Synapse Release Version 3.2.1 Workstation Software Application Synapse Workstation Software is the multi-modality viewing software for Synapse, Fujifilm’s Picture Archiving and Communication System (PACS). Synapse Workstation Software provides viewing and manipulation of radiological data including images, reports, patient status and clinical information. It also provides for integrations to clinical appli- cations including dictation systems, RIS and three dimensional processing appli- cations. It is a multipurpose, enterprise wide application used for Radiologist interpretation, in-house clinical review and physician desktop image & informa- tion access. Synapse Workstation Software is an entirely web-based, thin-client application using Internet technology at the founda- tion of its design. The only locally installed component is an ActiveX control plug-in to Internet Explorer ® on Microsoft ® Windows ® . This design allows for a user interface that takes advantage of the familiar functions of Internet Explorer and Windows, such as Back, Forward, Links, Favorites and right-click context menu while also providing power- ful imaging functions necessary in today’s radiology department and beyond. As a thin-client application, Synapse is accessible by anyone connected to a Synapse web server via the Intranet or Internet over standard HTTP or a secure HTTPS (SSL) connection. While users in Synapse can be assigned different securi- ty levels to access patient and study fold- ers and are assigned different privileges around their ability to save or modify information permanently in the Synapse database, all tools are available to all users regardless of their physical location or health provider function. Synapse is designed for the needs of the radiologist as well as clinicians, referring physicians, technologists and administrators from the same user application with the same tools and user interface. Image and Display Features • Intuitive use of colors and layout for worklists, PowerJacket ™ , icons, and toolbars • One hand Mouse Operation for common manipulation tools: o Window/Level o Zoom o Pan • Image Processing presets with keypad shortcuts by modality • CR Image Processing including Dynamic Range Control (DRC) and Multi-Frequency Processing (MFP) • CT Image Processing with DRC and sharpness enhancement • Zoom to 1x (acquisition pixel = display pixel) • Zoom to Fit Window • Interactive Region of Interest with zoom, magnification and window/level • Rotation and flip • Manual and DICOM image shuttering • Color display • Annotations and Measurements including: o Line length and line ratio ruler o Curved line measurement o Free text o Arrows o Density Values (Hounsfield Unit, Optical Density or Pixel Value depending on image type) o Elliptical, rectangular and freehand ROI with calculated area, perimeter as well as mean and standard devi- ation of density o Label palette for spine labeling • Annotation save • Cine tool with speed and direction control, as well as support for cine of multiple linked series simultaneously • Stack-in-Place – fast image stack scrolling via mouse control • Image bookmarking (annotated images are auto-selected as bookmarks) • Keyboard or mouse driven image series navigation • Selectable image up-count • Configurable page layout • Drag/drop for copy and paste to other Windows applications • Drag/drop to create Synapse shortcuts • Intelliscroll – synchronized stack navigation • Intellilink – Crosshair 3D navigation • Cross-sectional reference lines • Monitor calibration for true size display • Lossless and lossy image decompression and display • Selectable image compression version for initial display with support for changing version during display • Customizable modality specific overlays for patient, study and image information (see release specification for detailed system defaults) • Synapse 3D – Integrated MIP/MPR reformatting application • Context integration to 3rd party 3D reconstruction products including:
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Synapse Release Version 3.2.1
Workstation Software
ApplicationSynapse Workstation Software is themulti-modality viewing software forSynapse, Fujifilm’s Picture Archivingand Communication System (PACS).Synapse Workstation Software providesviewing and manipulation of radiologicaldata including images, reports, patientstatus and clinical information. It alsoprovides for integrations to clinical appli-cations including dictation systems, RISand three dimensional processing appli-cations. It is a multipurpose, enterprisewide application used for Radiologistinterpretation, in-house clinical reviewand physician desktop image & informa-tion access.
Synapse Workstation Software is anentirely web-based, thin-client applicationusing Internet technology at the founda-tion of its design. The only locallyinstalled component is an ActiveXcontrol plug-in to Internet Explorer® onMicrosoft® Windows®. This design allowsfor a user interface that takes advantageof the familiar functions of InternetExplorer and Windows, such as Back,Forward, Links, Favorites and right-clickcontext menu while also providing power-ful imaging functions necessary in today’sradiology department and beyond.
