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DIVA-D 0123

Digital Imaging Video Acquisition


with full DICOM compatibility

User’s manual
Release 4 January 2006 (Rev. 0)
USER’S MANUAL
Contents

Contents
1 INTRODUCTION 1
1.1 Icon appearing in the manual ................................................................. 1

2 SAFETY ASPECT 2
2.1 Warning.................................................................................................. 3
2.2 Environmental risks and displacement ................................................... 5
2.3 Symbols used ......................................................................................... 6

3 DESCRIPTION 7
3.1 Identification labels ................................................................................ 7
3.2 Description ............................................................................................. 8
3.2.1 DIVA-D composition ................................................................... 9
3.2.2 Monitors..................................................................................... 9
3.2.3 Accessories................................................................................. 9

4 TECHNICAL DATA 10
4.1 DIVA-D AS 25....................................................................................... 10
4.2 CRT Monitor ......................................................................................... 15
4.3 LCD Monitor ......................................................................................... 17
4.4 Environmental conditions..................................................................... 18
4.5 Standards............................................................................................. 18

5 KEYBOARD AND FUNCTIONS 19


5.1 Functions description ........................................................................... 20

6 UNIT SWITCHING ON 22
6.1 CCD camera not connected .................................................................. 24
6.2 System fault ......................................................................................... 25

7 PATIENT DATA 26

8 FLUOROSCOPY 28
8.1 Fluoro special function ......................................................................... 30

9 MODALITY SELECTION 31

10 GRAPHY 33

(Rev. 0) i DIVA-D
USER’S MANUAL
Contents

11 POST PROCESSING 35
11.1 Special function .................................................................................... 39
11.2 Multi image........................................................................................... 41
11.3 Image print ........................................................................................... 42

12 DICOM FUNCTIONS 43
12.1 Waiting list ........................................................................................... 44
12.2 Queue view and flush ........................................................................... 45
12.3 Print ..................................................................................................... 47
12.4 Store ..................................................................................................... 49
12.5 CD - ROM ............................................................................................. 51

13 MAINTENANCE AND CLEANING 54


13.1 Frequency of maintenance and cleaning actions ................................... 54

This publication can only be reproduced, transmitted, transcribed, or translated


into any human or computer language with the written consent of VILLA SISTEMI
MEDICALI S.p.a.

This manual in English is the original version.


DIVA-D ii (Rev. 0)
USER’S MANUAL
Introduction

1 INTRODUCTION

G
NOTE:
The present manual is updated for the product it is sold with in order to
grant an adequate reference to use properly and safely the product.
The manual may not reflect changes to the product not impacting
operating modes or safety.

DIVA-D is an acquisition, storing and processing digital system studied


to process digitalized images.

The purpose of this manual is to give the User instructions for a safe and
efficient use of the DIVA-D.

The device must be used in compliance with the procedures described in


the user manual and never used for purposes different than the ones
described in the user manual.

Qualified personnel only, having necessary knowledge on X-ray


protection can use the device.

1.1 Icon appearing in the manual

G
This icon indicates a NOTE: please read thoroughly the items marked
by this picture.

This icon indicates a WARNING message; the items marked by this icon
refer to the safety aspects of the patient and/or of the operator.

(Rev. 0) 1 DIVA-D
USER’S MANUAL
Safety aspect

2 SAFETY ASPECT

WARNING: Please read this chapter thoroughly.

VILLA SISTEMI MEDICALI devices comply with the related safety


requirements; furthermore it supplies all information necessary for a
correct use and the warnings related to danger associated with X-rays
generating units.

VILLA SISTEMI MEDICALI, has not to be held responsible for:

• use of DIVA-D different from the intended one as described in this


manual;
• damages to the unit, to the operator, to the patient, caused either by
wrong installation or maintenance procedures, different from those
described in the Servcie manual and in the user manual supplied
with the unit, and by wrong operations;
• mechanical and/or electrical modifications performed during and
after the installation, different from those described in the official
documentation of the product.

Any technical intervention must only be performed by VILLA


SISTEMI MEDICALI qualified technicians.

Only the authorized personnel can remove the covers and/or have
access to the components under voltage.

DIVA-D 2 (Rev. 0)
USER’S MANUAL
Safety aspect

2.1 Warning

This device has not been designed to be used in environments where


vapors, anaestethic mixes flammable with air, or oxygen and nitrous
oxide can be detected.
Avoid pouring water, even accidentally, or other liquids into the device,
as this could cause short-circuits.
Before cleaning the device, please disconnect it from the line voltage.
Wherever necessary, use the fit accessories, such as the leaded aprons,
to protect the patient from radiation exposure.
While performing the radiography, no one, apart from the operator and
the patient, must remain in the room.
Though this unit has been designed with a quite acceptable protection
level from electromagnetic interference, it is advisable to install it at a
certain distance from electrical energy transformation rooms, from static
continuity units, from portable receiving-transmitting units for
amateurial use and for cellular use. Cellular telephones are only
admitted at a distance of more than 1.5 m from any component of the
device.
Other medical instruments and devices that must be used in the same
installation area of the unit must comply with the Electromagnetic
Compatibility rules in force. Non-complying instruments, of which the
poor immunity from electromagnetic fields is well known, must be
installed at least 3 m away from the DIVA-D and supplied by a different
electrical line.
DIVA-D cannot be installed in operating theatres.
DIVA-D must be off while using devices such as electrical scapels or
similar instruments.
The equipment automatically performs some self-test functions and
therefore is able to detect some anomalous conditions. However,
whenever there are doubts on the performance of the equipment (e.g.
images too clear, too dark or with artifacts), the activity must be
suspended and a Villa Sistemi Medicali qualified and authorized engineer
must be contacted.

WARNING:
If during the self-test phase the equipment shows a failure message
caused by the electronic circuits or the Ram disks, the images of a given
patient retrieved for post processing may not belong to the requested
patient.
In this case, immediately contact an authorized Villa Sistemi Medicali
engineer and do not make any diagnosis or evaluation on the stored
images.
In addition, as the failure may have occurred during the last working
session, diagnosis carried out after the last exam cannot be
considered valid.

