Document No.

DC-2008-013-05P

PrexViewer
User’s Manual
Rev. 2.2.1

PreXion, Inc.
 Index
1. PREFACE 4
1-1 DISCLAIMER 4
1-2 ABOUT PREXVIEWER 4
1-3 RENDERING FEATURES 4
1.3.1 3DVR 4
1.3.2 MPR (Multi Planar Reconstruction) 5
1.3.3 RaySum (Ray Summation) 5
1.3.4 MIP（Maximum Intensity Projection） 5
1.3.5 MinIP (Minimum Intensity Projection) 6
1.3.6 Panoramic CPR 6
1.3.7 Panorama Cross Section 6
1-4 MINIMUM SYSTEM REQUIREMENT 7
1-5 UNSUPPORTED FUNCTIONS 7
2. STARTING PREXVIEWER 8
2-1 LAUNCH VIEWER 8
2-2 LOADING DATA 10
2-3 DISPLAY ADJUSTMENT 12
2.3.1 Window Level 12
2.3.2 Panning 13
2.3.3 Zoom In/Out 13
2.3.4 Rotation 14
2.3.5 Slice 14
2-4 3DVR IMAGE ADJUSTMENT 15
2-5 MPR IMAGE ADJUSTMENT 16
2.5.1 Window level adjustment 16
2.5.2 RaySum Display 16
3. CUTTING 17
3-1 USING AN OUTLINE 17
3-2 USING THE SLAB FUNCTION 19
3.2.1 Example Use of the Slab Function 20
4. CPR FUNCTION 22
4-1 CPR MODE SCREEN 22
4-2 CREATING CROSS-SECTION IMAGES 23
4.2.1 Swiching Cross-Section Images to RaySum Images 25
5. MEASUREMENT FUNCTION 26
5-1 MEASURING DISTANCE 27
5-2 MEASURING THE ANGLE 28
6. PANORAMIC IMAGE DISPLAY 29
6-1 LOAD PANORAMIC IMAGE 32
6-2 GAMMA SETTING AND WINDOW LEVEL 34
6-3 PRESET 36
6-4 COLOR TEMPLATE 38
6-5 COLOR MAP 40
6-6 EDGE FILTER 43
6-7 ZOOM SHORTCUTS 44
6-8 FLIP 46
7. 2D IMAGE DISPLAY 48

2
 7-1 CHANGING THE LAYOUT 49
7-2 ADJUSTMENT OF THE MULTI-SETTING DISPLAY 51
8. SCENE 52
9. CONTACT INFORMATION 53

PrexViewer User’s Manual 3

 1. Preface
1-1 Disclaimer
PrexViewer is a review software application. Please refer to PreXion3D Viewer Software [of the
PreXion3D Scanner] for clinical diagnostics. By running the PrexViewer software you acknowledge
having read the disclaimer.

1-2 About PrexViewer

PrexViewer Data CD(“Data CD”) is generated by PrexViewer CDMaker(“CD Maker”).
The PrexViewer can run without installation on Windows computers and laptops.

1-3 Rendering Features

1.3.1 3DVR
This is a 3D volume rendering image. It is abbreviated as VR.
Volume rendering is a visualization method that uses volume data consisting of cubes called voxels. This
is used to visualize the 3D image to the interior, and image is displayed by adding colors and shadows
that have been calculate using the light penetration and reflection.

4 PrexViewer User’s Manual

1.3.2 MPR (Multi Planar Reconstruction)
MPR stands for the Multi Planer Reconstruction method. This method stacks the slices to create solid
volume data which can be used to display freely generated cross-section images.
Cross sections from different angles can be displayed based on multiple three-dimensionally imaged
image data such as horizontal cross sections (Axial) and vertical cross sections (Sagittal).
This is used to make a detailed check of the affected area and other applications.

<Axial> <Coronal> <Sagittal>

1.3.3 RaySum (Ray Summation)

This is the ray summation method. The CT value is added to the projected rays to create an image that
mimics a simple X-ray photograph.

