C-arm control panel

upper/lateral keys
Brakes for C-Bogen
movement
orbital, angular, horizontal longitudinal, horizontal swivel
Lift/lower Rotate image
C-arm

Switch laser light Switch metal

localizer on/off function on/off

Set pulse rate Reduce/enlarge kV/

mA

ARCADIS Avantic
Control stop Switch off acoustic-
(ADR stop) warning signal

VB 13C lower keypads

- Subtraction - Continuous
- Roadmap fluoroscopy
- Digital radiography - Pulsed
- Digital Cine Mode fluoroscopy
Quick Guide
Switch Power Select dose level
Mode on/off (with display)

Set zoom factor for Selecting the noise

live image reduction factor

Image reversal Open, close

horizontal, vertical iris diaphragm

Rotate slot Open, close

diaphragm slot diaphragm

Set degree of edge Enlarge/reduce

enhancement saved images (zoom
in/out)
Contrast adjustment Digital Cine Mode
for left/right monitor review (DCM)

Read image from Save, print image

memory forw.,
backw.
Monitor trolley symbol keypad

Brightness –/+

Contrast –/+

Scroll to previous/next study

Scroll to previous/next series

Scroll to previous/next image

ARCADIS Avantic Quick Guide

Switch between Send to network

negative and positive node 1
image
This product is provided with a CE marking in
Enter a study Mark image accordance with the regulations stated in
comment
Directive 93/42/EEC of June 14th, 1993 con-
cerning medical devices.
Copy to film sheet Call up Patient The CE marking applies only to medical
Registration
devices which have been put on the market
according to the above-mentioned EC Direc-
Select Patient tive.
Browser
The original language of this document is Ger-
man.
This Quick Guide is available in German,
English, French, Italian and Spanish.
Introduction

We welcome you as a user of the powerful

ARCADIS Avantic C-arm system from Sie-
mens.
This clearly laid out Quick Guide is intended
to guide you through the operation of the sys-
tem.

The Quick Guide is valid only in conjunction

with the Operator Manuals and the safety
information they contain:
❏ Please observe the Operator Manual
and all supplements/addenda
❏ Please observe all safety information

The right-hand pages contain step-by-step

instructions corresponding to the typical
workflow in the OR.
The pages to the left contain illustrations and
and supplemental notes.

The description focuses on easy and fast

operation of the ARCADIS Avantic from star-
tup through to shutdown of the system
including optional functions such as connec-
ARCADIS Avantic Quick Guide

tion to a hospital network or subtraction.

More detailed and complete descriptions can
be found in the ARCADIS Avantic Operator
Manual.

3
 Table of Contents

Principles
Input devices ........................................ 7
syngo user interface............................. 9
syngo control elements ...................... 11

Product overview
C-arm system ..................................... 13
Monitor trolley .................................... 19

Examination procedure
Preparing the system ......................... 21
Patient registration ............................. 23
Preparation in the Examination
task card ............................................ 25
Radiation release and dose display .... 27
Power mode ....................................... 31
Image rotation and reversal ................ 33
Collimator setting ............................... 35
Image Quality ..................................... 37
Changing the contrast ........................ 39
Saving images .................................... 41
Fluoro Loop/LSH (option) ................... 43
Ending the examination ..................... 43
ARCADIS Avantic Quick Guide

Subtraction and Roadmap

Performing a subtraction scene ......... 45
Postprocessing a subtraction scene .. 47
Roadmap ............................................ 55

Postprocessing
Loading patient images
into the Viewing task card .................. 57
Image display ..................................... 59
Measuring and annotations................ 61
Image manipulation ............................ 65

4
Documentation
Printing ............................................... 69
Burning CDs ....................................... 79

Reports
Generating reports ............................. 81
Opening and printing reports ............. 83

Connectivity
Send/Storage Commitment ............... 87
Get Worklist ....................................... 91
MPPS – Modality Performed
Procedure Step .................................. 93
Query/Retrieve ................................... 95

Dismantling
Transport position .............................. 97
Switching off ...................................... 97

ARCADIS Avantic Quick Guide

5
 Principles

This chapter is addressed to syngo begin-

ners and users with little computer experi-
ence.

(1) (2) (3)

(4)
ARCADIS Avantic Quick Guide

(5) (6) (7)

Functions of the symbol keypad see fold-

out cover.

6
Principles

This chapter provides you with basic informa-

tion on the input devices of the computer at
the monitor trolley and on the syngo user
interface.

Input devices

The mouse
(1) Left button
Single click: select/mark
Double click: load data/program
Button kept pressed: drag/move
(2) Middle button
Button kept pressed: windowing (change
brightness and contrast)
(3) Right button
Single click: call up popup menu (context-
sensitive)

The keyboard
(4) Function keys
ARCADIS Avantic Quick Guide

F1 = syngo Online Help

(5) Alphanumeric keypad
Text input, e.g. patient data
(6) Cursor keypad
Movement of the mouse pointer in texts
(7) Symbol keypad
Direct selection of important syngo func-
tions (e.g. calling up Patient Registration
or local database; image postprocessing
functions)

7
 Principles

After the ARCADIS Avantic system has

been switched on, the syngo user interface
automatically appears on the monitor trol-
ley screens.

(1)

(2)

(3)

(4)

(5) (6)
ARCADIS Avantic Quick Guide

(7)

(8)

(9)

8
Principles

syngo user interface

syngo consists of several stacked task cards.

These are assigned to the individual steps of
the workflow.

Task cards
(1) Menu bar
Calling up of main menus and submenus
(2) Tabs
Selection/switching of task cards
(3) Stack of subtask cards
Selection of processing tools and display
functions
Switching of subtask card via tab
(4) Status bar
Display of system messages
(5) Control area
Display of image and examination param-
eters, selection of functions (via subtask
cards)
(6) Image area
Display and processing of images
ARCADIS Avantic Quick Guide

Windows/Dialogs
Windows are called up separately or dis-
played automatically.
Windows can be closed again after process-
ing.
(7) Title bar
Name of window, "Close window" button
(8) Window content
Input and selection of data
(9) Softkeys/buttons
Confirmation or cancellation of actions
and messages

9
 Principles

(1) (2)

(3) (4) (5)

ARCADIS Avantic Quick Guide

(6) (7)

(8) (9) (10)

10
Principles

syngo control elements

Control elements on the screen are easiest

selected with the mouse.

