Grubstr- 6-8 D Vörstetten Tel.: +49(0) Fax: +49(0) Steinhart Medizinsysteme GmbH

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1 Hipax Diagnostic Workstation Table of Contents 1. PRODUCT DESCRIPTION HIPAX DW MODULES DW BASE MODULE DW BASE MODULE STANDARD (05-010) DW BASE MODULE LIGHT (05-020) DW IMAGE ACQUISITION DW X-RAY DIGITIZING (05-060) DW X-RAY MODULE FOR CR/DR CONNECTION (05-030) DW X-RAY JOURNAL (05-260) DW VIDEO (05-090) DW MODULES FOR WORKFLOW DW GDT INTERFACE (05-250) DW HL7 INTERFACE (05-380) DW DICOM WORKLIST (SCP) (05-185) DW DICOM WORKLIST (SCU) (05-180) DW AUTOROUTING (05-360) DW COMMUNICATION MODULES DW DICOM COMMUNICATION (05-200) DW DICOM (05-270) DW MODULES FOR IMAGE PROCESSING DW 16 BIT FILTERS (05-035) DW STITCHING (05-230) DW MAMMOGRAPHY (05-350) DW ORTHOPLANNER CONNECTION (05-370) DW 3D (05-400) DW VOLUME RENDERER (05-420) DW MIP (05-410) DW MPR (05-020) DW MODULES FOR IMAGE OUTPUT (PRINT, CD, DVD) DW LOCAL ARCHIVE (05-110) DW PATIENT CD (05-120) DW CD/DVD ROBOT (05-280) DW DICOM PRINT (05-190) DW SOFTWARE LICENSE SYSTEM REQUIREMENTS OF HIPAX DW Steinhart Medizinsysteme GmbH Grubstr- 6-8 D Vörstetten Tel.: +49(0) Fax: +49(0) info@hipax.de Steinhart Medizinsysteme GmbH 2012/02/29 Hipax Diagnostic Workstation 1 of 10

2 1. Product Description The medical image processing software Hipax Diagnostic Workstation (Hipax DW) has specially been developed for radiologists. It offers an extremely fast image loading and provides an optimum workflow even for processing very big series. The images can already be processed while the series is still loaded the loading process is carried out in the background, unnoticed by the user and without loss of performance (parallel processing). The different image processing functions can be used in maximum speed even on very big image series. Mammography reporting and 3D image processing opens additional possibilities for radiologists to evaluate images. The Hipax DW is based on a capable SQL database and can therefore also be used as Mini PACS server solution. 2. Hipax DW Modules The Hipax DW has a modular architecture. The different modules are described in the following chapters. 2.1 DW Base Module The Base Module is part of each Hipax DW installation. It contains the basic functions for image processing and can be supplemented by additional Hipax DW modules. Hipax offers two DW Base Modules with different functions: The DW Base Module Standard (see chapter 2.1.1), and the DW Base Module "light" (see chapter 2.1.2) DW Base Module Standard (05-010) The DW-Plus Base Module Standard contains various functions for image and series processing. It can be combined with all other Hipax DW modules Functions for Image/Patient Administration and Reporting: local study list patient CD study list DICOM Query study list thumbnails of the images SQL database Report creation and import (DICOM SR, DICOM PDF, Word) 2 von 10 Hipax Diagnostic Workstation 2012/02/29

3 Functions to Process Single Images: processing of gray and color images window-leveling and dynamics magnifying glass image zooming rotating and reflecting cropping image display in configurable series areas and image areas full screen display of images with interpolation image import (DICOM), also from CD import of several images at one time (directory import) image export (DICOM, BMP, JPEG, PNG, AVI) printing with different layouts on Windows printers writing and marking measurement of lines, angles and areas creating image copies with burned-in measurements Functions for Multilayer (e.g. CT, MRI) and Multi-Frame (e.g. XA, US, NUK) Images: parallel processing hanging protocol scout lines intelligent loading of MRI series, skipping the scout image display in stacks or side by side (spread mode) paging through series or sequence stacks synchronized paging through two or more image stacks synchronized comparison of two series cine-loop of image stacks at any speed cine-loop of several sequences at one time zoom on whole series or sequence centre/window leveling of the whole series or sequence marking single images of a series or sequence selection of relevant layers printing either single images or a whole series or sequence on Windows printers series import/export DW Base Module light (05-020) The DW Base Module "light" is a simplified variation of the DW Base Module Standard to be used as a viewer to process and administrate single color- and gray scale images. It includes all functions given in chapters and , with the exception of measurements. The DW Base Module "light" can only be combined with the DICOM Communication module (see chapter 2.4.1). 2012/02/29 Hipax Diagnostic Workstation 3 of 10