(Rev. 0) 3 DIVA-D
USER’S MANUAL
Safety aspect

During the use of the equipment, the operator must comply with the
local work safety regulation, in particular with the ones referring to the
use of video terminals.
The cathode X-ray tube (CRT) of the monitors, when present, is
manufactured in order to minimize the risk of implosion. However, if
heavily hit it may break thus projecting out pieces of glass, powder and
toxic gas. Avoid hitting the CRT with any object and make sure that it
does not hit any object.
These risks are not present when LCD monitors are used.

DIVA-D 4 (Rev. 0)
USER’S MANUAL
Safety aspect

2.2 Environmental risks and displacement

The DIVA-D contains in some of its parts, materials that at the end of the
units life, must be recycled at an approved location.
Particularly the device contains the following materials and/or
components:

• Central unit and control console: iron, copper, aluminum, non-


biodegradable plastic material, glass-resin for printed circuit board
(PCB)
• CRT Monitor, TV camera: glass vacuum tubes, iron, copper,
aluminum, glass-resin for printed board, non-biodegradable plastic
material.

WARNING
Glass vacuum tube may implode with projection of glass pieces, powder
and toxic gas.

(Rev. 0) 5 DIVA-D
USER’S MANUAL
Safety aspect

2.3 Symbols used

Symbol Description

Warning, read the relevant documentation

The equipment contains in some of its parts,


materials that at the end of the units life, must be
recycled at an approved location

∼ A.C.

Complies with Medical Equipment Directive 93/42


0123

Device with type B applied parts

Dangerous voltage

DIVA-D 6 (Rev. 0)
USER’S MANUAL
Description

3 DESCRIPTION

3.1 Identification labels

1
4

2
3

1
Main label (rack)

2
Control keyboard label

3
CRT Monitor label

4
LCD Monitor label

(Rev. 0) 7 DIVA-D
USER’S MANUAL
Description

3.2 Description

DIVA-D is a digital acquisition, storing and processing system for


radiological images. The large storing capacity allows performing the
following functions:
• Image acquisition and storing in FLUOROSCOPY
• Image acquisition and storing in EXPOSURE with the following
working programs: SPOT, BONE, ANGIO, PERIF, STEP, TOMO
• Post-processing of the acquired images, thanks to a dedicated
program
• Printing of the acquired images through a laser printer.
• Sending via Dicom network acquired images to Pacs system.

The images coming from the image intensifier are acquired through a
CCD camera, then fed to the digitalization stage (A to D Converter) after
that they can be stored in the permanent memory (Ram disk).
From this moment on the images can be processed thanks to the
dedicated software programs.
The system has a large accessible database, which allows for the entry
and retrieval of patient information along with exam description, remark
and notes.

DIVA-D is available in 2 versions:

DIVA-D RF 12

Ram Disk capacity 36 Gbytes


Operator monitor 1 or 2 on request
"In room" monitor 0, 1 or 2 on request
Imaging acquisition (max speed and 12 imag/sec matrix 1024x1024
matrix)
12 imag/sec matrix 1024x1024
Functions • standard acquisition: YES
• imaging subtraction: NO
• road mapping: NO
• fluoro store: YES

DIVA-D AS 25

Ram Disk capacity 72 Gbytes


Operator monitor 1 or 2 on request
"In room" monitor 0, 1 or 2 on request
Imaging acquisition (max speed and 25 imag/sec matrix 1024x1024
matrix)
25 imag/sec matrix 1024x1024
Functions • standard acquisition: YES
• imaging subtraction: YES
• road mapping: YES
• fluoro store: YES

DIVA-D 8 (Rev. 0)
USER’S MANUAL
Description

3.2.1 DIVA-D composition

DIVA-D contains the following components:


• Rack containing all electronics (computer, PCB's, Ram disk, power
supply, etc).
• Control keyboard.
• CCD TV camera.
• POD (Printed Ouput/input Device) pcb interface for table and
generator.
• Laser interface for standard digital protocol (P831) when Dicom
module is not present only.

3.2.2 Monitors

All DIVA-D models are available with CRT or LCD monitors for operators
and "in room".
The size of these monitors depends on customer request.

3.2.3 Accessories

Depending on the request, DIVA-D can be supplied with accessories:


• DICOM module equipped with SW package for:
− print
− store
− worklist
− CD write
• Remote control function.
• Ceiling suspension for "in room" monitor.

(Rev. 0) 9 DIVA-D
USER’S MANUAL
Technical data

4 TECHNICAL DATA

G
NOTE:
Technical data, performance and instructions provided in this manual
are referred to the DIVA-D AS 25 model. Therefore, some of these
characteristics are not applicable for DIVA-D RF 12 systems.

4.1 DIVA-D AS 25

Identification
Type DIVA-D AS 25
Model NDR 632 E00 + NDR transf 02
Components
Central unit Rack composed by:
Power supply; Computer; Pcb's; Ram
disk
Control system Flat control keyboard
Acquisition by CCD Camera 1024 x 1024
Interface system Generator and Remote Control Table
interface PCB
Connection cables Prepared interconnection cables
Operator: 1 or 2 on request
Monitor
"In room": 1 or 2 on request
Dimension and weight Central Unit (Rack)
Weight 15 Kg
Height 254 mm
Depth 345 mm
Width 440 mm
Dimension and weight Control keyboard
Weight 6 Kg
Height 50 mm
Depth 235 mm
Width 460 mm

DIVA-D 10 (Rev. 0)
USER’S MANUAL
Technical data

Dimension and weight CCD Camera


Weight 2 Kg
Height 95 mm
Diameter 140 mm
Dimension and weight Interface Card (POD)
Weight about 0,5 Kg
Height 20 mm
Depth 98 mm
Width 200 mm
Dimension and weight Laser Printer Interface Box
Weight about 1 Kg
Height 38 mm
Depth 150 mm
Width 235 mm
Technical characteristics / Acquisition and memorization
Acquisition, visualization and With digital processor and an A/D
memorization converter 12 bits
Memorization of the images 12 bit
Visualization of the images 12 bit
A/D frequency conversion 66 MHz
Processor management AMD TM

Clock frequency of the processor 1,2 GHz


CCD camera With medical grade 2/3" CCD sensor
offering high resolution with progressive
scanning.
1024x1024 matrix.
Integrated optical system with focus and
diaphragm.
CCD camera signal-noise ratio During exposure acquisition <65 db
Control keyboard Alphanumerical with special function.
Qualified functions indicated by LED
display.
Flat and waterproof surface.
Generator and remote control table Remote table: with dedicated input \
interface card output system.
Generator: Digital mode; analogic mode;
serial mode (RS 232)
Laser printer interface box (when Dicom With parallel output for digital
module not present). connections.
Communication protocol P831, P859.
Maximum connection distance 500m.

