Radiant Manual
Radiant Manual
Radiant Manual
User manual
Version 4.0.2
5/29/2017
http://www.radiantviewer.com
Copyright © 2009-2017 Medixant.
All rights reserved.
Table of contents 3
Table of contents
1.3 Installation
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1.4 Activation
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Trial license activation 15
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Paid license activation 20
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Deactivation 28
2 Basic Topics 34
2.1 Opening a DICOM study from a CD/DVD
................................................................................................................................... 34
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Browsing series and images 51
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Changing brightness / contrast 53
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Changing zoom level / position 57
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Length 59
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Ellipse 65
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Angle 67
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Cobb angle 68
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Deviation 69
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Pencil tool 71
2.10 Annotations
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3 Advanced Topics 82
3.1 Exporting images
................................................................................................................................... 82
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Multiple windows 90
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Synchronization 92
Auto synchronization
......................................................................................................................................................... 93
Manual
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synchronization 94
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Cross-reference lines 95
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Adding more studies 97
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Splitting series 98
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Changing the viewing plane 107
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Browsing volume 110
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Changing zoom level and position 111
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Changing brightness / contrast 113
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Changing thickness (MIP/MinIP/Avg) 115
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Length measurement 117
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Exporting images 118
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Window configuration 120
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Rotations 125
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Changing zoom level and position 127
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Changing color and opacity 128
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Removing unwanted structures 130
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Length measurement 133
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Exporting images 135
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PACS configuration 147
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Table of contents 5
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PACS troubleshooting 152
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PACS integration 153
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Structured report (SR) 154
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MPEG2/4 video 155
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Encapsulated PDF 157
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DICOMDIR 157
4 Appendix 165
4.1 Keyboard shortcuts
................................................................................................................................... 165
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Options.xml 176
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Overlay.xml 178
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6 RadiAnt DICOM Viewer
RadiAnt DICOM Viewer is an application for processing and displaying medical images in DICOM
format (Digital Imaging and Communications in Medicine).
The viewer allows users to open studies from CD/DVD/BluRay disks, flash memory, local and
network folders, and PACS locations.
Studies obtained from different imaging modalities can be displayed in RadiAnt DICOM Viewer:
· Monochromatic (e.g. CR, CT, MR) and color (e.g. US, 3D reconstruction)
· Static images (e.g. CR, MG, CT) and dynamic sequences (e.g. XA, US)
· Uncompressed and compressed (RLE, JPEG Lossy, JPEG Lossless, JPEG 2000, JPEG-LS)
· MPEG2/MPEG4 compressed video files
RadiAnt DICOM Viewer is not a medical product. It has no FDA/CE or any other certifications
and is not intended for diagnostic purposes.
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Welcome to RadiAnt DICOM Viewer 7
1.1 Features
· Opening DICOM studies from CD/DVD/BluRay disks and local or network folders.
· Searching and downloading DICOM studies from PACS locations (servers, workstations,
modalities).
· A simple and intuitive interface with full-screen mode.
asynchronous reading (you can browse images while they are being opened), advanced memory
management system which facilitates concurrent opening of studies with thousands of images. All
provided within a compact application (installer size is just around 3MB).
· Image operations:
§ Rotations (90 and 180 degrees), and flips (horizontal and vertical).
§ Measurement of mean, minimum and maximum parameter value (e.g. density in Hounsfield
§ Measurement of deviation.
· Browsing of several series concurrently in multiple panels with automatic synchronization between
series with images acquired in the same plane (e.g. Computed Tomography series before and
after contrast media administration) or manual synchronization between series from different
studies with similar patient orientation and cross reference lines in series with different image
planes (e.g. Magnetic Resonance study).
· Display of dynamic sequences/series (CINE) with adjustment of frames per second.
· 3D (oblique) Multi-planar Reconstruction (3D MPR) with MIP (maximum intensity projection), MinIP
· Fusion of series with different modalities (e.g. PET-CT) or with different protocols (e.g. MR T1/T2
– DWI).
· Time-intensity curves (TIC, e.g. for Breast MRI).
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· Support for DICOM overlays (annotations or graphic overlays included in the file).
· Export of DICOM images to JPEG and BMP picture formats and DICOM series/sequences to
· Microsoft Windows system (XP SP3, Vista, Windows 7, Windows 8, Windows 8.1 and Windows 10
are supported)
· Intel or AMD 1GHz or faster processor (multicore Intel processor recommended)
· 5MB of available hard-disk space for installation; additional free space required for image
caching
· 1024x768 screen resolution
1.3 Installation
Save the file to your computer - depending on your connection speed, the software may require
between one second and one minute to download in full.
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Welcome to RadiAnt DICOM Viewer 9
or in Downloads:
Windows 7, Windows 8/8.1 and Windows 10 users may be prompted with a “User Account Control”
alert; if so, select Yes or Continue to proceed with the installation.
If you answer No , RadiAnt DICOM Viewer will be installed only for the current user.
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10 RadiAnt DICOM Viewer
Follow the steps outlined by the setup wizard to complete the installation.
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Welcome to RadiAnt DICOM Viewer 11
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12 RadiAnt DICOM Viewer
The next time you want to use RadiAnt DICOM Viewer, simply double-click its desktop icon to begin
using the software immediately!
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Welcome to RadiAnt DICOM Viewer 13
1.4 Activation
Activation in trial mode allows you to use a fully functional version of RadiAnt DICOM Viewer during
the evaluation period.
The evaluation version expires after a predetermined period of time (displayed after activation).
After expiration, the installation needs to be reactivated for further evaluation.
Old versions may not qualify for the evaluation. In that case, you can purchase a license if you want
to continue to use the old version or download the most recent version from RadiAnt's website and
activate it in trial mode.
Product activation is the process of verifying the validity of a product's license. Once the product is
activated, the user can access the software.
The product activation process protects both your rights as a consumer and the rights of Medixant
as a software developer.
It verifies that you have installed genuine RadiAnt DICOM Viewer software and that the product has
not been activated on more computers than those permitted by the EULA.
First, you need to deactivate the license on your "old" computer. After successful deactivation, the
license can be activated on a new machine.
Please note, a license can be transferred only once in a 90-day period.
I have purchased N licenses. Can I install RadiAnt DICOM Viewer on more than N computers?
No, you need a separate license for each computer (or terminal) on which RadiAnt DICOM Viewer is
installed (or used).
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Deactivation
What is deactivation?
Deactivation lets you transfer your RadiAnt DICOM Viewer paid license to another computer.
Deactivation is intended for situations in which you no longer plan to use RadiAnt DICOM Viewer on
your "old" computer.
It is not designed for transferring the paid license back and forth between two computers that are
in active use. As such, the software can only be deactivated on the same computer twice.
When this limit is reached, you will not be able to deactivate the license.
Please contact us in such cases and provide full details of the license (license ID or order number)
and the computer (name or machine ID). We will deactivate the license for you.
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Welcome to RadiAnt DICOM Viewer 15
Automatic activation
The steps below illustrate the process by which you can activate RadiAnt DICOM Viewer in the
evaluation mode on computers that are connected to the Internet.
If your computer has no Internet connection, you can activate the software manually.
1. Launch RadiAnt DICOM Viewer by clicking on the product icon on your desktop.
3. Click the Next button. RadiAnt DICOM Viewer will attempt to connect to the license server.
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Welcome to RadiAnt DICOM Viewer 17
Manual activation
The process by which you can activate RadiAnt DICOM Viewer in the evaluation mode on computers
that are not connected to the Internet is described below.
1. Launch RadiAnt DICOM Viewer by clicking on the product icon on your desktop.
3. Click the Next button. After a failed attempt to connect to the license server, the offline
activation screen will be displayed.
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4. Go to https://radiantviewer.com/trial and complete the form with the request code. Click the
Get your activation code button.
6. Enter this code in the appropriate field on the RadiAnt DICOM Viewer offline activation screen
and press the Next button.
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Automatic activation
The steps below illustrate the process by which you can activate RadiAnt DICOM Viewer on
computers that are connected to the Internet.
If your computer has no Internet connection, you can activate the software manually.
1. Launch RadiAnt DICOM Viewer by clicking on the product icon on your desktop.
If you have previously activated the software in trial mode, click the arrow next to the Help
button on the toolbar and select Enter a license key .
Alternatively, you can click Update your license if your RadiAnt DICOM Viewer installation was
activated with the paid license and you have now purchased Update & Support renewal.
