit capability and short circuit
protection
Inverter Frequency 50 kHz optional
Ripple Frequency/Amplitude 100 kHz optional < 2%
Output power 3500 W 35 kVx100 mA
(5000W optional)
kV range 20 / 35 kV
kV resolution (Manual & Auto mode) 0.5 kV
kV precision ±1%
kV repeatability ± 0,1%
kV rise time ≤1.5 ms from 0 to100%
kV display XX,X kV (3 digits)
Anode current max 100 mA (140mA optional)
mAs range Small focus: 1/200 mAs (from 20 to 30 kV)
1/180 mAs (from 31 to 35 kV)
Large focus 1/640 mAs (from 20 to 30 kV)
1/500 mAs (from 31 to 35 kV)
mAs values according to series R’20 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 13, 16, 20, 25,
32, 40, 50, 63, 80, 100, 130, 160, 180, 200,
250, 320, 400, 500, 640
mAs resolution (Automatic) 0,1 mAs
mAs display XXX,X mAs (4 digits)
Exposure Time Automatically selected in function of selected
mAs
Safety timer 10 sec
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IMAGE QUALITY
Spatial resolution Conformity with:
“European Guidelines for quality assurance in
mammography screening”, third edition,
and with
”Recommended specifications” for Quality
assurance in mammography of American
College of Radiology
C-ARM
F.F.D. 65cm for standard and BYM C-ARM.
Optional (only available for BYM C-ARM) 65
to 70 cm variable with motorized movement
Rotation Manual ±180° with disc brake
Vertical movement with respect to Breast 65cm F.F.D. STANDARD C-ARM
support (C-ARM in vertical position) 55 to 130 cm
65cm F.F.D. BYM C-ARM
83 to 149 cm
65/70 cm variable F.F.D. BYM C-ARM
83 to 149 cm F.F.D. 65 cm
78 to 144 cm F.F.D. 70 cm
Patient protection Face shield with plastic screen for patient’s
face protection
C-arm rotation angle Showed on C-arm by mechanical goniometer.
Optional showed on display
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COLLIMATOR
Light beam With automatic switch ON when operating
compression and electronic timer
Light intensity ≥ 150 lux
Light BEAM collimation accuracy according to IEC 601-1-3
Mirror with automatic OUT of FIELD function
Collimation plates (standard) 18X24cm, Ø 14cm
Collimation plates (optional) 24x30, 10x24
COMPRESSION SYSTEM
Compression Plate movement Manual or motor driven
Compression Plates (standard) 16x22 shifted, 12x8 straight,
Compression Plates 10x22 shifted, 24x30 shifted, 10x8 shifted,
(optional) 12X22 straight 16x22 shifted for biopsy
Free space available between 65cm F.F.D. STANDARD OR BYM C-ARM
Compression Plate and image receptor 39,5 cm with shifted Compression Plates
65/70 cm variable F.F.D. C-ARM
39,5cm /44,5cm
in Magnification Mode F.F.D.= 65cm
MAG. X2 = 140mm
MAG. X 1.8 = 180mm
MAG. X1,5 = 240mm
Compression Thickness on Display 0-80 mm in steps of 5 mm.
Compression Paddle Release after Selectable from control panel, Automatic or
exposure Manual for 2D Biopsy
Compression plate aluminium Less than 0.2 mm Al (0.135 mm Al@30 kV)
equivalence
MAGNIFICATION
Magnification ratio x1,5 / x2 (standard) with Bucky table
x1.8 with automatic focal spot selection,
cassette holder without grid and cassette
detector (optional)
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POTTER BUCKY
Bucky factor (grid) 1,96
Ratio 5:1
Lines/cm 36
Contrast factor 1,47
Cassette size 18x24 standard
24x30 optional
Cassette compatibility All the most diffused models with window as:
Agfa, Dupont, Fuji,Kodak,3M
Cassette detector switch With alarm in 8 languages to avoid double
exposure or exposure without cassette
Top Cover Carbon fiber
Film marker Integrated with 9 brass labels
Test with NORMI Phantom Typical 3,5 balls
Other features Easily interchangeable with other accessories
without tools
Grid movement synchronized with X-RAY
beam
DOSE CALCULATOR
Data visualization On display, label printer and data memory
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CONTROL TABLE
Technology Microprocessor controlled with unique safety
features exceeding IEC 601-1-4-, all
functions under active operator control
Display GRAPHIC LCD Display 240x128 dots
Alarm messages In 8 languages
Serial port exposition data for Easylabel Dedicated for Film Labelling device Easylabel
(200 characters printed), A.E.C. / tube
calibration and last 100 exposures memory
download.
Calibration and service Serial port For service laptop
Special Features Last 1300 exposure memory;
Tube Thermal Unit display and active
protection.
Technical display for self-test and defective
block identification, firmware release,
exposure counter and last exposure
time/date.
Error and faulsts data logger.