As a thin-client application, Synapse isaccessible by anyone connected to aSynapse web server via the Intranet orInternet over standard HTTP or a secureHTTPS (SSL) connection. While users inSynapse can be assigned different securi-ty levels to access patient and study fold-ers and are assigned different privilegesaround their ability to save or modify
information permanently in the Synapsedatabase, all tools are available to allusers regardless of their physical locationor health provider function. Synapse isdesigned for the needs of the radiologistas well as clinicians, referring physicians,technologists and administrators from thesame user application with the sametools and user interface.
Image and Display Features• Intuitive use of colors and layout forworklists, PowerJacket™, icons, andtoolbars
• One hand Mouse Operation forcommon manipulation tools:
o Window/Levelo Zoomo Pan
• Image Processing presets with keypadshortcuts by modality
• CR Image Processing includingDynamic Range Control (DRC) andMulti-Frequency Processing (MFP)
• CT Image Processing with DRC andsharpness enhancement
• Zoom to 1x (acquisition pixel = displaypixel)
• Zoom to Fit Window• Interactive Region of Interest withzoom, magnification and window/level
• Rotation and flip• Manual and DICOM image shuttering• Color display• Annotations and Measurements including:
o Line length and line ratio rulero Curved line measuremento Free texto Arrowso Density Values (Hounsfield Unit,
Optical Density or Pixel Valuedepending on image type)
o Elliptical, rectangular and freehandROI with calculated area, perimeteras well as mean and standard devi-ation of density
o Label palette for spine labeling• Annotation save• Cine tool with speed and directioncontrol, as well as support for cine ofmultiple linked series simultaneously
• Stack-in-Place – fast image stackscrolling via mouse control
• Image bookmarking (annotated imagesare auto-selected as bookmarks)
• Keyboard or mouse driven image seriesnavigation
• Selectable image up-count• Configurable page layout• Drag/drop for copy and paste to otherWindows applications
• Drag/drop to create Synapse shortcuts• Intelliscroll – synchronized stacknavigation
• Intellilink – Crosshair 3D navigation• Cross-sectional reference lines• Monitor calibration for true size display• Lossless and lossy imagedecompression and display
• Selectable image compression versionfor initial display with support forchanging version during display
• Customizable modality specificoverlays for patient, study and imageinformation (see release specificationfor detailed system defaults)
• Synapse 3D – Integrated MIP/MPRreformatting application
• Context integration to 3rd party 3Dreconstruction products including:
• Mammography Toolseto Multiple CAD object supporto CAD can be turned on/off inde-
pendently from other annotationso Mouseover tooltip displays CAD
manufacturer, version and markingtype (calcification or density)
o CAD status displayed in imageoverlay
o Pixel Padding supporto Quadrant viewo Image Linking allows propagation
of window level, zoom and panchanges
Workflow Features• Reading protocols (detailed descriptionin the next section)
• Customizable system populated workfolders based on image, demographic,census and other HIS/RIS/DICOMprovided data
• Synapse installs with commonly usedfolders that can be duplicated and mod-ified to make site specific configurations
• Conference folders that can store short-cuts to any Synapse object for confer-encing, collaboration and othermanually managed workflows
• Folder columns can be sorted (up to 3sorts at once) and filtered using onscreen query by example
• Auto-compare selection for relevantpriors can autoselect “n” number ofexams by one of the following criteria:
o Same modalityo Same procedure codeo Related procedure code across
modalitieso Related procedure code and same
modality• Unread workflow automation macro
o F8 to start workflow from anunread studies folder
o F8 again to mark dictated and opennext available study
o F9 to skip and open the next avail-able study
• Barcode scanning workflow automationoption
• Concurrency tracking and alerts toeliminate duplicate, simultaneous reads
• Dictation system integration via serialport, XML or TCP/IP communication.At time of initial 3.2.1 release, supported3rd party dictation products include:
o Digital Dictationo Dolbey Fusiono MediSpeech
o GE RIS-ICo Lanier VoiceWritero 3M ChartScipto Magview (for MG)o MedQuist SpeechQo MedQuist Ovationo MRS (for MG)o Med Remote Dictateo MIS (for MG)o Nuance Powerscribeo Nuance Commissureo Envision 3000o VoxReporto Speech Technologyo iRecordero PC Dictationo Agfa Talk Stationo Crescendo DigiDictate-IPo Spheriso WinScribe
• Reservations allow users to lock anunread study for themselves or foranother user
• Reservations Folder displays a list ofreserved studies that can be sorted bypriority and dictated using F8/F9 macro
• Study’s folder icon changes if a useralready has a study locked
• Subscription technology can:o Monitor any Synapse folder for
content changeso Cache the content locally for faster
o Automatically reserve the newcontent for the alerted user
o Subscriptions can be reactivatedwhen the user logs in from anotherworkstation at any time