(Rev. 0) 11 DIVA-D
USER’S MANUAL
Technical data

DICOM module (optional) Technical characteristics


Processor management Intel ™
Working frequency 1 GHz
Ram memory 512 Mbytes
Transit memory Ram disk 40 Gbytes
Dicom images backing Ram disk 40 Gbytes
Network access speed 100 Mbit
SW package available -Print (1024x1024 16bit)
-Store (1024x1024 16bit @ 3 Mbyte)
-CD write (1024x1024 8bit)
(512x512 8 bit)
-Worklist
Imaging acquisition (speed and matrix)
Mode 12 bits progressive scanning acquisition
and visualization
Fluoroscopy Matrix 1024x1024
Acquisition max rate 25 fr/sec
Pulsed fluoroscopy Matrix 1024x1024
Acquisition selectable rate:
1-3-6-12-25 fr/sec
Exposure and angiography Matrix 1024x1024
Acquisition max rate 25 fr/sec
Imaging memorization
Storage Automatic and permanent.
Maximum access time to disk for image 30 msec.
write and read (with matrix 1024x1024
16 bit)
Memory capacity 72 Gigabytes
Maximum storage capacity of images 36000 images
with matrix 1024x1024
Electrical characteristics
Standard power supply (transf 02) 230 V ac ±15%
Standard power supply (DIVA-D rack) 24 V ac ±15%
Frequency 50-60 Hz
Current absorbed 650 mA @ 230 V ac
Power absorbed 150 W @ 230 V ac

DIVA-D 12 (Rev. 0)
USER’S MANUAL
Technical data

Working configuration
Remote R\ F control table - Apollo
- Mercury 332
R\ F tilting table - Vision
Integration with generator Genius 65/80 HF-A with serial mode
(RS 232) interface
Clinical application
Fluoroscopy Continuous and pulsed HCF
Standard exams and with contrast agent Gastroenterological, bone exams, ERCP,
Urology, Mielography, etc.
Tomography In low dose modality
Vascular exams Thoracic angiography, carotid,
peripheral, phlebography.
Exams with on-line subtraction and
post processing.
Peripheral steps Angiography Optional. Possible application with
Apollo remote control table only.
Working characteristics
User interface Windows representation
Fluoroscopy mode
Storage Manual start on Ram disk
Regulation of the parameter Auto video level regulation.
Auto radiological parameter regulation.
Manual selection of six field video levels
Edge enhancement Two selectable levels
Positive/Negative function (grey scale In line/off line
inversion)
Noise reducer Two selectable level
Road mapping Direct masking
Imaging comparison Automatic or manual transfer of the
image
Last image hold (LIH) With integrated image
Manual regulation of the video level Three selectable levels
Motion detection filter Automatic exclusion of the recursive
filter during the movement of the image
(no blurring effect)
Dynamic recursive filter DRF Automatic noise/blurring optimization
effect offers zero persistence

(Rev. 0) 13 DIVA-D
USER’S MANUAL
Technical data

Radiography mode
Storage On Ram disk
Five standard acquisition modality with Spot – Bone – Angio - Peripheral angio –
different functions. Tomo.
One optional acquisition modality Stepping angio (optional)
Anatomic program for each acquisition 20
modality
Low dose acquisition For pediatric exams
Maximum opacification function Track due to the storing of the contrast
(maxop) liquid flow with subtraction acquisition
mode
Acquisition time selection Auto-self in according with the selected
program.
Manual in real time.
Positive/Negative (grey scale inversion) In line/off line
Last image hold (LIH) Each exposure
Post processing mode
Electronic collimator With scrolling
Edge enhancement Nine regulation levels
Windowing Auto/manual
Road map contrast Nine regulation levels
Positive/negative (grey scale inversion) Default or manual
Image visualization Full screen or multi format size
Angle measurement Displayed data
Length measurement Displayed data and ratio
Editing on the image Available in full screen
Zoom Zoom x 4 with scrolling
Exams review With acquisition speed; image stand;
single reply
Visualization with subtraction Possible with standard acquisition
exams
Exams with subtraction review With Remasking and Maxop functions
Optimization of the subtraction Pixel shift function
Image printing Full screen

DIVA-D 14 (Rev. 0)
USER’S MANUAL
Technical data

4.2 CRT Monitor

G
NOTE:
The characteristics of the monitors are the same for both DIVA-D's
model.

Technical data
Type Monitor CRT B&W
Manufacturer Nical
Model Refer to optional
Dimensions and weight Monitor 17” Monitor 21”
Weight 17,5 Kg 21,8 Kg
Height 335 (359) mm 394 (418) mm
Depth 350 mm 380 mm
Width 405 mm 489 mm
Screen dimensions 17" (414 mm) 21" (511 mm)
Electrical characteristics
Standard power supply 230 V ac ±15%
Frequency 50-60 Hz
Current absorbed 350 mA
Power absorbed 80 W
Scanning
Type Interlaced
Line number 1049
"Refresh" frequency 60 Hz
Standards EIA
Video input signal
Type Video input connected ac
Connection type BNC
Impedance 75 Ω
Input video signal 0,5 to 1,5 V pp (negative
synchronism)

(Rev. 0) 15 DIVA-D
USER’S MANUAL
Technical data

Display characteristics
Deflection angle 90°
Aspect ratio 4:3
Band width 40 MHz ±3 dB
Raster 0.25 mm
Phosphor White P45
Geometric error <1.5 %
Vertical/horizontal linear error <1.5 %
Maximum brightness 850 cd/m2
Light transmission 46%
Dynamic focus Yes
Stabilized EHT Yes
Optional
Contrast and brightness control with digital Available on request on all models
push-button on front panel and rear remote
control connection
Self luminosity sensor on front panel
Contrast and brightness control only with Available on request on all models
rear remote control connection

DIVA-D 16 (Rev. 0)
USER’S MANUAL
Technical data

4.3 LCD Monitor

G
NOTE:
The characteristics of the monitors are the same for both DIVA-D's
model.