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Welcome to RadiAnt DICOM Viewer 21
· I have a serial number . Use this option if you received serial number information
in your confirmation email.
· I have a license key file . Use this option if you have a legacy license key file
(purchased for software versions <= 3.X).
3. Enter your serial number or browse for the license key file and click the Next button. RadiAnt
DICOM Viewer will attempt to connect to the license server.
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Welcome to RadiAnt DICOM Viewer 23
Manual activation
The steps below illustrate the process by which you can activate RadiAnt DICOM Viewer on
computers that are not connected to the Internet.
1. Launch RadiAnt DICOM Viewer by clicking on the product icon on your desktop.
If you have previously activated the software in trial mode, click the arrow next to the Help
button on the toolbar and select Enter a license key .
Alternatively, you can click Update your license if your RadiAnt DICOM Viewer installation was
activated with the paid license and you have now purchased Update & Support renewal.
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· I have a serial number . Use this option if you received serial number information
in your confirmation email.
· I have a license key file . Use this option if you have a legacy license key file
(purchased for software versions <= 3.X).
3. Enter your serial number or browse for the license key file and click the Next button. After a
failed attempt to contact the license server, the offline activation screen will be displayed.
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Welcome to RadiAnt DICOM Viewer 25
4. Go to https://radiantviewer.com/activate and fill in the form with the serial number and request
code. Click the Get your activation code button.
6. Enter this code in the appropriate field on the RadiAnt DICOM Viewer offline activation screen
and press the Next button.
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Welcome to RadiAnt DICOM Viewer 27
RadiAnt DICOM Viewer can be activated on local and remote computers using the command-line
tool located in the installation folder (radcmd.exe):
1. Get the request code from the computer you want to activate by executing the following
command: radcmd.exe -reqcode
2. The output of the command above includes the request code in one line.
3. Use your serial number and the request code to activate your license at
https://radiantviewer.com/activate
(replace ACTIVATION_CODE with the activation code obtained in the previous step)
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1.4.3 Deactivation
Automatic deactivation
The steps outlined below illustrate the process by which you can deactivate RadiAnt DICOM Viewer
on computers that are connected to the Internet.
If your computer is not connected to the Internet, you can deactivate the software manually.
1. Select Deactivate this computer from the drop-down menu next to the help button.
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Welcome to RadiAnt DICOM Viewer 29
3. Click the Next button. RadiAnt DICOM Viewer will attempt to connect to the license server.
When you see the confirmation message, deactivation is complete.
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Manual deactivation
The steps below illustrate the process by which you can deactivate RadiAnt DICOM Viewer on
computers that are not connected to the Internet.
1. Select Deactivate this computer from the drop-down menu next to the help button.
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Welcome to RadiAnt DICOM Viewer 31
3. Click the Next button. After a failed attempt to contact the license server, the offline
deactivation screen will be displayed.
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32 RadiAnt DICOM Viewer
RadiAnt DICOM Viewer can be deactivated on local and remote computers using the command-line
tool located in the installation folder (radcmd.exe):
2. The output of the command above includes the activation ID and the deactivation code in two
lines.
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Welcome to RadiAnt DICOM Viewer 33
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34 RadiAnt DICOM Viewer
2 Basic Topics
1. Insert a disk with a DICOM study into a CD/DVD drive. If the default viewer is automatically
started from the CD, close it in order to obtain better reading speeds in RadiAnt DICOM Viewer.
3. Click the CD/DVD button on the toolbar in main window (this button is hidden when no
CD/DVD drive is detected), or use shortcut Ctrl + Alt + O .
4. The process of disk scanning will start. You can browse images of the study as soon as they
begin appearing in the series preview bar.
5. The status bar shows the number of remaining files, elapsed time and estimated time to finish.
6. Remove the disk from the CD/DVD drive only when you finish viewing the study. (Ejection will
render images unavailable for viewing.)
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Basic Topics 35
2. Click the Folder button on the toolbar in main window, or use the shortcut Ctrl +
Shift + O .
3. Find the folder you want to scan for DICOM files, select it, and then click OK .
4. The process of scanning will start. You can browse images of the study as soon as they begin
appearing in the series preview bar.
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5. The status bar shows the number of remaining files, elapsed time, and estimated time to finish.
1. Drag & drop the selected folder(s) onto either RadiAnt DICOM Viewer main window:
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Basic Topics 37
2. Right-click the context menu on the selected folder(s) and choose Open with RadiAnt DICOM
Viewer .
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2. Click the arrow next to the folder icon on the toolbar in the main window.
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Basic Topics 39
5. The process of unpacking and file scanning will start. You can browse images of the study as
soon as they begin appearing in the series preview bar.
6. The status bar shows the number of remaining files, elapsed time and estimated time to finish.
1. Drag & drop selected ZIP archive onto either RadiAnt DICOM Viewer main window:
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2. Use right-click context menu on the selected ZIP archive and click Open with / RadiAnt
DICOM Viewer .
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Basic Topics 41
2. Click the arrow next to folder icon on the toolbar, or use the Ctrl + O keyboard shortcut.
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4. Find the DICOM file(s), make your selection, and click Open .
5. The process of loading will start. You may browse images of the study as soon as they begin
appearing in the series preview bar.
6. The status bar shows the number of remaining files, elapsed time, and estimated time to finish.
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Basic Topics 43
1. Drag & drop the selected DICOM file(s) onto either RadiAnt DICOM Viewer main window:
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44 RadiAnt DICOM Viewer
The RadiAnt DICOM Viewer PACS client feature lets you search and download studies from PACS
hosts (Picture Archiving and Communication System).
Before you begin, you need to make sure that your PACS server and RadiAnt are properly
configured. Please refer to the advanced section of this manual for configuration instructions.
Sometimes the configuration process may be quite complicated or even impossible without the
technical support from the vendor of your PACS server.
2. Click the Download button on the toolbar in the main window, or press Ctrl + F .
3. If the PACS host was not yet configured, you will see the message asking you to add a new PACS
host. Please refer to the advanced section of this manual.
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Basic Topics 45
4. Once the configuration is finished, you will see the PACS search window.
Preset or specific begin and finish dates can be chosen - just select "Custom date range."
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6. You can choose one of the following main search field types: Patient name, Patient ID, Accession
number, Study description, Referring physician, Performing physician, Reading physician, Institution
name. Enter the text into the field and press Enter or click the Search button.
7. The results coming from the server will start appearing in the list. The number of studies found
will be displayed in the lower left corner. Select the study you want to download from the list and
click the Download button or press Enter . You can also just double-click the study to start
the download process. You can browse images of the study as soon as they begin appearing in the
series preview bar.
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Basic Topics 47
8. The status bar shows the number of received files, the transfer speed, elapsed time, and
estimated time to finish.
By default, the study will be downloaded to the active viewer window (if another study was
previously opened in this window, it will be closed). Other download modes are available from the
pop-up menu displayed after clicking the right mouse button on the selected study/studies. Click
Add to active window or press Shift + Enter to download the study to the active
window without clearing previous study. Click Download to new window or press Ctrl +
Enter to open a new window and start downloading the study to it. Click Download to
separate windows or use the shortcut Ctrl + Shift + Enter to download each of
the selected studies to a new window.
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You can search all studies of the selected patient (that is, studies that have the same Patient ID field)
by clicking Find all studies of this patient in the pop-up menu or pressing Ctrl + P .
You can stop the download process at any time by clicking the stop icon or using the shortcut
Ctrl + Del .
Press the Info icon or use the shortcut Ctrl + L to show the list of active and finished
downloads along with detailed statistics and status messages.
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Basic Topics 49
They represent basic tools which are available in RadiAnt DICOM Viewer:
· Browse series
· Pan image
· Zoom image
· ROI tools:
§ Length
§ Ellipse
§ Angle
§ Cobb angle
§ Pencil
§ Deviation
The default ROI tool is length measurement. The ROI tool can be changed by clicking the arrow on
the right side of the button and choosing specific tool from the drop-down menu.
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Each tool can be assigned to one of three mouse buttons. Just click the tool button with the left,
middle or right mouse button. The current assignment is represented by a mouse icon with one (or
more) buttons highlighted: left , middle or right .
By default the left mouse button is assigned to the "Browse" tool. The middle button controls
brightness and contrast (window level / width), and the right mouse button is used for zooming in
or out.
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Basic Topics 51
Browsing series
Click the thumbnail image in the series preview bar to load the
desired series and browse its images.
· Patient name
· Patient birth date
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Browsing images
As soon as the images start appearing in the panel you may begin browsing them.
