Senographe Essential Mastógrafo
Senographe Essential Mastógrafo
Senographe Essential Mastógrafo
Operator Manual
5307915-10-1EN
Revision 3
© 2006-2022 by General Electric Company
All Rights Reserved
Senographe Essential 5307915-10-1EN
IMPORTANT...X-RAY PROTECTION
IMPORTANT...X-RAY PROTECTION
CAUTION
If not properly used, x-ray equipment may cause injury. Accordingly, it is your obligation to
confirm that the instructions herein contained are thoroughly read and understood by everyone
who will use the equipment before you attempt to place this equipment in operation. The General
Electric Company, Healthcare Technologies, will be glad to assist and cooperate in placing this
equipment in use.
Although this apparatus incorporates a high degree of certain protections against x-radiation
other than the useful beam, no feasible design of equipment can provide complete protection
from all potential injury. Nor can any feasible design force the operator to take adequate
precautions to prevent the possibility of any persons carelessly exposing themselves or others to
radiation.
It is important that anyone having anything to do with x-radiation be properly trained and fully
knowledgeable about the recommendations of the National Council on Radiation Protection and
Measurements as published in NCRP Reports available from NCRP Publications, 7910
Woodmont Avenue, Room 1016, Bethesda, Maryland 20814, and of the International
Commission on Radiation Protection. It is your obligation and responsibility to take adequate
steps to protect against injury.
The equipment is sold with the understanding that the General Electric Company, Healthcare
Technologies, its agents, and representatives have no responsibility for injury or damage, which
may result from improper use of the equipment. Various protective materials and devices are
available. It is urged that such materials or devices be used in accordance your site’s clinical
practice.
IMPORTANT...X-RAY PROTECTION
Use these links for quick access to frequently used information in the Operator Manual:
Physical description
- 5 Gantry on page 39
- 6 Accessories on page 51
- 7 Control Station on page 59
- 8 X-Ray Console on page 65
- 9 Generator Cabinet on page 71
Procedures for examination
- 3 Safety recommendations on page 29
- 10 Examination steering guide on page 73
Operator Messages
- 2 Operator messages displayed on the X-ray Console on page 212
- 3 Operator messages displayed on the AWS LCD monitor on page 225
- 4 Operator messages on the Gantry readout on page 229
- 4-1 Messages regarding breast supports on page 229
- 4-2 Messages regarding FOV (Field Of View) on page 232
- 4-3 Error messages on page 234
Procedures for System Hygiene and Planned Maintenance
- 25 System Hygiene on page 205
- 1 Introduction on page 205
- 1-1 Levels of hygienic maintenance required on page 205
- 2 General precautions for hygienic maintenance on page 206
- 3 Precautions for cleaning specific parts on page 207
- 4 Suggested hygienic cleaning products on page 208
- 27 Planned Maintenance on page 251
- 2 Planned maintenance performed by the Field Service Representative on page 251
- 3 Planned maintenance performed by the Radiologic Technologist on page 251
- 4 Planned maintenance performed by the Medical Physicist on page 251
Table of Contents
Table of Contents
IMPORTANT...X-RAY PROTECTION . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3
Favorite links for Operators . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5
Table of Contents . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7
Chapter 5. Gantry
1. Gantry components . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 39
Table of Contents
2. Gantry Arm . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 40
3. X-Ray tube head . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 41
4. Compression carriage and Paddle holder assembly . . . . . . . . . . . . . . . . . . . . . . . . . . . . 44
5. Image Receptor . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 46
6. Gantry readout . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 50
7. Footswitches . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 50
Chapter 6. Accessories
1. Compression paddles. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 51
2. Breast supports . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 54
3. 2D Localization accessories . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 55
4. Patient positioning accessories . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 55
5. Patient identification accessories . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 56
6. Image quality control accessories . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 56
Table of Contents
Table of Contents
Table of Contents
Table of Contents
Publication presentation
1 Applicability
This manual is provided for Senographe Essential system Operators.
The manual describes the use of the Senographe Essential system in its most complete configuration. If
any of the options described in this manual are not included in your system, skip the corresponding
chapter or sections.
See your GE Representative for the options available with the Senographe Essential system.
Please send a request to your Sales or Service representative. They will transfer your request to
[email protected]. In the European Union, in application of the EU Commission Regulation
on electronic instructions for use of medical devices, your request should be processed within seven
days.
Publication presentation
search field
Publication presentation
Physical description
chapters.
Procedural description
chapters.
Functional description
chapters
Chapters are arranged in an order which is intended to suit the learning requirements of a new Operator.
This means that similar types of chapter are not necessarily grouped together.
Publication presentation
Publication presentation
DANGER
Indicates an imminently hazardous situation that, if not avoided, will result in death or serious
injury.
WARNING
Indicates a potentially hazardous situation that, if not avoided, could result in death or serious
injury.
CAUTION
Indicates a potentially hazardous situation that, if not avoided, may result in minor or moderate
injury.
! Notice:
Used for instructions to the Operator to prevent damage to property.
Note:
Used to draw attention to information that is important for the Operator to know.
Publication presentation
6 Revision History
This table is intentionally left in English.
Publication presentation
Publication presentation
1 Standards compliance
• If the label is affixed to the product, it complies with Council Directive 93/42/EEC concerning
medical devices.
European registered place of business:
GE MEDICAL SYSTEMS SCS
283 RUE DE LA MINIERE
78530 BUC France
• The first year of CE marking of this product is 2006.
• Code of Federal Regulations Title 21, Subchapter J - Radiological health.
• Applicable standards from the following organizations:
• Underwriters' Laboratories, Inc. (UL), an independent testing laboratory,
• Canadian Standards Association (CSA),
• International Electrotechnical Commission (IEC), an international standards organization.
• Medical Device Good Manufacturing Practice Manual issued by the FDA (Food and Drug
Administration, Department of Health and Human Services, USA).
• SFDA:
• Product Name: Mammography X-ray Equipment
• SFDA registration number: SFDA (I) 20133300309
• Product standard number: YZB/FRA 4206-2012
USA/HHS: United States Federal law restricts this device to use by or on the order of a physician.
The original document was written in English.
Use within the patient environment
All components of the Senographe Essential system (Generator Cabinet, Gantry, Control Station)
are designed to be suitable for use within the patient environment, and are compliant with the
relevant standards.
2 Installation requirements
Packing materials
The materials used to pack our equipment are recyclable. They must be collected and processed in
accordance with the regulations in force for the country where the machines or accessories are
unpacked.
Use in the presence of flammable gases
The Senographe Essential must not be used in the presence of flammable gases.
Electromagnetic Compatibility (EMC)
This equipment complies with IEC 60601-1-2 Edition 2 EMC standard for medical devices.
This equipment generates, uses, and can radiate radio frequency (RF) energy. The equipment may
cause radio frequency interference to other medical and non-medical devices and radio
communications. To provide reasonable protection against such interference, this product complies
with radiated emissions as per CISPR11 Group 1 Class A standard limits.
Detailed requirements and recommendations about power supply distribution and installation are
listed in the Pre-Installation section of the Service Documentation shipped with your system.
However, there is no guarantee that interference will not occur in a particular installation.
If this equipment is found to cause interference (which may be determined by turning the equipment
on and off), the Operator (or qualified service personnel) should attempt to correct the problem by
one or more of the following measure(s):
- reorient or relocate the affected device(s),
- increase the separation between the equipment and the affected device,
- power the equipment from a source different from that of the affected device,
- consult the point of purchase or your GE Service Representative for further suggestions.
The manufacturer is not responsible for any interference caused by using other than recommended
interconnect cables or by unauthorized changes or modifications to this equipment. Unauthorized
changes or modifications could void the users' authority to operate the equipment.
All interconnect cables to peripheral devices must be shielded and properly grounded. Use of cables
not properly shielded and grounded may result in the equipment causing radio frequency
interference.
Do not use devices which intentionally transmit RF Signals (Cellular Phones, Transceivers, or Radio
Controlled Products) in the vicinity of this equipment as it may cause performance outside the
published specifications. Recommended separation distances are detailed in the Pre-Installation
section of the Service Documentation shipped with your system. Keep the power to these types of
devices turned off when near this equipment.
The medical staff in charge of this equipment is required to instruct technicians, patients, and other
people who may be around this equipment to comply fully with the above requirement.
Further data and recommendations for meeting Electromagnetic Compatibility (EMC) requirements
for a typical installation are given in the Pre-Installation section of the Service Documentation
shipped with your system. Note that the magnetic field of an MRI device located nearby may cause a
risk of interference. Magnetic field amplitude limits are specified in the Pre-Installation section of the
Service Documentation shipped with your system.
5 Labeling
5-1 Meaning of symbols
Type B equipment
Alternating current
This symbol indicates that waste electrical and electronic equipment must not be disposed
of as unsorted municipal waste and must be collected separately. Please contact an
authorized representative of the manufacturer for information concerning the
decommissioning of your equipment.
Name and address of the manufacturer
Date of manufacture
Caution
-or-
Attention, consult accompanying documents
Symbol indicating that the Instructions for Use are supplied in electronic form
Radiation filtration
5-2 Glossary
This glossary describes non-translated parts of the labels.
System Cabinet X O O O X X
Operator Console X O O O X X
Gantry X O O X X X
X-Ray Detector X X X X X X
X-Ray Tube O O O O O O
Collimator X X X X X X
Biopsy Positioner O O O O O O
Computers X X X X X X
UPS O O O O O O
Cable Set O O O O X O
O: Indicates that this toxic or hazardous substance contained in all of the homogeneous materials for
this part is below the limit requirement in SJ/T11363-2006.
X: Indicates that this toxic or hazardous substance contained in at least one of the homogeneous
materials used for this part is above the limit requirement in SJ/T11363-2006.
• Data listed in the table represents best information available at the time of publication.
• Applications of hazardous substances in this medical device are required to achieve its intended
clinical uses, and/or to provide better protection to human beings and/or to environment, due to
lack of reasonably (economically or technically) available substitutes.
Safety recommendations
1 Introduction
It is considered mandatory that examinations can be performed regularly, without problems. All aspects
of mammographic exams, and especially safety, must be optimized to ensure effective diagnosis and
allow the development of screening programs.
Safety precautions and recommendations for the avoidance of potential hazards, and against misuse,
are given throughout this document. They must be made known to, and be practised by, all Operators of
the Senographe Essential.
Review the on-screen Operator Manual from time to time and be sure that you are familiar with all
aspects of use of the equipment, and especially those affecting safety.
Important safety precautions and recommendations are brought to your attention in this chapter.
Stop all examinations and call your GE Service Representative immediately if you believe that the
equipment is not operating correctly.
3 System configuration
WARNING
No modifications to system hardware or software (e.g. loading application programs onto the
system computer) shall be made without prior approval from GE. GE cannot guarantee the
integrity of the system if this recommendation is not followed.
Safety recommendations
WARNING
Check the integrity of the covers on the Arm, Column and Control Station. If any of these covers
is damaged or detached, contact your GE Service Representative to have it replaced.
4-2 Check the paddle, the Bucky and the magnification stands
CAUTION
Check that the paddle and the Bucky or the magnification stand are clean and free from dust.
Impurities on the surface of the paddle, Bucky or magnification stands may generate artifacts in
captured images.
CAUTION
Check that the Bucky or the magnification stand does not have any scratches or has not
sustained any damage to its surface. Damage or scratches to the surface of the Bucky or the
magnification stand may generate artifacts in captured images.
CAUTION
Check that the compression paddle and the Bucky or magnification stand are well inserted in
their supports, and are being used as recommended. If the Bucky is used, be sure that it is locked
(not only inserted).
WARNING
Only accessories and components supplied by or specifically recommended by GE may be used
with the system. GE cannot guarantee the integrity of the system if this recommendation is not
followed.
WARNING
Only Senographe Essential system compression paddles may be used with the system. Use of
other paddles may adversely affect image quality by causing inaccurate measurements of breast
thickness (if another paddle is used, exposure is forbidden in all modes except in manual mode).
CAUTION
All accessories must be checked regularly to ensure that their surfaces do not contain cracks and
that they have no sharp edges or corners that might cut, pinch, or otherwise hurt a patient.
WARNING
Only specific models and configurations of PC and monitors are suitable for use with the
TechInsight option. For compatible configurations, please see the latest product data sheet for
this system, which may be obtained from your local GE sales representative.
Safety recommendations
WARNING
If equipment is damaged or fails, have it repaired immediately by authorized GE service
personnel, even if the damage or failure does not affect the functions you normally use. The
damage or failure can result in a potentially serious patient safety hazard under other
circumstances.
CAUTION
The digital detector contains thallium doped cesium iodide, a substance which requires special
precautions for handling and recycling. If the protective casing of the digital detector sustains
damage, please consult your GE Service Representative.
CAUTION
If the digital detector casing is punctured, the detector must be removed by authorized GE
service personnel wearing protective gloves and dust masks.
To avoid excessive exposure to radiation, Operators must remain behind suitable radiation
shields whenever X-ray exposures are made.
To avoid excessive exposure to radiation, Operators must remain behind suitable radiation shields
whenever X-ray exposures are made.
It is mandatory that the X-ray Console used to control X-ray exposures be permanently mounted behind
a radiation shield, in such a way that it can only be used by an Operator in the protected area. The
Acquisition Workstation (AWS) controls are used during exposures, then they also must be installed in
the protected area.
These requirements are met by the Senographe Essential Control Station, which includes a radiation
shield (700 mm/25 inches wide; at least 0.3 mm lead equivalence shielding) and provides a suitable
mounting position for the X-ray Console in the protected area. Other radiation shields are available if
required to meet the requirements of local regulations or hospital working practices.
Safety recommendations
It is essential to maintain both visual and voice contact with the patient throughout the
examination.
Safety recommendations
CAUTION
Users must be instructed to monitor all movements, and to take all due care and precautions
when moving any part of the equipment in the vicinity of themselves or other persons.
To ensure safe operation at all times, the compression system is fitted with a magnetic braking
mechanism, which prevents the compression paddle from falling in the event of power loss. If power loss
does occur while a patient is under compression, the compression force remains unchanged. Disengage
the patient by raising the paddle gently, using the manual compression knobs. See section
4 Compression carriage and Paddle holder assembly on page 44.
To minimize potential injury to the patient in decompression mode, the upward movement of the
compression paddle is stopped if a downward force greater than 3 daN is applied.
Safety recommendations
8 Archiving
CAUTION
The digital technology used by the Control Station provides the ability to transfer acquired images
between workstations, and to store them on a hard disk system. However, it is not intended or
approved for use as an archiving device. To prevent any loss of data, make sure to periodically
archive your data using a device intended for reliable long-term storage.