Menus
(1) Main menu
Opens by pressing left mouse button
(2) Popup menu
Opens by pressing right mouse button
The content depends on the mouse posi-
tion ("mouse focus") on the screen

Input elements
(3) Text input field
(4) Selection list
Selection of preset parameters and data;
opens via arrow
(5) Spin box
Setting of values with arrow keys
(6) Radio buttons
Only one option selectable
ARCADIS Avantic Quick Guide

(7) Check box

Several options selectable

Icon buttons
(8) Dimmed
Function not selectable
(9) Inactive
Function selectable, but not active
(10)Active
Function activated

11
 Product overview

(1)
(6)
(2)

(3)

(4)

(7)
(5)

As soon as you press the emergency stop

button, motorized up and down movement
of the C-arm system is disabled.

(4)
ARCADIS Avantic Quick Guide

(8)

12
Product overview

C-arm system

C-Arm
(1) Hand switch
(2) Emergency stop
(3) Control panel
(4) Steering lever
(5) Holder for footswitch
(6) Image intensifier
(7) X-ray tube

Steering
(4) Steering lever
❏ Steering lever straight:
Move C-arm system straight ahead
❏ Steering lever set to the left or right:
Move C-arm system in transverse direc-
ARCADIS Avantic Quick Guide

tion e.g. parallel to the table

Brakes
(8) Electromagnetic brakes on the control
panel and optional remote control unit
❏ Brake for the desired direction of move-
ment released (display of open lock):
Move C-arm system

13
 Product overview

(2) (1)

(3a) (3b)

(3c)

(4)

ARCADIS
ARCADIS Avantic Quick Guide

Avantic

(5a) (5b)

14
Product overview

Remote control unit (option)

The remote control unit is used in the same
way as the control panel on the C-arm sys-
tem.
(1) Displays and buttons of the remote con-
trol unit
(2) Integrated EMERGENCY STOP button

(3) Installation on the patient table

(a) Fit the adapter plate diagonally on the
table railing and fold it down (engages)
(b) Pull the sterile patient drapes over the
adapter plate
(c) If necessary, put the remote control
unit in the sterile cover provided and
mount it (attaches magnetically)

(4) Connection on the C-arm system (above

monitor trolley connector)
ARCADIS Avantic Quick Guide

(5) Removal from the patient table

(a) Remove the remote control unit by
slightly tilting it to the side
(b) Fold the adapter plate up again and pull
it off.
➭ Storage on the side of the monitor trolley:
Attach the remote control unit magneti-
cally. Fit the adapter plate diagonally in the
railing holder and fold it all the way down.

15
 Product overview

(1)
² ²

(2)

190° 190°

(3)

20 cm
ARCADIS Avantic Quick Guide

When moving the support arm from the

outer area (12 – 0) into the collision area
(0 – 8), you will have to override a slight
resistance at the 0 position (safety stop).

16
Product overview

Moving the C-arm system

Release the brakes to perform the following
movements.
(1) Orbital movement
Change between a.p. and lateral position
➭ Starting from the basic position (0°), the
C-arm swivels up to +90° or up to –42°
(132° in total).

(2) Angulation
Rotate C-arm about support arm in verti-
cal plane
by up to 190° in both directions.

(3) Horizontal travel

Move C-arm horizontally
up to 20 cm
➭ Ideal for fine adjustments directly at the
OR-table.
ARCADIS Avantic Quick Guide

17
 Product overview

(1)

10 ° 10 °

(2)

38 cm

(3)

(4)
ARCADIS Avantic Quick Guide

(5)

(6)

(7)

(8)

Description of keyboard see Basics chap-

ter.

18
Product overview

(1) Swivel
Swivel C-arm about unit column in hori-
zontal plane
by up to 10° in each direction

(2) Vertical travel (motorized)

Lift and lower C-arm
up to 38 cm
➭ Ideal for fine adjustments directly at the
OR-table.

Monitor trolley

(3) TFT flat screen monitors

(4) Keyboard
(5) Power on/off switch
ARCADIS Avantic Quick Guide

(6) CD drive
(7) Direction locks on the back wheels
(8) Brakes on the front wheels

19
 Examination procedure

ARCADIS
Avantic
(1) (2)

(3)

(4)
ARCADIS Avantic Quick Guide

If an additional access control mechanism

is configured for the system, you have to
log in with your name and password.

(5)

20
Examination procedure

Preparing the system

Connecting, switching on and booting

✧ Connect the monitor trolley connecting
cable to the C-arm system (1).
✧ If necessary, plug in the cable of the
remote control unit (2).

✧ If available, connect the network cable (if

the system is connected to an information
system or network printer) (2).

✧ Plug the power plug into the power outlet.

✧ Switch on the C-arm system at the moni-

tor trolley (3).
➭ The system boots.

ARCADIS Avantic Quick Guide

Covering the C-arm with sterile covers

✧ If necessary, cover the C-arm, e.g. with
the three-part sterile cover (4).

21
 Examination procedure

During operation, the window

can be opened by pressing the
Patient Registration icon button
on the monitor trolley.

(1)

(2)
ARCADIS Avantic Quick Guide

(3)

22
Examination procedure

Patient registration

First, the Patient Registration window (1)

appears directly.
(Here: maximal configuration)

✧ Enter the patient data into this mask (1).

At a minimum, the bold fields must be filled

out.
✧ Using the mouse, click on the Exam (2)
button.

➭ The patient data appear in the Examina-

tion task card (3).
➭ The unit is now ready to start an examina-
tion.

Alternatives
ARCADIS Avantic Quick Guide

❏ Preregistration/Scheduler
The patient has already been registered in the
Scheduler, from where it can be loaded into
the Patient Registration card.
❏ Emergency
If the patient data are unknown, the patient is
assigned a provisional number consisting of
the date and the time of the entry. These data
can later be corrected.
❏ Search
If an information network (e.g. hospital net-
work) is connected, you can start a search for
registered patients here.