4 2.2 DW Image Acquisition DW X-ray Digitizing (05-060) The "X-ray Digitizing" module enables the user to adopt images directly from all X-ray digitizers of the manufacturers VIDAR and Microtek DW X-Ray Module for CR/DR Connection (05-030) The "X-Ray" module for CR/DR connection enables the user to receive images directly from different non-dicom capable CR or DR systems, for example, Dürr Vista-Scan, icrco, Kodak POC, ScanX, Samsung, Thales, Varian, Xcan Crystal LT, etc. Please tell us, which system you are going to use. The filters described in chapter are part of the X-Ray module DW X-ray Journal (05-260) The X-ray Journal module is an extension to the X-Ray module (chapter 2.2.1) adopting images from a CR or DR system. The X-ray Journal module enables the user to save the settings used for the current X-ray study in an own database. Storing a new image the corresponding X-ray parameters are written automatically into the DICOM Header DW Video (05-090) Using the "Video" module, single images or whole sequences can be grabbed from devices providing a Firewire- or USB interface, or a video plug. The video grabbing via Firewire or USB can be made directly. For video grabbing via video plug a frame grabber is required. The type of frame grabber depends on the type of video signal. Standard video signals can be grabbed by any standard frame grabber card to be addressed by DirectShow driver (e.g. DFG/SV1). 2.3 DW Modules for Workflow DW GDT Interface (05-250) Integration of Hipax into a patient administration system. Hipax adopts text files, where the patient data are given in a defined format defined by Steinhart. This module is required for Art. No : DICOM Worklist SCP (see chapter 2.3.3) DW HL7 Interface (05-380) RIS connection. The patient data can be read from HL7 messages in ASCII format and entered into a DICOM Worklist table. Hipax supports HL7 versions 2.3 and 2.5. This module is required for Art. No : DICOM Worklist SCP (see chapter 2.3.3) 4 von 10 Hipax Diagnostic Workstation 2012/02/29

5 2.3.3 DW DICOM Worklist (SCP) (05-185) The "DICOM Worklist (SCP)" module is able to create worklists and to make them available for DICOM Worklist (SCU) capable modalities or image acquisition workstations. Thus, the DICOM Worklist (SCP) is an interface between the patient administration system and the modalities. For full workflow including the image reception form the DICOM modalities, the DICOM Communication module (05-200, see chapter 2.4.1) and the GDT or HL7 Interface (05-250, see chapter or , see chapter 2.3.2) must also be installed on the same workstation DW DICOM Worklist (SCU) (05-180) The "DICOM Worklist (SCU)" module can be installed on an image acquisition workstation. It adopts the worklists provided by the DICOM Worklist (SCP) module. The patient data taken from the worklists are then inserted automatically into the local database. Thus, patient data have not to be entered manually. Using the DICOM Worklist (SCU) module, the DICOM Communication module (05-200) must also be installed on the same workstation (see chapter 2.4.1) DW Autorouting (05-360) Using the "Autorouting" module, incoming images can be forwarded to defined destinations. Furthermore, it is possible to store the image copies automatically in pre-defined directories locally or on another Hipax Diagnostic Workstations within a network. Thus, images can, for example, be made available on the diagnostic workstation of the doctor for fast loading. Nearly any header content as well as called- or calling AE title can be used as filter criteria to forward the images. Using DICOM Send or DICOM , images can be forwarded delayed at pre-adjusted times. To forward images using DICOM Send or DICOM- the DICOM Communication module (05-200, chapter 2.4.1) or the DICOM module (05-270, chapter 2.4.2) must also be installed. 2012/02/29 Hipax Diagnostic Workstation 5 of 10