There are several different ways of paging through the images of the series:
1. Click the Browse series button on the toolbar (or press the B key). Next, press the left
mouse button over the image, and drag the mouse up or down to browse a series in both
directions.
2. Turn the mouse wheel while the cursor hovers over the panel with the image.
4. Press the Up Arrow or Down Arrow on the keyboard to return to the previous image,
or move on to the next.
6. On a multi-touch device, touch the image with one finger and drag it up or down. (The tool must
be associated with the left mouse button - if it is not, touch the "Browse series" tool button.)
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Basic Topics 53
Click the Adjust image window button on the toolbar (or press the W key).
Next, press the left mouse button over the image and drag the mouse to change brightness
(window level - WL), or contrast (window width - WW):
By default, the windowing tool is associated with the middle mouse button.
Press the Ctrl key and drag the mouse with the left button down, and the windowing tool will
be active regardless of current association.
On multi-touch devices, touch the image with three fingers and drag them in the directions
described above to adjust window level and width.
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Window presets
2 - 9 set different WL/WW depending on image modality. In the table below presets for CT
images are shown.
Key Preset WL WW
2 CT Abdomen 60 400
3 CT Angio 300 600
4 CT Bone 300 1500
5 CT Brain 40 80
6 CT Chest 40 400
7 CT Lungs -400 1500
These presets are also available from the Adjust image window drop down menu.
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Basic Topics 55
The preset values for PET (Positron Emission Tomography) series apply to the maximum value of
the displayed range and are presented as the percent of the highest value in the entire image
series.
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Negative mode
Press the F11 key or click the Negative menu item to toggle negative mode for the image.
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Basic Topics 57
Click the Zoom image button on the toolbar (or press the Z key).
Next, press left mouse button over the image and drag the mouse Up to zoom in or Down to zoom
out.
By default, the zooming tool is associated with the right mouse button.
Another way to zoom is to place the cursor over the image, press the Ctrl key, and turn the
mouse wheel in both directions to zoom in or out.
Alternatively, the Ctrl + Plus (+) and Ctrl + Minus (-) keyboard shortcuts
can be used to zoom.
On multi-touch devices, touch the image with two fingers and drag them apart to zoom in, or
toward each other to zoom out.
Key Preset
Ctrl + 0 Fill viewport with image
Ctrl + 1 100% (1 image pixel = 1 screen pixel)
Ctrl + 2 200% (1 image pixel = 2 screen pixels)
Ctrl + 3 400% (1 image pixel = 4 screen pixels)
Ctrl + 4 800% (1 image pixel = 8 screen pixels)
These presets are also available from the Zoom image drop down menu.
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Image panning
When an image is zoomed in, panning can be used to reveal areas lying outside the viewing panel.
Click the Pan image button on the toolbar (or press the M key).
Next, press the left mouse button over the image and drag the mouse to move image around the
screen.
Press the Shift key and drag mouse with the left button down, and the panning tool will be
active regardless of the current left mouse button association.
Alternatively, Ctrl + Arrows (Up, Down, Left or Right) can be used to pan.
On multi-touch devices, touch the image with two fingers and drag them across the panel to move
image. Keep the distance between the fingers unchanged to maintain the current zoom ratio.
Press Ctrl + 0 to revert the zoom and pan settings and fill the viewport with the image.
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Basic Topics 59
Select Length from the Measurements drop down menu (or press the L key).
Place the cursor over the starting point, then press left mouse button and drag the mouse to draw
a segment with length measurement. Release the button to finish drawing.
The distance value will be shown in either millimeters or pixels (when the calibration data is not
included in the image file).
You can move the entire segment or one of its endings by dragging while pressing the left mouse
button.
The label may be also dragged to a more convenient place if necessary.
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Press Shift while drawing the segment to make it either vertical or horizontal.
Calibration of measurements
Depending on the source of the calibration data, the label with a measurement will be displayed in
different colors:
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Basic Topics 61
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There is no calibration data available (measurement in pixels of the source DICOM image).
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Manual calibration
The image can be manually calibrated (if no calibration data was present in the DICOM file) or
recalibrated.
1) Measure the object with a known size, and then right-click the segment or its label to show a
pop-up menu.
2) Click Calibration to open the dialog window. Enter the distance and select the units
(millimeters, inches or French sizes), click OK to recalibrate the image.
3) Now the measurements will be taken with the manual calibration data and shown in millimeters.
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To revert the manual calibration show the "Calibration" window and click the Reset
calibration button.
DICOM images coming from the ultrasound devices often include calibrated regions. Depending on
the region type, different parameters can be measured.
Below is the sample screenshot showing the measurement of distance, velocity and time.
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2.7.2 Ellipse
Select Ellipse from the Measurements drop down menu (or press the E key).
Press left mouse button and drag the mouse to draw an ellipse with pixel value measurement.
Release the button to finish drawing.
Name Description
SD Standard deviation
You can move the ellipse or change its size by dragging it or the surrounding cross-marks with the
left mouse button pressed.
The label may also be dragged to a more convenient place if necessary.
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When drawing an ellipse in a magnified image, you can press the Ctrl key to show the
boundary of actual pixels taken into account in calculations.
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2.7.3 Angle
Select Angle from the Measurements drop down menu (or press the A key).
Press the left mouse button and drag the mouse to draw the first arm of the angle. Release the
button and move the mouse to draw the second arm. Click the left button to finish drawing the
angle.
You can move the entire angle or one of its endings by dragging it or the cross-marks with the left
mouse button pressed.
The label may also be dragged to a more convenient place if necessary.
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Select Cobb angle from the Measurements drop down menu (or press the C key).
Press the left mouse button and drag the mouse to draw the first segment of the Cobb angle, and
then release the button. To draw the second segment, again press the left mouse button and drag
the mouse. Release the button to finish drawing the angle.
You can move the segments of the Cobb angle or one of their endings by dragging the segment or
the cross-marks with the left mouse button pressed.
The label may also be dragged to a more convenient place if necessary.
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2.7.5 Deviation
Select Deviation from the Measurements drop down menu (or press the D key).
Place the cursor over the starting point, then press left mouse button and drag the mouse to draw
a segment. Release the button to finish drawing.
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The distance value in millimeters measured from one end of the segment to the straight line (either
horizontal or vertical) intersecting the other end of the segment will be shown.
The second displayed value is the angle (in degrees) between the segment and the straight line
intersecting one of its ends.
You can move the entire segment or one of its endings by dragging it or the cross-marks with the
left mouse button pressed.
The label may also be dragged to a more convenient place if necessary.
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Select Pencil from the Measurements drop down menu (or press the P key).
Press the left mouse button and drag the mouse to draw with a pencil. Release the button to finish
drawing.
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Original image
Rotations
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Flips
· To flip an image horizontally, select Flip horizontal from the Transformations drop down
menu, or use Ctrl + Shift + [
· To flip an image vertically select Flip vertical from the Transformations drop down menu,
or use Ctrl + Shift + ]
You can also apply rotations and flips from a drop-down menu.
Multiple rotations and flips can be applied to the image to obtain desired orientation.
Select Clear transformation (or use Ctrl + Shift + \ ) to restore the original
orientation.
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Dynamic sequences such as ultrasound (US, IVUS) or digital angiography (XA) are started
automatically in cine (movie) mode upon loading.
Thumbnails representing such series have a little "play" icon in the lower left corner.
Cine mode can be also enabled manually for multi-image series such as computer tomography (CT)
or magnetic resonance (MR).
Press the Cine toolbar button or use the Space key to start/stop cine mode.
While cine mode is enabled and the cursor hovers over the image, the cine bar is overlaid at the
bottom of the image.
The actual frame rate is displayed in the top left corner of the image.
Other annotations are hidden during cine run.
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2.10 Annotations
DICOM files contain a lot of information stored in tags associated with the image.
The most important data is overlaid on top of the image displayed, grouped in the corners.
Depending on image modality, some fields may be missing.
Top left
The following additional fields are presented only for MG modality (mammography):
· Image laterality
· View position
Top right
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· Study comments
· Rotation/flip (if applied)
Bottom left
· Mouse cursor position (coordinates of the pixel in displayed DICOM image) and value of the
pixel
· Window level and window width (brightness and contrast), name of window preset, negative
mode indicator
· Thickness and location of the slice (e.g. CT and MR modalities) or rotation and tilt of x-ray
lamp (XA modality)
Bottom right
If the DICOM image contains scale information (pixel spacing), two 10cm rulers with 1cm marks are
displayed along left and bottom edges of the panel (red arrows).