Statistics funtion Average dose, amount of exposure for every
kV value, amount of exposure in every test
technique
PROTECTIVE GLASS
Protective glass (for shield model Stand Alone full size 210cm (h) x 70 cm (w)
2SPDES and 2SPDES-F) (optional) >0,34mm Pb equivalent @35kV
Protective glass (for shield model Stand Alone half size 115cm (h) x 70 cm (w)
2SPDES-T) (optional) >0,34mm Pb equivalent @35kV
Special features (optional) Wireless Infrared X-RAY push-button
Remote control panel glass backside
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ENVIRONMENTAL CONDITIONS
Storage and delivery conditions (while temperature -20°C / + 70°C
packed) relative humidity 10% / 90%
barometric pressure 500 hPa/1060 hPa
Operating conditions temperature +10°C / + 40°C
relative humidity 30% / 75%
barometric pressure 700 hPa/1060 hPa
Protection degree according to standard IP 30
IEC 529
Heat dissipated in load condition of 35 KV 264 Kcal/h
500 mAs (1 shot every 5 minutes)
NOTE:
The manufacturer reserves the right to make further improvements while
keeping main features unchanged
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Information: Fixed equipment or system cabling, which can not be removed by the user,
is not listed. This cabling is part of the system and was present at all EMC-measurements.
Without this cabling there is no complete functionality of the system.
Warning: The use of accessories, transducers and cables other than those specified, with
the exception of transducers and cables sold by the manufacturer of the equipment or
system as replacement parts for internal components, may result in increased emission or
decreased immunity of the equipment or system.
Warning: The equipment or system should not be used adjacent to or stacked with other
equipment and that if adjacent or stacked use is necessary, the equipment or system
should be observed to verify normal operation in the configuration in which it will be used.
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NOTE 1 At 80 MHz and 800 MHz, the higher frequency range applies.
NOTE 2 These guidelines may not apply in all situations. Electromagnetic propagation is affected by absorption
and reflection from structures, objects and people.
a
Field strengths from fixed transmitters, such as base stations for radio (cellular/cordless) telephones and land
mobile radios, amateur radio, AM and FM radio broadcast and TV broadcast cannot be predicted theoretically with
accuracy. To assess the electromagnetic environment due to fixed RF transmitters, an electromagnetic site survey
should be considered. If the measured field strength in the location in which the FLAT E is used exceeds the
applicable RF compliance level above, the FLAT E should be observed to verify normal operation. If abnormal
performance is observed, additional measures may be necessary, such as reorienting or relocating the FLAT E.
b
Over the frequency range 150 kHz to 80 MHz, field strengths should be less than 3 V/m.
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that is present on the device, means that within the European Union the product must be
taken to separate collection at the product end-of life. Therefore, at the and of the life-cycle
of the device, the user should deliver the device to the proper collection facilities of the
Electric and Electronic Equipments. Alternatively, the user can return the device to the
seller, on a one-to-one basis, as long as he is buying a new one of equivalent type and
that fulfills the same functions as the old one.
Disposing of the device separately avoids possible negative consequences for the
environment and health deriving from inappropriate disposal and enables the constituent
materials to be recovered to obtain significant savings in energy and resources.
Who disposes any Electric and Electronic Equipment, reporting the above symbol, as
unsorted municipal waste, instead of collecting it separately, incurs the administrative
sanctions in accordance with law.
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WARNINGS
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DEVICE CLASSIFICATION
The identification label is placed on the back of the device and a true copy of
it is also placed inside on it.
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IDENTIFICATION LABELS
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PROTECTED AREAS
To obtain the maximum protection against the stray radiation, significant zone
of occupancy and protected area can be identified according to the following
drawing.
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The FLAT E has features that make the whole system particularly light and user-friendly, also for
inexperienced operators. So that it, and its accessories, are presented to the market using a low
price range for this class of product.
The FLAT E is equipped with an automatic exposure device (AEC), based on an extremely
advanced concept. The AEC allows, using special phantoms, PC and software, to memorize in the
mammographic unit, during installation, the typical calibration curves. For each available
film/screen and for each desired technique a curve is memorized, that is essential in order to
obtain constant iconographic results for all the examined breasts independently from their intrinsic
density.
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This unit is extremely reliable, and allows to perform high quality diagnostic exams at low cost and
without any retakes. The purchasing price of this unit is very highly competitive compared with all
the other units of the same type in the market: in fact, the configuration of its accessories has been
perfected to facilitate the standard exams excluding accessories with special functions.
The FLAT E, is a completely independent radiological system. It is provided with H.F. generator
incorporated with an X-ray tube dual focus, Potter-Bucky with mobile carbon fibre grid, an efficient
magnification device, and a complete range of accessories that help the operator to do his job.
For Flat E a large optional accessory selection is available in order to expand its features to the
maximum levels achievable today.
Isocentric C-ARM with variable F.F.D. (film-focus distance) allows easy and fast operation for
every projection of the breast without moving the patient and without changing C-ARM vertical
position.
Stereo biopsy device BYM 3D for film or DIGITAL BYM for whether digital mode or film.
Easylabel daylight or darkroom film ID system with auxiliary display close to the unit for enhanced
patient comfort and check of personal data before printing on Film.
Using special accessories (Easylabel film printer, and bright display for patient identification), the
patient can check her name before exam so that she may be sure that the data printed on film are
correct.