23
 Examination procedure

To select parameters, use the mouse to

click the monitor trolley.

(1)

(2)

(3)
(5)

(6)
(4)

(7)
ARCADIS Avantic Quick Guide

If the optional laser light localizer is avail-

able, the object should be positioned with
the laser light localizer, i.e. without radia-
tion, as far as possible for reasons of radia-
tion protection.

(8)

(9)

24
Examination procedure

Preparation in the Examination

task card

✧ Select the medical application area (1).

✧ Select the body region by clicking the VPA

(Virtual Patient Anatomy) (2).
✧ Select the required application program
(3).
➭ With the application program you simulta-
neously select a dose level (reduced,
standard, increased). This is shown by a
bar (4).
✧ Select the desired operating mode (5).
Alternative: Select/switch operating
mode on the C-arm keyboard (see cover)
or using the optional multifunctional foot-
switch (→ Page 27).
➭ The selected operating mode is shown as
a symbol (6).
➭ The readiness of the C-arm is shown in
the status bar (7). ARCADIS Avantic Quick Guide

Setting with the laser light localizer

✧ Press the button on the C-arm system (8).

➭ Depending on your system version, either

the I.I. laser aimer (9) (option) and/or the
single-tank laser targeting device (option)
is switched on.

25
 Examination procedure

SIEMENS SIEME
NS

(1) (2)

If required, the footswitch assignment can

be changed by Siemens Service.

Exception: If continuous fluoroscopy is set,

pressing the footswitch releases a single
exposure.

(6) (3)

MODE
ARCADIS Avantic Quick Guide

(4) (5)

Exception: If continuous fluoroscopy is set,

pressing the footswitch releases a single
exposure.

(7)

26
Examination procedure

Radiation release and dose

display

Radiation release with the footswitch

✧ Actuate the footswitch marked with the
fluoroscopy symbol (1).
➭ Continuous fluoroscopy is released.
✧ Actuate the other footswitch (2).

➭ The set operating mode is activated.

Radiation release with the multifunc-

tional footswitch (option)
✧ To change the operating mode set, press
the operating mode button (3) several
times.
✧ Actuate the footswitch marked with the
fluoroscopy symbol (4).
ARCADIS Avantic Quick Guide

➭ Continuous fluoroscopy is released.

✧ Actuate the other footswitch (5).

➭ The set operating mode is activated.

➭ Storage of the images displayed with the
save button (6).

Radiation release with the hand switch

✧ Press the release button to release the
set operating mode (7).

27
 Examination procedure

(1)

(2)
(3)

(4)

ADR stop is recommended, for example,

for
❏ Thin objects, e.g. wrist (the movement
causes the object to slide out of the
central beam, the image is underex-
ARCADIS Avantic Quick Guide

posed)
❏ Metal (high density of the metal leads
to strong overexposure)
❏ Transition between thoracic and lumbar
spine (movement of the diaphragm/
midriff causes changes in the expo-
sure).

(7)

(6)

(5)

28
Examination procedure

Radiation time and dose display

(1) Display of accumulated fluoroscopic time
at the C-arm system
(2) Display of accumulated fluoroscopic time
at the monitor trolley (Examination task
card)
(3) Display of accumulated dose at the moni-
tor trolley (with optional dose measuring
chamber)
Alternative: Display of air kerma values
(preceding item: accumulated air kerma).

➭ After every five minutes of radiation, an

audible alarm sounds at the C-arm sys-
tem.
✧ To deactivate the warning signal, press
the button (4) on the C-arm system.

Manual entry of radiation parameters

All exposures are taken with automatic expo-
sure control.
This rule is turned off using ADR stop. The
ARCADIS Avantic Quick Guide

kV/mA values can then be selected manually.

✧ Select ADR stop at (5).

✧ If required, set a manual value with the +/

- buttons (6).
➭ kV and mA values are shown on the dis-
play at the C-arm system (7).
➭ As long as ADR stop is activated, the
manually set value remains unchanged.

29
 Examination procedure

In the DCM mode the Power Mode func-

tion is automatically selected.

(1)
ARCADIS Avantic Quick Guide

30
Examination procedure

Power mode

Power Mode is an additional function for the

fluoroscopy mode.
With Power Mode a higher contrast is
achieved, but with a higher dose.

✧ Select the Power Mode function at the

C-arm system (1).
➭ If the Power Mode function is activated,
a continuous warning signal sounds dur-
ing fluoroscopy.
➭ The duration of the Power Mode function
is limited to 15 s.

ARCADIS Avantic Quick Guide

31
 Examination procedure

The rotation is performed without radiation

and can be observed on the monitor.

(3)

(2)

(1)
ARCADIS Avantic Quick Guide

(4)

(5)

32
Examination procedure

Image rotation and reversal

At the C-arm system

✧ Press one of the image reversal buttons
to flip the image horizontally or vertically
(1).
➭ The display of the fluoroscopic image is
updated correspondingly.

✧ Press one of the image rotation buttons

for the required direction of rotation (2).
➭ The angle of rotation in relation to the
starting position is shown (3).

At the monitor trolley

Image display and processing in the Viewing
task card is possible only for stored images
(e.g. single exposure) (in the Examination
task card you can rotate images with the
mouse at any time).
✧ Activate the image rotation function in the
ARCADIS Avantic Quick Guide

Viewing task card (4).

✧ Rotate the image with the left mouse
(keep left mouse button pressed).
➭ Angle display in the control area (5):
First value = angle of rotation in relation to
starting position.
Second value = angle of rotation in rela-
tion to last image setting.

33
 Examination procedure

(1)

(2)

(3)

(4)
ARCADIS Avantic Quick Guide

(5)

34
Examination procedure

Collimator setting

The diaphragms allow optimal collimation to a

specific object. They can be set at the C-arm
system.
(1) Moves the iris diaphragm into/out of the
beam path
(2) Rotates the semitransparent diaphragm
(3) Moves the semitransparent diaphragm
into/out of the beam path

The iris diaphragm is a multileaf collimator. It

is used preferably for collimating smaller
objects in the image center.
✧ Activate the iris diaphragm for small
objects, e.g. the wrists (1).
➭ The X-ray beam is limited to an octagon
(4).