If the DICOM image contains information about patient orientation in space, there is a letter (or
combination of letters) symbolizing the patient’s sides displayed at the center of each panel's edge
(green arrows).
· A – anterior
· P – posterior
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· L – left
· R – right
· S – superior
· I - inferior
Annotations can be turned off and on by clicking the Annotations button on the toolbar or
pressing F12 key.
To hide all patient data (in series preview bar, panel title bar, overlaid annotations) click Hide
patient data menu item or use the Shift + F12 shortcut.
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Image displayed in the active panel can be easily copied to the Windows clipboard and then pasted
into other Windows application such as Microsoft Word, PowerPoint, etc.
Click the Copy to clipboard in the Export drop-down menu or use the Ctrl + C
shortcut.
Switch to the application where you want to paste the image and click Ctrl + V
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Full-screen mode allows you to hide the frame of the window and increase the viewing area.
Normal mode
Full-screen mode
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Click the Full screen mode button located on the right side of the toolbar or press F .
To restore the normal window, use the Exit full screen mode toolbar button or again
press the F key.
Switching between full screen and window modes can be also achieved by double-clicking the
toolbar area.
To maximize the viewing area, both the series preview bar and the toolbar with the status bar can
be temporarily hidden.
Click Window / Series preview bar menu item or use Ctrl + Alt + F2 to toggle
preview bar visibility.
Click Window / Toolbar and status bar menu item or use Ctrl + Alt + F3 to
toggle toolbar and status bar visibility.
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Full-screen mode with hidden toolbar, series bar and status bar
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3 Advanced Topics
RadiAnt DICOM Viewer can export opened images or series to the following formats:
· JPEG
· BMP
· WMV (movie)
· DICOM
Basic export
Click Export tool button or use Ctrl + E to show the export window.
The export window will be opened so you can choose the destination format and source images:
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Advanced export
For advanced settings click More options before starting the export.
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Additional controls will become visible (some may be inactive, depending on the destination file
format).
Export location
File settings
Image size
· Default (1:1) - the size of the exported image will exactly match the source image in DICOM file.
· Current size - the size of the exported image will be exactly as seen in the panel.
· Fit to - the size of the exported image can be chosen from the list of dimensions or set to custom
values.
Annotations
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JPEG/WMV Quality - move the slider left to reduce the destination file size (worse quality), or right
for larger destination files (better quality).
· Default - the destination movie frame rate will match the source DICOM image default frame rate.
· Custom - the frame rate can be set to custom value.
Source files are copied directly to the destination folder when DICOM is chosen as destination
format.
Export to DICOM files is unavailable for secondary images obtained with the use of either MPR
(Multiplanar Reconstruction), Fusion, or TIC (Time-intensity curve) tools.
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Multiple series of either one or several studies can be concurrently opened in multiple panels for
comparison purposes.
Move the cursor over the "cells" symbolizing the image panels:
Click again to select the splitting template (a maximum of five columns and four rows of panels can
be selected).
Using the left mouse button, drag and drop thumbnails from the series preview bar into the panels
to load the chosen series.
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Another way of opening a series in new panel is to click its thumbnail while pressing the Ctrl
key.
All panels will be automatically repositioned and new series will be loaded in the last panel.
Maximizing/restoring/closing panel
A panel can be quickly maximized by double-clicking the image it contains, or by pressing the
Maximize button on the title bar of the panel or using Ctrl + M .
Press the Restore button, double-click the image it contains, or press Ctrl + M to
restore the panel to its normal size and view all panels again.
Use the Tab key to switch between opened panels in maximized mode.
Click the Close button on the panel's title bar to close it or use Ctrl + F4 .
If you hold the Ctrl key and click the Close button the panel will be cleared instead of
being closed.
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The above actions are also available in the Window drop-down menu.
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To speed up the process of opening more than one series at the same time, click the Open
multiple series menu item or press the F4 key.
Hold the Ctrl key and select series to opening by clicking them with left mouse button. Click
OK to open the chosen series in multiple panels. All previously opened panels will close
automatically.
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You can open up to 16 viewer windows. These windows can be placed on the same or different
monitors.
To show a new empty window, press Ctrl + N or click New window in the pop-up menu
under the folder icon. Double clicking the RadiAnt icon on the Desktop is another way to open a
new window.
Use the duplicate window feature to open a new window with the series displayed in the active
window. Click Duplicate window or use the shortcut Ctrl + Shift + N .
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When the series from the same study are opened in two different windows, they are auto-
synchronized; also, the cross-reference lines are displayed, if applicable. Finally, a fusion of images
is possible too. This can be helpful when browsing series of the same study in a multi-monitor
setting.
Press Alt + F4 to close the active window. To exit the application when multiple viewer
windows are opened, press Ctrl + Alt + F4 or click Exit in the pop-up menu under the
folder toolbar icon. You can also press Ctrl while clicking the close button in one of the viewer
windows.
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3.2.2 Synchronization
The synchronization feature lets you apply the same settings (slice position, zoom & pan, window)
to the series of images opened in multiple panels.
There are three synchronization modes available in RadiAnt DICOM Viewer: Auto , Manual
and Disabled .
You can switch between these modes by clicking the Toggle series synchronization
button on the toolbar.
The synchronization mode can by also toggled by clicking the Toggle series synchronization
drop-down menu item or by pressing the F5 shortcut key.
In the same menu you will also find items controlling the options of synchronization:
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Series consisting of images that have been acquired in the same plane (or in similar planes, with the
dihedral angle up to 5 degrees), within the same study (e.g. Computed Tomography series before
and after administration of the contrast medium) are automatically synchronized by default (slice
location, zoom level).
The toolbar button shows when the automatic synchronization mode is enabled.
You can disable the synchronization by pressing this button or by using the F5 shortcut key.
By default only slice position and zoom & pan settings are synchronized.
To enable the synchronization of window settings click Synchronize window settings .
Note that after the synchronization is enabled you have to change a setting to apply it to other
series. E.g. you have to scroll series in one panel to synchronize the position of slices in other
panels.
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Series acquired in similar planes (with the dihedral angle up to 30 degrees) belonging to the same
or different studies (of the same or different patients) can be synchronized manually.
To enable manual synchronization, scroll series opened in different panels to the same level (e.g.
the bifurcation of the aorta), pan images so that they are positioned similarly in viewports and click
the Toggle series synchronization button or press F5 .
The toolbar button shows when the automatic synchronization mode is enabled.
By default only slice position and zoom & pan settings are synchronized.
To enable the synchronization of window settings click Synchronize window settings .
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Cross-reference lines are displayed for better correlation of the anatomy when browsing series with
different image planes (e.g. Magnetic Resonance study). They are visible as yellow lines that mark
the intersection of the image planes.
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Cross-reference lines are always displayed in inactive panels (those with gray title bars) as a
reference for the image in the active panel (brown title bar).
To change the reference source, activate the other panel by either clicking on its title bar or the
image it contains.
Cross-reference lines can be switched off and on by clicking the Cross reference lines menu item
or by using Ctrl + F12 .
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When a new study is opened, all images in panels and the series preview bar are cleared.
To add new images from different location use the Add DICOM images drop-down menu.
New images can be added from a folder, selected files, or decompressed from a ZIP archive.
Notice that you cannot open directly two or more DICOM CD/DVD disks at the same time - when
the first one is ejected, the images become unavailable for viewing. If you want to open more than
one disk at the same time, first you need to copy their contents to a folder on your hard drive and
then scan the folder for DICOM files.
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Sometimes a single series of DICOM images obtained from a given modality contains multiple
volumes. This is where the split series feature comes in handy.
It detects all the volumes contained in one series (e.g. arterial/venous post-contrast, PD/T2, DWI or
cardiac CT multi-phase) and opens them in separate panels.
This makes simultaneous display and synchronization of images between such series possible.
Open a multi-sequence series and click the arrow next to the split screen icon on the toolbar in the
main window, then click Split series or press Ctrl + F5 .
Each of the volumes from the original series will be opened in a separate panel.
If the split series feature is used on a series containing non-volumetric images (CR, DX, MG, US, XA,
etc.), each of the images of the series will be opened in a separate panel (up to 20 panels at the
same time).
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Select an object (segment, ellipse, angle, etc.) by clicking it with left mouse button. The object will
turn red after it is selected.
Use the Edit measurements drop down menu to copy, paste or duplicate objects.