WARNING
Do NOT perform REPROCESSING of images acquired with the Senographe Essential, using
another acquisition system, as this may result in artifacts due to incompatibility.
Product presentation
1 Overview
1-1 Senographe DS and Essential family
Senographe DS and Essential models belong to the family of Digital Mammography Systems from GE.
They have been designed to perform Screening examinations as well as Diagnostic Views (including
Spot compression, Magnified and/or Coned views). These systems eliminate the need for film cassettes,
and take advantage of digital technology, including on-screen image display, Networking, Filming, and
Archiving.
The raw and processed images are available on the AWS LCD monitor within a few seconds after the
exposure.
The Senographe Essential is a large Field Of View (FOV) system while the Senographe DS is a normal
FOV system. It has a larger detector which allows the examination of large breasts. The position of a
small breast can be de-centered on the left side or the right side by adjusting the sliding paddles.
Product presentation
2 System components
Control Station Generator Cabinet Gantry
(see Chapter 7 Control Station) (see Chapter 9 Generator Cabinet) (see Chapter 5 Gantry)
X-ray Console
(see Chapter 8
X-Ray
Console)
Product presentation
3 System options
System options available are listed below. See your GE Representative for more information on
accessories and options.
3-2 Networking
The Senographe Essential is DICOM (standard for Digital Imaging and Communication in Medicine)
compliant, allowing it to be connected in a network with other compliant devices for the exchange of
images. Networking allows transmission of images acquired with the Senographe Essential system
to other DICOM-compatible review stations, using the “Network Push” function of the Browser. In
some cases, detailed evaluations will be needed for the implementation of customized connections.
WARNING
For softcopy diagnostic interpretation, images must be reviewed on an approved Digital Imaging
and Communications in Medicine (DICOM)-compatible review workstation with screens whose
resolution are at least 5 Mpixels each.
3-3-1 Use of review workstations
WARNING
Images acquired on the Senographe Essential digital mammography acquisition system are
larger than the images produced by the Senographe DS. Displaying or printing large images on a
review workstation without the ability to handle them correctly may result in errors in object size
evaluation and measurement.
GE review stations (IDI Mammo Workstation and Seno Advantage 2_03.1.5 or later) can be used for
review.
When using other GE Workstations (RWS and Seno Advantage 1.x) to display or print large Senographe
Essential images users may misjudge the size of objects in the image, because the zoom factor may be
different from one and is not annotated on the displayed or printed images.
Before using a non-GE review workstation, the user should contact the workstation provider and verify
that the product is capable of correctly displaying and printing images generated by Senographe
Essential with a zoom factor of one or alternately displaying the zoom factor on the image.
Product presentation
If you send images from the Senographe Essential by network or by CD for review on remote
workstations, please advise your correspondents of this requirement.
3-5 Printer
To provide “hard copies” of images, the Senographe Essential system can be connected to a high
resolution DICOM MG compatible printer for film printing.
WARNING
Only images produced by GE-recommended printers can be used for final interpretation of
examinations. For compatible printers see the latest product data sheet for this system, which
may be obtained from your local GE sales representative.
3-6 TechInsight
TechInsight is a mechanical adaptation which integrates the additional PC and monitor components
required by the Mammography Documentation Station with the acquisition console.
WARNING
The Acquisition Workstation and the Mammography Documentation Station are not linked for
synchronisation of displayed data. It is possible to view the data of one patient on the
Mammography Documentation Station, while the data of a different patient is displayed on the
Acquisition Workstation.
See the TechInsight Operator Manual for further details.
WARNING
Only specific models and configurations of PC and monitors are suitable for use with the
TechInsight option. For compatible configurations, please see the latest product data sheet for
this system, which may be obtained from your local GE sales representative.
Gantry
Chapter 5 Gantry
1 Gantry components
The main components of the gantry are shown below:
Gantry Arm
Emergency stop See 2 Gantry Arm on page 40
button Main components:
- X-Ray tube head
- Compression Carriage and Paddle
holder
- Image Receptor
Column
Gantry readout
(see 6 Gantry readout on page 50)
Footswitches
(see 7 Footswitches on page 50)
• Emergency stop buttons: There are two emergency stop buttons, one on each side of the Column.
Press one of these buttons to immediately stop all Gantry movement. After performing a Gantry
emergency stop, you can reactivate movement on the Gantry by performing a Gantry reset (See
section Gantry reset on page 90).
• Column: The Gantry Column is securely fixed to the floor. It supports the Arm and allows it be moved
vertically.
Gantry
2 Gantry Arm
X-ray tube head
See 3 X-Ray tube head on page 41
Image Receptor
See 5 Image Receptor on page 46
Hand rest
• Handle: The patient’s hand may be positioned on the handle as required, for greater comfort and to
optimize access to the breast, especially for lateral and oblique views.
• Compression Arm: The Compression Arm is connected to the Column by a rotating shaft; it can be
rotated through the range of +185 degrees to -165 degrees.
Gantry
2D Cross-hair device
See 3-4 2D Cross-hair device on page 43
1 4 5 5 4 1
2 2
3 3
Arm rotation
control buttons
Gantry
When a new position is memorized, the same numeric value is set for positive and negative movement.
For example, if an exposure is made which sets the last-used +Oblique angle to +50°, the last-used -
Oblique angle is set to -50°. The new position is only memorized for the current exam. On power-up and
each time a new exam is started, the oblique position is set to the DEFAULT value.
How to reach a memorized position
• To rotate the Arm to one of these positions, press the button shown for more than one second and
then release it.
• An automatic rotation movement started by pressing one of these buttons can be stopped at any time
by pressing any of the buttons located on the Arm or one of the footswitches on the floor, or by
touching the compression paddle.
How to choose a Default position value
• The two factory settings for the Default values are ± 45°.
• To change these values, use the X-ray Console set-up menus; see section 4 Configuring the X-ray
Console set-up menus on page 86.
3-1-2 Arm elevation control buttons (reference 5 in the illustration)
• Use one of these buttons to move the Arm up or down. Press the top or bottom of the button lightly to
move the Arm up or down at low speed. Press harder to increase the speed of movement. Release
the button to stop the movement.
Note:
If the Arm touches an obstacle during downward movement, the movement is stopped.
Gantry
CAUTION
The face protection shield must be removed when using a magnification stand.
The face protection shield must always be mounted by sliding it onto the rails from the the front.
The rails at the back are for mounting the 2D Cross-hair device.
To make sure the face protection shield is securely installed, push it toward the rear of the tube
head until you hear the click and feel the mechanical stop.
CAUTION
The 2D Cross-hair device must never be inserted in place of the face protection shield. It must be
inserted below the X-ray tube head covers from the REAR onto the rails of the mounting plate.
The optional 2D Cross-hair device is mounted by sliding it onto the rails from the rear.
Gantry
Arm movement
control buttons
See 3-1 Arm
movement control
buttons on page 41
Interchangeable compression paddles are fitted to this assembly as required. The assembly can be
moved up and down on the Arm to apply the desired amount of compression to the patient’s breast.
Compression may be controlled by using manual adjustment knobs (see below) or by using footswitches
placed on the floor to control motorized movement of the carriage. See section 7 Footswitches on
page 50.
• Manual compression and decompression adjustment knobs:
The knobs located on each side of the paddle holder allow manual adjustment of the compression.
Turn the top of the knob towards the patient to increase compression, away from the patient to
decrease compression.
WARNING
Only the paddles and accessories recommended for your Senographe model should be used
with this equipment. Failure to heed this warning may cause unexpected results and possible
data loss.
! Notice:
Paddles must be handled carefully. Foreign matter, such as dust, dirt, or small objects, can enter
their mechanisms and cause damage to the paddles. Physical shock and vibration can also
damage paddles. Therefore, when paddles are not in use, they must be stored in an accessories
cart where they are protected from dust, dirt, small foreign objects, physical shock and vibration.
! Notice:
To avoid any risk of premature failure, it is recommended that the 2D large localization paddle and
all spot paddles (sliding square, sliding round, and 2D spot localization) be used with a
compression force no greater than 20 daN.
Gantry
CAUTION
Before any use of a compression paddle, make sure that the paddle is correctly locked. Check
that the paddle locking button on the compression carriage is in the locked position, and check by
hand that the paddle cannot be moved. For sliding paddles, take care not to activate the sliding
release button while making this check.
The type of paddle inserted in the paddle holder is recognized by the system and displayed on the
Gantry readout. Only paddles designed and validated for use with the Senographe Essential system
must be used; the characteristics of these paddles are known by the system and are taken into
account, together with the known characteristics of breast tissue, when calculating parameters such
as compression force and breast thickness.
Note:
When a paddle is used to apply compression to a rigid phantom (for example, Plexiglas), the
thickness indicated on the Gantry readout is not correct because of the different characteristics of
the material as compared to breast tissue.
4-1-3 Modifying the position of a sliding paddle with pre-defined positions
Sliding paddles can be off-centered to the left or to the right of the Detector center in order to compress
all the needed tissue in angulated views.
A sliding paddle has the following three defined positions:
- Centered
- Off-centered to the left (by 3.85 cm)
- Off-centered to the right (by 3.85 cm)
Sliding paddles are locked on the Paddle holder in the same way as non-sliding paddles, so the
Operator can easily distinguish the following actions:
- Sliding action using one of the paddle sliding release buttons (available only on sliding paddles):
See next paragraph.
- Unlocking action using the paddle unlocking button (available for all paddles):
See section 4-1-4 Removing a paddle on page 46.
Gantry
• To allow the paddle to slide along the paddle holder, press one of the Paddle release buttons
two paddle release buttons (the two buttons function identically, use the
one that is easier to access). Release the button as soon as the paddle
has slid from its initial position. When a pre-defined position is reached,
the sliding paddle automatically locks itself into the new position.
Compression and exposure are disabled if the sliding paddle is not in
one of the three defined positions.
5 Image Receptor
The Image Receptor includes the Digital Detector and Breast Supports.
Breast supports include:
- Bucky,
- Magnification stand,
- Stereotactic Positioner.
CAUTION
The digital detector is a very fragile and highly sensitive piece of equipment. The Bucky and the
Mag Stand serve as a protective cover of the digital receptor. Take care never to leave the
detector without the Bucky or the Mag Stand installed. To avoid damage to the digital detector:
- Do not place small objects (needles, pens, etc.) on its surface.
- Take special care not to drop anything on the detector.
Dropping an object onto the detector may damage it and can lead to expensive repair work or
replacement of the digital detector. Damage caused by these sorts of accidents are not covered by the
GE warranty.
Gantry
Bucky
CAUTION
The surface of the Bucky is fragile. Scratching the surface of the Bucky may provoke artifacts in
captured images. When handling the Bucky, take special care to protect the surface from shocks
and objects that may induce a scratch.
CAUTION
The surface of the magnification stand is fragile. Scratching the surface of the Magnification
Stand may provoke artifacts in captured images. When handling the Magnification Stand, take
special care to protect the surface from shocks and objects that may induce a scratch.
Gantry
CAUTION
• Press on the front side of the breast support until motor noise is
heard, indicating the start of the locking phase. Motor noise is
heard during the entire locking phase.
• Once locking begins, the Operator can release pressure on the front side: locking takes place
automatically.
CAUTION
Before locking the breast support into place, check that there is no small object that could
become wedged between the breast support and the white image receptor cover. This could
degrade image quality.
Gantry
CAUTION
To avoid any risk of pinching fingers during installation of a breast support (Bucky or
Magnification stand), slide the breast support onto the rails and push it rearward by pressing on
its front side until the locking motor starts. During the automatic locking phase, keep hands away
from the moving part (breast support) and white covers of the Image Detector. In an emergency
to stop the automatic locking or unlocking of the breast support, just press briefly on either of the
breast support unlocking buttons. The breast support can at this point be unlocked by the usual
procedure (simultaneously press both breast support unlocking buttons).
See section 5-4 Removing the breast support on page 49).
• For magnification views, remove the Bucky and install a Magnification stand. The Magnification stand
is installed in the same way as the Bucky. Insert it until it reaches a position where motorized locking
occurs. The Magnification stand is then automatically locked.
Magnification factors are defined in the middle of a 4 cm thick breast, i.e., 2 cm above the
Magnification stand. Two Magnification stands are available: one for a magnification factor of 1.5 and
one for 1.8.
• The Image Detector is placed as required for correct patient positioning by moving the Arm. The
height of the Bucky breast support surface from the floor is adjustable between about 650 mm
(26 inches) and 1500 mm (59.1 inches) with the Arm in the 0° position.
Note:
Surfaces which contact the breast (for example the Bucky, Magnification stand, and compression
paddles) must always be kept clean. See Chapter 27 Planned Maintenance.
CAUTION
Breast support unlocking
buttons
The side of the breast support that is the last to slide free of the rails is
heavier than the other side. Be sure to be prepared for this extra
weight by grasping the breast support at a sufficient distance from the front edge before removing
it. The Operator must use both hands during the entire breast support removal procedure. The
careful attention of the Operator during the entire breast support removal procedure is necessary.
! Notice:
Do not remove the breast support by force.
! Notice:
Breast supports (Buckies and Magnification stands) must be handled carefully. Foreign matter,
such as dust, dirt, or small objects, can enter their mechanisms and result in damage to the breast
supports. Physical shock and vibration can also damage breast supports. Therefore, when breast
supports are not in use, they must be stored in an accessories cart where they are protected from
dust, dirt, small foreign objects, physical shock and vibration.
Gantry
6 Gantry readout
• The Gantry readout display normally shows the following
information (left to right):
- Compressed breast thickness in mm.
- Angle of rotation.
- Compression force in daN.
- Magnification factor that appears for a few seconds in a
specific Operator message at the moment when the
Magnification stand is installed.
• It may also be used for warning messages and (in
stereotaxy applications) angulation information.
7 Footswitches
• The footswitches are used to apply/release
compression and increase/decrease the Arm
height. There are two sets of footswitches placed
on the floor at the base of the Gantry, one on the
left and one on the right.
Accessories
Chapter 6 Accessories
Accessories are classified into six categories. See the corresponding sections:
• Section 1 Compression paddles on page 51
• Section 2 Breast supports on page 54
• Section 3 2D Localization accessories on page 55
• Section 4 Patient positioning accessories on page 55
• Section 5 Patient identification accessories on page 56
• Section 6 Image quality control accessories on page 56
The following accessories are optional or basic depending on country. Please contact your GE Sales
Representative.
1 Compression paddles
1-1 Paddles characteristics
A large variety of paddles may be used with Senographe Essential.
- They may be parallel or flexible,
- They may be sliding with pre-defined positions, sliding without pre-defined positions, or non-sliding at
all,
- Their shape may be rectangular, round or square,
- They may be used for compression or localization,
- They may be used in contact view or magnification view.