ARCADIS Avantic Quick Guide

The semitransparent diaphragm acts as a

density compensation. It is used to collimate
to extremities, for example.
✧ Rotate the semitransparent diaphragm
corresponding to the position of the
object (2).
✧ Adapt the semitransparent diaphragm to
the size of the object (3).
➭ A diaphragm is moved close to the object
on both sides. This prevents overexpo-
sure at the edges of the object (5)

35
 Examination procedure

(2)

(1)
ARCADIS Avantic Quick Guide

(3)

(4)

36
Examination procedure

Image Quality

Selecting the dose level

You can select up to three different dose lev-
els (reduced, standard, increased).
✧ Press the dose level button several times
until the required value is reached (1).
➭ The currently set dose level is shown in
the bar display on the monitor and in the
segment display (2).

Activating the metal function

If there is metal in the measuring area you
can optimize contrast and brightness by acti-
vating the metal function.
✧ Press the metal function button (3).

➭ The LED is on when this function is

selected. ARCADIS Avantic Quick Guide

Lowering noise reduction

You can select a lower integration factor for
exposures of fast moving objects. With nor-
mal noise reduction, a higher integration fac-
tor is selected (for very slow movements).
✧ When there is motion in the image, press
the Noise reduction factor button (4).
➭ The LED lights up, noise reduction is low-
ered.

37
 Examination procedure

(3)

(1) (2)
ARCADIS Avantic Quick Guide

38
Examination procedure

Changing the contrast

If the image quality is insufficient, a different

gray-level curve can be selected at the control
panel of the C-arm system during the exami-
nation to change the contrast of the image
(and all further images).
In addition, the edge enhancement of the live
images can be changed.

✧ If necessary, repeatedly press the follow-

ing buttons to change between preset val-
ues:
(1) Change contrast left monitor (Examina-
tion task card)
(2) Change contrast right monitor (Refer-
ences task card)
(3) Change edge enhancement left monitor
(Examination task card)

ARCADIS Avantic Quick Guide

39
 Examination procedure

At the end of radiation, the image last

acquired is displayed (LIH, Last Image
Hold). If radiation is released again, the LIH
image is overwritten.

(1)

MODE
ARCADIS Avantic Quick Guide

(2)

(3)

(4)

(5)

(6)

40
Examination procedure

Saving images

Single exposure, Digital Cine Mode (DCM)

In these operating modes the generated
images are automatically saved in the local
database of the Patient Browser.

Fluoroscopy, pulsed fluoroscopy, subtrac-

tion, Roadmap
In these operating modes images are stored
in the temporary image memory and over-
written by new images.
✧ To manually save the current image, press
one of the following buttons:
(1) Save image button on the multifunctional
footswitch (option)
(2) Save image button on the hand switch
(3) Save image button on the C-arm system
➭ This image is displayed in the References
task card and stored in the local database.
ARCADIS Avantic Quick Guide

Scrolling and printing

✧ Review image series as a movie in the
Examination task card (4).
✧ Scroll backward/forward through the
stored images in the References task
card (5).
✧ Print out individual images from the Ref-
erences task card with a local printer
(option) (6).

41
 Examination procedure

(3) (2) (4)

(1)

If Autoloop (option) is configured in the

exam set used, review of the scene is
started automatically at the end of radia-
tion.

You can load the scene into the Viewing

ARCADIS Avantic Quick Guide

task card at any time and review it there.

If the MPPS option is installed, the Modal-

ity Performed Procedure Step window
for performance documentation is now dis-
played automatically.

In the Configuration menu (Options > Con-

figuration > Transfer), define the rules for
auto transfer, e.g.:
❏ Required processing status
❏ Target addresses
❏ Data type

42
Examination procedure

Fluoro Loop/LSH (option)

In the fluoroscopy, subtraction and Roadmap

modes, scenes can be reviewed and stored
(Last Scene Hold) during the examination.

Reviewing a scene
After radiation is ended, the buttons for con-
trolling the scene review are displayed.
(1) Start
(2) Stop
(3) Previous frame
(4) Next frame.

Storing the scene

As soon as the scene has been reviewed, it
can be stored.
✧ Select Patient > Save LSH Scene in the
main menu or press function key F9 on
the keyboard.
➭ The current scene (up to 120 images) is
stored in the local database.
ARCADIS Avantic Quick Guide

Ending the examination

✧ Select Patient > End Examination or

press function key F4 on the keyboard.
➭ Patient and examination data are deleted
from the Examination card.
➭ If Automatic transfer is active, the exam-
ination images are automatically saved to
CD-R or sent to the information system
(option).

43
 Subtraction and Roadmap

The Subtraction and Roadmap modes

are an option for C-arms used in cardiac and
vascular surgery.

(1)
(2)
ARCADIS Avantic Quick Guide

(3)

44
Subtraction and Roadmap

Performing a subtraction scene

Contrast medium injected into the vessels

helps to show vessels and changes of/in
these vessels (e.g. aneurysms, ruptures).

Procedure
✧ Prepare the examination in the Examina-
tion task card:
(1) Selection of the required application pro-
gram
(2) Selection of the Subtraction mode
✧ Trigger the subtraction scene with the
footswitch or the hand switch.
The footswitch or hand switch must remain
pressed during the entire series. If the series
is interrupted, it must be started again from
the beginning.

(3) The syringe symbol appears in the Exam-

ination task card. The physician now
injects the contrast medium.
ARCADIS Avantic Quick Guide

➭ After a few seconds the syringe symbol

disappears again. The physician can end
the contrast medium injection. The con-
trast medium bolus remains displayed.

45
 Subtraction and Roadmap

If auto store is activated in the configura-

tion menu, the images of a subtraction
scene are automatically saved in the local
database. They can then be retrieved for
postprocessing at the end of the examina-
tion.
ARCADIS Avantic Quick Guide

(1)

46
Subtraction and Roadmap

Postprocessing a subtraction
scene

✧ Load the subtraction scene from the

Patient Browser into the Viewing task
card, if required.