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Delete all in current image Ctrl + Del Deletes all objects in image
displayed in active panel.
Delete all in current series Ctrl + Shift + Del Deletes all objects from the
series displayed in active panel.
Delete in all visible panels Shift + Del Deletes all objects from all
visible images.
Increase font size Ctrl + Shift + Makes text in ROI labels larger.
Plus(+)
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To hide (and show) measurements (objects) in active panel click Hide measurements menu item
or use Alt + F12 .
Once you start drawing an object in a panel with hidden measurements, all the objects will become
visible again.
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The MPR tool provided within the RadiAnt DICOM Viewer can be used to reconstruct images in
orthogonal planes (coronal, sagittal, axial or oblique, depending on what the base image plane is).
This can help to create a visualization of the anatomy which was not possible using base images
alone.
Click the MPR button on the toolbar, and select the plane you would like the series to be
reconstructed to (the current plane of source series is checked and grayed out).
This process takes 1-2 seconds on a fast machine, but can be substantially slower on computers
with less memory.
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If the button is grayed out, the MPR tool cannot be applied to the series (e.g. in case of images with
nonparallel planes).
One series can be reconstructed in three planes in order to easily localize an area of interest thanks
to cross-reference lines.
Use the screen splitting tool to open three panels, and drag the source series thumbnail into each
of them.
Click first panel to activate it, and then select the new image plane using the MPR tool. Repeat this
step for the second panel.
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The 3D MPR tool provided within the RadiAnt DICOM Viewer can be used to reconstruct images in
arbitrary planes (oblique). This can help to create a visualization of the anatomy that would not be
possible using base images alone.
1. Open the volume series in the 2D viewer window and click the MPR button on the toolbar and
then 3D MPR . Alternatively, you can use the F2 shortcut.
2. After the series is loaded into memory and preprocessed, the 3D MPR representation will be
displayed in a new window. This process can take a few seconds on slower systems.
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Some series cannot be used with the 3D MPR tool (e.g., images with nonparallel planes).
If the images are not spaced evenly within the volume, the missing slices will be interpolated, and
some visual artifacts may appear in presentation and measurements.
Note, some larger series (e.g., >2000 CT images) require more than 1GB of free memory and the
64-bit RadiAnt DICOM Viewer version to load successfully.
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There are three viewports in the 3D MPR window; each shows the image reconstructed in a plane
perpendicular to the other two viewports. In each viewport, there are two axes overlaid on the
image. These axes represent intersections of planes from the other two viewports with the specific
viewport's image plane. The color of the axis is consistent with the color code of the source
viewport (small square in the top-right corner).
Initially, the viewports are set to the default planes (sagittal, axial, coronal). The orientation of those
planes can be changed by rotating the axes, whereas the position of the plane is changed by
dragging the intersection of the axes.
Moving axes
Place the mouse cursor over the intersection of the axes, press the left mouse button and drag the
intersection to change the position of the planes in the two other viewports.
Rotating axes
Place the mouse cursor over the axis arm, press the left mouse button and rotate the axes to
change the orientation of the planes in the two other viewports.
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3D rotation
Click the 3D rotate button on the toolbar (or press the R key).
Next, press the left mouse button over the image and drag the mouse to rotate the image plane
around the X and Y axes (parallel to the viewing plane).
Press the Alt key and drag the mouse with the left button depressed. The 3D rotation tool will
be active regardless of the current left mouse button association.
Alternatively, the 3D rotation can be performed using Alt + Arrows (Up, Down, Left
or Right) .
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Roll
Click the Roll button on the toolbar (or press the T key).
Next, press the left mouse button over the image and drag the mouse to rotate the image plane
around the Z axis (perpendicular to the viewing plane).
Press the Ctrl + Alt key and drag the mouse with the left button depressed. The roll tool
will be active regardless of the current left mouse button association.
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There are several different methods by which you can page through the volume (moving the
viewing plane to front or back without changing the orientation of the image plane):
1. Click the Browse button on the toolbar (or press the B key). Next, press the left mouse
button over the image, and drag the mouse up or down to browse a volume in both directions.
By default, the browse tool is associated with the left mouse button.
2. Press the Up Arrow or Down Arrow on the keyboard to move to back or front in
small steps.
3. On a multi-touch device, touch the image with one finger and drag it up or down. (The tool must
be associated with the left mouse button, if it is not, touch the Browse tool button.)
4. Press the left mouse button on the intersection of the axes in some other viewport and drag it
up/down or left/right.
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Image zooming
Click on the Zoom button on the toolbar (or press the Z key).
Next, press the left mouse button over the image and drag the mouse up to zoom in or down to
zoom out.
By default, the zooming tool is associated with the right mouse button.
Alternatively, the Ctrl + Plus (+) and Ctrl + Minus (-) keyboard shortcuts
can be used to zoom.
On multi-touch devices, touch the image with two fingers and drag them apart to zoom in, or
toward each other to zoom out.
Click Fill viewport or press Ctrl + 0 to revert the zoom and pan settings and fill the
viewport with the image.
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Image panning
When an image is zoomed in, panning can be used to reveal the areas lying outside the viewing
panel.
Click the Pan button on the toolbar (or press the M key).
Next, press the left mouse button over the image and drag the mouse to move the image around
the screen.
Press the Shift key, and drag mouse with the left button depressed and the panning tool will
be active, regardless of the current left mouse button association.
Alternatively, you can use Ctrl + Arrows (Up, Down, Left or Right) to pan.
On multi-touch devices, touch the image with two fingers and drag them across the panel to move
the image. Keep the distance between the fingers unchanged to maintain the current zoom ratio.
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Click on the Adjust image window button on the toolbar (or press the W key).
Next, press the left mouse button over the image and drag the mouse to change brightness
(window level - WL) or contrast (window width - WW):
By default, the windowing tool is associated with the middle mouse button.
Press the Ctrl key and drag the mouse with the left button down and the windowing tool will
be active, regardless of the current association.
On multi-touch devices, touch the image with three fingers and drag them in the directions
described above to adjust the window level and width.
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Negative mode
Press the F11 key or click the Negative menu item to toggle the negative mode for the
image.
Synchronization
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Thickness
Click the Thickness button on the toolbar (or press the H key).
Next, press the left mouse button over the image and drag the mouse up to increase thickness or
down to decrease thickness.
The value of the slab thickness in millimeters (and the rendering mode) is displayed in the top-left
corner.
Press the Ctrl + Shift key and drag the mouse with the left button depressed, and the
thickness tool will be active regardless of the current left mouse button association.
Alternatively, the Plus (+) and Minus (-) keys can be used to change thickness.
On multi-touch devices, touch the image with four fingers and drag them up or down to change
thickness.
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Immediately after the 3D MPR windows is opened, the images are displayed with minimal possible
thickness (in accordance with the size of the voxels in the volume).
When the thickness is increased, images are rendered in one of the following modes:
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Click the Length button on the toolbar (or press the L key).
Place the cursor over the starting point, then press left mouse button and drag the mouse to draw
a segment with length measurement. Release the button to finish drawing.
You can move the entire segment or one of its endings by dragging while pressing the left mouse
button.
The label may also be dragged to a more convenient place if necessary.
Press Shift while drawing the segment to make it either vertical or horizontal.
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Click on the Export button or use Ctrl + E to save the image in the active viewport as a
JPEG file.
Browse for the destination folder and click OK to save the image.
Click the Export all images in the Export drop-down menu or use the Shift + E
shortcut to save images from all three viewports combined in one JPEG file.
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The image displayed in the active viewport can be easily copied to the Windows clipboard and then
pasted into other Windows applications such as Microsoft Word, PowerPoint, etc.
Click the Copy to clipboard in the Export drop-down menu or use the Ctrl + C
shortcut.
To copy images from all three viewports combined into one bitmap, click the Copy all to
clipboard in the Export drop-down menu or use the Shift + C shortcut.
Switch to the application where you want to paste the image and click Ctrl + V .
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Viewport layout
The default position of viewports in the 3D MPR window can be changed from the Viewport
layout drop-down menu.
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The size of the viewports can be changed by dragging the borders between them.
To temporarily maximize the active viewport, press Enter or double-click on the viewport.
Repeat this process to restore the viewport to its original size.
Axes
Click the Axes button on the toolbar (or press the F3 key) to toggle the visibility of the axes
in the viewports.
The auto centering mode for the intersection of the axes can be set in the Axes drop-down
menu.