Technical data
Type Monitor LCD B&W
Manufacturer Nical
Model Refer to optionals
Dimensions and weight Monitor 18” Monitor 20”
Weight 5,5 Kg 6,0 Kg
Height 340 mm 355 mm
Depth 60 mm 60 mm
Width 430 mm 457 mm
Screen dimensions 18" 20"
Electrical characteristics
Standard power supply 230 V ac ±15%
Frequency 50-60 Hz
Current absorbed 250 mA
Power absorbed 50 W
Display characteristic
Visibility angle 180°
Contrast 600:1
Resolution 1280x1024
Gray scale 768 levels
Max luminance 700 Cd/m2
Calibration automatic
Optional
Contrast and brightness control with digital Available on request on all models
push-button on front panel and rear remote
control connection
Contrast and brightness control only with Available on request on all models
rear remote control connection

(Rev. 0) 17 DIVA-D
USER’S MANUAL
Technical data

4.4 Environmental conditions

Operative Temperature: from -10° to +45° Celsius


Humidity: up to 95 % not
condensing
Transport and storage Temperature: from -35° to +65° Celsius
Humidity: up to 95 % not
condensing

4.5 Standards

DIVA-D system with accessories and optional complying with the relevant
standards:

Electro medical equipment. General safety requirement


EN 60601-1
(included amendment A1+A2+A11+A12+A13)
Electro medical equipment. General safety
requirement.
EN 60601-1-2
2 – Collateral standards: Electromagnetic
compatibility.
EN 60950 Information device safety
The symbol CE grants that DIVA-D complies with
0123 European directive 93/42

Further information regarding standards complying can be requested to:

VILLA SISTEMI MEDICALI S.p.A.


Via delle Azalee, 3
20090 - Buccinasco - (MI) - Italia
Tel: +39-02-48.859.1
Fax: +39-02-48.818.44

The manufacturer of the equipment DIVA-D is (according to the


93/42/CEE European directive):

NICAL S.p.A.
Via Soffredini, 43
20126 - Milano - Italia
Tel.: +39-02-25.711.10
Fax: +39-02-25.722.07

DIVA-D 18 (Rev. 0)
USER’S MANUAL
Keyboard and functions

5 KEYBOARD AND FUNCTIONS


All functions of DIVA-D are activated through buttons located on a
dedicated keyboard.
The following picture and relevant buttons functions descriptions permits
to locate easily all reference of the present manual.

(Rev. 0) 19 DIVA-D
USER’S MANUAL
Keyboard and functions

5.1 Functions description

To adjust the kV value when automatic mode is


active.
It is possible to increase and decrease the image
level with XX steps.
R.O.I. selection. 6 different areas can be selected for
the auto kV correction in function of dimension and
position of the image area to be optimized.

To store fluoroscopy images.

To enable the road mapping function. It is used as


support during catheter insertion.

To select the fluoro modality between continuous


and pulsed.

To select the frame rate exposure acquisition.

When a new patient must be recorded the key


permits to access the patient data window.
Mode is used to enter into modality and anatomic
exam selection.

To enter into patient data base to perform post


processing mode.

In post processing mode, when a patient is recalled


from data base, to select run into the patient and
the frame into run.

To play a run that contains more then one frame


and to stop the sequence visualization.

DIVA-D 20 (Rev. 0)
USER’S MANUAL
Keyboard and functions

These keys allows to enter into different post


processing mode:
− symmetric and asymmetric image limitation
− negative-positive
− zoom x4 with scroll
− cine loop review
− multi image runs selection.
These keys allows to enter into different post
processing angiographic mode:
− mask shift with 1/8 pixel step
− mask present or removed
− manual mask selection
− remasking.
To modify images quality in post processing:
− manual windowing
− edge enhancement
− auto windowing
− reset of the modifications.

To access into fluoroscopy or post processing


special function.

To enter into DICOM (optional) modality, to save


data into DICOM module and to print or store the
captured images.
This group of keys are used as auxiliary functions
during the different modality.

Alphanumeric keys used to write characters in


different working modalities.

This manual is divided in different chapters, each of one is dedicated to a


working modality which DIVA-D supports.
In any chapter it is explained how to use the buttons located on the
keyboard to optimize the DIVA-D use.

(Rev. 0) 21 DIVA-D
USER’S MANUAL
Unit switching ON

6 UNIT SWITCHING ON
Any time that DIVA-D is switched on, it performs an auto test to verify if
the CCD camera is connected and correctly working and if the electronics
of the main rack, including RAM disks are normally operating.

At start up, self test starts and the window is displayed:

where software and hardware information is displayed.


In the first area the software versions present in the unit are indicated.
This information allows the user and service engineer to identify the unit
configuration.
In the second area the hardware characteristics and the “license level”
are displayed. This field permits to identify which functions are available
on the DIVA-D.

At the end of start up, three conditions are possible:


- No error code
The Unit automatically goes to full operation and the display shows.

SYSTEM READY

Device is ready to operate.

DIVA-D 22 (Rev. 0)
USER’S MANUAL
Unit switching ON

If a DIVA-D is equipped with DICOM module after about 2 minutes


from this condition, the monitors shows:

SYSTEM READY

DICOM READY

This delay is determined by the DICOM module initialization time


that is longer than the DIVA-D one.