Pixelshift
Pixelshift allows you to make the mask and
fluoroscopy image coincide.
This function is used if the position of the
patient has changed in the course of the
series in relation to the position of the mask.

✧ Click the Pixelshift button (1).

➭ The mouse pointer appears as an arrow.

✧ Using mouse clicks, move the mask and
fluoroscopy image so that one is on top of
the other.
➭ In the lower image area it is indicated by
how many pixels the mask was shifted in
the x-plane (= to the left or right) or the y-
ARCADIS Avantic Quick Guide

plane (= up or down).

47
 Subtraction and Roadmap

(1)
ARCADIS Avantic Quick Guide

(2)

48
Subtraction and Roadmap

Auto Pixelshift
This function allows automatic pixelshift for a
selected region.

✧ Click the Auto Pixelshift button (1).

➭ The mouse pointer changes into a square.

✧ With the left mouse button pressed,
move the square to the location where
you want to achieve coincidence.
✧ Release the mouse button again.

➭ The mask and fluoroscopy image are

made to coincide optimally in the marked
area.
➭ The shift of the mask in the x- and y-axis is
indicated in the bottom right image area.

Selecting a different mask

The selected application program defines
ARCADIS Avantic Quick Guide

which of the generated images is used as the

mask in the subtraction series. This image is
then subtracted from all following images.

✧ Click on Mask + (Next) or Mask – (Previ-

ous) (2).
➭ The mask for this series is changed in indi-
vidual steps. This change is automatically
adopted for the entire series.

49
 Subtraction and Roadmap

(1)

(2)
ARCADIS Avantic Quick Guide

50
Subtraction and Roadmap

Dual channel function

With this function the entire series is dis-
played unsubtracted during postprocessing in
the Native task card (on the right-hand moni-
tor).
At the same time, the subtracted display is
shown in the Viewing task card (on the left-
hand monitor).

✧ Click the Dual channel function button

(1).
➭ The entire series is additionally shown
unsubtracted on the right-hand monitor,
even when scrolling through individual
images of the series.

Native display in the Native task card

The image shown in the Native task card
directly corresponds to the image of the
series shown in the Viewing task card (2).
✧ Scroll through the individual images of the
series in the Viewing task card.
ARCADIS Avantic Quick Guide

➭ The Native task card always shows the

corresponding image unsubtracted.

51
 Subtraction and Roadmap

(1)

(2) (3) (4)

ARCADIS Avantic Quick Guide

(5) (6) (7)

52
Subtraction and Roadmap

Landmark
The Landmark function allows you to subse-
quently add an anatomical background for ori-
entation purposes (0 to 30 %).

✧ Keeping the left mouse button pressed,

drag the bar to the required value (1).

Movie mode
The replay of the subtraction scene can be
repeated in the Viewing task card.

✧ Select the required function with the

mouse:
(2) Scroll image back
(3) Stop the movie function
ARCADIS Avantic Quick Guide
(4) Scroll image forward
(5) Replay series at half the speed
(6) Replay series in real time
(7) Replay series at double speed

53
 Subtraction and Roadmap

During catheter placement the images are

not automatically stored.
To manually save images, use the save but-
ton on the hand switch, on the multifunc-
tional footswitch (option) or on the C-arm
system.

It is not necessary to create a subtraction

scene if the Roadmap exam connects to a
subtraction angiography. The existence of a
subtraction screen is then indicated by a
screen icon.

✧ In this case, press the ROADMAP but-

ton on the control panel once.
✧ Immediately start catheter positioning
under fluoroscopy control.
ARCADIS Avantic Quick Guide

54
Subtraction and Roadmap

Roadmap

The Roadmap mode is also used in vascular

surgery. This mode is used to place catheters
in vessels under fluoroscopy.
The examination comprises the following
steps:

Generation of a subtraction scene

✧ Select the Roadmap operating mode in
the Examination task card.
The procedure is the same as that described
in Section Performing a subtraction scene.
❏ First, a mask is generated.
❏ Then, the vessel is filled with contrast
medium and displayed using subtraction
technique.

Catheter positioning in the vessel

❏ If radiation is released again, the catheter
placement is shown in real time in the
Examination task card.
ARCADIS Avantic Quick Guide

55
 Postprocessing

Images are postprocessed in the Viewing

task card.

(1)

(2)
ARCADIS Avantic Quick Guide

(3)

(4)

56
Postprocessing

Loading patient images into the

Viewing task card

✧ Open the Viewing task card.

✧ Open the Patient Browser with the Call

up Patient Browser button on the moni-
tor trolley (1).

✧ Load the required series into the Viewing

task card with a double click (2).

ARCADIS Avantic Quick Guide

✧ To load individual images, double-click on

the image symbol (3).

➭ The name of the patient is displayed in the

control area of the Viewing task card (4).

57
 Postprocessing

(1)

(2)
ARCADIS Avantic Quick Guide

(3) (4)

58
Postprocessing

Image display

In the View subtask card you can choose

between different monitor layouts.

(1) Different screen divisions

(2) Hiding graphics and patient data in the

image area
(3) Stripe display:
the images of a series are arranged next
ARCADIS Avantic Quick Guide

to each other
(4) Stack display:
the images of a series are arranged on top
of each other

59
 Postprocessing

(1) (2)

(3)

(4)
ARCADIS Avantic Quick Guide

(5)

60
Postprocessing

Measuring and annotations

In the Tools subtask card images can be mea-

sured and annotations can be added.

(1) Diaphragms
The subsequent simulation of diaphragms
(drawn in with the mouse) improves the
visualization of fine structures that are dif-
ficult to see in the image.
(2) Magnifying glass
Individual areas of the loaded image are
shown enlarged at the mouse position
with the left mouse button pressed

(3) Annotations
Selecting predefined or entering free
annotations for image areas via the key-
board (with marking arrow)
(4) Calibrating and subsequently measuring
distances
ARCADIS Avantic Quick Guide

(5) Angle measurement

The angle between two straight lines to
be drawn is indicated

61
 Postprocessing

Distances cannot be measured directly in

the images, since the position of the object
in the beam path and thus the
magnification effect is not clear. A
calibration must be performed first before a
distance can be clearly determined.