Accessories
Accessories
Accessories
2 Breast supports
2-1 Types
Breast supports include:
• Bucky,
• Magnification Stand.
Accessories
3 2D Localization accessories
Name Illustration Context Basic or Optional Physical/Functional
Characteristics description
2D Cross-hair device Localization Optional See section 1 Face
for biopsy shield and 2D
Cross-hair device
on page 199
Accessories
Accessories
Accessories
Control Station
1 Overview
1-1 Control Station functions
The Control Station provides the following AWS (Acquisition WorkStation) functions:
• Image acquisition from the Digital Detector
• Image display and manipulation
• Management of patient information and Examination database
• Image transfer to other Workstations using the DICOM standard
• Filming of images (on optional printer)
• Archiving images (on optional mass archiving system)
• Saving of images on recordable CD-ROMs
Senographe Essential applications are based upon a graphical, multi-window, mouse- or trackball-driven
interface.
Images, lists, menus, and control panels are displayed within graphical windows on the AWS LCD
monitor. Selections are made using on-screen buttons, menus and control panels, etc., by pointing and
clicking with the mouse or optional trackball. See sections 2-1-2 Windows on page 60 and 2-1-3 On-
screen tools on page 60).
1-2 Control Station hardware
AWS LCD monitor
Radiation screen See 2-1 AWS LCD Monitor on page 60
AWS keyboard
See 2-3 Keyboard on page 63
AWS Cabinet
Control Station
• A computer unit (with internal hard disks for system software and image storage), housed inside the
AWS Cabinet.
WARNING
The AWS LCD monitor must NOT be used for final interpretation of examinations.
Note:
The AWS LCD monitor must be used in a suitably dark environment when reviewing a digital
image. The maximum recommended ambient light level is 100 lux.
CAUTION
To reposition the monitor (to move it forward, backwards or rotate around the lead glass shield)
only use the handle to avoid being pinched.
2-1-2 Windows
There are several types of windows that will be encountered as you use the Senographe Essential AWS.
The most important ones are:
• The Browser. This is the main window used to manage the database, start the Review application,
etc. See Chapter 17 Browser.
• The Worklist is used to display a list of scheduled operations. From this window you can start image
acquisition and review operations. See Chapter 18 Worklist.
• The Viewer is used by the acquisition and review applications to display and process the images.
See Chapter 20 Viewer
These main windows give access to other windows, such as the Medical Procedure Card window, the
Annotations window in the Viewer, various Operator selection windows, etc.
Also, small message windows concerning procedures in progress appear on the AWS LCD monitor as
you perform various functions. Some of these disappear on their own, others remain on the screen and
the application remains blocked until the message is acknowledged by clicking on OK or Cancel.
Note:
If the system does not respond because two or more windows are open one on top of another, it
is possible to recover by holding down the ALT key and pressing the TAB key on the keyboard
(several times if needed) to access hidden windows.
2-1-3 On-screen tools
2-1-3-1 Cursor
The cursor is the on-screen symbol, usually an arrow, which you maneuver across the screen
using the trackball or mouse, to point to menus, lists, images, and windows.
The cursor changes shape or orientation to indicate a change in function. Some examples:
• When you point to a menu item and click with the left mouse button to open a pull-down
menu, the cursor changes to an arrow pointing to the right, to indicate you can now make a
selection in the pull-down menu.
Control Station
• The cursor changes into a watchface if a function that you have selected takes more than a moment
to implement; no further function selection is available until the procedure is completed.
Once the procedure is finished, the cursor returns to an arrow shape, indicating that the
Workstation (AWS) is ready to accept further input.
2-1-3-2 On-screen buttons
Most windows contain on-screen buttons (areas in the form of buttons, containing explanatory graphics
or text labels) to activate specific functions. These functions are described in detail elsewhere in this
manual. Such buttons are sometimes referred to as icons.
To select (or activate) a button, click it.
When a button's label is shaded grey rather than white, it means that the button's function
is currently not available.
2-1-3-3 Menus
Reprocess
Certain buttons activate specific functions directly. Others activate drop-down menus that
allow you a choice of functions.
To select (or activate) a function in a menu, move the cursor onto the menu item and click. The
Workstation (AWS) carries out your command, and the menu disappears.
When a menu item is shaded grey rather than white, it means that the function is currently not available.
2-1-3-4 Scroll Bar
A scroll bar is an on-screen tool that you use to page through data that cannot be fully displayed at once
on the screen or in a particular window, such as lists of patients or exams in the Browser.
• To move through the data controlled by the scroll bar (images, items in a Browser list, etc.), you can
place the cursor on the vertical rectangular bar within the scroll bar.
Then, press and hold the left mouse button, and drag the cursor up or down to move
backward or forward through the list. The vertical bar within the scroll bar shows you where
you are within the list as compared to the list as a whole.
Release the mouse button when the desired data are displayed.
• If you want to move through the data one item at a time, place the cursor on either the
upper or lower arrow and click the left mouse button. Each click moves you up or down by
one item of the data.
• If you want to move through the data one page at a time, place the cursor either above or
below the vertical bar and click the left mouse button. Each click now moves you up or
down by one page of data.
Control Station
A scroll bar becomes active only if the display capacity of the list is exceeded. Otherwise, the vertical bar
fills the full height of the scroll bar, and clicking on the vertical bar or the arrows has no effect.
Control Station
2-3 Keyboard
Back Space
Tab
Caps
Lock
Depending on the keyboard delivered with your system, the Caps Lock and Control keys may be
inverted.
The keyboard is used for entering text at on-screen prompts and alphanumeric data in data entry fields.
Use the Delete or Back Space key to erase entered text or data. Reference will be made to the other
keys, Shift, Caps Lock, Tab and Return in various parts of this manual.
Control Station
X-Ray Console
1 Overview
• The console is normally mounted on the AWS Cabinet, behind the radiation screen.
• The X-ray Console:
- Controls power On/Off facilities. It is used to power up the complete system, and to power down
the Gantry and Generator.
- Provides control buttons and status indicators which enable the Operator to prepare, execute,
and monitor X-ray exposures.
- Provides LCD panels that display operating parameters and messages from the system.
Labels
See 2 Labels on page 65
2 Labels
The symbol on the X-ray Console indicates that you must have read and understood the Operator
Manual before taking any action.
The symbol on the X-ray Console indicates that this is X-ray equipment. It is dangerous to both
patient and Operator unless measures of protection are strictly observed.
X-Ray Console
5 6 7 8 9 10 12 13 14 15 20 21 22 17
X-Ray Console
3. Set-up button
• Press this button to access X-ray Console set-up functions; language selection, MEDICAL menu,
and view selection for recumbent patients. See section 4 X-ray Console set-up menus on
page 70 for more information.
4. Readout display
The readout displays two lines of up to 40 characters.
• The upper line displays information, safety, and error messages.
• The lower line displays the selected parameters: focal spot, focal track, filter, breast Laterality,
View names, presence of magnification view, and arm rotation angle.
5. Focal Spot selection button
• Small and large focal spots (0.1 or 0.3 respectively) are selected automatically according to the
presence or the absence of a magnification stand. Do not try to override this selection as the
exposure will be forbidden. The readout indicates the size of the selected focal spot.
Focal Spot automatic selection
Magnification Stand not installed 0.3
Magnification Stand installed 0.1
X-Ray Console
X-Ray Console
X-Ray Console
Generator Cabinet
1 Presentation
The Generator Cabinet contains power switching equipment, the generator and system management
electronics, and a chiller (connected to the Digital Detector for control of the detector environment).
Generator Cabinet Power control panel
These switches control power to the AWS Cabinet and to the UPS.
They are provided for service and emergency use; they should not be
used in normal operation
• The Generator Cabinet is mounted on wheels for ease of installation; it is not recommended that it be
moved in normal operation.
• Do not obstruct the ventilation slots.
• The power control panel visible on the cabinet controls power to the Control Station and to the UPS.
It is normally used only for service operations.
Generator Cabinet
1 Prerequisites
1-1 Training
See section 2 Training program on page 85.
4 Prepare examination
CAUTION
It is essential to maintain both visual and voice contact with the patient throughout the
examination.
WARNING
Before starting the examination, always review the complete patient information you have
entered or selected to make sure it actually is that of the current patient. Failure to do so can
result in data mismatch.
4-1-1 Patient exam selection with Worklist
Exposures can only be made after patient/exam selection from the Worklist (see Chapter 18 Worklist).
4-1-2 Patient exam selection without Worklist
If the examination has not been scheduled and included in the Worklist, a new entry can be made, but
image acquisition is not permitted until basic patient information has been recorded in the system.
CAUTION
Do not use any radio-opaque markers other than BB markers within the AOP ROI. BB markers
having diameters up to and including 1.6 mm diameter may be used. Larger markers will affect
the calculation of tissue density, which may lead to a degraded image.
In contact views using AOP and 24 x 31 image size No large markers in shaded area
acquisition, the region used to identify the densest part of the
breast has an area of 230 mm by 190 mm, is adjacent to the 230 mm
chest wall side, and is centered on the image receptor (the
shaded area in the diagram). AOP ROI
190 mm
5-5 Compression
Note:
A warning message to the operator is displayed on the X-ray Console if there is lack of
compression (< 3 daN) when the operator wants to expose.
If the compression force is less than 3 daN, exposure in AOP mode is forbidden.
It is important to use adequate breast compression because the benefits in image quality and dose
reduction are significant:
• Compression reduces motion blurring by immobilizing the breast.
• Compression reduces geometric blurring by ensuring direct contact between the breast and the
image receptor and by spreading glandular breast tissue.
• Compression reduces scattered radiation and improves subject contrast in proportion to the
reduction in thickness of tissue irradiated.
• Compression spreads the breast laterally, giving it a uniform and reduced thickness. This reduces
exposure and consequently the mean glandular dose.
5-5-1 Apply compression
To apply compression to the breast, depress the compression footswitch. Manual adjustment can be
made using the two knobs, one located on each side of the compression paddle holder. Compress until
the breast surface is taut to the touch. Take great care with patients with mammary implants. The
compression force appears on the Gantry readout, and can be displayed on the image as an annotation
(see Chapter 20 Viewer).
The maximum compressive force available using motorized compression is 20 daN. Using manual
compression, the maximum force available is between 27 daN and 30 daN with the Arm in the 0°
position, reducing to about 20 daN at 90°. An audible warning is given when the limit has been reached.
When using the flexible compression paddle provided with your system, please use the collimator
centering light after final compression is achieved and before acquiring the image, to verify that the chest
wall side of the paddle is not flexed into the field of view.
If the paddle wall is observed in the FOV, please reposition the patient so that her chest wall does not
push the paddle wall forward. If that is not possible, switch to the standard compression paddle
corresponding to the breast size.
Note:
As a safety measure, the compression system is designed to avoid having the paddle fall in the
event of power loss. If power loss occurs during an examination, the current compression force
remains applied to the compression paddle. Disengage the patient by lifting the paddle gently
using the manual compression knobs. Do not try to lift it quickly.
Note:
Automatic decompression can be programmed to occur when the exposure is terminated, to
minimize the time spent under compression by the patient. See section 4 Configuring the X-ray
Console set-up menus on page 86 of Chapter 11 Initial training and set-up.
Note:
If automatic decompression is not enabled, decompress the patient after the exposure by pressing
the compression release button located at the lower right of the X-ray Console.
CAUTION
8 Store images
Go to the Browser and manually push images to the designated DICOM-compatible hosts on the
network (see section 7-2 Transfer on page 125 of Chapter 17 Browser). Such hosts can be mass
archiving systems.
1 Operator profile
The use of the Senographe Essential requires specific technical and medical knowledge and skills. As a
minimum, operators must have acquired knowledge and skill in the areas of:
• radiation protection
• safety procedures, and
• patient safety
through approved training and professional education.
2 Training program
Before using the Senographe Essential to work with patients, it is mandatory that all users have received
adequate training. Contact your GE Representative for information on suitable training programs.
For systems subject to Mammography Quality Standards Act (MQSA) rules, the Radiologist, Interpreting
Physician, and the Medical Physicist are each required to obtain eight hours of new-modality training for
full-field digital mammography.
Additional information can be found on the Food and Drug Administration’s (FDA's) website:
http://www.fda.gov
in the Mammography pages.
3 User account
Before the system is put into service, the system administrator must set up suitable users accounts for
all "Operators" (The word "user" belongs to network access management vocabulary and is synonymous
with "Operator" used elsewhere in this manual).
Each Operator must enter their user name and password to be allowed to access the system.
See 13 User session and account management on page 91.
1 Startup procedure
To power up the system, press the power switch I located on the top left of the X-ray Console. Power is
applied to the whole system (Gantry, Control Station, Digital Detector, etc.); green power indicators are
lit on the Generator, the Control Station, and the AWS LCD monitor.
• A series of system initialization messages appears on the AWS screen, then the Login: prompt
appears. Type sdc (all lower case) followed by <Enter>. The AWS login screen shown below
appears after a short delay.
2 System shutdown
Note:
It is recommended that the system should be shut down at the end of every working day.
To power down the system, click the system shutdown button located towards the bottom right
of the Browser window. A confirmation message appears asking if the entire system should be shut
down. If your response is Yes, power is removed from the Senographe Essential Gantry and other
system components, while the Control Station begins a controlled shutdown, designed to safeguard
data. Complete system and UPS shut down takes about two minutes from switch-off.
Note:
The Control Station follows an automatic shutdown procedure, which protects image and patient
data. No prompts are displayed. Do not disturb this procedure by attempting to enter commands
at this time.
CAUTION
NEVER switch off at the UPS (Uninterruptible Power Supply) except in emergency, it may cause
a loss of data.
4 Gantry reset
Certain configuration operations require the Gantry to be switched off and restarted. It is usually
desirable to reset the Gantry without disturbing the operation of the Control Station.
• To do this, switch off the Gantry and Generator by pressing the X-ray Console power switch labelled
O located on the left hand side of the X-ray Console. Switch them on again by pressing the power
switch I.
1 Introduction
• When several users (Operators) work regularly on the same Senographe Essential, the system can
be set up to provide a separate access for each user (Operator).
• If a system has been set up for multiple users, certain tasks need to be performed regularly, such as
management of the list of authorized users, and management of the auto-logoff delay for every user.
• To ensure correct coordination, a single person (the administrator) should normally perform these
tasks.
Note:
The administrator may be the data processing manager for the site, the IT coordinator, or an
experienced user. A single user on an individual system may act as his or her own Administrator.
Note:
When the system is delivered two accounts are available:
- A user account; user name clinical, password clinical.
- An administrator account; user name admin, password admin.