1.3.4 MIP（Maximum Intensity Projection）

Maximum Intensity Projection provides a display that emphasizes the areas with the highest CT values.
This is displayed in a 3D monochrome image. This is used to easily identify the overall shape, implant
areas, etc.

CAUTION
・ An MIP image differs from a simple X-ray projection image.

PrexViewer User’s Manual 5

 1.3.5 MinIP (Minimum Intensity Projection)
Minimum Intensity Projection provides a display that emphasizes the areas with the lowest CT values.
This is used to check nerve holes and similar areas.

1.3.6 Panoramic CPR

This is a panoramic image. Discretionary cross sections of 3D volume data are joined together to form a
single image. This makes it possible to see the entire tooth alignment in one view.

CAUTION
・ This differs from images taken using a panorama X-ray machine.

1.3.7 Panorama Cross Section

This displays the discretionary cross sections of a panorama CPR image.

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1-4 Minimum System Requirement
Operating System: WindowsXP Service Pack2, Windows7
CPU: Intel Pentium4 or later (SSE2 feature must be required)
Memory: 512MB
Optical drive: CDROM (x52 or faster recommended)
Display: 1024x768 pixel

1-5 Unsupported Functions

This product does not support following functions.
• Printing
• 2D/3D protocol (movie)
• DICOM file import/export
• Save Scene
• Simple Report/Interactive Report
• Multi Data
• Mask
• Implant Planning
• Fusion

PrexViewer User’s Manual 7

 2. Starting PrexViewer
These methods are used to adjust the image display. The display settings for angle, color, image
information, and other items can be set.

2-1 Launch Viewer

1 Operation
Insert the Data CD into the
optical drive.
The PrexViewer will start
automatically.
If viewer does not start,
Double click ‘My Computer’
icon on Desktop, and then
right click the optical drive.

2 Operation
Select AutoPlay from menu.

8 PrexViewer User’s Manual

3 Operation
PrexViewer will be launched

4 Operation
To exit from PrexViewer,
click Exit button.

PrexViewer User’s Manual 9

 2-2 Loading Data
1 Operation
Double click the examination
to be read.

Note
• The data can be read from the series list. Double click on the series to be read or right click on the series and then
click on Open 3D View.

2 Operation
The Review screen is
displayed.
Of the series included in the
selected examination, the
series with the most images is
read.

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3 Operation
To return to Patient screen,
click Patient List button.

PrexViewer User’s Manual 11

 2-3 Display Adjustment
The tool buttons at the top left are used to zoom, rotate, and change the display position of the images.

Note
・ Adjustment can also be performed from the menu that is displayed by a right click.

2.3.1 Window Level

After clicking on the button, drag on the screen display view image to change the window level.
The window level can also be changed without using a button by dragging on the screw display view
image with the right and left buttons at the same time.

When not using a button

Simultaneous
right and left drag

Left drag

12 PrexViewer User’s Manual

2.3.2 Panning
After clicking on the button, drag right or left, up or down on the screen display view image to change
the display position.
The display position can also be changed without using a button by using the mouse right button to drag
right or left, up or down on the screen display view image.
When not using a button

Right drag

Left drag

2.3.3 Zoom In/Out

After clicking on the button, drag on the screen display view image to zoom in or zoom out the display.
The zoom can also be done without using a button by dragging the wheel button up or down on the
screen display view image.
When not using a button

Wheel drag (vertical)

Left drag

PrexViewer User’s Manual 13

 2.3.4 Rotation
This is used with the 3DVR image display.
After clicking on the button, drag on the screen display view 3DVR image to rotate the image display.
This cannot be used for MPR images.
Select this button when changing the screen.

Left drag

2.3.5 Slice
This is used with MPR image displays.
After clicking on the button, drag on the screen display view MPR image to move the slice. Click on the
[▼] button to specify the slice movement speed.
This cannot be used for 3DVR images.

Left drag

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2-4 3DVR Image Adjustment
The 3D Settings tab is used to adjust the 3DVR image display.