· Always: Centering is performed whenever the intersection is moved off the center.
· Only hidden: Centering is performed only when the intersection is moved outside the viewport.
· Never: Centering is disabled.
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To center all axes manually, press Ctrl + F3 or click the Center all menu item.
As you move the mouse cursor over viewports, the position of location markers (color dots
projected on axes) is updated.
The location markers of the same color represent the same point in the volume and, thus, help
identify structures in different viewports.
Resetting scene
Click the Reset scene button on the toolbar (or press Ctrl + R ) to restore the initial
view in the 3D MPR window.
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The 3D Volume Rendering tool provided by RadiAnt DICOM Viewer can be used to visualize large
volumes of data generated by modern CT/MR scanners in three dimensional space. The different
aspects of the data set can be interactively explored in the 3D VR window.
1. Open the volume series in the 2D viewer window and click the 3D Volume Rendering
button on the toolbar, or use the F3 shortcut.
2. After the series is loaded into memory and preprocessed the VR representation will be displayed
in a new window. This process can take a few seconds on slower systems.
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Some series cannot be used with the VR tool (e.g. in case of images with nonparallel planes).
If the images are not spaced evenly within the volume, the missing slices will be interpolated and
some visual artifacts may appear in presentation and measurements.
Note that some larger series (e.g. >2000 CT images) require more than 1GB of free memory and
64-bit RadiAnt DICOM Viewer version to be loaded successfully.
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3.6.1 Rotations
3D rotation
Click the 3D rotate button on the toolbar (or press the R key).
Next, press the left mouse button over the image and drag the mouse to rotate the volume around
the X and Y axes (parallel to the viewing plane).
By default, the 3D rotate tool is associated with the left mouse button.
On multi-touch devices, touch the image with one finger and drag it to rotate the volume.
Alternatively, Arrows (Up, Down, Left or Right) can be used to perform the 3D
rotation.
The orientation cube shown in the upper right corner shows the position of planes facing the
viewer.
The rotation angles are presented in the lower right corner.
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Roll
Click the Roll button on the toolbar (or press the T key).
Next, press the left mouse button over the image and drag the mouse to rotate the volume around
the Z axis (perpendicular to the viewing plane).
On multi-touch devices, touch the image with two fingers and rotate them to roll the volume.
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Rotation presets
Key Preset
1 Anterior (front)
2 Posterior (back)
3 Left
4 Right
5 Superior (top)
6 Inferior (bottom)
These presets are also available from the 3D rotate drop down menu.
Image zooming
Click the Zoom button on the toolbar (or press the Z key).
Next, press left mouse button over the image and drag the mouse Up to zoom in or Down to zoom
out.
By default, the zooming tool is associated with the right mouse button.
Alternatively, the Ctrl + Plus (+) and Ctrl + Minus (-) keyboard shortcuts
can be used to zoom.
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On multi-touch devices, touch the image with two fingers and drag them apart to zoom in, or
toward each other to zoom out.
Click Fit volume or press Ctrl + 0 to revert the zoom and pan settings and fill the
viewport with the image.
Image panning
When an image is zoomed in, panning can be used to reveal areas lying outside the viewing panel.
Click the Pan button on the toolbar (or press the M key).
Next, press the left mouse button over the image and drag the mouse to move image around the
screen.
Press the Shift key and drag mouse with the left button down, and the panning tool will be
active regardless of the current left mouse button association.
Alternatively, Ctrl + Arrows (Up, Down, Left or Right) can be used to pan.
On multi-touch devices, touch the image with two fingers and drag them across the panel to move
image. Keep the distance between the fingers unchanged to maintain the current zoom ratio.
Click the Adjust window button on the toolbar (or press the W key).
Next, press the left mouse button over the image and drag the mouse to change the range of
displayed voxel values.
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By default, the windowing tool is associated with the middle mouse button.
Press the Ctrl key and drag the mouse with the left button down, and the windowing tool will
be active regardless of current association.
On multi-touch devices, touch the image with three fingers and drag them in the directions
described above to adjust window level and width.
Click Default window or press 0 to set default window for the current volume.
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Click the Scalpel button on the toolbar (or press the S key).
Next, press the left mouse button over the image and draw the area.
· Press Del or click the Cut inside button to delete structures inside the area.
· Press Enter or click the Cut outside button to delete structures outside the area.
· Press Esc or click the Clear area button to clear the area.
Rotate the volume and make additional cuts to remove all unwanted structures from the image.
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Press the Alt key and drag the mouse with the left button down, and the scalpel tool will be
active regardless of current association.
Click Restore volume or press Ctrl + Alt + 0 to cancel all scalpel actions.
To revert all changes made while exploring the volume (position, zoom, window, scalpel actions)
click the Reset scene button on the toolbar, or use the Ctrl + R shortcut.
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Click the Length button on the toolbar (or press the L key).
Place the cursor over the starting point, then press left mouse button and drag the mouse to draw
a segment with length measurement. Release the button to finish drawing.
You can move the entire segment or one of its endings by dragging while pressing the left mouse
button.
The label may be also dragged to a more convenient place if necessary.
Press Shift while drawing the segment to make it either vertical or horizontal.
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Caveats
The structures may appears thinner or thicker, depending on the window (color and opacity)
adjustment.
The distance is measured between points lying in the plane parallel to the viewing plane. If the
points are located at different depths, the displayed length is shorter than the actual distance.
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Click the Export button or use Ctrl + E to save the displayed image as a JPEG file.
Browse for the destination folder and click OK to save the image.
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The displayed image can be easily copied to the Windows clipboard and then pasted into other
Windows application such as Microsoft Word, PowerPoint, etc.
Click the Copy to clipboard in the Export drop-down menu or use the Ctrl + C
shortcut.
Switch to the application where you want to paste the image and click Ctrl + V
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Image fusion allows you to overlay a color-mapped PET image onto a CT scan in order to obtain
anatomical references for regions with increased FDG (fluorodeoxyglucose) uptake values.
This tool can also be applied to other imaging modalities, such as Magnetic Resonance, (e.g., DWI
images can be fused with T1 or T2-weighted scans).
Enabling fusion
1) Use the screen splitting tool to open CT and PET series in two panels.
2) Activate the panel with CT series by clicking the image it contains or its title bar.
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3) Click the Fusion button on the toolbar or use the Ctrl + Alt + F shortcut.
Color scale
The default color scale used for rendering a fused image is set to "Hot iron". It can be changed by
clicking a bar with a color scale to the left side of the image.
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The range of values represented on a color scale is adjusted by using the windowing tool in the
panel with the series used as overlay (PET).
The opacity of fused images is adjusted by pressing the left mouse button over a color scale bar
and dragging the mouse up to increase opacity or down to make the fused image more
transparent.
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SUV measurement
Use the ellipse tool in the panel with fused images to measure maximum, minimum and average
values of SUVbw (Standardized Uptake Value calculated using body weight) for a specified area.
The SUV measurement is possible only when there is necessary data included in the DICOM files
(patient weight, radio pharmaceutical dose and time, etc.), otherwise, the ellipse tool will show the
uptake measured in Bq/ml (or in other units specified in the 0054,1001 DICOM tag).
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The time-intensity curve tool allows you to visualize the lesions' enhancement behavior (e.g. in
Breast MRI) by plotting the signal intensity values over time after the administration of contrast
material.
2) Press F4 to show the "Open multiple series" window, select the dynamic series (including the
unenhanced one). A series with subtraction enabled will also come handy to quickly localize lesions.
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3) Find a lesion that you would like to analyze and draw an ellipse over it.
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4) Quickly duplicate the ellipse ROI into other series by using the Ctrl + Shift + D
shortcut.
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6) RadiAnt DICOM Viewer selects the series for curve generation automatically.
Make changes to the selection if you want to use other series. Click OK to confirm the selection
and generate curve.
7) A new panel will be added. It contains the time-intensity curve and screen captures of the region
in dynamic series used for calculations.
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The PACS (Picture Archiving and Communication System) client feature lets the RadiAnt DICOM
Viewer query and retrieve studies from other PACS hosts.
Supported service class users/providers are: C-ECHO SCU, C-ECHO SCP, C-FIND SCU, C-MOVE-
SCU, C-STORE-SCP (Only transfers initiated from the RadiAnt DICOM Viewer are accepted. If you try
to send studies from other PACS nodes without searching them first and starting the download in
RadiAnt, they will be ignored).
Received DICOM files are stored in a temporary folder and are deleted when RadiAnt closes.