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1. STAND
2. C-ARM
3. X-RAY TUBE
4. COLLIMATION PLATE
5. C-ARM ROTATION HANDLES
6. COMPRESSION PLATE HOOKING
7. POTTER-BUCKY TABLE OR CASSETTE HOLDER 18x24 and 24x30
8. C-ARM ROTATION HUB
9. ON/OFF SWITCH
10. STAND-BY LAMP
11. CONTROL PANEL
12. COMPRESSION AND LIGHT BEAM DOUBLE-PEDAL CONTROL
13. REMOTE INFRARED X-RAY PUSHBUTTON RECEIVER (optional)
14. HAND HELD X-RAY PUSHBUTTON
15. SERIAL PORTS FOR EASYLABEL, DIGITAL IMAGING AND SERVICE
16. KNOB FOR MANUAL OPERATION OF MOVING CONTROL PANEL (optional)
17. C-ARM ROTATION BRAKE PUSHBUTTONS
18. A.E.C. DETECTOR
19. FILM-MARKER
20. C-ARM UP/DOWN MOVEMENTPUSHBUTTONS
21. EMERGENCY PUSHBUTTONS
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The FLAT E BYM has the same main features of the Flat E: the whole system is particularly light
and user-friendly, also for inexperienced operators. It, and its accessories, are presented to the
market using a low price range for this class of product.
The isocentric C-Arm, called BYM C-Arm, is the feature that makes the FLAT E BYM even more
powerful than the FLAT E. As a matter of fact no changes in the position of the patient are
requested between one exposure and another. The BYM C-arm allows easy and fast operation for
every projection of the breast without moving the patient and without changing C-ARM vertical
position.
Moreover, the BYM C-arm allows to upgrade the mammography unit with the stereotassic biopsy
device BYM 3 D.
On the BYM C-arm also the variable F.F.D. (film-focus distance) from 65 to 70 cm is available as
an optional.
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The FLAT E BYM is equipped with the same automatic exposure device (AEC) than the FLAT E,
that is based on an extremely advanced concept. The AEC allows, using special phantoms, PC
and software, to memorize in the mammographic unit, during installation, the typical calibration
curves. For each available film/screen and for each desired technique a curve is memorized, that is
essential in order to obtain constant iconographic results for all the examined breasts
independently from their intrinsic density.
This unit is extremely reliable, and allows to perform high quality diagnostic exams at low cost and
without any retakes. The purchasing price of this unit is very highly competitive compared with all
the other units of the same type in the market: in fact, the configuration of its accessories has been
perfected to facilitate the standard exams excluding accessories with special functions.
The FLAT E BYM, is a completely independent radiological system. It is provided with H.F.
generator incorporated with an X-ray tube dual focus, Potter-Bucky with mobile carbon fibre grid,
an efficient magnification device, and a complete range of accessories that help the operator to do
his job.
For Flat E BYM a large optional accessory selection is available in order to expand its features to
the maximum levels achievable today.
Stereo biopsy device BYM 3D for film or DIGITAL BYM for whether digital mode or film.
Easylabel daylight or darkroom film ID system with auxiliary display close to the unit for enhanced
patient comfort and check of personal data before printing on Film.
Using special accessories (Easylabel film printer, and bright display for patient identification), the
patient can check her name before exam so that she may be sure that the data printed on film are
correct.
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OPERATING INSTRUCTIONS
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CONTROL PANEL
1. LCD DISPLAY
2. FOCAL SPOT SELECTION ( large focus, small focus)
3. kV SELECTION (0.5 kV step)
4. mAs SELECTION
5. OPERATING MODE SELECTION (0 POINT, 1 POINT, MANUAL)
6. X-RAY EMISSION CONTROL LAMP
7. FILM/SCREEN SELECTION
8. A.E.C. FIELD SELECTION
9. MANUAL DENSITY CORRECTION
10. AUTOMATIC COMPRESSION RELEASE ENABLE / DISABLE
11. COMPRESSION FORCE SELECTION
12. ALARM RESET
13. C-ARM UP/DOWN PUSHBUTTONS
14. Mo/Rh FILTER SELECTION (optional)
15. DIGITAL MODE SELECTION (optional)
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DISPLAY
20 19 18 17 16
21
15
1
14
2
13
3
12
4 5 6 7 8 9 10 11
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TABLES
For any table size and model, radiographic cassette can be inserted from both sides, and
can be extracted even from the other side.
To insert cassette push back the white lever shown in the figure below. Cassette must be
inserted till the lever is released.
Exposure is disabled if cassette is not inserted, properly inserted or already exposed.
LED
LEVER
Proper insertion of the cassette is detected by means of the Kodak compatible notch,
shown in the picture below. If the used cassette has not a notch like this, internal sensing
switch can be disabled (refer to sevice).
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EXAMINATION ROOM
X-Ray units can only be operated inside dedicated room provided with X-ray protection
that meets local standards and regulations.
SWITCHING ON
Before switching ON the unit, check that Emergency Push Buttons n°21 are unlocked and
Blue Lamp n°10 is bright; if not, check main switch on the wall.