<3DVR Example>

PrexViewer User’s Manual 15

 2-5 MPR Image Adjustment
The MPR image display can be adjusted using the MPR operation panel.

2.5.1 Window level adjustment

Window level adjustment is set using the Window Level tab of the MPR operation panel.
This adjustment can be set by directly inputting the window width value in WW and the window level
value in WL.
In addition, the slide bar can be dragged to set the window level and both knobs of the slide bar can be
dragged to set the window width.

Slide bar

Knobs

2.5.2 RaySum Display

The three basic windows slice thickness can be set using the RaySum tab of the MRP operation panel.
Check the box for RaySum and then select Thickness from the list.
To move by the selected RaySum mode thickness, remove the check from the box for Snap to Slab.

CAUTION
• When a check is place in the box for Snap to Slab, the normal MPR image slices are moved one at a time.

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3. Cutting
Freely cutting any area allows you to remove unnecessary information and display only the area of
interest.

3-1 Using an Outline

An outline and anchor points are displayed when an MPR is displayed.
The outline on the MPR image can be dragged to cut the 3DVR image.

Outline
An outer frame broken line is
displayed on each image.

<Flow when cutting away the front portion>

Move the outline to the cut position
on the MPR (axial) image.

3DVR image before cut MPR (axial) image 3DVR image after cut

PrexViewer User’s Manual 17

 1 Operation
Drag the outline to the area to
be cut on the MPR image.

2 Operation
The area in front of the drag
is cut off and the cut 3DVR
image is displayed.

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3-2 Using the Slab Function
This function can be used to cut at a diagonal to the oblique coordinates or create a cut image that leaves
just a specified thickness (slab).
An oblique can be created by dragging the cross line and anchor point.
Aligning the cut with the tooth alignment makes it possible to create an MIP image of just the required
area and a MinIP image that shows an overall image of a neural tube.
Cuts at the thickness specified for the cut line

Cut line

Cuts at the thickness

specified for the cut line

Cut line

Cross line

Anchor points

Note
・ An oblique is a discretionary cross-section image. A discretionary diagonal image is called a double oblique.

<Flow when cutting using the slab function>

Move the green line on the Use the yellow lines on A 3DVR image cut to the
MPR (axial) to the place to both sides of the green specified thickness is
be cut. line to adjust the displayed.
thickness.

PrexViewer User’s Manual 19

 3.2.1 Example Use of the Slab Function
1 Operation
Move the center of the cross
lines to the area to be shown
by the Slab function.
The cross lines are moved by
dragging them at their center.

2 Operation
Click on the Slab tab of the
3D operation panel and place
a check in the box for Slab.

20 PrexViewer User’s Manual

3 Operation
Move the cross lines and
anchor points to adjust the
display area.
Drag the displayed yellow
line to change the thickness of
the displayed area.

4 Operation
The 3DVR image cut the set
slab thickness is displayed.

Note
・ Drag the anchor points to change the cut direction.
・ Right click on the 3DVR image to switch between MPR, MIP and MinIP images.

PrexViewer User’s Manual 21

 4. CPR Function
Curved Planar Reconstruction (CPR) is one type of MPR method. With MPR straight line cross sections
are displayed, but with CPR free curve cross-section views (cross-section images) are displayed.
This function can be used to create discretionary cross-section images.

4-1 CPR Mode Screen

Click on the [CPR] button from the tool buttons at the top right of the Review screen to switch to the
CPR mode.
A free curve can be drawn in the CPR mode and displayed and analyzed as a continuous cross-section
view.
CPR button

22 PrexViewer User’s Manual

4-2 Creating Cross-Section Images
A continuous horizontal cross-section view is called a cross-section image.
When a curve is drawn in the CPR mode screen, a cross-section view that intersects with the drawn
curve (CPR line) is created.
The intersecting lines are called cross-sections and continuous horizontal cross-section views
corresponding to the number of displayed cross sections are created.
The CPR line cross-section view is displayed as a panoramic image.