• You are recommended to proceed immediately to set up new accounts with new passwords, as
described in the following sections.
• The administrator is responsible for deleting an account if it is not used.
Ticking/un-ticking the Show protected users check box allows you to show/hide the protected system
user accounts, which cannot be removed from the system. The protected system user accounts are
highlighted in blue.
• By default any user that gets created has does not belong to any group and will have StandardUser
privileges, meaning they will have access to the medical application interface when they log in. If you
want the user to access the administrative interface instead of the medical application interface, refer
to 6 Managing groups on page 98.
5-2 Managing the Emergency Login button on the AWS login screen
The administrator can define whether or not the Emergency Login button appears on the AWS login
screen. The Emergency Login button allows users to login without specifying their credentials. By
default, the Emergency Login button is not displayed on the AWS login screen.
The Emergency Login button must only be displayed in emergency situations (e.g. when an Operator
cannot remember their credentials).
To display/hide the Emergency Login button appears on the AWS login screen:
• First open an administrative session and display the default option Local User Management (see
section 2 Opening an administrative session on page 92).
• Click the Configuration tab.
• Tick the Display Emergency Button check box to display the Emergency Login button, or un-tick the
Display Emergency Button check box to hide the Emergency Login button.
• Click the Apply Configuration button, then click the Apply now to apply the changes.
6 Managing groups
6-1 Privileges
The Group and Permission Mapping tab of the administrative interface allows you to create groups to
which you may assign the following privileges:
• GEService
• Not functional. Do not use.
• LimitedUser
• Not functional. Do not use.
• Administrator
• This privilege can be assigned to a group.
• This privilege enables the users in this group to access the administrative interface when they log
in.
• StandardUser
• This privilege can be assigned to a group.
• This privilege is enables the users in this group to access the medical application interface when
they log in.
Administrator and StandardUser privileges should never be assigned together to the same group.
1 Introduction
• View names are based on the ACR (American College of Radiology) standardized abbreviations for
mammography projection position codes.
• View names are normally selected automatically, according to the selected Laterality, the presence
or absence of a magnification stand, and the Gantry angle, as described in section 4 Core View
name - selected automatically on page 105.
• For views that do not correspond to the automatic selection, the Operator must select additional
information manually, as described below in sections 5 Core View name modified manually (standing
or sitting patients) on page 106 and 6 Core View names for recumbent patients on page 106.
2 Coding principle
The illustration below explains the coding principle of the View names:
View name
R M MLO
L CC RL
Prefixes and suffixes are used with the main View names; for example, RMMLO equals Right Magnified
MedioLateral Oblique, and LCCRL equals Left CranioCaudal with upper breast tissue Rolled Laterally.
Tube Head to the +11°+10° -10°-11° Tube Head to the Tube Head to the +11°+10° -10°-11° Tube Head to the
Left Right Left Right
LCC RCC
LFB RFB
Not accessible
Not accessible
-165° -165°
+169°+170° +185° +169°+170° +185°
4-3 Example
The tube is at -45° and the selected Laterality is R, so the inferior side of the breast is against the
receptor. The system therefore selects the View name SIO, and adds the Laterality prefix R. Because
a magnification stand is present, it also adds the prefix M.
View names displayed in parentheses, e.g. (RMLO), are not used for medical purposes.
Tube Patient
Tube Laterality Left Breast Laterality Right Breast
angulation
Automatic Recumbent view Automatic Recumbent view
View name View name
Head to Left Head to Right Head to Left Head to Right
selection selection
LCC LML LLM RCC RLM RML
To simplify the display for the Operator, only integer values are used for:
- The FOV size indicated on the Gantry readout.
- The FOV size indicated on screen and film annotations. The symbol used to indicate a FOV size in
annotations is #.
- The image size indicated on screen and film annotations. The symbol used to indicate an image size
in annotations is [ ].
The system works with two image sizes: 24 x 31 when the large field of view size is used, and 19 x 23
otherwise. The table below shows, for each actual FOV size, how the FOV size appears on the Gantry
readout and the corresponding image size in screen and film annotations.
See also illustration 2 Marking on Bucky - FOV size on page 112.
Table 2 FOV sizes on the Gantry readout / image sizes in screen and film
Actual FOV size & position Display on Gantry readout Screen and Film annotations
FOV size & position FOV size ( # ) image size ( [] )
24 x 30.7 cm 24 x 31 24 x 31 24 x 31
19.2 x 23 cm 19 x 23 19 x 23
19.2 x 23 cm left 19 x 23 Left 19 x 23
19.2 x 23 cm right 19 x 23 Right 19 x 23
13 x 18 cm 13 x 18 13 x 18
13 x 20.7 cm left 13 x 21 Left 13 x 21 19 x 23
13 x 20.7 cm right 13 x 21 Right 13 x 21
9 x 9 cm 9x9 9x9
9 x 19.05 cm left 9 x 19 Left 9 x 19
9 x 19.05 cm right 9 x 19 Right 9 x 19
13 x 23 cm 13 x 23 13 x 23
Image size and FOV size are symbolized by [ ] and #, respectively. For example, when the 13 x 18 FOV
is used, the annotation is [ ] 19 x 23 # 13 x 18.
View mode Paddle type Arm angle Initial FOV at paddle insertion
size position
none any 24x31 centered
24x31 any 24x31 centered
2D Spot localization any 13x18 centered
2D Large localization any 19x23 centered
-10° ≤ angle ≤ +10° centered
or
+170° ≤ angle ≤ +185°
Contact (1x) Sliding 19x23 19x23
+11° ≤ angle ≤ +169° right
-165° ≤ angle ≤ -11° left
-10° ≤ angle ≤ +10° 13x18 centered
or
Sliding round spot +170° ≤ angle ≤ +185°
Sliding square spot
+11° ≤ angle ≤ +169° 13x21 right
-165° ≤ angle ≤ -11° 13x21 left
Magnification any Magnification paddle: any 13x23 centered
(1.5x or 1.8x) - Round spot magnification
- Square spot magnification
- 19x23 magnification
Table 4 FOV Sizes and Positions According Paddle Types and Positions
1 AOP mode
1-1 Description of AOP
When the AOP (Automatic Optimization of Parameters) mode of operation is selected, the Senographe
takes full control of the quality and quantity of x-rays by automatically setting the exposure parameters.
The AOP mode can be used for contact views, magnification views, or for the examination of the chest
wall.
In AOP mode, all exposure parameters are automatically set by the system:
• Anode track (Mo or Rh),
• Filter (Mo or Rh),
• kVp value,
• mAs value.
At the beginning of each exposure made in AOP mode, a brief exposure is performed and a low dose
image is acquired. The radiological-equivalent thickness and density of the breast are then determined
based on the signal levels of this image in the area corresponding to the densest part of the breast.
This information is used for the automatic selection of the exposure parameters (anode track (Mo or Rh),
filter (Mo or Rh), kVp), so that the resulting X-ray beam maximizes the contrast to noise ratio (CNR) in
the image relative to the dose delivered to the breast.
Finally, the mAs value is determined to generate a target image signal level, predetermined as a function
of the breast radiological-equivalent thickness and density, the desired level of image quality and dose.
Note:
Focal Spot selection depends on the selected configuration, that is contact or magnification
configuration. The system automatically selects the large focal spot when a standard (contact)
exam is selected, and the small focal spot when magnification is selected. Exposures are not
possible if these settings are overridden.
Note:
When a flexible paddle is used, the determination of breast density would no longer be accurate.
As a result, when using a flexible paddle, the breast density used in the determination of the
exposure parameters is automatically forced to a fixed average value. The optimization of
exposure parameters remains effective, based on the measured breast radiological-equivalent
thickness.
Use of the AOP mode is not recommended for examinations of patients with breast implants: manual
mode should be used instead. See section Implants on page 117 for further explanations.
Note:
Breast compression of at least 3 daN (30 newtons or 6.7 pounds) is essential when using AOP
mode.
In case of site specific requirements, the access to CNT mode can be restricted as described in the
Service Documentation.
2 Manual mode
The manual mode can be used for contact views, magnification views, for the examination of the chest
wall, and for examination of biopsy specimens and cores. Manual mode should be used for implant
imaging, a detailed procedure is available in section 3 Implants.
The Operator selects the following parameters:
• Focal track (Mo, Rh)
• Filter (Mo, Rh)
• kV
• mAs
Select the desired track/filter configuration according to the thickness and density of the breast to be
examined, then select suitable kV and mAs values.
Note that while the examination of a very dense breast using the rhodium or molybdenum tracks
provides similar contrast images, the same breast examined via the rhodium track benefits from better
tissue visualization and a lower average glandular dose.
See table 1 Suggested manual techniques - No implant on page 116 below for suggested parameters
according to breast type and thickness. These suggested parameters are valid for routine exams (i.e.
Non-Stereotaxy exams).
See table 2 Maximum and recommended kV ranges on page 116 for available maximum and
recommended kV ranges.
For thick (>6 cm) or dense breasts, the Mo/Rh and Rh/Rh configurations may provide equivalent or
better image quality with reduced patient dose.
Although subject contrast depends on the kV value used, note that an increase in the kV value may
reduce the radiation dose to the patient. Potential contrast losses will be handled by digital image
processing.
A reduction in the kV value improves contrast but increases the radiation dose to the patient.
Increasing the kV setting by 1 or 2 kV will reduce exposure time.
In manual mode, the choice of priority to dose reduction or to the desired contrast is left to the discretion
of the Operator.
Note:
By default, the system selects the large focal spot (0.3) when a contact view is selected, and the
small focal spot (0.1) when magnification view is selected. Exposures are not possible if these
settings are overridden.
Note:
If the Operator makes a filter selection error, the system automatically changes the filter. A warning
message appears on the first line of the X-ray Console readout.
3 Implants
Manual mode is recommended for implant views. The suggested acquisition parameters should be used
when acquiring the images without displacing the implants. When the implant is displaced, AOP mode
can normally be used. If the PVi (Premium View optional processing) feature is enabled, "Implant
present" label must be set to "Yes" in the medical procedure card to have PVi processing applied to all
images of the patient. Premium View is explained in Chapter 21 Image processing and display, section 2
Processing, on page 177.
PVi is a processing option particularly adapted to images presenting white or dark local areas (such as
dense breast tissue or implant). If available, this processing can either be automatically applied to
images from a patient with implants, and/or replace the HIGH strength of Premium View to be applied to
all images.
Exposure Parameters
Breast Thickness
Track / Filter kV mAs
Range
<40mm Rh / Rh 29 42
40mm-50mm Rh / Rh 29 45
50mm-60mm Rh / Rh 29 56
60mm-70mm Rh / Rh 30 63
70mm-80mm Rh / Rh 31 71
>80mm Rh / Rh 30 125
Browser
Chapter 17 Browser
Network panel Title bar Filter panel Log off button
Tools menu button
QAP button
Delete icon
1 Overview
The Browser window illustrated above (usually called “the Browser”) appears when the Senographe
Essential system is first switched on and the Operator has logged in. Note that the Tools menu function
(section 8 Tools menu utilities on page 127) allows a number of Browser display options, so the windows
and icons displayed may differ from those shown here.
The Browser is used to:
• Shut down the Senographe Essential system.
• Link with the HIS/RIS/MIS (Hospital/Radiology/Mammography Information System).
• Access the Worklist for setting up and starting patient examinations.
• Select images in the AWS database for review.
• Manage the database (in particular to remove images that are no longer required).
• Transfer images to other Workstations.
• Save images on recordable CDs for data interchange.
• Archive images (if the optional mass archiving system is present).
• Launch the embedded Technical Publications.
Browser
2 Browser restart
If it is necessary to restart (reset) the Browser, proceed as follows:
• Place the cursor in the title bar at the top of the Browser window.
• Use the left mouse button to drag the window down, leaving a blank space on the screen above the
window.
• Place the cursor in the blank space; click the right button.
• Select Restart Browser from the pop-up menu.
If Network, Printing, or Save operations are in progress, a warning Restart Browser
box appears, allowing you to proceed with the restart or to cancel it.
Network queue (non empty)
Jobs in progress are interrupted and may be lost when the Browser is
restarted. Network transfers are stopped, but are automatically retried Restart Browser
after the restart. Printing and save operations are stopped, and must
be launched again after the restart. Note that interrupted save OK Cancel
3 System shutdown
• To shut down the Senographe Essential system, click the Power off icon at the lower right
of the Browser window. Power is removed from the Gantry and Generator; the Control Station follows
a shutdown procedure lasting about two minutes, designed to ensure that no information is lost.
4 Log off
• This function may be used to prevent access by unauthorized persons to the system and locally
stored patient data, especially between two acquisitions.
• To use the function, click the Logoff icon at the top right of the Browser. The system
returns to the AWS login screen (see section 1 Startup procedure on page 89 in
Chapter 12 Startup and shutdown). Follow the usual login procedure to resume
operation.
• The system administrator can configure the system to log off automatically after a chosen delay.
Browser
5 Browser display
5-1 Date Display
The date displayed on Browser is in English, regardless of the language of the system.The format of
displayed date is the month (first three letters), the day (two digits) and the year (four digits), i.e.: MMM
DD YYYY. The following table gives the English abbreviations of month names:
Month English
Abbreviation
January Jan
February Feb
March Mar
April Apr
May May
June Jun
July Jul
August Aug
September Sep
October Oct
November Nov
December Dec
5-2 Lists
The Browser contains lists showing the patients, examinations, series, and images presently on the
internal disk system:
• Patients list: patients for whom examinations are stored on the internal disk system.
• Examinations list: Examination for the selected patient.
Note: examinations are sometimes referred to as studies.
• Series list: The different series of images within the selected examination; Raw, Processed, and
Screen Save images.
• Images list: images within the selected series.
The number of items (patients, examinations, series, or images) currently selected, and the total number
of items contained in the list, appears at the lower right corner of each list.
In addition to raw and processed images acquired locally by the AWS, the Browser lists may also include
Secondary Capture (SCPT) images.
Browser
• To link with the HIS/RIS and access the Worklist management function: click the Worklist
button.
• To start Quality Assurance Procedures: click the QAP button; select the required
procedure from the list presented. See the Senographe Essential Acquisition QC Manual
for more information on starting and using the Quality Assurance Procedures.
• Media transfer status. A dot moving along the lower line indicates that a media
transfer operation (e.g., to or from CD-ROM) is in progress.
• Database query. If present, this icon indicates that a query is in progress (local internal hard
disk system access of the AWS). This icon may appear only very briefly. Any error messages
that may result from a database query are also displayed in this position.