(1)

(2)

(3)

The calibration object must be

perpendicular to the central ray in the area
of the structure to be measured (generally
ARCADIS Avantic Quick Guide

in the center of the measuring field to avoid

I.I. distortion).

(4)

(5)

62
Postprocessing

Calibrating and measuring distances

❏ Calibrating (1st step)

✧ Activate the Calibration function by click-
ing the corresponding button (1).
➭ A line appears in the image area which
can be lengthened, shortened and posi-
tioned as desired with the mouse (2).

✧ Draw the line along a known distance (2).

➭ As soon as you release the mouse button,

a dialog box appears (3).
✧ Enter the known distance and confirm
with OK (3).
➭ The calibration is shown in the image
area. At the same time, a measuring scale
ARCADIS Avantic Quick Guide
appears on the right edge of the image.

❏ Measuring distances (2nd step)

✧ Activate the Distance function by clicking
the corresponding button (4).
✧ Using the left mouse button, draw a line
along the required structure.
➭ As soon as you release the left mouse
button, the distance from the start to the
end point of this line is shown (5).

63
 Postprocessing

(2)
(1)

(4)
(3)

(6)
(5)
ARCADIS Avantic Quick Guide

Edge enhancement (3) means artificially

increasing the difference between two gray
levels.

64
Postprocessing

Image manipulation

Images can be postprocessed in the Image

subtask card.

✧ Prior to postprocessing, activate the

required function by clicking the corre-
sponding button:
(1) Change of contrast
The contrast is changed in four defined
steps
(2) Image rotation
Rotation with the left mouse button
pressed
(3) Edge enhancement
Edge enhancement is increased/reduced
in steps of ten
(4) Grayscale inversion
Change from positive to negative image
(5) Double/half image size
(6) Zoom/pan the image
Mouse at image edge: change image size
Mouse in image center: pan image
ARCADIS Avantic Quick Guide

65
 Postprocessing

Windowing means changing the gray levels

in an image and thus the brightness (center
of the grayscale) and contrast (width of the
grayscale) of the images.

(1)
ARCADIS Avantic Quick Guide

(2)
(3)

66
Postprocessing

Windowing
❏ With buttons/softkeys
✧ Select the preset contrast levels by click-
ing the buttons on the Image subtask
card
(→ Page 65).

❏ With the keyboard of the monitor trolley

✧ Select the brightness and contrast step
by step (1).

❏ With the mouse on the monitor trolley

✧ With the middle mouse button pressed,
move the mouse in the image.
Up/down movement changes the bright-
ness
Movement to the left/right changes the
contrast

Display of window values

Edge enhancement and gray values of the
ARCADIS Avantic Quick Guide
image are displayed in the lower image area:
(2) Edge enhancement
(3) Grayscale window
W = window width (contrast)
C = window center (brightness)

67
 Documentation

In radiology the terms "filming" (= printing

process), "camera" (= output device) and
"exposing" (= printing) are used for the
printing of patient images.
The syngo user interface uses correspond-
ing terms.

(1) (2) (3)

ARCADIS Avantic Quick Guide

(4)

(5)

68
Documentation

Printing

If the printing function is configured, the

Filming task card additionally appears on the
right monitor.
Here, the images to be printed are collected
in film sheets, processed if necessary, and
then sent to the printer as a film job.

Procedure
(1) Copying images to the film sheet:
– from the C-arm system
– from the Viewing task card
– from the Patient Browser
(2) Editing/checking the film sheet:
in the Film Preview dialog or in the Film-
ing task card
(3) Printing the film job:
– on a local printer
– on a network printer
With a local printer you can print individual
images on paper or film directly in the OR.
Printing in the network is possible if a net-
work printer (e.g. central printer in the OR or
ARCADIS Avantic Quick Guide

the radiology department) is connected via

the network connection (4).

Copying images to the film sheet from the

C-arm system (for local printing)
✧ Press the Print key on the control panel of
the C-arm system (5).
➭ The image shown on the right monitor
(References task card) is copied to the
film sheet.
➭ The local printer is preset as output device
for the print job.

69
 Documentation

(1)

(2)
ARCADIS Avantic Quick Guide

(3)

(4)

70
Documentation

Copying images to the film sheet from the

Viewing task card
Print jobs can be created in the Viewing task
card in parallel with image postprocessing.

✧ Click the patient image to be copied to the

film sheet (1).

✧ Then click Copy to Film Sheet (2).

Copying images to the film sheet from the

Patient Browser
ARCADIS Avantic Quick Guide

If the complete data record of a patient is to

be printed on film, this can also be done
directly from the Patient Browser.

✧ Click the series to be printed in the local

database of the Patient Browser (3).
✧ Copy the patient images to the film sheet
(4).

71
 Documentation

(1)

(2)
(3)

(4)
(5)
(6)

(7)

(8)
ARCADIS Avantic Quick Guide

72
Documentation

Checking the film job and printing from

the film preview
✧ Click the Film Preview button in the
Patient Browser (1).

➭ A dialog box is opened which shows dif-

ferent functions for the film sheet:
(2) Dog ears for scrolling through the film
sheets
(3) Patient name
(4) Setting the number of copies of a film job
(5) Display of the status of individual film
jobs, e.g. "queued", "completed" etc.
(6) Deleting individual images from the film
sheet
(7) Sending the film job and exposing/print-
ing the film
(8) Automatic sending of a film job when film
sheet is full
ARCADIS Avantic Quick Guide

✧ Click Expose to send the film job to the

printer/camera (7).

73
 Documentation

(1)

(2)
ARCADIS Avantic Quick Guide

(3)

(4)

(5)

(6) (7)

74
Documentation

Editing the film sheet in the Filming task

card
✧ Click the Filming task card on the right
monitor (1).

❏ Layout
✧ Select the required film layout in the Lay-
out subtask card (2).