Press button n°9, and keep it pressed until the lamp switches OFF.
The machine takes about 10 seconds to switch on; wait that LCD screen is completely
filled, so that the machine is ready for use.
If a cassette was inside the tables during switch on, the set up process is blocked, the
message “CHECK CASSETTE” appears, and a sound signal takes place.
In this case, the operator must either remove the cassette (for example because it is
already exposed or empty), then press the reset button, or press the reset button to use
the cassette.
SWITCHING OFF
This action is possible only from the control panel by means of the two buttons n° 13, or
from the optional auxiliary up-down push-button for C-ARM n° 20 (see main parts plan).
If the C-arm is moved during compression, the compression is automatically released.
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ROTATING C-ARM
To rotate C-arm unlock the brake pushing the buttons n° 17 (see main parts plan) located
on the handles. The maximum rotation is ±180°. When the unit is OFF the C-ARM can’t be
moved.
The rotation is showed by a goniometer on the C-arm, or on the display, depending on the
configuration of the device.
If the C-arm is rotated during compression, the compression is automatically released.
For safety reasons, C-arm rotation is disabled if the table is not inserted, because the C-
arm is not balanced (not applicable for BYM C-Arm).
TABLE INSERTION
To insert table simply align it with slide guides, push till to the stop and check that table
front wall is aligned with support front wall.
After connecting tables with grid, check that grid moves pressing pushbuttons n°12 (alarm
reset) and n°11(compression minus) of control panel at the same time.
To remove table simply pull it out.
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Tables have integrated sliding ID labels to identify projections, magnification ratio etc.
Note: the above table is not exhaustive of all possible mammographic views. For further
details, and for the correct positioning and compression of the patient, refer to the ACR
protocol or other official sources of information.
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To insert or remove compression plates push the locking system as shown in the picture
below.
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During compression the breast thickness is written on the display as shown below:
Compression
thickness
Compression
Compression
release
force
This value is displayed only if the operator chooses a correct exam configuration:
• For contact technique: select large focus, use grid tables and shifted
compression plates.
• For magnification technique: select small focus; use grid-less tables and
straight compression plates
If thickness measurement is outside limits the display shows:
---mm
The compression force previously set using the panel board is automatically restored
when the compressor is reactivated.
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To insert collimation plate, align the back edge and after push it up until it’s engaged by
the locking mechanism.
AUTOMATIC COLLIMATION
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The cassette adapter, code 2PMX-55-xx, is an accessory that allows the operator to
change cassette size without changing the table. It is similar to a 24x30 Potter-Bucky, and
24x30 cassette can be inserted normally, but the 2PMX-55-xx is also provided of a special
adaptor that allows to use the 18x24 cassette.
This accessory is able to detect the cassette size inserted. This allows the automatic
collimation to work properly.
After changing film size, wait for countdown before to operate X-ray exposure.
To avoid extra delay, insert cassette before patient positioning, collimator positioning will
take place during that time.
Do not insert adapter without cassette inside, detecting functions can be wrong.
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Slide guide
2x
1,5x
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KV SELECTION
kV selection is possible only in MANUAL mode and ONE POINT mode. It increases and
decreases kV values through 0.5 kV steps. In MANUAL mode the selectable range is 20 ÷
35kV, in ONE POINT mode the range is 23 ÷ 32 kV. Commands are n°3 in control panel.
In ZERO POINT mode the same buttons are used to fine tuning of kV range.
mAs SELECTION
This command is active only in MANUAL mode. mAs values can be selected in log scale
by buttons n° 4 on control panel (see console plan). In ZERO POINT mode the same
buttons are used to select the exposure technique (STD, EXT, HC, LD).
In ZERO POINT and ONE POINT mode, the mammography unit selects kV and mAs
depending not only by breast density, focal spot, anodic and filter material and other
geometric parameters, but also depending by the film/screen response to X-rays. A total of
16 Film/Screen combinations, programmed during installation, can be calibrated. To
modify selectable film/screen combinations or add more, service intervention is required.
The selection is obtained by button n° 7 on control panel (see console plan). Only the
film/screen combinations that have been programmed during installation can be selected
on the control panel. Some of the 16 film/screen combinations are dedicated to the use of
CR cassette, and must be calibrated during installation with the same concept of the
combinations dedicated to analogical cassettes for mammography.
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With this command it is possible, in ZERO POINT or ONE POINT mode, to increase or
decrease the darkness of the exposed film. During calibration the operator chooses a
desired optical density. The obtained darkness may change and diverge from the chosen
darkness for many reasons (development chemicals, sensitivity of film and supporting
screen, performance of X-ray tube, operating temperature etc.). It is also possible that the
operator wants a darker or brighter exposure. So that, it is possible to correct the exposure
to obtain the most satisfactory optical density value. Commands are buttons n° 9 on
control panel (see console plan), and the range is from -5 to +5. The optical density
difference between two adjacent steps is set during calibration and usually varies from 0.1
to 0.2.
RADIOGRAPHIC EXPOSURE
X-ray push-button has a single action (PREP + EXP). The button must be kept pressed
until the exposure is over. Exposure is announced by a sound signal and by light n° 6 on
control panel.