• Filter indicator. If present, this icon indicates that a filter is currently applied (see section
9 Filters on page 138). Click the indicator to display the current local filter window.
• Current date and time and Auto Delete status. Shown in text form just below the GE logo at
the right of the screen. The status of the Auto Print, Auto Push, and Auto Delete options is also
shown (ON or OFF). Auto Delete is OFF by default. GE recommends setting the Auto Delete option
to ON when Storage Commitment from a mass archiving system is available.
• Disk space available is shown as the number of remaining exposures. Note that each exposure
includes two images (raw and processed).
Browser
6 Browser management
6-1 Viewing items in lists
If more items are present in a list than can be displayed at one time, use the scroll bar on the right of the
list to move through the items in the list (see Chapter 17 Browser for information on how to use the scroll
bar).
An arrow button beneath a list indicates that more columns of information may be available; click the
button to view the additional information.
Browser
Browser
7 Network transfer
7-1 Network options
The Senographe Essential system can be provided with a networking option, Remote host icons
allowing you to transfer acquired images to remote DICOM-compatible hosts
(e.g. review workstation, Computer Aided Detection (CAD) system, or mass
archiving system (PACs)). When the system is connected to a remote host, it Dicom Dicom CDR
JFR_AWS
is represented by a remote host icon in the Network panel. The name that IC_LMO
appears below a remote host icon is determined during installation of the Local storage device icon
networking option (host label).
When the Senographe Essential is connected to a mass archiving system, acquired images can be
transferred to the archiving system for permanent storage. A list of patients imaged on the Senographe
Essential system is maintained on the mass archiving system, ensuring quick and easy data retrieval.
Transfers are made manually or by using the Auto Push function (selected in Medical Application
preferences).
7-2 Transfer
To copy patients, studies, series, or images to another Workstation or storage device (remote host):
• Select the items you want to copy to the remote host in the patients, examinations, series, or images
list.
• EITHER: Drag the selected group, using the middle mouse button, and drop it over the icon
representing the remote host in the Network Panel,
OR: Use the Push function; click the Network Push button under the list (if the button is not
displayed, it can be turned on using Browser preferences; see section 8-2 Browser preferences on
page 127).
The Network Push window appears, listing remote hosts:
Push selected exam(s) on...
ZNR2_IC0
Browser
• When the transfer is finished, the remote host icon animation stops; the images are now available
on the selected remote host.
• If the remote host cannot be reached, a dialog box reports this fact; you should verify that the
remote host is operational.
Call your network manager if the problem persists.
• If the Auto Push option is selected in Medical Application preferences:
- With RRA disabled: Then all images in this exam will be automatically transferred to the
selected remote host after exam closure.
- With RRA enabled: Behavior is the same as above except for repeated or rejected images,
which will be automatically transferred only if Auto Push Repeated images? or Auto Push
Rejected images? are set to Yes, respectively.
• To archive exams to a mass archiving system, select the mass archiving system in the same way
as any other remote host (select its icon as the drag-and-drop target, or its address as the push
destination).
During a network transfer:
• To monitor network transfer tasks, click the Network status display to open the
Network queues window, shown below:
Network queues Job currently in progress
Push images
653/1 Active
2899 Pending
273/3
Pull images
653/1 Active
2899 Pending
273/3
Browser
• Click the Tools menu button (near the top right of the Browser screen) to display the utilities
menu, then select the desired item from the drop-down menu:
Filter management
Browser preferences
Messages
Network management
Worklist management
Printer Management
Review Room Management
PPS Management
Needle Setup
Medical Application preferences
Edit Patient/Procedure
Set patient anonymous
Service desktop
Copyright Info
Restart Browser
Shutdown
Note:
Only select the items shown here in bold type
Do not attempt to select the other items (shown here in italics). They are intended for use only by
your GE Service Representative and are not described here; uninformed use may lead to
unpredictable results.
Browser
• After making selections in each window, use the five buttons at the bottom of the window to apply or
save the changes:
- Save. Apply the changes to the current display and save them. The displayed settings will
continue to be applied until changed.
- Apply. Apply the changes to the current display but do not save them. The displayed settings will
be lost when you leave the Browser.
- Reload last saved. After making and applying changes, use this button to apply the last saved
preferences.
- Reset. Apply default settings.
- Cancel. Cancel your changes and close the window.
• Layout. This window allows selection of icons and windows to be displayed in the Browser window,
as shown below:
Allow Deletion by Drag and Drop
Display only Patients and
examinations lists
Display Delete icon below each list
No Filter
Click here to select a filter to apply to local lists of AWS
No Filter
Click here to select a filter to apply to remote lists
Browser
• Sort. Use this window to specify an order by default for displaying lists of patients and examinations,
series and images:
Modality MG
Split series
Yes No
Note:
1. You must select MG for Modality (the system currently defaults to show DX).
2. Leave the selection of Split series as Yes. Other selections are not valid for this system.
Auto Push Auto Print Annotations Auto Windowing Quality Check Auto Delete Test Hosts Names Image Process.
ON
Auto Push
OFF
Remote Hosts
Save Close
Browser
Note:
Do not click the Printer Properties ... button as it contains the current printer configuration. The
Operator does not need to change any value there to set the Auto Print function. Film size value
indicated in Printer Properties panel is the film size used for the last printing, which may have been
an auto-print or a manual print. If Auto Print is set to ON, at exam closure, the film size value that
will be considered for the Auto Print is the one of Auto Print tab. The film size value of Printer
Properties panel will be erased and replaced by the film size value set in Auto Print tab.
MedAppPrefs
Auto Push Auto Print Annotations Auto Windowing Quality Check Auto Delete Test Hosts Names Image Process.
ON
Auto Print
OFF
DICOM printers Review Rooms
Printer 1 MyRoom1 Print mode Fit to Film
Printer 2 MyRoom2
Film size Automatic
Save Close
Browser
8-3-3 Annotations
Select the level of screen and print annotation desired. Screen annotation levels are chosen from Full,
Partial, None, or Custom; the list of annotation types at the middle of the window shows the current
default selections for the selected level. For print annotations, select the model (1, 2, 3, or 4) to be used
by default (see Chapter 22 Printing).
Note:
Only annotation Models 3 and 4 contains all the information required by MQSA Quality
Mammography Standards.
MedAppPrefs
Auto Push Auto Print Annotations Auto Windowing Quality Check Auto Delete Test Hosts Names Image Process.
Patient information
Screen annotations Printing annotations
Acquisition date and time
Full Model 1
Processing information
Display parameters
Measurements
Save Close
Auto Push Auto Print Annotations Auto Windowing Quality Check Auto Delete Test Hosts Names Image Process.
Auto Windowing
Standard
High
Low
User
Save Close
Browser
MedAppPrefs
Auto Push Auto Print Annotations Auto Windowing Quality Check Auto Delete Test Hosts Names Image Process.
No
Save Close
Browser
Auto Push Auto Print Annotations Auto Windowing Quality Check Auto Delete Test Hosts Names Image Process.
ON
Auto Delete
OFF
Save Close
Browser
Auto Push Auto Print Annotations Auto Windowing Quality Check Auto Delete Test Hosts Names Image Process.
Save Close
8-3-8 Names
Use this screen to enter and store the names of Operators, Performing physicians, and Referring
physicians. The stored names may then be recalled from the AWS database when required, avoiding the
need for retyping each time a Medical Procedure Card is created or updated.
MedAppPrefs
Auto Push Auto Print Annotations Auto Windowing Quality Check Auto Delete Test Hosts Names Image Process.
modify
delete
Save Close
Browser
Auto Push Auto Print Annotations Auto Windowing Quality Check Auto Delete Test Hosts Names Image Process.
Enable Enable
Disable Disable
Save Close
Browser
If the Premium View strength selection feature is enabled on your equipment, the following screen is
displayed:
MedAppPrefs
Auto Push Auto Print Annotations Auto Windowing Quality Check Auto Delete Test Hosts Names Image Process.
Low
Save Close
If the Premium View strength selection feature is enabled, default strength will be Medium. This value
corresponds to the Premium View strength used when the feature is not activated.
Two more strength settings are available, to provide alternative balance between local contrast and
global contrast:
- High setting should be used to get a higher local contrast
- Low setting should be used to get a lower local contrast
8-3-9-1 Optional PVi feature
PVi processing can be used in order to optimize the display of images presenting white or dark local
areas. This processing can be systematically applied to patients having implants and/or replace the
default Premium View HIGH contrast enhancement setting.
If the implant feature is enabled, PVi processing will automatically be applied to the images of the
patients for whom the implant present flag has been set to "Yes" in the medical procedure card (see
Chapter 18 Worklist, section 2-1 Medical Procedure Card). This processing will be used whatever
strength is selected in the medical application preferences.
If the replacement of the default HIGH Premium View by PVi has been enabled, PVi processing will be
applied if HIGH setting is selected in the medical preferences.
Browser
Browser
9 Filters
Filters allows the lists of patients and exams shown in the Browser to be “filtered”; in other words, to
display only items which correspond to your chosen criteria (for example, between chosen dates, with
certain Patient name or IDs, etc.).
Filters can be temporary, in which case they will be lost after the current session, or can be “registered”
as a named filter which can then be recalled for later use.
To change the current selection, click the Filter button in the Filter Panel and make your
selection from the drop-down menu:
Custom... Use registered filters that have been defined and saved beforehand Custom1
Custom2
(Custom1 and Custom2 in this example), Temp. Filter
No Filter
Temp. Filter Use a temporary filter,
No Filter Display all available patients, Examinations, Series, and images.
Browser
Patient ID
Begins with
- Patient level:
you can choose to begin the listing with a specified Patient name or Patient ID.
- Exam level:
you can choose to begin the listing with a specified Exam description, Performing physician or
Referring physician name, or to list only exams made between certain dates and/or times. Do not
change the default selection of mammography exams (MG), since the AWS cannot display
images from other modalities.
- Series level:
you can choose to list only exams with a specified text in the Series description, and to list only
Secondary Capture (SCPT), Raw, or Processed exams.
• When you have made your selections in each level, click one or more of the boxes at the bottom of
the screen (Patient, Exam or Series) to specify at which level the filter is to apply.
Each choice made at patient, exam, or series level allows you to select how the specified text is to be
used to select listed items:
- “Begins with”
Items are displayed if they begin with the specified letter or word(s).
- “Contains”
Items are displayed if their description contains the specified text.
Browser
- “Is”
Items are displayed only if their description exactly matches the specified text.
• At any time you can click the Clear button to delete the choices made and start again, or the Cancel
button to return to the previous screen.
• When your selections are correct, click Apply.
The filter is applied, but is lost when the current session ends.
Worklist
Chapter 18 Worklist
1 Worklist function
The Worklist is a list of scheduled tasks. Typically, it shows all patients scheduled for examination during
a working day.
When the Senographe Essential system is connected to a DICOM Worklist Management Service Class
Provider (SCP) system, entering the Worklist function displays a Worklist downloaded from the SCP
system, using the DICOM Basic Worklist Management Service. Downloading information in this way
reduces the Operator’s workload, increasing throughput and decreasing the risk of errors. However,
Worklist entries can also be made locally, from the AWS.
Click the Worklist icon at the right of the Browser to display the Worklist window as shown
below. To start an exam, select the required patient in the list. Selections can be made by
clicking with the left mouse button, or by entering appropriate text in one of the four Selection
Criteria text boxes above the list: Patient ID, Patient Last Name, Accession Number, or Study
ID. When the correct patient has been selected, click the Start Exam button or double-click your
selection to continue with Image Acquisition. See below for more information.
Selection Criteria
Worklist
• The Worklist title bar shows the date and time of the last update (manual or from HIS/RIS).
• Click the Browser button to return to the Browser.
• By default, when the Worklist window opens, it is sorted by Patient Name, the first item in the list in
which the number of images is zero is selected, the cursor is in the first selection criteria entry field,
and the default push-button is Start Exam.
• The Worklist information appears in columns. You can sort the entries according to the information in
any column, in ascending or descending order, by clicking the title at the head of the column. For
example, to sort on patient name, click the Patient Name column header. The entries are
automatically displayed in ascending order of name, and a + sign appears in front of the title
(+Patient Name). Click the column header again; a - sign appears in front of the title (-Patient Name),
and the entries are now displayed in descending order of name.
• Items in the Worklist are selected/deselected by pointing and clicking. Non-consecutive multiple
items are selected by holding down the <Control> key while clicking. To select a range of
consecutive multiple items, select an item, then hold down the <Shift> key while clicking another;
both items and all in between are selected.
• To find and select an item in the list, use the Selection Criteria at the top of the window. As soon as a
character entry is made in one of the boxes (Patient ID, Patient Last Name, Accession Number,
Study ID), the window scrolls to show and select the first matching entry. When an entry is made in
one of the criteria boxes, the other three are automatically cleared.
• Click the Refresh Worklist button to download the current Worklist from the configured DICOM
Worklist Provider. If the DICOM Worklist feature is not installed, or the Provider is not configured, this
button is greyed out and not active.
• Click Query... to display the Query definition window, to define the networked Worklist parameters.
Query definition
Which system
Date
Today Tomorrow
Save as default
From: To:
Cancel
Patient Name:
Patient ID:
Worklist
2 Image acquisition
2-1 Medical Procedure Card
The Medical Procedure Card (MPC) is used to enter all patient-, procedure- and Operator-related data.
This data is saved together with the exam images.
Note:
Patient Last Name and Patient ID are mandatory: you cannot start an exam if these fields are not
completed. The remaining information on the card is optional.
There are three ways to enter the data:
• Manually.
Enter the information directly into each of the MPC fields.
• Using a bar code scanner (optional on Senographe Essential).
If your facility produces bar code labels to identify patients and their scheduled exams, all the data
stored on the bar codes can be scanned with the bar code scanner option. Scanning produces an
MPC for each patient scanned, saving time and reducing errors as compared with an exclusively
manual data entry process.
• Through a DICOM HIS/RIS/MIS system.
In this case the Worklist receives directly from the HIS/RIS/MIS the patient and/or procedure
information needed to fill in the MPC.
Patient information and some procedure information (accession number and Study ID) received in
this way cannot be modified.
Worklist
When you select a single patient in the Worklist and click Edit..., or when you click New Patient... or Start
Exam, the Medical Procedure Card window appears. See next illustration:
Medical Procedure Card
PATIENT
Middle initial
Cancel
First Name
Patient ID
Start Exam
PROCEDURE
Study ID
Study Description
Accession Number
Procedure Description
Operator
Performing Physician
Referring Physician
• For a new patient, all fields are blank; move the cursor (use the mouse, or use the Tab or Enter keys
to move through the fields) inside the Last Name, Middle initial (optional) and First Name fields and
enter the patient name. Then move the cursor inside the Patient ID field and enter the patient ID.