<Flow when creating a cross-section image>

3DVR Image Draw the cut line (CPR line) Put cross sections in the CPR line)

CPR line cross-section view (panorama

display) Cross-section views

1 Operation
Click on while holding down
the Ctrl key at the MPR view
and draw a discretionary CPR
line.
A green line will be drawn.

CPR line

Note
• To clear the drawn CPR line, click on the [Reset] button from the CPR tool buttons.
• The lines shown on both sides of the drawn CPR lines show the CPR line slice.

PrexViewer User’s Manual 23

 2 Operation
Drag the anchor points to
correct the drawn CPR line.
To delete the anchor points,
click on while holding down
the Shift key.

Anchor Points

3 Operation
The cross-section images for
the drawn CPR line are
displayed in the cross-section
view.
The drawn CPR line
panoramic image is displayed
in the panorama view.

24 PrexViewer User’s Manual

4.2.1 Switching Cross-Section Images to RaySum Images
Cross-Section images with CPR mode can be switched to RaySum Images.

1 Operation
Display the cross-section
image and click button
on the top of the screen.

2 Operation
1. Check the box of
[RaySum].
(1) 2. Select the thickness from
the pull down menu.
(2) 3. Click [OK] button, the
cross-section image
(3) switched to RaySum
image is displayed.

PrexViewer User’s Manual 25

 5. Measurement Function
The discretionary distance on an image, the surface area of an area of interest, signal values, and other
values can be measured in the Review screen.
The Measurement menu is used for measurements. The Measurement menu is displayed by clicking on
the [Measurement] button of the tool buttons at the top left of the Review screen.

Button Name Description

Select and move measurement result values, lines, etc.
Select

Delete measurement results, lines, etc.

Delete

Measure straight lines. Drag to draw a straight line. Displays the length.
Distance

Multiple Line Measure curve distance. Click on to draw a curve. Double click on the end point
Distance to display the measurement results.

Measure the relative distance of multiple lines. Drag to draw a straight line. The
Relative
first line is used as the reference and the distance relative value for the second and
Distance
subsequent lines is displayed.
Measure the angle of two straight lines. Drag to draw a straight line. The first line
Angle is used as the reference and the angle with the second is displayed.

26 PrexViewer User’s Manual

5-1 Measuring Distance
This is used to measure the distance of the drawn line.

1 (1) Operation
1. Click on the [Distance]
button.
2. Drag on the area of the
image to be measured to
draw a straight line.

(2)

2 Operation
Display the measurement
results.

PrexViewer User’s Manual 27

 5-2 Measuring the Angle
This is used to measure the angle between the drawn lines.

1 (1) Operation
1. Click on the [Angle]
button.
2. Drag on the discretionary
position on the image to
draw a straight line.
3. From the starting point of
the first line drag to draw
a straight line.

(2)

(3)

2 Operation
The measurement results are
displayed.

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6. Panoramic Image Display
The Panoramic image can be loaded from the Patient List screen. The image is displayed in various
ways.

 Adjustment of Gamma setting and Window Level

The Gamma setting, Window Level (WL) and the Window Width (WW) can be changed.

► Refer to 6-2 Gamma Setting and Window Level.

 Preset
Only by clicking a button, one of five presets of Gamma setting, Window Level and Window
Width can be applied.
► Refer to 6-3 Preset.

PrexViewer User’s Manual 29

  Color Templates
Color templates such as sepia-toned, inverted color can be applied.

► Refer to 6-4 Color Template.

 Color Map
The area which has the pixel value of your interest can be tinted with colors.

► Refer to 6-5 Color Map.

 Edge Filter
The image filter can be applied to the image. Two filters of edge enhancement.

30 PrexViewer User’s Manual

 ► Refer to 6-6 Edge Filter.

 Flip
The image can be flipped vertically and/or horizontally.

► Refer to 6-8 Flip.

PrexViewer User’s Manual 31

 6-1 Load Panoramic Image
Load a panoramic image into Panoramic Image View from Patient List. When the scan is done, an
panoramic image is generated in Series 100.