If the X-ray pushbutton is released, the X-ray emission stops immediately.
The CPU is able to recognize the cassette status. In case of no cassette inserted, if the X-
ray push-button is pressed, the alarm CASSETTE NOT INSERTED appears on the
display. In case of cassette already exposed, if the X-ray push-button is pressed, the alarm
CASSETTE ALREADY EXPOSED appears on the display. Before starting exposure check
that on the display the notice READY is present in the lower right corner.
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When high speed tube Pantix or others are in use, and more than two exposures Prep/Exp
per minute are performed, continuous rotation will start and continue for one minute. After
one minute tube will brake by itself. Don’t switch off the unit to stop the tube otherwise tube
will remain in rotation. To recover from such situation, if it occurs, switch on the unit again,
press the X-ray pushbutton and release it immediately. Tube will brake.
RESET COMMAND
The button n° 12 on control panel stops the acoustic error signal, that is related to the error
message on the display.
Some error messages are automatically reset when the cause of the alarm stops. Also
refer to the next chapter “Maintenance”, paragraph “Error messages”.
At the end of each exposure, the microprocessor calculates the heat units accumulated by
the RX tube. Two values appear on the display areas n° 13 and 12:
“HU xx% TD xx”, which refer respectively to the total heat units accumulated by the tube
and to the time in seconds that must elapse before next exposure is possible. The
exposure is not permitted until the value relating to TD is zero. When 90% of the maximum
thermal capacity of the tube is reached, an alarm sounds and the exposure is not
permitted until the HU drops below the maximum permitted value.
If ambient temperature is higher than 25°C, HU can be greater than zero even if no
exposures have been released for a long time.
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EXPOSURE TECHNIQUES
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DOSE MINIMIZATION
Dose released to the patient is function of each one of the parts composing the
mammographic system.
To reduce the dose take care of the following points:
Film Processor
Temperature and process time have to be selected according to film manufacturer’s
specifications; if not available, adjust temperature to 35 C° and process time for extended
process.
Chemicals
Be careful to replace them when aged and unable to guarantee the optimal performances.
We recommend the use of sensitometer, densitometer and sensitometric chart for daily
processor check.
Film/Screen
Actual state of the art can reduce the dose to ½ with respect to older types.
Optical Density
Refer to the most diffused Quality Protocols to select reference O.D. and take into
consideration that dose and film darkness are directly related.
Mammo Unit
Be sure that ADVANCED CALIBRATION PROCEDURE has been performed to assure
max O.D. linearity.
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IMAGE QUALITY
The image quality is the final product of a mammographic system, so that it is of course
the last and most important aspect.
Film Processor
Supposing that all the components have been selected and tuned properly, the film
processor covers a very important role among them.
A dirty processor or with damaged rolls can generate artifacts on the film that reduce
dramatically the image quality.
kV selection
ZERO POINT MODE kV range has been selected in order to remain below 30 kV when
taking pictures with very large and dense breasts.
Everybody knows that image contrast reduces when kV increase.
Test phantom
To check image quality, several test phantom and related procedures are available from
the market.
If RMI 156 phantom is used, a score is associated to each detail, total score is used to
judge image quality.
Using phantom, the role of each component can be investigated and the final image
quality enhanced.
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MANUAL MODE
In MANUAL MODE the operator can select mAs and kV and the UNIT itself take care of
Max loading conditions.
At the actual state of the art, having the unit a very powerful A.E.C., MANUAL MODE is
not used for routine examination.
MANUAL MODE is used for special purposes like breasts with silicone prosthesis.
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This is the most used operating mode and it is recommended because it is able to
guarantee the maximum performances of the unit.
In ZERO POINT MODE kV and mAs depend on the real breast density measured by a
short X-ray pre-exposure.
Optical density repeatability, over a very large breast density range, is assured by
advanced A.E.C. calibration.
Using ZERO POINT MODE, the operator has only to take care of patient positioning and a
top quality image is assured, examination time and retake are minimized.
KV range in ZERO POINT MODE has been selected so that even with large and dense
breasts kV value if far enough from 30kV and image contrast is not reduced.
During exposure an audible signal is emitted, to alert the operator that the X-rays are
emitted in that moment. In ZERO POINT MODE and ONE POINT MODE the signals are
two: the first corresponding to the pre-exposure pulse, and the second corresponding to
the exposure. The first is very short, and the seconds depends on the exposure time. Don’t
let the X-ray pushbutton till the end of the second audible signal.
After exposure the display shows kV, mAs and dose released during the exam.
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+0 + 0.5 +1 + 1.5
By means of the two above described functions, operator has a very powerful tool to
manage the examination with the most appropriate technique.
The number on the display at position 6 varies between -5 and +5. If the operator chooses
to increase optical density, a higher dose is released to the patient, and the darkness of
the film increases, and vice-versa. Any step of optical density set on the mammography
unit, corresponds to a definite value of optical density, normally between 0.1 and 0.2. This
value of any single step is chosen during calibration.
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Detector position
Depending on the breast size and morphology the operator can manage detector position.