If the patient has an implant (in whatever breast), tick "Yes" after "Implant present" label. If Premium
View and PVi implant feature are both enabled, PVi processing will be applied to all the images of the
patient for whom the "Implant present" label has been set to "Yes". In case the review station used at
your facility can read this field, it will automatically load an adequate protocol and/or adapt the
autowindowing for review of images of this patient.
• For a new examination (existing patient) the patient information fields cannot be modified.
Complete the other fields as required, then click the Start Exam button. The Medical Procedure Card
window closes, and the Viewer appears.
• For a patient selected on the HIS/RIS Worklist, verify that the information in all fields of the Medical
Procedure Card is correct and click Start Exam to begin the exam, or Cancel.
Worklist
• After the first acquisition has been made, the information in the Medical Procedure Card cannot be
changed. However, errors can be corrected by creating duplicate information using the Edit Patient
option in the Tools menu (described in Chapter 17 Browser). The original information is saved for
security.
Worklist
Worklist
2. Press the scanner trigger: the scanner LED beam lights. The scanner has successfully read the
symbol if:
• You hear a beep.
• The LED beam turns off.
Worklist
Right Wrong
- If the scanning still fails, contact your Field Engineer to check the setup of the bar code scanner.
1 Overview
The Modality Performed Procedure Step (PPS) function is an automated function that allows the
Senographe Essential acquisition system to automatically inform a remote network host (typically
located on the Radiology Information System (RIS) or the Picture Archiving and Communications
System (PACS)) of the Radiology department about the completion status of the locally performed
examinations. Typically, it enables the Senographe Essential to automatically inform the other
connected devices such as the PACS, the Computer Aided Detection (CAD) system and the RIS
whether a given scheduled or unscheduled exam is in progress, completed or on hold.
The activation of this function within a Radiology Department is subject to the following pre-requisites:
• An image archiving system (PACS) must be accessible for Auto Push of the acquired images via the
DICOM protocol.
• A DICOM Performed Procedure Step Service Class Provider (PPS SCP) must be connected to the
Senographe Essential. In general, such a DICOM service is available from either the RIS or the
PACS.
• It is strongly recommended that the Senographe Essential also be connected to a DICOM Worklist
Management SCP for automated Worklist retrieval. For additional information on the Worklist
function, see Chapter 18 Worklist.
2 Operation
Once activated, the PPS function performs background tasks to exchange information with the
configured PPS SCP. This function is activated for both routine and stereotactic (if the option is present)
examinations.
When the Viewer is started and after the first image has been acquired, an initial PPS message is sent
from the AWS to the PPS SCP to inform it that the examination is now in progress. This message also
contains the patient and clinical data stored in the Worklist entry used to launch the Viewer. These data
can either have been downloaded from a Worklist server or entered manually on the AWS itself.
When the Viewer is closed, a second PPS message is sent to the PPS SCP to update the examination
data with the following information:
• A Operator-selected exit status (see section 4 PPS in the Viewer on page 151).
• A list of the images that will be automatically sent, via the Auto Push feature, to the associated Image
Archiver or CAD.
Note:
In order for the PPS messages to be sent, the Auto Push feature from AWS to the associated
Image Archiver or CAD must be activated.
Note:
In case some images have been excluded from the Auto Push list (e.g. using the Quality Check
feature) those images will not be listed in the PPS messages sent to the PPS SCP.
• The cumulative AGD (Average Glandular Dose) calculated based on the AGD estimation available
for images acquired in AOP. This dose per examination estimation is computed using the following
rule: images that have been acquired and excluded from the Auto Push list (e.g. using the Quality
Check feature) are accounted for in the overall dose value.
3 PPS configuration
PPS configuration is accessed by clicking the Tools menu button and selecting PPS Management as
shown in section 8 Tools menu utilities on page 127 of Chapter 17 Browser.
Note:
The PPS Management panel is not intended for use by Operators of the Senographe Essential,
and therefore is not described here. Refer to your GE Service Representative (or possibly your
local network administrator) for assistance on setting up PPS hosts, as unassisted use may lead
to unpredictable results.
Interrupt exam
Yes No
OR
Question
Closing the exam without saving will result in the loss of user
modifications made to one or more image.
Interrupt exam
Viewer
Chapter 20 Viewer
1 Overview
The Viewer window appears when:
- the Review exam button in the Browser window is clicked after selection of a Patient, examination, or
series. The Viewer window opens and displays the first acquired image.
- the Start Exam button in the Worklist window is clicked after selection of a Patient in the Worklist. The
Viewer window opens, with the Medical Procedure Card displayed, ready to display the acquired
image.
The Viewer window allows you to display, manipulate, and analyze images that have either been
acquired using the Digital Detector or recalled from the disk system for review:
View Composition
Zoom
Fit to True
1
3 Display Parameters
Inv. Standard
4
Reproce Quality
• Most of the screen is used for the Viewing Area (1), in which images are displayed.
• At the left of the screen, there is a Command window, which includes three main sections:
- The Mosaic Image Browser (2).
- The Control Panel (3).
Two selection buttons at the top of the panel allow one of two different Control Panels (View
Control and Annotation) to be displayed, according to the functions required. A third selection is
possible if the Stereotaxy option is present. Functions available from the two panels are
described in sections 2 View Control on page 157 and 3 Annotation on page 159.
- Function panel (4). Provides access to the Medical Procedure Card, image reprocessing, image
printing, scrapbook, image quality check, Middle mouse button function selection, and exit from
the Viewer. See section 4 Function panel on page 167 for more details.
• To leave the Viewer, click the Close Exam button in the Function panel. All changes to
annotations are saved. They are saved locally but are not transmitted to the Seno Advantage or
PACs. If changes have been made to brightness or contrast settings, you are asked to Exit with save,
Exit without save, or Cancel.
Viewer
CAUTION
Except for the case of FB views, the View and Laterality indication is NOT positioned near the
axilla.
Note:
If the Operator has performed rotations or flips to the image on the Viewer, the axilla might be in a
different position from that stated above. The Operator can always use the "Display Normal"
function to restore the initial image display. In any case, the rotations and flips applied to the
images are not stored at exam closure.
Viewer
The table below clarifies the orientation of images and their respective View and Laterality marker
positions on the AWS monitor:
General case for View and Laterality label Axilla
Left Views incorrectly positioned.
LFB Axilla
RFB Axilla
Viewer
Viewer
2 View Control
To use the View Control Panel, click the View Control icon to highlight it.
View Composition. Click the appropriate icon to display a single image, two
images side by side, two images one above the other, or four images.
Images are arranged in order (left to right, top to bottom) according to the order in View Composition
which they were acquired. To display images on the monitor according to the ACR
standard, they should therefore be acquired in the order: RCC, LCC, RMLO,
LMLO. Zoom
Fit to True
Zoom: Click the appropriate Zoom icon to choose a Zoom mode. See 2-1 Zoom on Screen Size
page 157.
Contrast and Brightness (window width and window level, respectively) Display Parameters
sliders. See 2-2 Contrast and Brightness sliders on page 158.
2D Loc.. Click this icon to display horizontal and vertical lines on the screen; they
can be moved with the mouse to identify a particular position on the image. This
facility is available only in acquisition mode (with the camera icon displayed in
the Mosaic area). See 2-3 2D Loc. - electronic Cross-hairs on page 158.
Image Control: Use these controls to choose appropriate display parameters. See Inv.. Standard
2-4 Image control on page 159.
2-1 Zoom
Applying a Zoom factor is a way of fitting more (or less) of the captured image into the viewing screen, by
adjusting the resolution. The Zoom factor is not applied to the real size of the object, it is applied to a
notional linear dimension on a reference plane 2 cm above the breast contact surface. When the image
is first displayed in the viewing area, it appears with a Zoom factor called “Fit to Screen”, which is
calculated to adjust the image size so that it fits the entire available viewer area.
Click the appropriate Zoom button to select the desired Zoom factor:
- Zoom=1 corresponds to a full resolution display: each pixel on the screen corresponds to a pixel
on the Digital Detector.
- Zoom=1/2 corresponds to a half resolution display: a pixel on the screen corresponds to an
average of 4 pixels on the Digital Detector.
- Fit to Screen: the image appears at a Zoom factor that optimizes the screen layout.
- True Size: the image on the screen appears with a zoom factor such that a linear dimension,
which is contained in the reference plane, is represented at its true size on the monitor. This
facility is not available when viewing SCPT images.
WARNING
When a small image and a large one are displayed side by side, both with zoom "Fit to Screen",
there is no consistency in size between them, as a different zoom factor is applied to each of
them.
Viewer
Viewer
3 Annotation
To use the Annotation Level Control Panel, click the Annotation “pencil” icon to highlight it.
Annotation Level: Click the appropriate icon to select the required annotation level. Annotation Level
See 3-2 Annotation Level on page 161.
Full Partial None Custom
Graphics & Meas.: Click the appropriate icon to select and display a measurement Graphics & Meas.
tool, to add annotations, or to hide or erase displayed tools and annotations. See
3-3 Graphics and measurements on page 162.
Geom. Transformations: Click the appropriate icon to flip or rotate the image, or on Geom. Transformations
the Display Normal button to return to the original display. See 3-4 Geometric
transformations on page 164.
Display Normal
Change View name: Click the Change View name button to make a correction to
Laterality and View name, if these were incorrectly selected on X-Ray Console. Change View name
See 3-5 Change View name on page 164.
Viewer
Viewer
• A check box appears next to each group. To select the annotation groups that you want
displayed, click the corresponding check box. To deselect a group, click the button a second time.
• Click the OK button to use the selected annotations, or the Cancel button to cancel the operation.
WARNING
When there is no consistency in size between images displayed side by side, there will be no
indication of relative size if the display parameters (zoom factor, image size and FOV size) are
hidden.
Viewer
WARNING
All measurement calculations for graphical annotations (length, surface area, etc.) are made in a
reference plane which is 2 cm above the breast contact surface. These values therefore do not
correspond to the true size of an object unless it is situated in the reference plane.
It is not possible to determine in the 2D projection image if a pathological feature is situated in the
reference plane, so these measurement tools must not be used to measure the size of
pathological features. Furthermore, it is not possible to duplicate breast position from one exam
to another, so they must not be used to compare the size of pathological features over time.
Viewer
Text annotation
• This function allows you to add text annotations on the image, for example to highlight a specific
point for further reference, or as a communication tool for another practitioner.
Click the aA button to open the Annotations window, shown below:
Annotations
Text area
Arrow
Apply Cancel No arrow
• Move the mouse pointer inside the text area, and type the required text.
• Press the <Enter> key to start a new line. To make corrections, move the mouse pointer to the
desired place and click, to position the text cursor. You can now insert text, or press the
<Backspace> key to delete text.
• An arrow pointing to the area of interest can be attached to the annotation. To do this, enable the
Arrow check box.
• When you have entered the desired text, click the Apply button. The Annotations window closes, and
the text annotation appears on the image.
• To position the text annotation, click it to select it, and then drag it to the desired position.
• If you chose to attach an arrow, you can now also click the tip of the arrow and drag it to the desired
position. The length of the arrow is adjusted automatically.
Note:
Annotations added by the Operator on the AWS are present only on the AWS and on images
printed from the AWS. They are lost during image transfer to another workstation.
Displaying and Removing User Annotations
To hide all Operator annotations (graphics and text) on an image temporarily:
• Click the Hide/Show button. Hide
Viewer
To delete ALL USER annotations (graphics and text) present on the image permanently:
• Click the Erase all button. You are asked to confirm the deletion (Yes or No).
Erase all
Note:
The system annotations cannot be deleted, but you can use the Annotation Level
buttons to set the amount of system annotation displayed. See section 3-2 Annotation Level on
page 161.
3-4 Geometric transformations
The buttons in this area of the panel allow you to flip or rotate the image to improve viewing comfort or
for easier comparison with other images.
• Click the button for the desired action:
- Flip image around horizontal axis. The top of the image becomes the bottom, and
vice-versa. Left/right orientation is unchanged.
- Flip the image around vertical axis. The left of the image becomes the right, and
vice-versa. Up/down orientation is unchanged.
• Click Display Normal to return the image to the initial orientation (regardless of how
Display Normal
many flip and rotate operations were performed).
Viewer
Save
Cancel
In example above: Default selections of Laterality and View name are displayed in the panel
for an image acquired with Laterality = L and positioner angle = - 35°
- In this panel, select the correct Laterality (R in the present example) and the View name.
The list of Laterality/View name available depends on position of the Gantry; see section 3 View
names code chart on page 104 in Chapter 14 View name selection for the complete list in all
positioner configurations.
Laterality and View name selection
Cancel
Viewer
Note:
The view prefix cannot be modified: if a Magnification stand was present for the image acquired,
the prefix ("M") is automatically kept for the View name.
• At this point, you can either Cancel or Save the selection:
- If you click the Cancel button, the Laterality for the raw, processed, and all reprocessed images
from this raw, remains as previously selected (i.e., "L" in the present example).
- If you click the Save button, the new Laterality applies for the raw, processed and all reprocessed
images from this raw file (i.e., "R" in the present example).
3-5-3 Resulting image display
The currently displayed image may be rotated by 180° on the monitor, depending on the chosen View
name, as described in the table below:
New View name selected Laterality chosen Impact on image display on the monitor
CC R The image appears with chest wall on the RIGHT.
XCCM
L The image appears with chest wall on the LEFT.
XCCL
FB
CV Does not matter. 180° rotation is not applied.
MLO
AT
SIO
LMO
LM
ML
Viewer
4 Function panel
The Function Panel is used to exit from the Viewer, as well as for access to
information on the Medical Procedure Card, Scrapbook, Quality Check,
Image reprocessing, Print, and Middle mouse button functions.
Quality
Reprocess
Check
4-2 Scrapbook
Click this button or press the <F3> keyboard button to open the Scrapbook. This allows you
to position selected images on Scrapbook “pages”, ready for printing. See section
5 Scrapbook on page 173 for more information.
4-3 Reprocess
Click this button to apply the selected processing algorithm to the currently selected image.
Reprocess
If the image has already been correctly processed, or if it is an SCPT image, the operation
will have no effect on the image, but a new processed image, identical to the first one, will
be created.
Depending on the processing selected (PV or TE), you can select the alternative processing under Tools
/ Medical Application Preferences and then reprocess the raw image to have both TE and PV.
4-4 Close exam (Exit Viewer)
Click this button to leave the Viewer and return to the Browser. If an exam has been
reviewed with no changes, the Viewer closes with no message.
• If changes have been made to image WW or WL, a confirmation box appears (Exit with
save, Exit without save, Cancel).
• If New Acquisition has been selected, but closed before images were acquired, a confirmation box
appears (Yes or No).