- Camera not connected (see paragraph 6.1)


It is necessary to press ENTER key to escape from this condition.
Unit goes to off line operation only.
- System fault (see paragraph 6.2)
Unit stops.
A service engineer is required.

(Rev. 0) 23 DIVA-D
USER’S MANUAL
Unit switching ON

6.1 CCD camera not connected

During auto test, the unit could recognize a fault in the CCD camera
connection.
In this condition the window shows:

It is necessary to press ENTER key to escape from this message.


In this condition the device goes into post processing mode in which it
will be possible to perform review only of exams already stored.
No acquisition of new images is possible.

DIVA-D 24 (Rev. 0)
USER’S MANUAL
Unit switching ON

6.2 System fault

If auto test recognizes an analogic, digital or disks fault the window


shows:

The unit is out of work and a service engineer must be contacted.

(Rev. 0) 25 DIVA-D
USER’S MANUAL
Patient data

7 PATIENT DATA
Before starting with a new exam is necessary to insert into DIVA-D the
data of the new patient.
If this is not done, as soon the exposure images acquisition is required,
the message:

is displayed.
It is necessary to press NEW PATNT key to open the patient data
entering window.

G
NOTE:
If fluoroscopy mode is activated, without storing any LIH or any fluoro
sequence, the images visualization is present also if no patient data is
inserted. This because a patient could perform a fluoroscopic
investigation only. In all other cases, because all radiographic images are
automatically stored on RAM disks, the patient data must be entered into
the data base.

When the key NEW PATNT is activated the new patient window is
displayed:

DIVA-D 26 (Rev. 0)
USER’S MANUAL
Patient data

If DICOM module is present the “worklist” selection is allowed, otherwise


no.
For this function, please refer to DICOM functions chapter.

By using UP or DOWN arrow keys activate the selection required between


"DATA ENTRY" or "LAST PATIENT".
Press ENTER key to confirm.

If “data entry” is selected, the window appears:

By using UP or DOWN arrow keys select the required fields.


The surname field is mandatory, the others are optional.

G
NOTE:
If the birth date is not entered, the patient age in the data base will be
recorded as 0.
If sex is not inserted, O (other) will be present in the data base).

Confirming by ENTER, the data are stored into the data base and the
modality window is displayed to permit the acquisition mode selection.

If "last patient" is selected, the PATIENT DATA window appears with the
data relevant to the last patient stored.
This selection is used when during exam on a patient, the unit has been
switched off.
This feature is very useful to avoid 2 files for the same patient.

(Rev. 0) 27 DIVA-D
USER’S MANUAL
Fluoroscopy

8 FLUOROSCOPY
If DIVA-D is equipped with 2 monitors in the control desk area, one of
them is reserved to fluoroscopy images only, otherwise the fluoro window
is present any time the fluoro command is activated.

The following functions and information are available in this modality:


• Status
The visualization could be X-ray during acquisition or L.I.H. (Last
Image Hold) in off line.
• Reg. of int
The visualization is modified according to selection.
ROI (Region Of Interest) must be modified in function of position and
dimension of the organ. 6 different ROI are available trough
correspondent keys. Maintaining pressed the key relevant to the ROI
selected for 3 sec, the ROI dimension and position is displayed on the
image.
• Modality
This field could be STD or PULSE xx fr/sec.

By means of the key the fluoro mode can be selected.


When led is off, STD is displayed in the window, meaning that the
fluoro mode selected is continuous.
When led is on PULSE with the frame rate is displayed in the
window. This rate can be modified using keys FR/s + and FR/s -.

DIVA-D 28 (Rev. 0)
USER’S MANUAL
Fluoroscopy

• Store
In normal use the condition is OFF. To activate the fluoro storing
modality it is necessary to press STORE. The relevant led turns on
and the images number stored are indicated at the bottom of the
display.
When fluoro acquisition is interrupted also the storage is stopped.
At new fluoro acquisition it will be necessary to press the STORE key
again to perform a new storage.
In LIH condition, pressing the STORE key, the LIH will be stored into
the hard disk.
• Edge
By default the value is OFF. It means the edge level used is the
default one. Using E key, the visualization is ON and the edge level
selected is the one configured at the installation.
• Noise
By default the value is OFF. It means the noise suppression level
used is the default one. Using N key, the visualization is ON and the
noise level selected is the one configured at the installation.
• Road map
Road mapping function is available on DIVA-D AS25 only.
The function is activated by using the ROAD MAP key. Pressing the
key, the relevant led turns on and the fluoro images will be in
subtractions mode.
Releasing fluoro, on the display the LIH will be in sub mode and
following fluoro images will have the mask overlapped.
To reset the road mapping mode and the mask, press the key with
fluoro off.
The Led will be turned off and next fluoro will be performed in
standard mode.
• Kv – mA – Dose
In these fields the actual kV and mA are displayed.
Dose field is not yet activated.
• Run – Frame
In these fields the fluoro run number stored for the present patient
and the images contained in the run are displayed.

The dose level can be modified by using the keys kV+ and kV-.
The effect of this action is the image contrast level becoming higher or
lower depending by the key activated. 3 decreasing steps and 3
increasing steps are available starting from the standard level.
The radiological parameters are automatically adjusted by the system,
during fluoro acquisition to optimize the image video level.
This adjustment is calculated based on ROI selection.

(Rev. 0) 29 DIVA-D
USER’S MANUAL
Fluoroscopy

8.1 Fluoro special function

In fluoro off line mode, by pressing the SPEC FUNCT key, the relevant
window is displayed:

By using UP or DOWN arrow keys select the field required.


Press RESET key to activate the relevant selection.

• Store XX Fr/s
The storage rate in fluoro can be selected to preserve disk space.
This selection modifies the storage speed only without modifying the
visualization rate.
• Standard / Pulsed
This selection can also be done in on line mode by using the pulsed
key as described above.
• Ref image
This selection appears when DIVA-D is equipped with 2 monitors in
control desk area only.
When this selection is active the graphy monitor is used to display
the LIH while on fluoro monitor the live images are displayed.
• Pattern 1 / 2
Allows to display 2 different patterns in order to adjust correctly the
monitor brightness and contrast.