o Icon in Synapse folders indicateswhich studies have cached locally
• Temporary storage of all webpages andimages in local Internet cache
• Visual study indicator for studiescompletely stored in cache due tosubscription
• MultiView allows one Synapse work-station to be configured to access multipleSynapse systems
• Optional sent status to allow for QCbefore exams are marked unread –configurable by modality
• Option to hold MG exams for readingfor “n” minutes to allow CAD to processand arrive
Reading Protocols (RPs)• RPs automate the display layout andsequence of images for study and itscomparisons into multiple pre-definedreading protocol steps
• Template RPs are for automation anddisplay of exams for diagnosis andreview
• Instance RPs specify the displayarrangement for a particular study andare used for conferencing and collabo-rating on specific studies
• The best protocol is chosen on initialdisplay and opening of a study
• Users can choose a different protocolfrom a pulldown list
• Users can move forward or backwardthrough protocol steps
• Each protocol step defines:o Page layout including monitor
location and covered monitor counto Tile format for each viewporto Apply tools settings (to all images
or to selected images)o Overlay display status (on/off)o Application of image presetso Whether to display the current
study only or with comparison(s)• RP steps can be reordered or deleted• Four levels of matching for Template RPs
o All studieso Specific modalityo Specific procedure code(s)o Specific series combination using
the DICOM series descriptionname to match the protocol
• For series matching, like series namescan be standardized to be treated as amatch (e.g. “Head w Contrast” = “HeadWith Contrast”)
• MG (mammography) images aregrouped at the image level as opposedto the series level due to specific MGworkflow requirements
• Match is specific to the monitor countdefined in the RP
• For series matching, near match willchoose a reading protocol that is closeto an existing RP if series or imagenames (MG case) are not an exactmatch to an existing RP
• Acceptable number of non-matches toestablish a near match is configurable
• Non-matching series appear in a proto-col step named “Extra Views”
• Duplicate named MG images can bestacked over one another with newestimage on top to support retake workflow
DICOM Transfer• To a datasource allows the user to transferthe contents of selected folders to anyother datasource
• To a teaching archive allows the user topush images and DICOM key imagenotes to teaching archives
• To media allows the user to save imagesas DICOM files which can beanonymized before saving. Images canbe buned directly to a local workstationCD burner
• To DICOM header allows a user toview the DICOM header associatedwith an image
Operating System Vendor Browser Comments Windows XP Professional with SP2
Microsoft Internet Explorer 6.0 SP2 Internet Explorer 7.0
Video card and/or PC should support DirectDraw
Windows XP Tablet Microsoft Internet Explorer 6.0 SP2 Internet Explorer 7.0
Video card and/or PC should support DirectDraw
Windows XP Home Microsoft Internet Explorer 6.0 SP2 Internet Explorer 7.0
Video card and/or PC should support DirectDraw Windows Home does not support domain-based user authentication and may lead to additional user authentication dialog boxes to maintain security.
Windows 2000 Professional SP2
Microsoft Internet Explorer 6.0 SP1+ Internet Explorer 7.0
Video card and/or PC should support DirectDraw XML parser V3.0 or higher is required
Workstation Operating System Support*
* Windows Vista SP1 will be supported in a Service Release
• For all configurations, an additional productivity monitor to the left (usually color LCD) is supported• True size monitor configuration requires a monitor with square pixel spacing (horizontal pixel width = vertical pixel height)• Image display monitors should be the same display resolution and color palette (grayscale, color, etc.)
CPU RequirementSynapse workstation supports Intel compatible 32-bit CPU from Pentium-II and after. Synapse workstation software is evaluated onsingle CPU Intel Pentium-II, Pentium-III, Xeon, Celeron, Pentium-IV, Pentium D CPU platforms and on the AMD Opteron platforms.If another type of Intel or AMD CPU platform is used with Synapse, a hardware qualification test specified in the releasespecification should be performed before it is used in a live environment.
Diagnostic workstations typically have other clinical applications with significant memory requirements. It is highly recommendedthese workstations contain as much memory as possible on the hardware available on a 32-bit operating system (Windows 32-bit oper-ating system can address up to 4 GB memory).
Internet Cache Size RequirementSynapse uses the Internet Explorer internet cache for the temporary storage of image files and webpages. While there is no specificcache size requirement, a small cache could force Synapse to retrieve images from the server multiple times even in one session.
Document Scanner SupportDirect scanning into Synapse requires a Microsoft WIA Specification Compliant scanner device.
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