Viewer
Qualification does not modify the image itself; it only records the applied image qualification level in a
specific database on the AWS. All qualification statistics are generated from this database.
Rejected images
Most of the time these are non-clinical images, such as Calibration or Quality Control (QC) images.
Occasionally a clinical image may not be worth keeping or the Operator will choose not to retake the
same view.
Repeated images (to be retaken)
In the RRA feature, Repeated means that the corresponding view will have to be retaken, or has been
retaken. An image can be qualified as Repeated either before or after the view has been retaken.
It is the responsibility of the Operator to actually retake the exposure. The examination should not be
completed before the exposure has been retaken.
Viewer
QUALITYCHECK
Reprocess Mark each image already acquired to status and reason selected
2. Qualify the image as either Repeated or Rejected, then select the associated reason in the list
provided. If the reason chosen is Other, a text field is available to type in a customized reason.
To apply the same status and reason to all images already acquired, select the "Mark each image
already acquired to status and reason selected" check box.
Click the Save button: If Repeated or Rejected was selected, the interactive QUALITYCHECK
current level status now indicates QUALITYCHECK NOK.
Viewer
This new qualification level is applied to both images (raw and processed):
Repeat and Reject Confirmation
All images are marked Accepted by default if status is not changed by the user.
marked as Repeated
marked as Rejected
If you select Cancel, you will be able to manually Push or Print images before leaving the viewer.
Planned Auto Push and Auto Print
If you select Cancel, you will be able to change AutoPush and AutoPrint configuration for Repeated and
actions, as defined in Medical Rejected images in Medical Application Preferences, Quality check panel.
Application Preferences, Quality If you select OK, you will exit the viewer and images will be AutoPushed and AutoPrinted as configured
Check part.
OK Cancel
3. After all images are qualified as desired, close the examination. The Repeat and Reject Confirmation
dialog box appears before closing, summarizing the image qualification and the planned Auto Push
and Auto Print actions.
4. Once you agree with the content of the Repeat and Reject Confirmation dialog box, click the OK
button. The dialog box for the final exit then appears.
Viewer
Inv.. Standard
4-6 Print
Click this button to print the displayed image. See Chapter 22 Printing.
Viewer
Viewer
5 Scrapbook
WARNING
The Scrapbook function allows more than one image to be printed on a single film for ease of
comparison and reference. DO NOT use any images printed from the Scrapbook for diagnostic
purposes. Be aware that there is no consistency in size between small and large images printed
side by side from the scrapbook.
• The Scrapbook function allows you to select images and arrange them in any desired order for
printing, by positioning them on “virtual pages” in the Scrapbook. Pages can contain multiple images,
according to the layouts available with the currently selected printer, and each page can have a
different layout. Pages can be sent for printing individually or all at once.
• A “delete after print” option can be turned on or off, as required, which causes pages to be
automatically deleted after printing, when turned on.
• Only images from a single patient can be loaded into the Scrapbook at one time. Images may be
loaded from different exams; a warning appears when the first image of the new exam is loaded.
• To use the function, either click the Scrapbook button on the Viewer Control Panel (see section 5-
2 Scrapbook functions on page 174) or press the <F3> keyboard function button. The Scrapbook
window appears:
Layout Formats: Use these buttons to select the format desired for the
current page. See 5-1 Layout formats on page 174.
Composer area: This area shows the contents of the current Scrapbook
page. It is divided into slots for images, according to the selected layout for
the page. Use this area to add and remove Scrapbook images. See 5-
3 Composer area on page 175.
Page navigation area: Use the arrows to display the next or previous pages.
See 5-4 Page navigation area on page 175.
Close button: Use this button to close and empty the Scrapbook. If the
Scrapbook contains unprinted images, a warning dialog box asks for
confirmation of the Close action.
Viewer
Print Menu
Click this button to display a menu of print options:
• Print page: Prints the contents of the current Scrapbook page.
• Print all pages: Prints all pages of the Scrapbook.
• Printing status: Displays the Printing status panel (see Chapter 22 Printing).
• Printer Configuration: Displays the Print Manager panel.
Options Menu
Click this button to display a two-line pull-down menu:
• Select Options to display a checkbox which allows you to enable or disable the
“delete after print” option. Options
• Select Layout Preferences to display a menu of all page layouts available for the Layout Preferences
Delete Menu
Click this button to display a two-line pull-down menu:
• Select Delete Page to remove the current page from the Scrapbook.
• Select Delete All Pages to remove all pages from the Scrapbook. Delete Page
Viewer
Viewer
1 Raw image
After making an exposure, the image acquired by the Digital Detector is automatically transferred to the
workstation, added to the exam and displayed on the Viewer screen as a raw image with low contrast.
During the transfer of the raw image all Operator interface functions are disabled.
• Fine View processing is applied to the raw image.
This increases the sharpness of the image. Although Fine View processing is applied before the
raw image is saved and displayed, the effect is not visible at this stage, because the raw image
appears with low contrast.
Note:
Fine View processing can be deselected for Quality Control purposes, However, it must always be
selected for clinical images. If Fine View is not selected, a warning message appears when starting
an exam.
The raw image is saved in the DICOM MG “for processing” format so that processing can be carried out
later if required, perhaps using a hospital-specific algorithm.
2 Processing
After acquisition, a number of calculations are applied to the image to create the processed image, which
then replaces the raw image on the screen of the AWS.
The main calculations that are applied to create the processed image are:
• Collimator Detection
This applies a black mask around the useful image area, covering areas which would otherwise be
white. It allows more comfortable viewing.
• Pseudo-log Transformation
This transformation facilitates the manipulation of brightness and contrast during the review. After
the transformation the image dynamic range is reduced to 12 bits, without loss of clinical information.
• Auto-contrast.
This improves image quality by optimizing the levels of brightness (window level) and contrast
(window width) in the image.
• Thickness Equalization or Premium View
Either Thickness Equalization or Premium View processing is applied, according to the setting of the
Premium View option in Medical Application preferences (see Medical Application preferences on
page 129):
- Thickness Equalization.
To apply Thickness Equalization processing, set the Premium View option to Disable.
Subcutaneous tissues can be difficult to see on the screen because of monitor display limitations.
This is corrected by applying a thickness equalization algorithm to decrease the image dynamic
range. Image information beyond a threshold level of gray, selected to correspond to
subcutaneous tissues, is modified for more visibility. The end result is clear visibility of the
medical information in all regions of the breast. When this algorithm is used, the processing
description applied is referred to as PROC_1_FV (or PROC_1 if Fine View is not applied).
The Thickness Equalization algorithm is not applied to the following images:
- Magnified, Spot, and Collimated views with a Field of View smaller than 19.2 cm x 23 cm.
3 Processed image
• After application of the selected algorithm(s), the processed image is added to the exam and
replaces the raw image on the AWS screen.
• Processed images are saved in the DICOM MG “for presentation” format, ready for review.
4 Image display
4-1 Processed image presentation
• By default, the processed image appears with the Standard contrast level,
• Options in the Viewer Control Panel window allow the default display level to be changed, by
selection of High, Low, Standard, or User levels. For images to which Premium View has been
applied, selection of the User level has the effect of selecting the Standard level, but a Operator level
can be set if the image is saved with modified levels.
5 Next exposure
As soon as the processed image has been transferred and displayed on the screen, the system is ready
for the next exposure. The images (first raw, then processed) from the new exposure replace the
previous image in the Viewer.
Printing
Chapter 22 Printing
1 Printing conditions
1-1 Potential printers
Any GE-recommended, high resolution, DICOM printer can be connected to the Senographe Essential
for printing hard copies of digital images. For compatible printers, see the latest product data sheets for
this system, which you can obtain from your local sales Representative.
WARNING
Only films formatted to print a single mammogram per sheet of film may be used for diagnostic
purposes, and only images printed to 10 x 12 inch film or small images printed to 8 x 10 inch film
have been validated for diagnostic purposes. Do NOT use films formatted to print multiple images
per sheet of film for diagnostic purposes.
WARNING
The size of the printed mammogram depends on which printing method is used to print the film.
Use the following table for guidance. The reduction in size is given with the Image True Size as
the reference.
Printing
Note:
Use of Print Model 3 when printing to 10” x 12” film results in a significant image reduction as
compared with use of Print Model 4 (refer to the table below). We therefore advise the use of Print
Model 4 as a default print model, rather than Print Model 3.
Workstation: AWS AGFA Carestream FUJI KODAK KONICA
Print Image Film DryStar AXYS DryView DryPix DryView DryView DryPro
Model size size 4500M 5850 4000 8900 6800 793
5500 5000
5503 7000
Model 1 SFOV 8x10" 0.2% 1.1% 0.8% 4.0% 3.3% 4.0% 3.5%
SFOV 10x12" 3.7% 4.5% 3.9% 3.7% 2.4% 3.1% 3.9%
LFOV 10x12" 4.0% 4.6% 3.9% 3.7% 2.7% 3.7% 3.7%
Model 2 SFOV 8x10" 0.2% 0.8% 0.8% 4.0% 3.3% 4.0% 3.5%
SFOV 10x12" 3.9% 4.6% 3.9% 3.7% 2.4% 3.1% 3.9%
LFOV 10x12" 4.0% 4.8% 3.9% 3.7% 2.7% 3.7% 3.7%
Model 3 SFOV 8x10" 4.1% 4.1% 3.7% 3.3% 1.3% 1.5% 1.8%
SFOV 10x12" 9.1% 9.4% 9.6% 7.6% 8.1% 8.6% 9.1%
LFOV 10x12" 9.5% 9.4% 9.4% 7.6% 7.7% 8.6% 9.4%
Model 4 SFOV 8x10" 4.3% 4.1% 3.7% 3.7% 1.3% 1.5% 1.5%
SFOV 10x12" 4.2% 3.9% 4.9% 3.7% 2.8% 3.1% 3.9%
LFOV 10x12" 4.3% 3.9% 4.8% 3.7% 2.7% 3.7% 3.7%
2 Printer management
Printers are set up and declared to the system at the time of installation by your GE Service
Representative; printer information cannot be changed by the Operator.
The access to this function is from the Tools menu .
Printing
3 Print functions
3-1 Auto Print
Auto Print is a function allowing the Operator to automatically initiate the printing of exam images on
closure of the exam from the AWS.
Images with a Quality Check value of OK are automatically printed by the Auto Print function.
If RRA is installed and enabled, the printing of images with a Quality Check value of NOT OK depends
on Quality Check settings in Medical Application preferences (see subheading 8-3-5 Quality Check on
page 132 in section 8-3 Medical Application preferences on page 129 of Chapter 17 Browser).
If RRA is not installed or disabled, images with a Quality Check value of NOT OK are not automatically
printed at the close of the exam.
To use Auto Print, open the Tools menu from the Browser (see Chapter 17 Browser), and select Medical
Application preferences. Click the Auto Print button in the Medical Application preferences window to
access the Auto Print set-up tool.
Facilities available from the Auto Print window are:
• DICOM printers: contains the list of all the available DICOM printers that have been declared for
printing. Click a printer in the list to select it.
• Review Rooms: contains the list of all environmental conditions of available review rooms. Select the
room corresponding to the printer. Refer to your GE Service Representative or printer manufacturer
for review room configuration.
• Auto Print buttons: click the On button to turn Auto Print on for the selected printer or the Off button to
turn it off. The selected button becomes dark gray.
• Save button: click this button to confirm any changes made and close the window.
• Close button: click this button to close the Medical Application preferences window. If the Operator
has made changes to the Auto Print window, a warning window opens requesting the Operator to
use one of the following:
- Save button (to save the changes and return to the Browser).
- Cancel button (to cancel changes made, close the warning window and return to the Auto Print
window).
- Discard button (to close without saving the changes and return to the Browser).
• Print mode: only Fit to Film. Can not be changed by the Operator in current AWS software release.
• Film size: either automatically selected according to image size or always 8 x 10" or always 10 x 12".
(See section 8-3-2 Auto Print on page 130). When selecting Automatic for film size, if the printer
takes only 8 x 10" film, a dialog box opens informing the Operator that large images will not be
printed.
When the Auto Print is performed at the close of the exam, if the printer provides only 8 x 10 inch
films and if there are large images in the exam to be printed, a dialog box opens informing the
Operator that large images cannot be printed.
• Number of Copies box: enter the required number of copies in this box.
• Printer properties button: click this button to open the Printer properties window (see section 3-
3 Printer properties on page 185).
Printing
PRINTER 1 My Room1
PRINTER 2 My Room2
PRINTER 3
Number Of Copies (1.. 9)
Printing
Note:
The user does not need to change any value here to set the Auto Print function. Film size value
indicated in Printer properties panel is the film size used for the last printing, which may have been
an auto-print or a manual print. If Auto Print is set to ON, at exam closure, the film size value that
will be considered for the Auto Print is the one of Auto Print tab. The film size value of Printer
Properties panel will be erased and replaced by the film size value set in Auto Print tab.
Printing
OK Refresh
Printing
Model 1:
Institution, physician, Operator, and patient
data at top, followed by view data.
Image and exposure data at bottom.
Top and bottom annotation areas are aligned
to the border opposite the chest wall.
This model does NOT contain all of the
information required by the Mammography
Quality Standards Act (MQSA).
Printing
Model 2:
Patient data at top, followed by view data.
Institution, Operator, image and exposure data
at bottom.
Top and bottom annotation areas are aligned
to the border opposite the chest wall.
This model does NOT contain all of the
information required by the Mammography
Quality Standards Act (MQSA).
Printing
Model 3:
View data at top, followed by exposure date
and time.
Patient data at bottom left, image data at
bottom middle, institution and Operator data at
bottom right, followed by exposure data.
The top annotation area is aligned to the
border opposite the chest wall. All bottom
annotations are restricted to the image footer
so as to avoid overlap with the image.
This model contains the information required
by the Mammography Quality Standards Act
(MQSA).
WARNING
Large (24 x 31) images printed using Print annotation Model 3 must not be used for final
interpretation.
Printing
Printing
Print annotation Model 4 for 24 x 31 (10" x 12") - film (view with chest wall to the left):
Printing
Print annotation Model 4 for 24 x 31 (10" x 12") - film (view with chest wall to the right):
Interchange media
1 Overview
The interchange media function provides a compact disk recording (CD-R) drive, installed inside the
Control Station (see illustrations below).
CAUTION
• An icon appears below each of the lists in the Browser. These icons may be turned off and
on in the Browser preferences window, accessed through the Tools menu, see Chapter 17 Browser.
Interchange media
CAUTION
GE recommend the use of CD-R media that have been officially validated for performance and
reliability of patient data interchange on the Senographe Essential system. These are identified
by GE labelling. GE cannot take responsibility for any data loss or incompatibility with other
systems resulting from the use of unsupported media.
