MODALIZER+
User’s Manual
Version 6.1
Title | Date | Link |
DICOM Conformance Statement | March 6, 2023 |
Table of Contents
1.2. Supported Image and Document Types 5
2.1. The New Patient Wizard (Yellow) 7
2.2. Capturing Images and Scanning Documents 7
2.4. Export DICOM Removable Media (CD/DVD/USB) 11
3.1. Loading images to the Viewer 15
4.2. Using Hounsfield units Contrast Presets 21
4.3. Distance /Optical Density / Angle Measurements tools 23
4.5. Using Zoom/Pan/Contrast/Scroll tools 29
4.8. Display Grayscale Softcopy Presentation State module 33
4.9. The DICOM Header view (editing DICOM objects) 34
5.3. Sending DICOM Images to the PACS 42
5.4. Modality Worklist Query 44
5.5. Query/Retrieve - Searching the PACS 46
6.2. Formatted Report Templates 49
6.3. DICOM Structured Reports (DICOM SR) 50
8.2. TLS (Transport Layer Security) Secure DICOM Networking 56
8.3. DICOM Listener configuration 56
8.4. Local Archive configuration 60
8.5. Storage Servers configuration 61
8.6. Worklist Servers configuration 63
8.7. External Acquisition Application configuration 65
8.8. Formatted Report Template configuration 67
8.9. Custom Actions configurations 68
8.10. DICOM templates - Override DICOM Attributes 70
8.12.1. File System Directory Organizations 71
8.12.2. Support of the Unicode character set 71
8.12.3. Per-User Configuration 71
8.12.5. DICOM Log level for operations as "Send ECHO", "Get Query" etc. 72
9. Completing tasks with MODALIZER+ 73
9.3. Using CD/DVD DICOM Viewer 73
9.4. Viewing PDF file in DICOM format 73
9.5. Attaching scanned documents to the patient folder 73
9.6. Sending the same study to multiple destinations 73
9.7. MPPS (Modality Performed Procedure Step) 74
11. Command line parameters 75
MODALIZER+ is a powerful and easy-to-use Point-of-Care Imaging and Reporting tool. It was carefully designed to capture, scan and display Images and documents in PACS Environment. MODALIZER+ provides a complete solution for Healthcare personnel to document patient encounters, attach media to the patient folder in the PACS, and perform other related tasks. MODALIZER+ is a state of the art DICOM Application with rich feature set combining Imaging Modality, Reporting Tool, DICOM Viewer and Conversion Tool:
Computer: Microsoft Windows compatible laptop/desktop/tablet or virtual machine
Display resolution: minimum 1024x768 pixels
Operating systems: Microsoft Windows 8, 8.1 and 10
.NET Framework: 4.5
Processor: minimum recommended speed – 1Ghz
Internal memory: recommended minimum 1GB
Storage: recommended minimum 40GB of hard disk/SSD
Network Protocol: Secure DICOM Networking (TLS) over TCP/IP
USB: optional for external imaging hardware supporting VIA TWAIN/WIA: optional for paper scanner integration. Use the scanner vendor TWAIN driver utility for configuration of the scanning profile parameters.
Digital Imaging and Communications in Medicine (DICOM) is the standard for handling, storing, printing, and transmitting medical images. DICOM is the most widely deployed healthcare-imaging standard in the world. DICOM images can be exchanged between two entities that are capable of receiving image and patient data in DICOM format.
DICOM enables the integration of scanners, archives, workstations, printers, and network hardware from multiple manufacturers into a picture archive and communication system (PACS).
MODALIZER+ supports the following conversions: PDF, JPEG, PNG, BMP, TIF, Jpeg 2000, MPEG-2, MPEG-4. MODALIZER+ can convert a series of images of the same type and size to Multi-Frame DICOM objects stored in a single file.
MODALIZER+ includes a free DICOM Viewer. Click "Free Viewer" or drag-and-drop DICOM file/folder onto the application window to open the viewer screen. When closing the free viewer, MODALIZER+ will open HRZ Website in your browser.