6 2.4 DW Communication Modules DW DICOM Communication (05-200) The "DICOM Communication" module can be used to send and receive images following the DICOM standard via TCP/IP protocol: DICOM-Send, -Storage, -Query (SCU/SCP). Images to be transmitted can be made anonymous and/or lossy or lossless compressed DW DICOM (05-270) The "DICOM " module can be used to send and receive images via according to DICOM Supplement 54. This also enables the exchange of images with systems of other manufacturers. The images to be transmitted can be encrypted using PGP or SSL and lossless compressed by factor 2 (Bzip). Big images or series can be split to the maximum size accepted by the provider. To use the DICOM module, the DICOM Communication module (05-200, chapter 2.4.1) has also to be installed. 2.5 DW Modules for Image Processing DW 16 Bit Filters (05-035) The "Filter" module offers a couple of predefined filters to be used for 16 bit images. The filters can be configured individually DW Stitching (05-230) Using the "Stitching" module, up to 4 images can be merged to create one image. This function can be used, e.g., to display long leg or full body X-rays. The transparency of the images can be adjusted to simplify the matching procedure. The currently active image is marked using a color. The position of the images can be changed using the mouse. Images to be combined must have been created by the same modality, and they must be of the same type (color or gray, 8 Bit or 12 Bit, small or broad) DW Mammography (05-350) The "Mammography" module provides special functions to display mammography images: Specific hanging protocol, parallel translation of the corresponding images, dual monitor display, magnification glass, short cuts to switch between different layouts, shutter to mask unimportant areas of the image. 6 von 10 Hipax Diagnostic Workstation 2012/02/29

7 2.5.4 DW OrthoPlanner Connection (05-370) The "OrthoPlanner" module is an interface to the software OrthoPlanner of the company Localite GmbH. OrthoPlanner provides, e.g., templates of hip joint endoprostheses to be magnified or reduced and to be moved on the image. This enables orthopedists to plan the implantation. The OrthoPlanner software itself is not included in the Hipax DW OrthoPlanner module DW 3D (05-400) The "3D" module is a capable tool for volume rendering, MPR, MIP, and MinIP. For example, full-length CT scans with up to 1536 single images can be displayed and processed interactively. For volume rendering the Hipax DW 3D module is optimally using the common multi core processor technology. Thus, high image quality and high interactivity can be achieved even with low hardware requirements. The Hipax DW 3D module provides the following measurements: 3D distance, 3D angle, traverse length, spline curve length. Modules (chapter 2.5.8), (chapter 2.5.7) and (chapter 2.5.6) are part of the Hipax DW module DW Volume Renderer (05-420) The "Volume Renderer" module is optimally using the common multi core processor technology. Thus, high image quality and high interactivity can be achieved even with low hardware requirements. The Volume Renderer is also part of the Hipax DW 3D module (05-400) DW MIP (05-410) The "MIP" module includes MIP (Maximum Intensity Projection) and MinIP (Minimum Intensity Projection) to evaluate CT- and MRI angiography series, e.g., to display blood vessels. MIP and MinIP are also part of the Hipax DW 3D module (05-400) DW MPR (05-020) With the "MPR" modules offers a tool to evaluate CT- and MRI series in all three viewing planes, and oblique (clipping). MPR is also part of the Hipax DW 3D module (05-400). 2012/02/29 Hipax Diagnostic Workstation 7 of 10