DIVA-D 30 (Rev. 0)
USER’S MANUAL
Modality selection

9 MODALITY SELECTION
When patient data are inserted, the modality and relevant anatomic
programs must be chosen.
The access to this function is automatic when exiting from patient data
window with ENTER key or any time the MODE key is activated.
This because when a new patient is inserted it is necessary to select the
modality for the first acquisition, and to change this modality if a patient
requires different exams type.
The acquisition modality can be:
• SPOT
• BONE
• ANGIO
• PERIF
• STEP
• TOMO.
SPOT, BONE and TOMO are allowed for both DIVA-D models RF and AS,
ANGIO and PERIF on AS only, STEP could be present on a AS model only
as supplementary option.
The step modality is allowed only if the system is based on APOLLO table
only.
The modality window looks as follows:

It is divided in 3 areas:
• modality selection
• anatomic selection
• parameters modification.
By default the left area is active when modality is selected. To inform
about the area selected, the background is light gray.

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USER’S MANUAL
Modality selection

By using UP and DOWN arrow keys, select the required modality, by


using RIGHT arrow key select the anatomic area, this background
becomes light grey and select now the desired anatomic program.

G
NOTE:
The not available modality (depending by the DIVA-D license level) will be
displayed in gray and not reachable by selection.

On the right area the parameters associated to the selected anatomic


program are displayed.
To modify permanently one or more parameters, press RIGHT arrow key,
the background will be light gray (as in picture) and by using relevant
keys, the associated parameter can be changed.
Using alphanumeric keys the anatomic name will be modified and the
message “ENTER to save” will appear on window bottom side.
By ENTER key the new anatomic configuration will be stored.

If a temporary modification, on an existing anatomic program, need to be


done it will be sufficient to modify the relevant parameter by using the
associated key.
Confirming by ENTER key, the acquisition mode will be selected with the
modified parameters.

In modality function, the parameters associated will be different as


summarized below:

SPOT BONE ANGIO PERIF STEP TOMO


ROI ROI ROI ROI ROI ROI
Frame rate Edge Frame rate Frame rate Frame rate Tomo frames
Edge Low dose Edge Edge Edge Edge
Low dose Neg – Pos Low dose Low dose Low dose Low dose
Neg -Pos Neg – Pos Neg – Pos Neg – Pos Neg – Pos
Auto mask Auto mask Auto mask Pulsed fluoro
Sub cont Sub cont Sub cont
Kv reduction

DIVA-D 32 (Rev. 0)
USER’S MANUAL
Graphy

10 GRAPHY
When the modality selection is done and confirmed, DIVA-D is ready for
graphy acquisition.
The window displayed is:

on which the patient data, modality and anatomic parameters are


displayed.
Now the acquisition can start or anatomic parameters modification can
be done by using the associated keys.
If a key for modification is pressed (i.e. ROI, Frame/sec ecc) the modality
window will be displayed.

Before to start with graphy acquisition, a fluoro acquisition must be


done.
This action allows DIVA-D to calculate the correct exposure parameters
(technique factors).
As matter of fact at the exposure request, DIVA-D informs the generator
about the technique factors to be used for the graphy acquisition.

The area “Run” is reserved to the number of exams stored for the present
patient.
During acquisition the areas “Run”, “Frame”, “mSec” and “kV” are
updated.

(Rev. 0) 33 DIVA-D
USER’S MANUAL
Graphy

At the end of acquisition the following window will be displayed:

DIVA-D 34 (Rev. 0)
USER’S MANUAL
Post processing

11 POST PROCESSING
To review the exams contained for the current “patient”, 2 options are
possible:
• by MENU key
• by STOP key.

Using STOP the Post Processing window is immediately displayed,


selecting MENU the patient selection window will appears.

Select the required patient using UP and DOWN keys.


Press ENTER to confirm.

(Rev. 0) 35 DIVA-D
USER’S MANUAL
Post processing

The window reporting the data relevant to the different runs of the
patient is displayed.
Select the desired run using UP and DOWN keys.
Press ENTER to confirm.

The post processing window appears:

On this window, in addition to the data relevant to patient, acquisition


modality, anatomic program etc, the following information is present:
• ROI used to acquire the present run
• Frame rate used to acquire the present run
• I.I. field used to acquire the present run
• mSec exposure time.

In addition to these information the following parameters are present:


• total runs number and run showed
• total frame number present on the active run and the frame showed
• in angio or perif mode only, the mask number selected
• in angio or perif mode only, the sub contrast value
• the windowing level
• the edge level.

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USER’S MANUAL
Post processing

All of them and other settings can be modified using the dedicated keys:

To select run in a patient and frame in a run.


The frame keys allow to review a run frame by frame
independently by frame rate acquisition.

To play a run containing more then one frame and


to stop the visualization sequence.
The frame rate in play mode is the same used
during acquisition and cannot be modified.

To introduce electronic diaphragm.


When this function is activated (led ON) by using
UP, DOWN, LEFT and RIGHT keys, upper and right
shutters will be closed and opened.
Using the four arrows contemporarily with SHIFT
key the lower and left shutters will be activated.
To reset the function press the key.
To reverse the gray scale of image from negative to
positive and reverse.
To zoom the present image 4 times.
When this function is activated (led ON) by using
UP, DOWN, LEFT and RIGHT keys, it is possible to
scroll the enlarged image.
To reset the function press the key.
When this function is activated the frames present
in the run are displayed with the frame rate used in
acquisition. The number of sequence depends by
the technical setting.
At the end of the last sequence the led turns OFF.
Any time the cine loop is required, press the key to
activate the function.
This function is available for exams acquired in
angio mode only. When the subtracted image is
displayed the pixel shift function can be activated
by relevant key. The led become ON and the mask
position can be modified by 1/8 pixel step. This
movement is obtained by UP, DOWN, LEFT and
RIGHT keys.
This function is available for exams acquired in
angio mode only. When the subtracted image is
displayed the mask can be removed or replaced by
means of the relevant key.
This function is available for exams acquired in
angio mode only. When a run is scrolling the
contained frames, using this key a new mask can be
selected. The mask will be captured at the exact
moment when the key is pressed.
This function is available for exams acquired in
angio mode only. When subtracted image is
displayed it is possible to increase or decrease the
image mask number.