1 Operation
Click the Study data in the
upper list of Patient List
screen to display the Series
List at the bottom of the
screen.

Double click the series that

has the number 100. It must
have only one image in it.

2 Operation
The panoramic image is
loaded immediately in the
Panoramic Image View.

32 PrexViewer User’s Manual

3 Operation
Click on [Enable/Disable
Orientation], the orientation
display is displayed.

PrexViewer User’s Manual 33

 6-2 Gamma Setting and Window Level
The Gamma setting, the Window Level and the Window Width can be adjusted.

1 Operation
Click on the icon for
Panorama Histogram
floating panel on upper
right of the screen.

2 Operation
The Panorama Histogram
floating panel is displayed.

You can change Gamma

setting, Window Level and
Window Width here.

Note that Window Level

and Window Width can be
changed by mouse
operation described in 2-3
Display Adjustment.

34 PrexViewer User’s Manual

3 Operation
An example of Gamma
setting. Gamma is set to
0.58.

4 Alternative Operation
The Window Level and the
Window Width can be
adjusted in the panel on the
right side of the screen, too.

PrexViewer User’s Manual 35

 6-3 Preset
You can apply the preset Gamma setting, window level and the window width to the image.

1 Operation
Click one of the buttons in
[Preset] section in the
panel. (e.g. Click [Tooth2])

2 Operation
The preset Gamma setting,
window level and the
window width is applied to
the image.

36 PrexViewer User’s Manual

3 Operation
To change the preset value,
right click [Preset] button
after adjusting the Gamma,
window level and window
width. Input the new button
name on the Set Panorama
Preset window and click
[OK] button.

[Default] button reverts the

values to the factory setting.

PrexViewer User’s Manual 37

 6-4 Color Template
Different types of the color template can be applied.

1 Operation
Click one of the buttons in
[Color Template] section in
the panel.
If you choose [Rainbow],
the image is switched to the
color gradation from blue to
red.

2 Operation
If you choose [Sepia], the
image will be switched to
brownish-red.

38 PrexViewer User’s Manual

3 Operation
If you choose [Invert], the
color of the image will be
inverted.

PrexViewer User’s Manual 39

 6-5 Color Map
You can color the area which has the specified pixel value range.

1 Operation
Click on [Display pixel
value] button.

You can start from the 2nd

operation below without
this step. In that case, the
pixel value cannot be
checked in the 2nd operation
because the pixel value is
not displayed.

2 Operation
Move the cursor and double
click on the pixel which has
the pixel value you are
interested in. This pixel value
will be the center value.

CAUTION
• In the panoramic image, the CT value is not displayed but the pixel value.

40 PrexViewer User’s Manual

3 Operation
The area that has pixel
value close to the center
value (the center value ±
range) is colored.

The original image can be

observed even if colored,
only when you chose the
Gray color template.

4 Operation
Double click again to add
another area of pixel value
range. You can have up to
three areas.

PrexViewer User’s Manual 41

 5 Operation
You can change the color of
the area.
Right click the row to show
the pull down menu.
Select [Color Edit] to
change colors.
Select [Up] or [Down] to
change the lap order.
Select [Remove] to remove
the colored area.

6 Operation
Use the range slider bar to
adjust the range of pixel
value to color.

7 Operation
Click [Remove All] button to
remove all the colored areas.

42 PrexViewer User’s Manual

6-6 Edge Filter
You can apply the image filter that enhances edges.

1 Operation
Click one of the filter buttons
in the [Filter] section of the
panel to apply the image
filter.

Note
• [No Filter]: The original image
• [Sharpen 1]: Edge enhance. When you load an image, this filter is applied.
• [Sharpen 2]: Stronger edge enhancement than Sharpen 1.

2 Operation
This is an example of
[Sharpen 2]

PrexViewer User’s Manual 43

 6-7 Zoom shortcuts
There are two zooming shortcut buttons in the [Zoom] section of the panel.