Be careful to avoid that detector remains partially out of breast, in this case exposure will
be shorter than necessary and picture will be useless, too bright.
Normal position is at the first stop patient side.
Compression plates have silk screen to locate AEC position on the breast.
When selecting AEC position take care that it’s not outside the breast, if it happens
DETECTOR OVER EXPOSED alarm is generated.
The unit is equipped with PHTM9000 detector, operating field/position can be selected
from the control panel by means of push button 8, selected position will be showed on the
display and by means of the three led on the C-arm.
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Anode/filter combinations
If the mammography unit has an automatic Mo/Rh filter or a double track Mo/W tube, in
ZERO POINT mode the mammo can choose automatically the anode/filter combination to
use for the exam. Use button 14 so that in the area n°4 of the display is written AUTO.
After exposure the EXP notice appears, and the used combination is showed on the
display on areas 2 (anode) and 3 (filter)
If the operator wants to choose the anode/filter combination by himself, he can set it in FIX
mode pushing the button over and over again. In zero point mode the mammography unit
can choose automatically the anode.
As the CR cassettes have a major attenuation to the X-rays than normal analogical
cassettes with film/screen, the 14, 15 and 16 technique, dedicated to CR cassette, have
an automatic compensation that guarantees the correct operations of the 0 Point
Technique.
If the Mammography unit is used both with analogical film/screen cassette and with CR
plates, it is mandatory to select the appropriate film/screen or CR technique depending on
the cassette that is used for the exam. As showed in the picture, the techniques dedicated
to CR cassettes are highlighted by the CR symbol.
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Note
Due to little difference in breast density related to different projections, for the same patient
kV may differ of 0.5 kV between one projection and another as well automatic filter can
change for some projection and not for others of the same patient.
This is due to the breast density that can be close to the trip point between a kV value and
another, of course a difference in mAs is normal too.
To avoid what above described, after the first exposure/image in Zero Point mode, select
One Point mode and kV will be automatically selected at the same value of the last
exposure.
To avoid filter selection different from the previous, select FIX anode/filter with the same
previous combination.
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Is a semiautomatic mode recommended only when the user needs to select kV manually
for special purposes under his control.
To avoid loss of contrast we recommend to select kV not higher than 30.
ONE POINT MODE is derived by ZERO POINT MODE and is based on the same concept
of breast density measurement by means of a short pre-exposure.
After an exposure in ZERO POINT MODE, selecting the ONE POINT MODE the kV value
set on display is the value used for the previous exposure, and of course the operator can
change it in the range showed on the display.
For optical density correction, AEC detector position, anode/filter combination and audible
X-ray emission signal refer to previous ZERO POINT MODE paragraph
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If Digital Bym with digital cassette Option is installed, Digital Mode can be selected by
means of pushbutton 15 of control panel.
On the right of DIGITAL label S (scout), R,(right), L (left) appears depending of C-ARM
inclination during biopsy.
In Digital Mode only Manual and 1 Point modes are available.
KV selection can be critical for proper CCD operation and values not lower than 26 are
recommended.
During Digital Mode operation take care that on the bottom right corner of PC screen
“READY FOR X-RAY” is displayed.
For more details about Digital Mode, refer to online Help of Digimam software.
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DOSE CALCULATOR
Unit is provided of Skin Dose or Average Glandular Dose (AGD) calculator upon request.
After each exposure, dose in mGy is displayed in the dedicated area of the display, is
recorded in the Last 1300 exposures memory and can be printed on the film if the
Easylabel film printer is available and such function has been enabled during installation.
For proper dose calculator operation, it’s necessary to use the appropriate compression
plates as described in the next chapter “tipical configurations”.
Shifted plates have to be used with large focus and straigh plates with small focus
because focal spot to skin distance measurement depend on it and dose calculation too.
Also refer to the Typical Configurations chapter.
Take note that with BYM C-arm and variable F.F.D. (film-focus distance; optional) breast
thickness and Average Galdulare Dose are displayed and valid only if F.F.D is 65 or 70
cm, and not in intermediate positions.
Mo/Rh automatic filter is an optional accessory and is not present in all the mammographic
units.
FILTROMAMM is used to have a double combination ANODE/FILTER (Mo/Mo Mo/Rh). It
optimizes the spectral characteristic of X-rays in function of real density of the breast.
Breast density is detected with a short pre-exposure X-ray pulse in ZERO POINT and
ONE POINT techniques. So that the appropriate TARGET/FILTER, other than the
exposure parameters, will be automatically selected.
Mo/Mo combination is used for normal density breasts while Mo/Rh combination is used
for others having high density. Trip point after which Mo/Rh combination is selected,
corresponds to about 6 cm of Tissue Equivalent RMI phantom.
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REMOTE CONTROL
The unit may be provided with infra-red remote control installed on the protective shield.
The remote control signal is encoded in such a way as to eliminate possibilities of
interference. 9VDC battery of the remote control needs to be replaced periodically as soon
as the error message “EARLY PUSHBUTTON RELEASE” appears on the display.
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TYPICAL CONFIGURATIONS
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The next typical configurations are intended to help the operator to avoid operating
mistakes.