(Rev. 0) 37 DIVA-D
USER’S MANUAL
Post processing

To modify images characteristics by means of the


relevant keys it is possible to change:
− windowing (changing the black and white levels)
− edge enhancement.
With AUTO WNDW key the windowing will be
automatically optimized at default level. Pressing
reset key any modification described above is reset.

When subtracted image is displayed it is possible to


increase or decrease the image background level by
means of the keys on the left side.

In post processing special functions are available in


addition to the functions described. This functions
are described in the next paragraph.

DIVA-D 38 (Rev. 0)
USER’S MANUAL
Post processing

11.1 Special function

When the post processing modality is activated by means of the SPECIAL


FUNCTION key the lower part of the window:

is represented as in the above figure.


By means of the UP and DOWN key it is selectable one of the four special
functions available:
• overwrite
• angle measure
• length measure
• test pattern display.

• Overwrite
Allows to report comments on the image. To position the cursor on
the required place use UP, DOWN, LEFT and RIGHT arrow keys.
Press ENTER key to confirm when the text insertion is completed.
Changing the image or using STOP key, the text inserted is cancelled.
• Angle measure
Allows to take a measure of the angle of a part of image.
Using UP and DOWN keys select the approx level from the table top
on which the part to be measured is located between the 3 levels
proposed 0, 10 or 20 cm. Press ENTER to confirm.
To position the cursor on the required place use UP, DOWN, LEFT
and RIGHT arrow keys.
Press ENTER key to confirm the starting measuring point. Move the
cursor on the angle vertex and confirm whit ENTER. Move the cursor

(Rev. 0) 39 DIVA-D
USER’S MANUAL
Post processing

at the end of second segment of the angle, the angle value is


displayed.
Changing the image or using STOP key, the text inserted is cancelled.

WARNING:
Because of different reasons ( II deformation, error in the level organ
position and others) the angle value obtained are only indicative. Do not
use this value for diagnostic purpose.

• Length measure
Allows to take a measure of a part of the image.
Using UP and DOWN keys select the approx level from the table top
on which the part to be measured is located between the 3 levels
proposed 0, 10 or 20 cm. Press ENTER to confirm.
To position the cursor on the required place use UP, DOWN, LEFT
and RIGHT arrow keys.
Press ENTER key to confirm the starting measuring point. Move the
cursor on the final measuring point and confirm with ENTER, the
length value is displayed.
Changing the image or using STOP key, the text inserted is cancelled.
More than one measure can be done on the same image. To do that
repeat the above described steps.
Ratio between 2 measure can be done selecting the relevant window.

WARNING:
Because of different reasons (II deformation, error in the level organ
position and others) the measures obtained are only indicative. Do not
use this value for diagnostic purpose.

• Test pattern
Allow to display a test pattern to adjust correctly the monitor
brightness and contrast.
Starting with any modality the test pattern is reset from monitor.

DIVA-D 40 (Rev. 0)
USER’S MANUAL
Post processing

11.2 Multi image

When the patient menu window is displayed, multi image function can be
used.
It is a short and easy way how to select the run to be review.

Using the key, on monitor the first image of any run present into
the selected patient is displayed.

By means of the UP, DOWN, LEFT and RIGHT arrow keys, select the
desired run and press ENTER to confirm.
The run selected will be displayed in full screen mode.

(Rev. 0) 41 DIVA-D
USER’S MANUAL
Post processing

11.3 Image print

If DIVA-D is not equipped with DICOM module, it is possible to send the


image to a laser printer directly.
The image present on display is also present on the printer output
channel.
To capture this image it is necessary to confirm from the printer
keyboard supplied by the printer manufacturer.

G
NOTE:
Do not change the image displayed until the laser printer acquisition is
completed.

DIVA-D 42 (Rev. 0)
USER’S MANUAL
DICOM functions

12 DICOM FUNCTIONS
If the DIVA-D is equipped with DICOM module, the DICOM key is active.
By means of this key the following window is displayed:

Depending from the license present the following functions can be


activated:
• print (to send images to a DICOM laser printer)
• store (to send images to a Pac’s via network)
• CD-ROM (to burn CD-ROM with images).

In addition to these functions another software package can be present:


• waiting list.

(Rev. 0) 43 DIVA-D
USER’S MANUAL
DICOM functions

12.1 Waiting list

This function is allowed if the network is equipped with HIS/RIS.


When new patient window is displayed (chapter 7) the waiting list
selection is allowed.
Confirm by ENTER, the window

is displayed.
On this window the patients present on the worklist are displayed.
By means of the UP and DOWN arrow key select the desired one, press
ENTER to confirm.
The patient data window will be displayed (chapter 7) reporting all data
inserted in HIS/RIS.
By this function any manual patient data entering is avoided.

DIVA-D 44 (Rev. 0)
USER’S MANUAL
DICOM functions

12.2 Queue view and flush

To enter into DICOM functions the dedicated key must be used.


The window

will be displayed.
If no queue error or messages are present, the last used function will be
proposed, anyway the queue view will be reachable by means of ENTER
key directly.
In any case UP and DOWN arrow keys can be used to reach the function
desired or queue view.
If errors or messages are present in the queue, the relevant field is with
white background; pressing ENTER key the window

will appears.

(Rev. 0) 45 DIVA-D
USER’S MANUAL
DICOM functions

The queue list will be showed and erasable.


To cancel the list, using UP and DOWN arrow keys, activate FLUSH
function and confirm with ENTER key.

DIVA-D 46 (Rev. 0)
USER’S MANUAL
DICOM functions

12.3 Print

When DICOM window is selected, the last function used in DICOM mode
is proposed.
By means of UP and DOWN arrow keys select the required function and
confirm with ENTER key.
If print function is selected the printer window selection is showed.
With UP and DOWN arrow keys, select the required printer and confirm.
With LEFT and RIGHT arrow key select the film subdivision and confirm.
The DICOM print window

is displayed.
Select the image required and modify, if necessary the characteristic as
in standard post processing mode.
In the lower section of the window, the frame number and position are
displayed.