1 Operation
Click [Fit] button to make
the image fit the current
viewing area. Left is an
example result.

Click [100%] button to

make the image
pixel-by-pixel
magnification.
Pixel-by-pixel means that 1
pixel of image corresponds
to 1 pixel of LCD display.

Note
• The display magnification ratio will be changed when you perform another zooming operation.
• The display magnification ratio is changed when you show or hide the operation panel on the right side of the
screen.

2 Operation
Left is an example result of
[100%] zoom.

44 PrexViewer User’s Manual

3 Alternative Operation
Right click on the screen,
the menu is displayed.
The same operation as
using [Zoom] button can be
done from the menu.

PrexViewer User’s Manual 45

 6-8 Flip
The image can be flipped horizontally and/or vertically.
Please note that the image is displayed the other way round in right and left. Enable the orientation
display and indicate LR code to avoid misidentifying.

1 Operation
Click [VFlip] button to flip the
image vertically.

The button is highlighted to

indicate the image is flipped.

2 Operation
Click on [HFlip] button to flip
the image horizontally.

3 Operation
This is an example of
horizontally flipped image.
Make sure to enable the
orientation display.

► Refer to 6-1 Load Panoramic

Image for the orientation
display.

46 PrexViewer User’s Manual

4 Operation
Click [Reset] button to revert
to the original status.

PrexViewer User’s Manual 47

 7. 2D Image Display
Multiple 2D images can be displayed at the same time just like for film diagnosis. Multiple displays of
one slice or simultaneous display of multiple slices are possible.
The types of slice multiple displays are explained below.
 Multi-setting Display
This shows multiple displays of one slice. Each display is shown at a different angle, so several
angles can be checked at one time. This is shown by clicking on the [Multi-setting] button on the left
side.
Multi-setting

Multi-setting display view 2D operation panel

 Multi-slice display
This displays multiple slices at one time. This allows the differences of each cross section to be
checked. This is shown by clicking on the [Multi-slice] button on the right side.
Multi-slice

Multi-slice display view 2D operation panel

48 PrexViewer User’s Manual

7-1 Changing the Layout
The multi-setting display layout can be changed from 1×1 to 2×2, and the multi-slice layout can be
changed from 1×1 up to 5×5.
This section explains the method for changing the multi-slice display layout.

1 Operation
Click on the [Multi-slice]
button.

Note
• For the Multi-setting display, click on the left side [Multi-setting] button.

2 Operation
Click on the [Change Layout]
button and drag the number to
be displayed to change to the
number of images you want
to display.

PrexViewer User’s Manual 49

 CAUTION
• The [Change Layout] button when the multi-setting display is used differs from that for the multi-slice display.
The number of displays that can be specified is 1×1 or 2×2.

3 Operation
The specified layout is
displayed.

50 PrexViewer User’s Manual

7-2 Adjustment of the Multi-setting Display
The top left tool buttons and 2D operation panel can be used to adjust the 2D image display.
Note
・ The top left tool buttons are used in the same manner as when working with 3D images.

■ Window Level Adjustment

This is used to adjust the displayed slice image window width and window level.
This can be set for each displayed slice. The setting method is the same as for 3D display.
The slices are set in the order of top left, top right, bottom left, bottom right from the top of the 2D
operation panel.

(1)

(2)
(1) (2)

(3)

(4)

(3) (4)

PrexViewer User’s Manual 51

 8. Scene
PrexViewer can load Scenes which saved in PreXion3D Viewer.

1 (1) Operation
4. Select the examination
containing the scene to
be opened.
The saved scenes are
displayed as thumbnail
images.
5. Select the thumbnail
(2)
image of the scene to be
opened and click on the
[Open] button or double
click on the thumbnail
image.

2 Operation
The display changes to the
Review screen and the scene
is displayed.

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9. Contact Information
PreXion, Inc.

Address: 2077 Gateway place, Suite 120

San Jose, CA 95110, USA
Tel: +1-650-212-0300
Fax: +1-650-212-0310
E-mail: [email protected]

Customer Service
Tel: +1-650-212-0314
E-mail: [email protected]

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