❏ Image display
✧ On the Images subtask card, select the
required display of the images on the film:
(3) Select text to be printed on film
All patient text (name, date of birth etc.),
ARCADIS Avantic Quick Guide

customized text or no text

(4) Show or hide graphics (e.g. distance,
angle measurements)
(5) Enlargement of the image so that the
shorter sides fill the film segment. Parts
can be cut off from the longer sides.
(6) Adjust the image size to the film segment
(7) Return to the original image

75
 Documentation

(1)

(2)

(3)

(4) (5)
ARCADIS Avantic Quick Guide

(6)

(10) (7)

(9) (8)

76
Documentation

❏ Camera/printer setting
✧ In the Camera subtask card, select a dif-
ferent camera/printer or film size, if nec-
essary:
(1) Select the camera if several cameras are
configured
(2) Display of the film job status,
e.g. "queued", "printed" etc.
(3) Select one of the film formats available in
the camera

❏ Zoom/Pan
✧ Activate the function by clicking the corre-
sponding button (4).
✧ Zoom/pan the image with the left mouse
button pressed.
Mouse at image edge: change image size
Mouse in image center: pan image
✧ If required, reset the image to the original
position and size (5). ARCADIS Avantic Quick Guide

Printing a film job from the Filming task

card
✧ Set the number of copies (standard = 1
copy) (6).
✧ If necessary, delete individual images
from the film sheet (7).
✧ Send the film job to the camera manually
(8) or activate automatic exposure (9).
✧ If necessary, check the processing of the
film job (10).
➭ The status ("queued", "printed" etc.) of all
film jobs of the selected camera is
shown.

77
 Documentation

Only non-rewritable CDs, i.e. CD-Rs, can

be used. Rewritable CDs (CD-RWs) are not
accepted.

The DICOM viewer is started directly from

the CD; no files are installed on the com-
puter.

(1)
ARCADIS Avantic Quick Guide

(2)

(1)

78
Documentation

Burning CDs

As your system is configured for multi-ses-

sion, you can store your data to unrecorded
CD-Rs, or CD-Rs that have already been writ-
ten to. The new data is added to the old data
on the CD-R.
❏ DICOM Viewer
In the first session, a DICOM viewer is
written to the CD together with the image
data. This allows you to view the images
stored on the CD on any computer.

Exporting workflow
✧ Click the patient(s) in the Patient
Browser (1).

✧ In the menu bar of the Patient Browser,

ARCADIS Avantic Quick Guide

click Transfer > Export to... (2).

➭ The dialog window for data export is
opened.

✧ Select the CD-R as the target and click

Export (1).
✧ The export process starts. The CD is auto-
matically labeled with the date and time.

79
 Reports

The prerequisite for generating reports is

the registration and examination of a
patient.

The radiation summary report is generated

automatically based on the present exami-
nation data. It cannot be postprocessed.
ARCADIS Avantic Quick Guide

(1)

(2)

(3)

80
Reports

Generating reports

If the reporting function is enabled on your

system, important examination data are auto-
matically compiled into a structured report for
documentation purposes.

Report types
❏ Radiation summary report
contains the accumulated values of the
examination for the number of exposures,
fluoroscopy time and dose area product

Using reports
You can read, print and send the reports.

Managing reports
Reports are stored and managed in the
Patient Browser as additional data objects in
2 formats. They can be selected via the rele-
vant icons like examination images:
(1) Report icon in the navigation area
ARCADIS Avantic Quick Guide

(2) Report icon in the content area

Format: Structured Report (SR)
To open the Report Editor
(3) Report icon in the content area
Format: Secondary Capture (SC)
Loading e.g. into Viewing possible; PACS-
compatible

81
 Reports

In the Viewing task card you can

open reports by clicking the rele-
vant button on the Reporting
subtask card.

(1)
(2)

(3)
ARCADIS Avantic Quick Guide

(4)

(5)

With this button in the Report Editor

you can call up the print preview of
the report.

82
Reports

Opening and printing reports

Opening a report
✧ Mark the required report in the Patient
Browser.
✧ Select Reporting > Open Report.

➭ The report is opened in the Report Editor.

Report Editor
(1) Print Report button
(2) Status area (report status)
Examination report (treatment in process)
Postprocessing report (treatment fin-
ished)
(3) Content area
(4) Button area

Setting the report status

✧ Select the applicable status in the selec-
tion lists of the status area (2).
ARCADIS Avantic Quick Guide

✧ Click Apply (5).

Printing
A report must have the „verified“ status
before it can be printed.
✧ Click Print Report (1).

✧ Click OK in the dialog window displayed.

83
 Connectivity

Monitor trolley

Monitor trolley
ARCADIS Avantic Quick Guide

84
Connectivity

ARCADIS can optionally be connected to a

network. The following two variants are avail-
able:

DICOM System Basic

Send/Receive + Storage Commitment,
Print
(1) Send/Receive
Sending and receiving of patient images
(2) Storage Commitment
Requesting a confirmation that images
have been securely stored after sending
(3) Print
Printing of patient images on X-ray films
via a network
→ Page 69

DICOM System Advanced

(in addition to the above-named func-
tions)
(4) Worklist
Querying the worklist (all patients for a
system) and loading the patient data
ARCADIS Avantic Quick Guide

(5) MPPS = Modality Performed Procedure

Step
Feedback to an information system about
the status of a work process
(6) Query/Retrieve
Searching for images in the network (incl.
other modalities), importing of images
into the local database

85
 Connectivity

You can also receive images from another

system (CT, MR etc.) or workstation. For
this, the images have to be actively sent
from this system or workstation to ARCA-
DIS.

(1)

(2)
ARCADIS Avantic Quick Guide

(3)

(4)

86
Connectivity

Send/Storage Commitment

The Send to function allows you to archive

patient images in an information system or to
send them to another workstation for post-
processing.

Send to
✧ Open the Patient Browser (1).

✧ Select the patient (or individual examina-

tions) whose data you want to send.
✧ Click the Send to... button (2).

✧ Select the network node (recipient) and

confirm with Send (3).
➭ The images are sent to the selected
address (information system or worksta-
tion).
ARCADIS Avantic Quick Guide

Sending to a standard address

✧ Press the Send key on the symbol keypad
of the monitor trolley (4).
➭ The selected patient images are sent to
the first "standard" node configured by
Siemens Service.