Use of different configuration can result in bad images with unwanted artifacts due to
compression paddle arms in the picture, wrong x-ray field coverage, wrong dose
measurement and others.
Proper collimator selection is essential to guarantee correct X-ray field and patient
protection according to applicable IEC standards.
Lexan face protection 2SCLx-XX can’t be used with magnification techniques not having
room enough to be fitted. Before to fit or remove it, collimation plate must be removed due
to handle interference.
The typical configurations are the same if isocentric C-ARM option is installed, in such
configuration take care of proper F.F.D (Film-Focus Distance).
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Use of shifted and reduced compression plate makes pulling of the small breast easy.
Compression plate back edge is masked out of the film by X-ray collimation plate with
reduced X-ray field depth.
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M3 MT- DWG0 1 4 - 0 0
Flat E with Isocentric C-ARM and variable F.F.D. (film-focus distance) option allows easy
patient positioning and stereo biopsy operation by means of BYM-3D accessory capable of
Film or Digital imaging operation.
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MAINTENANCE
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ERROR MESSAGES
One of the features of the FLAT E CPU is that it displays TEXT ERROR MESSAGES and
no error codes. 8 languages are available for error messages.
CHECK CASSETTE
A cassette that might already have been exposed is present in the potter when the
machine is turned on. Remove cassette before to reset alarm.
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CHECK FOOT PEDAL SWITCH, CHECK BRAKE PUSH BUTTONS & CHECK ARM
PUSH BUTTONS
There is probably a fault of an electrical nature or mechanical blockage of the respective
buttons. Attempt to remedy by keeping buttons/pedals depressed; should the fault persist,
call Service. In this event, all other functions are not permitted.
DOOR OPEN
Close the door of diagnostic room.
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MAINTENANCE
Maintenance procedures and checklist are included in Technical Manual and can be
carried out only by qualified personnel.
General maintenance procedures are suggested every 6 months or recommended every 1
year.
Other facultative procedures that the user can carry on by himself, mainly intended to
guarantee dose minimization and image quality optimization are the followings:
• Densitometric check DAILY
• A.E.C. [o] and [r] DAILY
• Image Quality Phantom Test SIX MONTH
Furthermore a daily sensitometric check is also recommended.
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A.E.C. TEST
During the test, the system should be configured as showed in the next figure.
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This configuration was so chosen as to exclude all variable elements, which may exist
between the X-ray source and the detector.
The phantom supplied with the unit can be used for the test.
SELF-DIAGNOSIS
Pressing pushbuttons 12 and 7 at the same time, the following information appear on the
display regarding the state of the unit:
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CLEANING
External Surfaces
Use only a soft cloth or, for more efficient cleaning, a neutral detergent to avoid damage to
painted surfaces and compression plate.
During cleaning operations, do not use excess of detergent and be careful that detergent
doesn’t enter the unit.
Compression plates
Use only neutral soap. Chemical detergents can damage polycarbonate getting it hard with
risks of cracks.
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ACCESSORIES
WARNING
USE ONLY ORIGINAL ACCESSORIES
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LIST OF ACCESSORIES
Note: The following list of accessories, and the distinction between standard or optional,
can vary depending on the availability and on the commercial agreement. For an updated
list or more details contact Metaltronica.
Standard accessories
Code Description
2CM16x22-xx 16x22 cm Shifted Compression paddle
2CM12x8P-xx 12x8 cm Straight Compression paddle
2CLSV18x24-xx 18x24 cm Interchangeable collimator plate
2CLSVD14-xx ∅ 14 cm interchangeable collimator plate
or or
2CL113D14-xx ∅ 14 cm interchangeable collimator plate for M113 X-ray tube
2SUPCOL-xx Kit interchangeable collimation plates (including 2CLSV18x24-xx and
2CLSVD14-xx/2CL113D14-xx)
2INFL-xx Device for geometric magnification 1,5x and 2x
2SCLX-xx Lexan screen for protection from parts not to do examine
2PMX-25-xx 18x24 cm potter bucky with carbon fiber grid with marking device of
projections
KTSVA0105-xx First pair of motorized compression foot-controls
KTSVA0105-xx Second pair of motorized compression foot-controls
PHTM9000-xx Automatic exposure control
PL/C2U RX pushbutton with extensible cable
CV0095-xx PC connection cable
MEEQ3514-xx Methacrylate phantom
MTFLATE-Uxx Technical manual
MOFLATE-Uxx Operator’s manual
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Optional accessories
Code Description
3-INFL-xx x1.8 Magnification platform with cassette holder and film lab. device
2CMB16x22-xx 16x22 cm Shifted Compression paddle with metallic grid for