8 2.6 DW Modules for Image Output (Print, CD, DVD) DW Local Archive (05-110) The "Local Archive" module, swappes out the oldest images to save memory on the local hard disk. The corresponding thumbnails remain on the hard disk for identification. The outsourcing can be made online, or offline on CD or DVD. Online archive: Moves images of a minimum age from the hard disk to an online archiving system, e.g. RAID. The archiving process can be started manually or automatically at pre-adjusted times. The archiving period can be determined. The process is stopped automatically, if the memory of the online archive runs short. Several online archiving media can be defined. Log files are created for each archiving process. For reasons of fast access, Hipax does not provide a compression tool for online archives. The standard Windows compression tool for directories can be used if required. Offline Archive: The offline archiving process can be started manually. The oldest images are then collected until the memory of the selected media (CD or DVD) has been achieved. Offline archived images can be lossless compressed by factor 3. A CD/DVD-writer software is included in the Local Archive module DW Patient CD (05-120) The "Patient CD" module enables the user to burn the images of one or several patients on a CD. The patient CD contains a Hipax viewer to open the images on any PC. The Hipax patient CDs are fulfilling the DICOM standard. Thus, DICOMDIR CDs can also be written, e.g. containing cardiac sequences. A CD/DVD-writer software is included in the module. To prevent data abuse, Hipax Patient CDs can be AES encrypted. To open an encrypted Hipax Patient CD, a password needs to be entered. Passwords are individually generated and stored for each single Patient CD DW CD/DVD Robot (05-280) The "CD/DVD Robot" module enables the user to connect a CD or DVD robot of the Primera Disc Publisher group to a Hipax workstation. Thus, patient CDs can be produced fully automatic directly from the Hipax viewer. To make this, the Patient CD module (05-120) needs also to be installed. Hipax writes the data into a temporary folder, where the CD/DVD robot can read them automatically and write them on the media. The integrated printer of the robotic system prints the label on the disk. To identify the patient CD the patient data for the printout (name, first name, birth date, ID, etc.) are taken directly from the DICOM header of the images. The praxis logo or other information can also be printed. The Primera PT-Burn software is not included in the Hipax DW CD/DVD Robot module. Hipax supports Primera PT-Burn Server SDK Version 2 and 3. 8 von 10 Hipax Diagnostic Workstation 2012/02/29

9 2.6.4 DW DICOM Print (05-190) Using the "DICOM Print" module, medical images can be printed on DICOM capable (SCU) wet or dry printers, e.g. to produce films. The print dialog of the Hipax Diagnostic Workstation enables the user to determine the layout of each print job individually using the printable space of the page to full capacity. This avoids half printed pages and helps therefore significantly to save costs. The Hipax DW DICOM Print module also supports the scaled 1:1 film-print of X-rays (STANDARD/1,1). DICOM print jobs can be created in few seconds and stored as files. The transmission of the print jobs to the possibly slow printer is then made in the background. 2012/02/29 Hipax Diagnostic Workstation 9 of 10

10 3. DW Software License A USB dongle is used for licensing a single dongle or a network dongle, depending on the demands. The network dongle can be used for a practice or hospital network to license all single Hipax installations by the same dongle. The Hipax Diagnostic Workstation can be installed on all PCs of the network. The number of licenses to be used at the same time are defined by the network dongle. The dongle is the license of the Hipax Diagnostic Workstation. Please take care for the dongle. To avoid the loss of the dongle we recommend to use an USB 2.0 board with internal USB plug. 4. System Requirements of Hipax DW The performance of the software increases with the capability of the hardware. Intel Core 2 Duo from 2 2,2 GHz or comparable AMD processor Minimum 2 GB RAM, 4GB for cardiology, mammography, stitching, 3D S-ATA II hard disk from 250 GB capacity Color or gray scale monitor from 17", better 20", special certified monitors for diagnosis, depending on the image type PCIe graphics card with at least 256 MB RAM, resolution at least in True Color mode. Special medical mega pixel PCI graphics cards for diagnosis (e.g., Matrox Med5mp) Wheel mouse CD drive to install the software USB 2.0 plug for the dongle (software licensing) Windows 2000, XP, Vista, Windows 7 Additional hardware and software might be required depending on the Hipax DW modules used, e.g. a network card an TCP/IP network for DICOM communication, a CD/DVD burning drive to burn media manually or the Primera Disc Publisher with corresponding driver software etc. burning media automatically. Requirements for 3D image processing (volume rendering, MIP, MinIP): Fast Core 2 Duo-CPU (better Quad-Core) OpenGL 1.5 and DirectX 9.0 Shader model 3.0 graphics card Network card TCP/IP capable network, at least 100/1000 Mbit 10 von 10 Hipax Diagnostic Workstation 2012/02/29