Welcome to the HVRA’s digital image distribution

To start:

Put CD into CDROM drive. Most windows computers are set to automatically start. If not, click on START in the toolbar, select RUN, type in your cd drive letter (usually D) followed by a colon and COTA.exe. Click OK.

Chain of Trust Agreement:

To insure maximum patient confidentiality you must agree to simple terms that insure protection of patient’s privacy. If you agree click on the appropriate option button, and click OKAY. If you don’t agree, click OKAY, and return the CD.

If you are not connected to the internet, you can still see these instructions using Internet Explorer by clicking on this button:
 

  To view the patient's images:

1. Click on the patient's name.

2. Click the VIEW button.

The images and toolbar should appear. You may need to window and level the images using the right mouse button. Do not be alarmed if the images appear all white or black. They just need to be adjusted. Hold the right mouse button down and move up/right and down/left.

Preset values are available on the toolbar at the drop down window next to the window/level icon:

These should get you to a pretty good image which can then be finely adjusted with the right mouse.

The default mouse functions are: Right Mouse (indicated by the “R” in the tool button): Adjusts the window and level. Hold the right mouse down and move up and to the right or down and to the left to adjust the image. (It takes a little getting used to!) 

Left Mouse (indicated by the “L” in the tool button): To scroll through the image stack hold the left mouse button down and drag up or down. You can also use the scroll bar on the right (drag the little gray box up and down), use the Page Up or Page Down keys on the keyboard or use the IM buttons on the tool bar.  

To change which series you are viewing (i.e. an MRI is composed of multiple series) – click on the SE buttons in the toolbar or right click on an image and select from the series pop up menu.                                  

Other mouse functions:                            

 
Moving image side to side: Click on the 4 directional arrow tool, which changes the left mouse action to moving the image. Click on the image, hold the left mouse down, and drag the image left to right, or up to down. 

MAGNIFY: Click on the magnifying glass to make the RIGHT mouse action magnify. Hold the right mouse button down, and drag up or down to magnify or minify the image.                        

MEASURE: Click on the ruler to change the right mouse action to measurement. Hold the right mouse button down, drag to another point on the image, and release. The distance will be displayed. 

                                                  
TOGGLE ANNOTATIONS: Click the big A to turn off (or turn back on) displaying of image text information. This can be useful if important structures are on the edge and obscured by the text.   

The default display is one image from two series, this screen layout, can be changed by clicking on the screen layout tool.

For example, if you want to display 2 images at a time from two series, select that from the screen layout options and click OK.

Clicking on the TOOLS option on the menu bar will display all the available tools.

 Of particular use is the ORIENTATION option. You use this option to flip images if they are displayed upside down or right/left inverted.

Another helpful tool is Muliplanar. This allows displaying of cross reference lines. Selecting one of the first 3 sub-menu options allows displaying of all, first & last, or the current cross reference line. You must have currently displayed the image and a suitable perpendicular image that can show the cross reference line.

In the example below, the SHOW ALL REFERENCE LINES was selected and an axial and sagittal image was selected.
Clicking on the axial image generates the following:

PRINTING:

You can print out images on a windows compatible printer.

1. Select the images you want printed by clicking on the box in lower right hand corner. It will change from transparent to opaque.
   
   
2. To format the output i.e. select the number of images per page click File, then Print Format from the menu.
3. To select the destination printer click File, then Print Setup.
4. To preview click File, then Print Preview from the menu.
5. To print the selected images click File, then Print (or on the keyboard Ctrl-P).
   

To exit the viewer: 

Click File on the menu and then Exit, or the ‘x’ in the upper right hand corner of the viewer window.

Eject the CD.