87
 ARCADIS Avantic Quick Guide

88
Connectivity

(2)
(1)

(3)

(4)
Connectivity

Tracking network processes

✧ Click the Network Status button (1).

➭ Current processes in the network are

shown (2).

Storage Commitment
If patient data are sent or archived in an infor-
mation system, the Storage Commitment
function requests a confirmation from the
ARCADIS Avantic Quick Guide
receiving station that images have been
securely stored (confirmation is not necessar-
ily sent promptly):
(3) Column for error messages
(4) Feedback in the status bar
("SV" = sent and verified)

➭ In the case of an error message, the data

in the Patient Browser must not yet be
deleted, because they have not yet been
properly saved or archived.
✧ Repeat the process again.

89
 Connectivity

Get Worklist offers the advantage of a sim-

plified workflow:
In an information system, the OR plan (i.e.
which patients are planned for a certain
operating room or C-arm) can be prepared
a day ahead and retrieved in the OR.
The patient data can then be retrieved just
before the intervention and transferred to
the Examination task card.
The Get Worklist function also prevents
the entry of incorrect patient data, since the
data do not need to be entered manually.
ARCADIS Avantic Quick Guide

(1) (2) (3)

(4)

To update the worklist again, initiate a new

request to the information system by dou-
ble-clicking on the Scheduler.

90
Connectivity

Get Worklist

The Get Worklist function contains a request

for a worklist within an information system.

✧ Double-click the Scheduler in the Patient

Browser (1).
➭ A worklist containing the patients to be
examined at this system appears.
✧ Select the patient to be examined in the
Scheduler (2).
✧ Click the Patient Registration button (3).
ARCADIS Avantic Quick Guide

➭ The Patient Registration window opens.

The data of the selected patient have
already been entered.

✧ Click Exam in the Patient Registration

window (4).
➭ The data are transferred to the Examina-
tion task card, and the examination can
be started.

91
 ARCADIS Avantic Quick Guide

92
(3)
Connectivity

(1)

(4)
(2)
Connectivity

MPPS – Modality Performed

Procedure Step

MPPS (Modality Performed Procedure Step)

is a confirmation to an information system
that a certain process (in this case the exam-
ination of a patient) has been completed.

Calling up MPPS after an examination

✧ Select Patient > End Examination in the
Examination task card (1).
➭ The MPPS dialog is displayed (2).

✧ If desired, enter information and com-

ments on the procedure (e.g. unusual
occurrences, complications).

✧ To end the dialog, click Completed (3).

➭ The OR documentation is sent to the

information system, where it is archived.
➭ The patient is deleted in the Scheduler.
ARCADIS Avantic Quick Guide

Calling up MPPS manually

If you have accidentally closed the patient by
registering a new patient, you can open the
MPPS dialog manually.
✧ Select Patient > Show MPPS in the
menu bar of the Patient Browser (4).

93
 Connectivity

The Retrieve function is important above all

for preoperative images that are needed for
virtually any procedure.

(1)
ARCADIS Avantic Quick Guide

(2)

(3)

(4)

94
Connectivity

Query/Retrieve

❏ Query
A query to an information system can be
started. If the patient is already known to
the information system, the existing
images are displayed.
❏ Retrieve
Images can be imported into the local
database and loaded into the Viewing
task card.

✧ Click the Search button in the Patient

Browser (1).

➭ The search dialog opens (2).

✧ Enter the known patient data (unknown
data can be replaced by the * wildcard,
ARCADIS Avantic Quick Guide

e.g. A*).

✧ Start the search by clicking Search (3).

➭ The patient images present in the infor-

mation system are displayed.

✧ Click the Import button (4).

➭ The patient images are imported into the

local database from where they can be
loaded into the Viewing task card.

95
 Dismantling

The C-arm can only be moved while it is

switched on.

(1)

(2)

To define the switch-on duration yourself,

you can perform a full shut-down manually.
ARCADIS Avantic Quick Guide

To do so, select Options > End session in

the main menu before turning the system
off.

(3)

96
Dismantling

Transport position

The C-arm system should be transported and

parked in a zero position.
✧ Move the C-arm to the 0 position for angu-
lation, horizontal movement and swivel.
✧ Move the C-arm into an orbital a.p. posi-
tion.
✧ Move the lifting column all the way down
into position 2 (1).
✧ Lock all electronic brakes.

Switching off

✧ Switch the unit off at the monitor trolley

(2).
➭ The imaging system is shut down and
switched off in the "hibernate" state.
Switching the system back on takes
approx. 45 secs. until it is fully opera-
tional.
ARCADIS Avantic Quick Guide

➭ The 16th time the system is switched off,

it is automatically completely shut down.
Switching the system back on then takes
approx. 3 mins. until it is fully operational.

✧ Disconnect the monitor trolley from the

C-arm system.
✧ Roll up the cables at the rear of the moni-
tor trolley (3).
➭ The C-arm system is ready for transport.

97
98
ARCADIS Avantic Quick Guide
Notes
Your opinion matters a lot to us!
We make every effort to continuously
improve our product documentation.
Therefore, we would like to offer you the
opportunity of giving us your direct feedback
concerning your requests, suggestions and
criticism with respect to this Quick Guide.
❏ For feedback by fax, please use the follow-
ing fax number:
+49 9131/84-2378
❏ If you prefer notification by e-mail, please
send your feedback to:
sp_ga.med@siemens.com
Thank you very much for supporting us in our
efforts to improve our products.

ARCADIS Avantic Quick Guide

Siemens reserves the right to modify the
design and specifications contained herein
without prior notice.
Please contact your local Siemens Sales Rep-
resentative for the most up-to-date informa-
tion.

Note: Original images always lose a certain

amount of detail when reproduced.

Siemens AG
Wittelsbacherplatz 2
D-80333 München, Germany
Contact:
Siemens AG, Medical Solutions
Special Systems
Henkestraße 127
D-91052 Erlangen, Germany

© 2007 All rights reserved

Print No.: SPR2-330.622.01.01.02
Printed in the Federal Republic of Germany
Siemens AG 01/07