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Basic settings
If you do this for the first time, you will be asked to configure PACS settings:
If the configuration was already performed, you have to click the options icon or use the
shortcut Ctrl + O to change PACS settings.
Each networked DICOM application is characterized by three basic parameters: IP address, port
and AE (Application Entity) title. The IP address is configured via system network settings. The port
on which RadiAnt listens for PACS connections and the AE title are configured in RadiAnt. By default,
the port is set to 11112 and the AE title to RADIANT.
Remember to configure your PACS server with the IP, port and AE title of RadiAnt DICOM Viewer.
Otherwise, you will not be able to search and download studies to RadiAnt from this server.
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To add a new PACS location, the AE parameters (IP, port and title) of the server are needed. Enter
them in the fields below, add a description and press Enter or click Add .
After clicking Save , you are ready to perform your first search and download.
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If this is your first configuration and Windows Firewall is enabled, you will be asked to unblock
network communication for RadiAnt. Click Allow access ; otherwise, you will not be able to
download DICOM studies from PACS locations.
After a new PACS location is added to the list, a proper configuration and network connectivity can
be verified using the C-ECHO DICOM service.
Click the button or press F2 to perform a DICOM ping (C-ECHO) on all hosts in the list.
The locations awaiting verification will be presented with a yellow background.
After positive verification, the host's background becomes green.
If the connection and association with a host cannot be established, the background turns red.
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Advanced settings
Click the right mouse button on the selected PACS location to show the pop-up menu.
Select Preferred transfer syntax to change the encoding used when communicating with a PACS
host. By default, the Explicit VR Little Endian transfer syntax is used. However, you may try other
encodings if some problems with communication are encountered.
The maximum active downloads option lets you set the limit of concurrent downloads from one
PACS host. The default value is 1. Usually, when set to a larger value, it will speed up the transfer of
multiple studies. However, changing this value may also lead to connection timeouts and errors,
depending on specific PACS server implementation.
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In case you have problems with PACS communication, start troubleshooting with the verification of
connectivity between RadiAnt and a PACS host using the C-ECHO service.
The connection has to be verifiable in both directions: from RadiAnt to the PACS host and vice
versa. Otherwise, you will not be able to search and download studies from the PACS host.
If the verification fails, please make sure that the following requirements are met:
1. Check for a general network connectivity errors, such as an unplugged network cable, incorrect
IP address, network downtime, or similar problem. You should be able to ping one machine
from the other.
2. You have to you use the proper parameters of your PACS server (IP, port, AE title) in the PACS
host configuration.
3. Make sure that your PACS server is configured with your RadiAnt computer's IP, port and AE
title.
4. The port and AE title used in RadiAnt must be unique, which means that you cannot have
another DICOM viewer installed on the same machine with the same parameters.
5. A fixed IP address has to be assigned to your RadiAnt computer. If you connect from a remote
site via a cable or DSL connection with a dynamic IP address, you will not be able to receive
DICOM studies.
6. There must be no firewall which blocks the communication:
a. from the RadiAnt computer to the configured port on the server.
b. from the server to the RadiAnt listener port configured in PACS options.
7. You can try changing the preferred transfer syntax used in communication with the specific PACS
host in RadiAnt PACS settings.
If the problems with the connection persist, please use your local IT support specialized in the PACS
field, as resolving the connectivity problems usually requires direct access to your local network and
your PACS server configuration.
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RadiAnt DICOM Viewer can be integrated with other systems via command line arguments. You can
launch the viewer, start downloading specific DICOM studies and display them using simple
commands.
Use the argument "-pstv" followed by one or more pairs of tag ID/value:
By default, all PACS nodes configured in RadiAnt are searched. You can define only one PACS node
by using "-paet" and its AE title:
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Structured report (SR) files are special type of DICOM files designed for exchanging clinical
information and findings.
They are rendered in the viewport as images, but they can be also browsed more conveniently as
text.
Press Enter or double click the panel with the SR document to open it in the HTML browser.
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RadiAnt DICOM Viewer can read DICOM files containing video and audio compressed with either
MPEG2 or MPEG4 codecs:
They are opened using an external media player. Not all formats can be played using the default
Windows media player, hence VLC media player (http://www.videolan.org/vlc/), which can play all
video formats, is recommended.
Press Enter or double click the panel with the video document to open it in the external media
player.
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The preview images of video files can be displayed in the series preview pane and in the viewport
with the help of the FFMPEG tool.
Just download the static build from https://ffmpeg.zeranoe.com/builds/ and copy the ffmpeg.exe
file to the RadiAnt DICOM Viewer program folder (the location where the RadiAntViewer.exe file was
installed).
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Press Enter or double click the panel with the PDF document to open it in the external viewer.
3.10.4 DICOMDIR
DICOMDIR is a special DICOM file usually found in the root folder of the CD/DVD media with
DICOM studies.
This file includes paths to the DICOM files found on the media.
RadiAnt DICOM Viewer uses DICOMDIRs to quickly generate thumbnail images of all series found
on the media.
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Each DICOM file contains much more information than can be displayed as annotations on the
image.
To view the DICOM tags associated with the image displayed click Show DICOM tags menu item
or use Ctrl + Alt + T .
A complete list of DICOM tags, their descriptions and values will be displayed.
The file path of the analyzed DICOM file is displayed on the title bar.
You can search the list of tags for a specific text by entering it in the "Find text..." box in the lower
left corner.
The following fields are searched: Tag ID, Description and Value.
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Press Enter to clear the text box and show all tags once again.
Click right mouse button on the tag list to show the pop-up menu.
Select Show DICOM file in Explorer or press Ctrl + O to show the folder with the
selected DICOM file in Windows Explorer.
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The value of a tag can be copied to clipboard by selecting an item and pressingCtrl +
Shift + V or by selecting Copy value from the pop-up menu.
To copy all fields of the selected tag, press Ctrl + C or click Copy selected item .
The entire structure of the file can be copied to clipboard by pressing Ctrl + Shift + C
or by selecting Copy all items .
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Thanks to our community, RadiAnt DICOM Viewer has been translated into more than 20 languages.
The language files (in XML format) are available for download from
https://www.radiantviewer.com/translation.php page.
Click an arrow next to the Help button and then the menu item Choose a language /
Import language XML file .
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The new language will be applied after restarting RadiAnt DICOM Viewer.
Keep in mind that not all translations are updated for the latest versions of RadiAnt DICOM Viewer.
If you use an older one, some texts may remain in English.
Translation files can be edited/updated using the online tool available at
http://www.radiantviewer.com/translation.
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Most of the keyboard shortcuts used in RadiAnt DICOM Viewer can be customized to user's
preference.
Click an arrow next to the Help button and then the menu item Customize keyboard .
Select the command from the list. You can also use the text box to display only commands
containing a specific text.
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Place the cursor in the field under "Press shortcut keys:" and press the new shortcut key(s).
Then click the Assign button.
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4 Appendix
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F11 Negative
F3 3D Volume Rendering
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1 Anterior view
2 Posterior view
3 Left view
4 Right view
5 Superior view
6 Inferior view
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3D MPR window
Left / Right Arrow Rotate view around the Z axis (roll)
Alt + Left / Right Arrow Rotate image plane around the Y axis
F11 Negative
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Ctrl + L Show the list of active and finished downloads along with
detailed statistics and status messages
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2D Viewer window
Left mouse button + mouse move Browse images of the series [default setting]
Middle mouse button + mouse Adjust image window (brightness/contrast) [default setting]
move
Right mouse button + mouse move Zoom image in/out [default setting]
Middle mouse button + mouse Adjust image window (color/opacity) [default setting]
move
Right mouse button + mouse move Zoom image in/out [default setting]
Alt + left mouse button + mouse Draw area with the scalpel tool
move
3D MPR window
Left mouse button + mouse move Browse volume back / front [default setting]
Right mouse button + mouse move Zoom image in/out [default setting]
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2D Viewer window
Drag one finger over series preview Scroll series list.
bar
Drag one finger over image Tool chosen in the toolbar (browsing series by default).
Three fingers over image Drag up/down to change brightness, drag left/right to
change contrast.
Two fingers over image Pinch to zoom, drag to pan image, rotate to roll image.
3D MPR window
Drag one finger over image Tool chosen in the toolbar (browse volume by default).
Two fingers over image Pinch to zoom, drag to pan image, rotate to roll image.
Three fingers over image Drag up/down/left/right to change window level and width
(WL/WW).