bidimensional biopsy
2CM10x8S-xx 10x8 cm Shifted Compression paddle
(*) 2CM10x22-xx 10x22 cm Shifted Compression paddle
(*) 2CM12x22-xx 12x22 cm Straight Compression paddle
2CM24X30-xx 24x30 cm Shifted Compression paddle
2CLSV24X30-xx 24x30 cm Interchangeable collimator plate
2CLAUTO-xx Automatic collimator
2SPDES Free standing and fully transparent anti-X shield for operator
(*) 2SPDES-F-xx Free standing and fully transparent anti-X shield for operator iron base
2SPDES-T-xx Free standing semi-transparent anti-X shield for operator
2TRIF-xx IR X-ray pushbutton for remote control
GRPB/EI-xx Ant-X rubber aprons for pelvis protection of the patient (medium)
GRPB/EI-xx Anti-X rubber aprons for pelvis protection of the patient (large)
2PMX-1-xx 18x24 cassette holder for exam. without grid with marking device of
projections
2PMX-35-xx 24x30 cm potter bucky with carbon fibre grid with marking device of
projections
2PMX-55-xx 24x30 cm potter bucky with sliding marking device equipped of 18x24
cm cassette adaptor (without cassette)
(*) KTFE/PMX-35 Kit PMX 3500 including collimator plate and compression paddle
MEEQ3833-xx 18x24 cm cassette adaptor (without cassette) for 24x30 Potter-Bucky
or Cassette holder
(*) 2FLMAMM-xx FILTROMAMM motorized change filter device (standard for PANTIX
tube)
2PAFL-xx Wall accessories bearing
2PPFL-xx Wall bearing for Potter Bucky
2PCBFL-xx Remote control panel to fix on the glass shield
2PCBFLW-xx Remote control panel to fix on the wall
KTTELIFL-00 Protection covers kit
MATRFL-xx Transport handles
Cassettes, different trademarks and models
KT/DELE-xx Display identificaz paziente
Chair for exams with sitting patient
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C-arm
Code Description
Non-isocentric C-arm - standard for FLAT E
AMLFC- xx Isocentric C-Arm with fix F.F.D. for biopsy device
(called “BYM C-arm”) - optional
AMLFC- xx Isocentric C-Arm with variable F.F.D. for biopsy device (called “BYM C-
arm”) - standard for FLAT BYM
X-ray tubes
Code Description
IAE XM12i IAE tube - optional
VARIAN M147 Varian tube - standard for FLAT E
VARIAN M113 Biangular Varian tube - standard for FLAT BYM
IAE XM 10/16 Biangular IAE tube - optional
PANTIX 40MoW- SIEMENS double track Mo/W X-ray tube Kit (including 9000 rpm kit and
100G Filtromamm) - optional
Optional devices
Code Description
KT/HS-FLT-xx 9000 rpm kit (standard for PANTIX tube)
2BY-3D-xx BYM 3D stereotactic biopsy device (only available with isocentric C-arm)
1ELUSC EASY LABEL film printer with base foot, without base foot (for desk) or
for darkroom
STAMP/SPR-LP1 S’PRINT adhesive label printer
DIGITALBYM Digital Imaging system with small field digital detector
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COMPRESSION PLATES
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2 cm
M3 MT- DWG0 4 9 - 0 0
1.8x magnification device with cassette holder (without grid) and film labeling device
Code 4-INFL-XX
Automatic focal spot selection is performed with this accessory.
Small focal spot selection when 4-INFL-xx is in.
To be used only with 2CLSVD 14-XX collimation plate and 2CM12x8P-XX compression
paddle.
For BYM C-Arm use F.F.D. 65 cm
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AUTOMATIC COLLIMATOR
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WARRANTY CONDITIONS
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WARRANTY CONDITIONS
METALTRONICA S.p.a. is committed to replacing, free of charge, any part of the machine
that proves to be faulty, for a period of twelve months from the date of installation.
THIS WARRANTY DOES NOT PROVIDE FOR DEFECTS DUE TO:
• damage caused during transportation
• damage caused by the incorrect installation of the unit, if not carried out by personnel
trained by METALTRONICA
• damage caused by inappropriate connection to other units
• damage caused by improper use, negligence, carelessness or inability to use unit.
• use of not original spare parts or accessories
THE WARRANTY DOES NOT APPLY TO MATERIAL SUBJECT TO WEAR AND TEAR .
X-Ray tube is covered by pro rata temporis warranty
The aforesaid terms are to be considered valid except as otherwise set forth in the
contract.
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FAILURE REPORT
IMPORTANT NOTICE:
This report shall be submitted whenever a failure occurs. Information given through this
form will expedite manufacturer’s technical assistance.
In case of warranty claim this report is mandatory: warranty will not be processed without
receiving this form properly filled in.
DISTRIBUTOR: NAME
ADDRESS
USER: NAME
ADDRESS
SERIAL NUMBER
DATE OF PURCHASE
DATE OF INSTALLATION
SOFTWARE RELEASE
NUMBER OF EXPOSURES
FAILURE: DESCRIPTION
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MECHANICAL
ELECTRICAL
ELECTRONIC
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SAFETY FEEDBACK
In order to continuously improve quality and safety of our medical products, we kindly ask
you to quickly signal us, filling in this form, any potential cause of risk bound to our medical
devices.
DISTRIBUTOR: NAME
ADDRESS
USER: NAME
ADDRESS
EQUIPMENT: TYPE
SERIAL NUMBER
PURCHASE DATE
INSTALLATION DATE
SOFTWARE REVISION
NUMBER OF EXPOSURES
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