(Rev. 0) 47 DIVA-D
USER’S MANUAL
DICOM functions

To add the image, the key must be pressed 2 times. After the first
time the window

is displayed.
Pressing once more the addition is confirmed and the image stored into
DICOM print temporary archive.
The previous window will be showed allowing a new image addition.
When the above window is present, 3 other functions are available (use
UP and DOWN arrow keys to select and press ENTER to confirm):
• Delete & exit
To reset the temporary DICOM print archive and exit from DICOM
functions.
• Study print
To print the image stored.

To print the study it is also possible to press 2 times the key


starting from the main DICOM print window.
• Change frame
To store the present image instead of an image already present into
the DICOM print archive.
To do that use LEFT and RIGHT arrow keys, the white portion of the
film will be moved on the film representation showing the place on
which the present image will be located.
Press ENTER to confirm, the previous image will be erased and the
new one stored.

DIVA-D 48 (Rev. 0)
USER’S MANUAL
DICOM functions

12.4 Store

By means of UP and DOWN arrow keys select the store function and
confirm with ENTER key.
When store function is selected the window is showed:

On the lower part of the window the following information are listed:
• Total Mbytes
Mbytes used by the images stored in the present DICOM store study.
This is referred to the temporary DICOM archive.
• Total Patient
This value can be 0 or 1.
As matter of fact a DICOM study to be stored cannot contain more
than 1 patient.
• Total runs
Is the number of runs stored to be transferred in the network.
• Total frames
Is the number of single image to be transferred in the network.
• Total sub-runs
Is the number of sub-runs stored to be transferred in the network.

(Rev. 0) 49 DIVA-D
USER’S MANUAL
DICOM functions

To add the image, the key must be pressed two times. After the
first time the window

is displayed. Pressing once more adds the selection to the archive.


By means of UP and DOWN arrow keys select if the memory addition
will be of the showed frame only, of the run or of the total patient.
Press ENTER to confirm.

The previous window will be showed allowing a new addition.


When the above window is present, 2 other functions are available
(use UP and DOWN arrow keys to select and press ENTER to
confirm):

• Delete & exit


To reset the temporary DICOM store archive and exit from DICOM
functions.

• Study send
To send the study stored.

To send the study it is also possible to press 2 times the key


starting from the main DICOM store window.

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USER’S MANUAL
DICOM functions

12.5 CD - ROM

By means of UP and DOWN arrow keys select the CD-ROM function and
confirm with ENTER key.
When CD-ROM function is selected the media type window is showed:

allowing to select the CD-ROM format between High resolution


1024x1024 or High speed 512x512.
High resolution saves images with 1024x1024 matrix but for static
images only.
High speed has matrix 512x512 but is capable to store images up to
25 images/sec.
By means of UP and DOWN arrow keys select the media type required
and confirm with ENTER.

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USER’S MANUAL
DICOM functions

The following window will be displayed:

On the lower part of the window the following information are listed:
• CD free space
The disk percentage space still available.
• Total Patient
This value can be 0 or 1.
As matter of fact a DICOM study to be stored cannot contain more
than 1 patient.
• Total runs
Is the number of runs stored to be transferred in the network.
• Total frames
Is the number of single image to be transferred in the network.
• Total sub-runs
Is the number of sub-runs stored to be transferred in the network.

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USER’S MANUAL
DICOM functions

To store into temporary DICOM archive, select the patient, the run or the
image required and press ENTER. The window:

is displayed.
By means of UP and DOWN arrow keys select if the memory addition will
be of the showed frame only, of the run or of the total patient.
Press ENTER to confirm.

The previous window will be showed allowing a new addition.


When the above window is present, 2 other functions are available (use
UP and DOWN arrow keys to select and press ENTER to confirm):
• Delete & exit
To reset the temporary DICOM CD-ROM archive and exit from
DICOM functions.
• Burn disk
To send the study stored to CD-ROM.

Before to select "burn disk", put a new CD-ROM into driver and press

key.
The dicomization procedure will start and at the end of this operation the
CD-ROM burning start.
This sequence is displayed on the window with a waiting notice.

G
NOTE:
If no CD-ROM or not valid one is present into the driver, an error will be
present in the queue.
DIVA-D will try again to access the CD after 30 sec.
Insert a valid CD-ROM into the driver before a new writing attempt.

(Rev. 0) 53 DIVA-D
USER’S MANUAL
Maintenance and cleaning

13 MAINTENANCE AND CLEANING


Like all electrical device, this equipment requires periodical checks.
This will insure an efficient and correct functioning for years to come.

This equipment is made up of electrical and electronic parts that need to


be checked out in order to guarantee high quality radiological results as
described in previous chapter.

The maintenance and cleaning procedures described in this chapter


must be done by the user.
In addition to the above, the authorized service technician will have to
perform the maintenance actions described in the Service Manual.

WARNING:
• Before proceeding with the cleaning of the equipment, disconnect it
from the mains.
• Make sure that water and any other liquids are not spilled inside the
equipment as this may cause corrosion and short circuits.
• Clean the painted surfaces by using a moist cloth and neutral
detergent, taking care to wipe them by using a dry cloth. Do not use
solvents (alcohol, petrol, and trichloroethilene) or corrosive or
abrasive products.

13.1 Frequency of maintenance and cleaning actions

Frequency Description

1 month Check the presence of labels and their condition


1 months Check of the image quality.
6 months Clean the monitors and the external parts.
6 year Visual checking of the status of the interconnection cables
and relevant connection.

DIVA-D 54 (Rev. 0)
Cod. 6995001003_Rev.0 0123

VILLA SISTEMI MEDICALI


Via Delle Azalee, 3
20090 Buccinasco (MI) - ITALY
Tel. (+39) 02 48859.1
Fax (+39) 02 4881844

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