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The options.xml file can be used to set RadiAnt DICOM Viewer default preferences.
When RadiAnt DICOM Viewer is used as a patient CD/DVD viewer, the options.xml file can be also
placed in the "COMMON" folder on the CD/DVD media.
Sample file:
<zoom>
<toregion>0</toregion> <!-- zoom-to-region mode (0 - disabled, 1 -
enabled) -->
<offcenter>0</offcenter> <!-- the image region pointed by mouse cursor (when
zooming is started) retains its position on screen (0 - disabled, 1 - enabled) -->
</zoom>
<browse>
<scrollwrap>1</scrollwrap> <!-- "endless" scrolling (0 - disabled, 1 - enabled) -->
</browse>
<window>
<presets> <!-- window settings - presets -->
<!-- <i m="CT" i="8" n="Preset 1" ww="70" wl="30"/> --> <!-- m - modality
(CR, CT, MR, XA, MG, etc.), i - shortcut key (2-9), n - preset name, ww - window width, wl - window level
-->
<!-- <i m="CT" i="9" n="Preset 2" ww="32" wl="30"/> -->
</presets>
</window>
<synchronization>
<enabled>1</enabled> <!-- automatic synchronization (0 - disabled, 1 - enabled) -->
<slice>1</slice> <!-- synchronize slice location (0 - disabled, 1 - enabled) -->
<zoom>1</zoom> <!-- synchronize zoom&pan (0 - disabled, 1 - enabled) -->
<window>0</window> <!-- synchronize window settings (0 - disabled, 1 - enabled) --
>
</synchronization>
<updates>
<notify>1</notify> <!-- notify about new updates (0 - disabled, 1 - enabled) -->
</updates>
<tools> <!-- tools assigned to mouse buttons (1 - browse series, 2 - zoom, 3 - pan, 4 - change
WW/WL, 5 - ROI) -->
<lmb>1</lmb> <!-- left mouse button -->
<mmb>4</mmb> <!-- middle mouse button -->
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<vr>
<penscalpel>0</penscalpel> <!-- associate the scalpel tool with pen (0 - disabled, 1 -
enabled) -->
</vr>
<mpr>
<autocenter>1</autocenter> <!-- auto center axes in viewports (0 - disabled, 1 -
enabled) -->
<axisthkpts>0</axisthkpts> <!-- display thickness regulation points on the axis (0 -
disabled, 1 - enabled) -->
</mpr>
<cine>
<autorun>1</autorun> <!-- Cine mode is started automatically for XA and US series
-->
<fps>10</fps> <!-- default frames-per-second rate for series without predefined FPS
-->
</cine>
<loading>
<autoshow>1</autoshow> <!-- mode of showing first image in viewport (0 - user has
to click a series to show it, 1 - first scanned image file is shown, 2 - after scanning all files, first series
from the preview bar is shown) -->
<ussep>0</ussep> <!-- show separate thumbnails for single frame ultrasound images
belonging to the same DICOM series (0 - disabled, 1 - enabled) -->
<desc>0</desc> <!-- study sorting mode (0 - ascending date, 1 - descending date) -->
</loading>
<disabled>
<!-- disabled features and toolbar buttons -->
<!-- <folders/> -->
<!-- <cddvd/> -->
<!-- <pacs/> -->
<!-- <export/> -->
</disabled>
<screen>
<split c="0" r="0"/> <!-- default split screen preset c - columns, r - rows -->
<clp>0</clp> <!-- close panel button behavior (0 - closes panel, 1 - clears panel) --
>
</screen>
<i18n>
<!-- <fiso>ISO_IR 192</fiso> --> <!-- define specific character set which overrides
value defined in (0008,0005) SpecificCharacterSet tag for all DICOM files -->
</i18n>
</options>
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4.4.2 Overlay.xml
The overlay.xml file can be used to change the default annotations displayed over images in
RadiAnt DICOM Viewer.
When RadiAnt DICOM Viewer is used as a patient CD/DVD viewer, the overlay.xml file can be also
placed in the "COMMON" folder on the CD/DVD media.
Sample file:
<set c="1">
<tl>
<i r="0" s="e" c="1"/>
</tl>
</set>
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</br>
</set>
</sets>
<!--
<set> attributes:
"m" modality (a set is considered as default if the "m" attribute is missing)
"c" c="0" - set defined for static images, c="1" - set defined for CINE mode
"e" e="0" - set overwrites default set, e="1" - set extends default set
<i> single row - can be one of the predefined annotations or a collection of elements (texts
and DICOM tag values)
<i> attributes:
"r" row index (0 ... n), starting from the panel border (0 - a row closest to the border)
"a" 1 - the row is hidden when anonimization is enabled
"c" font color: 0 - yellow, 1 - red
"d" 1 - the row is hidden when the included DICOM element(s) is missing
01 Current image number and total number of images in the viewport (e.g. "3/237")
02 Current series number (e.g. "Se: 4")
03 Lossy image compression info (e.g. "Lossy compression (JPEG 2000)")
04 Patient name (without ^^^)
05 Patient birthday and sex (e.g. "1952-02-09 M")
06 Rotation/flip info (e.g. "R: 90° CCW F: H")
07 MRI TE and TR times (e.g. "TR: 540.0 TE: 14.0")
08 MRI strength of field (e.g. "FS: 1.5")
09 Image acquisition date and time (or study date and time if acquisition timestamp is not
available) (e.g. "2009-12-03 19:23:12")
0A Thickness and location of the image (e.g. "T: 5.0mm L: -68.7mm")
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an example of a row consisiting of the text element and the DICOM tag value:
<i r="3" d="1"><e k="2" t="Body part examined: "/><e k="1" i="00180015"/></i>
-->
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radiantviewer.exe
-f Open DICOM files (radiantviewer.exe -f "file1" "file2" "file3")
-fl Open DICOM files listed in a text file, one file path in each
line (radiantviewer.exe -fl "filelist.txt" )
radcmd.exe
-reqcode Get the request code required for manual activation
(radcmd.exe -reqcode)
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The contents of the zipped archive after unpacking should be placed in the root
folder of a CD/DVD media. You need your own hardware and software to transfer
the autorun package contents to the media (e.g. a disc publisher).
The package contains 32-bit (RA32 folder) and 64-bit (RA64 folder) versions of RadiAnt DICOM
Viewer CD/DVD.
There is also the "COMMON" folder, which contains the following subfolders and files:
· "LANG" - the language XML files with RadiAnt DICOM Viewer CD/DVD translations may be placed
in this folder.
· "LICENSE" - a folder with the license agreements for RadiAnt DICOM Viewer CD/DVD and used
· "options.xml" - this file may be edited to change the default settings of the RadiAnt DICOM
Viewer CD/DVD.
· "overlay.xml" - this file may be edited to change the default annotations overlayed over the
images.
After the purchase you will receive a license key (one key per one recording device).
The license key file ("license.radiantlic", which name may be changed to "license.rlc" for the sake of
compatibility with the ISO 9660 Level 1 file system) must be copied to the "COMMON" folder.
After inserting media, the "autorun.inf" file automatically opens RadiAnt DICOM Viewer CD/DVD
which performs a search for DICOM files placed on the media. This search can be narrowed down
to the specific folders defined as command-line parameters (-d) in the "autorun.inf" file:
[AutoRun.Amd64]
LABEL=RadiAnt DICOM Viewer 64-bit
ICON=RA64\viewer64.exe,0
OPEN=RA64\viewer64.exe -d IMAGES
[AutoRun]
LABEL=RadiAnt DICOM Viewer 32-bit
ICON=RA32\viewer32.exe,0
OPEN=RA32\viewer32.exe -d IMAGES
The viewer may be also started manually with the "run.bat" file. It opens the "RA32/launcher.exe"
tool which, depending on user's operating system versions, runs either 32-bit or 64-bit version of
RadiAnt DICOM Viewer CD/DVD.
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RadiAnt DICOM Viewer CD/DVD can be opened with a chosen interface language (provided that the
specific translation xml file is present in the LANG folder).
You have to pass the language code after the "-lang" parameter to launcher.exe
Just replace the contents of the "autorun.inf" file with:
[AutoRun.Amd64]
LABEL=RadiAnt DICOM Viewer 64-bit
ICON=RA64\viewer64.exe,0
OPEN=RA32\launcher.exe -lang es
[AutoRun]
LABEL=RadiAnt DICOM Viewer 32-bit
ICON=RA32\viewer32.exe,0
OPEN=RA32\launcher.exe -lang es
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