To order compatible media, contact your GE local sales Representative.
- A recordable CD (CD-R) can only be recorded once.
- When saving image data on a CD-R, you must always use a blank CD-R.
2-2-1 Procedure
All image data that you want to save on a given CD-R must be selected beforehand, and will be saved in
a single pass. It is not possible to add data on a CD-R.
• Push the eject button under the tray on the CD-R drive. When the tray opens insert a new (blank)
recordable CD into the CD-R drive (see section 2-1 Handling recordable CD media on page 194 on
how to handle recordable CDs) and close the drive by pushing the button again. Wait for 40 seconds
for the CD-R drive to be ready (when the light on CD-R drive stops blinking).
• On the Browser, select the patient or patients to be saved in the same manner as selecting images
for review (click the required patient name in the Browser list; to select multiple patients, hold down
the <Control> key and click successively on each required patient name).
Interchange media
• Use the middle mouse button to drag the selected patient(s) to the CD-R icon in the Network
panel,
CDR
Or:
• Click the Push button below the patient list on the Browser (if the icon is not present, it may
be turned on by accessing Browser preferences from the Tools menu). A window opens to
show a list of available recording devices.
• Select the CD-R read/write device by clicking on its name in the displayed Save selected exam(s) on...
list, then click the OK button. If the Preview of CD-R content has been set List of devices
(see 2-2-2 Preview option on page 195) a list of data to be recorded on the CDR read/write
CD-R appears.
After about 15 minutes a message appears, indicating how much of the
CD-R capacity will be used.
• Click the Write button to start the operation, or on the Cancel button to
cancel it.
List of devices
CDR read/write
OK Cancel
Note:
While selecting items (before you start the save), the operation can be abandoned by
clicking on the CD-R icon and selecting Detach in the drop-down menu. This stops the
operation. The CD is ejected automatically and can be used again. CDR
Query
2-2-2 Preview option
Option
After clicking on the OK button or after using “drag-and-drop” to start recording, but before Detach
saving starts, the Preview of CD-R content automatically displays a list of the patients which
will fit on the CD-R, and the estimated time required. Note that the list may not be in the order selected
by the Operator, and that it cannot be assumed that all patients selected for recording will fit.
At this stage, you can still cancel the save operation and modify your selection if required.
• To set this option on or off, click the CDR icon in the Network/Archive panel on the main
Browser and select Option in the drop-down menu.
CDR
Query
Option
Detach
Interchange media
Interchange media
Quit button
examination list
image list
serie list
• In the Media Browser window, select the patient(s) and/or exam(s) to be restored in the same
manner as on the main Browser (see Chapter 17 Browser).
• Sort the lists as required using the Sort by buttons.
• After selecting the desired patient, exam, series or image item(s):
- With the cursor on the selection, press and hold the middle mouse button and drag the selection
directly onto the Return to Browser button at top left.
Or
- Click the corresponding Restore button (if the icon is not present, it may be turned on by
accessing Browser preferences from the Tools menu).
Interchange media
The selected items are copied from the CD-R to the AWS database.
• The Main Browser and Media Browser display the same columns of information in the Patients,
examinations, series and images lists. However, some of these columns may be empty in the Media
Browser. The full information will be displayed in the Main Browser after the images have been
restored.
2D Localization examination
• The face shield is used to keep the patient’s face, hair, ear lobes, etc. out of the X-ray beam during
exposure.
• The 2D Cross-hair device includes metallic wires which may be positioned in the field of view as
required. It is used during manual biopsy procedures, to target a position for the introduction of a
needle or to position a marker for a tangential view. Manual control knobs allow the wires to be
moved on the X and Y axes.
Metallic wires
Control knobs
2D Localization examination
• The 2D Cross-hair device is mounted by sliding it into the rear interface plate rails, from the rear of
the X-ray tube head.
2D Cross-hair device insertion:
CAUTION
The Face shield and the 2D Cross-hair device must be removed before installing the
Magnification stand. The face shield must always be mounted from the front, never from the rear.
The rear rails are intended for mounting the 2D Cross-hair device only. Make sure that the face
shield and the 2D Cross-hair device are pushed all the way onto the rails: you must hear a click
and feel a mechanical stop.
2D Localization examination
WARNING
Elevation and rotation movements are enabled when the displayed compression force is less
than 3 daN. Where possible, make sure the compression force is greater than 3 daN before
starting the biopsy. If compression less than 3 daN must be used (for example, if the patient has
a sore breast or an implant), great care must be taken to avoid unwanted Gantry movements,
and AOP cannot be used.
CAUTION
Ensure that the footswitches are placed so that the patient cannot reach them and release the
compression during positioning or imaging.
CAUTION
If the patient moves during the biopsy procedure or compression thickness changes, the
procedure should be started again from the beginning in order to guarantee the accuracy of the
biopsy.
WARNING
Always bear in mind the needle's height and insert it to a depth such that it will not pierce through
the breast and touch the Bucky. This way you will avoid unwanted lesions and damage to the
Bucky.
2-2 Preparation
• Insert the face-shield and the 2D Cross-hair device (see section 1-2 Mounting instructions on
page 200). Use the X and Y manual control knobs as necessary to be sure that the cross wires are
positioned out of the field of view.
• Insert a biopsy paddle (2D large localization paddle or 2D spot localization paddle):
2D large localization paddle 2D spot localization paddle
• The biopsy procedure can be performed at all angles, but the angle used must be chosen to provide
the shortest possible distance for the needle from the skin to the lesion.
• For views that do not require the patient to stand, the patient must be seated in a biopsy chair; the
chair must provide good support to the patient’s back and arms. An optional biopsy chair is available
from GE.
2D Localization examination
• It is suggested to turn off the Auto Push and Auto Print features in Medical Application preferences.
• At the control console, turn off Auto decompression (menu Medical/DECOMP/DECOMP/NO).
• Compress the patient’s breast. Make sure that the region of interest (target or suspicious area) is
located in the center of the graduated window of the biopsy paddle.
2-3 Definitions
Physical and electronic Cross-hairs:
The X-ray image of this crossed wires superposed on the Breast image will be named "physical
Cross- hairs" in the rest of this chapter, to distinguish it from the "electronic Cross-hairs" that can be
displayed on the image on the monitor, as explained in section 2-3 2D Loc. - electronic Cross-hairs on
page 158.
Physical Cross-hairs images:
X-ray image: making an exposure.
Light image: turning on the Collimator light.
Target:
Target is the object in the breast which is to be sampled with a needle.
Insertion point:
Entry point for the needle on the skin of the breast.
Image target:
X-ray image of the target.
• In the Viewer, click the 2D Loc. icon to display a set of electronic cross hairs on the monitor
image. This icon is enabled in acquisition mode only.
• Use the trackball or mouse to position the intersection of the electronic Cross-hairs over the center of
the target (see the instructions given in section 2-3 2D Loc. - electronic Cross-hairs on page 158).
• On the monitor, read the relative position of the graduations on the biopsy paddle (X and Y axes).
Use Zoom 1, Zoom 1/2 or Fit to Screen as required for the best visualization of the area. If the
graduations can not be seen in the zoomed view after the electronic cross hairs have been
positioned, reduce the zoom to display the graduations.
• Use the knobs on the 2D Cross-hair device to move the wires into the correct alphanumeric position.
The goal is to superpose the image of the physical Cross-hairs with the electronic Cross-hair.
• If needed, perform another acquisition to verify the correct position of the physical Cross-hair.
• To insert the needle, first anesthetize the insertion point if required. Turn on the Collimator light, then
place the needle tip at the intersection of the shadow of the cross wires at skin level and insert the
needle.
• With the needle in place, make sure that the shadow of the cross wires coincides with the hub of the
needle.
• Use the knobs on the 2D Cross-hair device to move the cross wires out of the field of view.
• Perform another acquisition to verify correct needle position.
• Use the manual compression knobs to decompress slowly and carefully.
2D Localization examination
2-5 Completion
• The images can now be annotated and/or measurements can be applied.
• Click the print icon to print each required image.
• Push the images to the Seno Advantage Workstation.
• In Medical Application preferences, turn Auto Push and Auto Print on or off as required.
• At the control console, turn Auto decompression back on for routine mammography.
2D Localization examination
System Hygiene
1 Introduction
This chapter describes cleaning requirements that must be performed regularly to maintain hygienic
condition of the Senographe equipment.
WARNING
Adequate cleaning and disinfection is necessary to prevent disease transmission. Be sure to
thoroughly clean and disinfect equipment surfaces that contact the patient, and all equipment
surfaces likely to become soiled during use. The parts of the Senographe Essential that come
into contact with patients must be disinfected before each new patient is examined.
System Hygiene
WARNING
Improper cleaning methods or the use of certain cleaning and disinfecting agents can damage
the equipment, cause poor imaging performance or increase the risk of electric shock. To avoid
possible injury or equipment damage:
- Do not use high temperatures, except for parts that need sterilization.
- Use suitable hygiene products. See "Suggested Hygienic cleaning products" later in this
chapter.
- Clean, disinfect, rinse and dry the parts that come into contact with a patient before each new
examination is started.
- Do not allow liquids to enter the equipment:
Never allow liquids to enter the internal parts of the equipment.
Do not apply cleaning sprays or liquids directly to the equipment; always apply such products
by using a clean cloth dampened with the spray or liquid, in accordance with the
manufacturer’s instructions.
Take great care to avoid any possibility of liquid running into the equipment, for example
around operating buttons and at the edges of moving parts. This is especially important when
cleaning keyboards and pointing devices (mouse or trackball).
If you become aware of liquid entry, disconnect the electrical supply and have the equipment
checked by qualified service personnel before returning it to use.
- Do not immerse electrical or metallic components:
Never immerse equipment parts that enclose electrical components, such as the Bucky/
Image Receptor, in any liquid. They must be cleaned with a soft dampened cloth, taking
special care not to allow liquids to enter the equipment.
WARNING
All parts are sensitive to mechanical damage. While cleaning, avoid accidentally striking or
bumping the equipment with cleaning implements.
WARNING
Always follow the cleaning or germicidal agent manufacturer's instructions and precautions for
mixing, storage, method of application, contact time, rinsing requirements, protective clothing,
shelf life and disposal to help assure effective and safe use of the product.
System Hygiene
WARNING
If it is necessary to clean the digital detector when no breast support is inserted, first ensure that
the Gantry and Generator power is switched OFF at the X-ray Console. If the power is applied,
there is a risk of short-circuiting electrical contacts, which would activate the breast support
locking mechanism, pinching and injuring the operator's fingers.
System Hygiene
WARNING
Always follow the cleaning or germicidal agent manufacturer's instructions and precautions for
mixing, storage, method of application, contact time, rinsing requirements, protective clothing,
shelf life and disposal to help assure effective and safe use of the product.
System Hygiene
System Hygiene
Operator messages
1 Introduction
Any operational anomalies found by the system during Senographe Essential operation are signalled by
Operator Messages. These may be displayed on the X-ray Console, in a pop-up window on the AWS
LCD monitor, or on the Gantry readout. They may be simple information messages requiring no action,
or they may indicate error or fault conditions requiring action from the Operator and/or Field Service
Representatives.
If you need to call your Field Service Representative about an Operator message, you should quote the
entire message or messages, complete with any identification characters.
The following tables list Operator messages which may occur, with explanations and recommended
actions.
- Table 1 Operator messages displayed on the X-ray Console on page 212
- Table 2 Operator messages displayed on the AWS LCD monitor on page 225
- Table 3 Messages regarding breast supports on page 229
- Table 4 Messages regarding FOV on the Gantry readout on page 232
- Table 5 Error messages on the Gantry readout on page 234
Operator messages
Operator messages
Operator messages
Operator messages
Operator messages
Operator messages
Operator messages
Operator messages
Operator messages
Operator messages
Operator messages
Operator messages
Operator messages
Operator messages
Operator messages
Operator messages
Operator messages
Operator messages
Operator messages
Operator messages
Operator messages
Operator messages
Operator messages
Operator messages
Operator messages
Operator messages
Operator messages
Operator messages
Operator messages
Operator messages
Operator messages
Operator messages
Operator messages
Operator messages
Operator messages
Operator messages
Operator messages
Operator messages
Operator messages
Planned Maintenance
1 Introduction
WARNING
This chapter describes planned maintenance procedures which must be performed regularly to
maintain safe and effective operation of the Senographe equipment.
Recommended planned maintenance procedures must be performed as specified by Field Service
Representatives, the Radiologic Technologist, and by the Medical Physicist.
Planned Maintenance
Specifications
Chapter 28 Specifications
1 Technical specifications
1-1 Scope
This chapter concerns only specifications linked to use by the Operator of the system once it is installed
and operational. For more detailed specifications regarding the pre-installation, transportation, storage,
installation and maintenance of your system, please refer to the corresponding Service Publications.
Specifications
Specifications
Specifications
The minimum filtration permanently installed in the useful beam of the X-ray tube is 0.008 mm aluminum
equivalent (8 µm aluminum equivalent) at 30 kV corresponding to the minimum thickness of beryllium of
the X-ray tube output window.
The switched filters are installed on a disk driven by a stepping motor which moves from one filter to the
other. Two different filters are supplied:
• Molybdenum: 0.03 mm,
• Rhodium: 0.025 mm,
Note:
The system electronics control the filters according to Operator requirements in manual mode, or
to software requirements in AOP mode
TARGET VOLTAGE FILTER EQUIVALENCE
(kV) (half-value layer)
Molybdenum 30 0.03 Mo 0.3 mm Al minimum
Molybdenum 30 0.025 Rh 0.35 mm Al minimum
Rhodium 30 0.025 Rh 0.4 mm Al minimum
Specifications
3 Environmental Requirements
3-1 Atmospheric Pressure Limits
Atmospheric pressure Altitude (from sea level)
Min. Max. Min. Max.
700 hPa 1060 hPa 0m 3000 m
0 ft 9840 ft
Specifications
Specifications
5 Tube information
Tube Cooling Curves and other tube-specific technical parameters can be found in the Tube Product
Data document, part no. 5145113-100, included with the system documentation.
8 Trademark information
• GE and the GE Monogram, IDI Mammo Workstation and the Mammography Documentation Station
are trademarks or registered trademarks of the General Electric Company.
• DICOM is a trademark or registered trademark of the National Electrical Manufacturers Association.
• Microsoft and Windows are trademarks or registered trademarks of Microsoft Corporation.
• Adobe and Acrobat are trademarks or registered trademarks of Adobe Systems Incorporated.
• All other trademarks, service marks, logos, company names and product names are the property of
their respective owners.
Specifications