This section is a quick step by step demonstration of MODALIZER+ Capabilities.
NOTE 1: You can open the user manual in the external PDF viewer from any screen of the application by clicking on the “User Manual” button at the bottom left corner of the application window.
NOTE 2: MODALIZER+ can be started from command line with parameters. See detailed description in the Command Line Parameters section of this document.
NOTE 3: Every function in the menu has a unique color code that continues through the operation. The color from the main menu item follows in the next screens icons and top separator.
For more details see New Patient.
MODALIZER+ Automatically detects and connects to TWAIN/WIA supporting devices such as the internal web camera of your laptop, USB cameras and most document Scanners. When a supported imaging device is detected, the capture and preview panels are automatically displayed. MODALIZER+ can work with multiple image sources simultaneously and can easily switch between devices within the same procedure.
MODALIZER+ can capturing video streams from Web camera and MPEG-2 or MPEG-4 video files. To start capturing, click the "Camera" button on the bottom left of the video panel.
When connected to a scanner, clicking the red capture button launches the scanner’s interface. The scanned documents are added to the bottom panel of attached documents.
Click the add files button to browse for images and documents and attach them to the procedure.
You can add image comments to every image by clicking the pencil button on every image thumbnail.
NOTE: if not edited, the comments are not inserted into the converted files.
NOTE: if user selects to build one multi-framed DICOM file - comments will be inserted into "PerFrame" sequence:
MODALIZER+ is a great reporting tool, automated, customizable, and fully integrated with your PACS and Worklist Manager.
MODALIZER+ Formatted Report automatically fills patient and study information into report templates. The report templates are customizable. You can add your own logo and signature, and use your own stationery style.
There are three ways to create a report in the acquisition screen:
Note: For more details on this feature read the Reporting chapter.
To complete this task, please verify that you have a CD/DVD Writer in your computer. If you don’t have a CD/DVD Writer, you can export the study to any removable media like Disk-on-Key or to a directory on your hard disk.
Prepare the DICOM files that you would like to export.
Note: For more information see Burn CD/DVD.
To display a DICOM file simply drag-and-drop the files on the MODALIZER+ window. You can drag-and-drop one or more files, a directory or a DICOMDIR file. You can also drag-and-drop files and folders on the MODALIZER+ desktop icon.
Note: Read more about HRZ's DICOM Viewer.
Maximize your MODALIZER+ capabilities by connecting to a PACS. Once MODALIZER+ is integrated with your Storage and Worklist servers you will be able to use Modality Worklist to obtain Patient and Procedure parameters and Query/Retrieve to search for studies stored in the PACS..
Read more about Storages Servers configuration and WorkList Servers configuration.
MODALIZER+ has a local DICOM Archive to store the created, converted, and imported studies. All the files in the local archive are stored according to the DICOM Standard using the DICOM file format and are registered in the internal application database.
To enable the local archive open the settings screen and checkmark “Use Local Archive”.
MODALIZER+ is a powerful and friendly Multi-Modality DICOM Viewer.
The DICOM Viewer consists of:
Click F11 to enter the full screen mode. In full screen mode the image display panel takes the entire screen and the other panels are hidden..
Full-screen can also be toggled from the right-click context menu and additionally can be turned off (once active) by clicking the ESC key or by clicking the ‘x’ button on the top-right corner:
The panels can be expanded/collapsed by clicking the arrow icons at the top left of each panel.
Right-click the toolbar area to open context menu allowing to customize the toolbar and select which groups of buttons are visible.
There are few ways to display DICOM files - you can drag and drop the items or to click “Open Files” or use the shortcut CTRL-O to browse for a folder and select the files to view. In order to display an entire folder’s content use “Open Folder” button.
There is also an option to open files from the History screen:
History screen can be opened by pressing ‘History’ button or by the shortcut CTRL-SHIFT-H.
Each "open action" (Files, Folder, DICOMDIR etc.) contains one or more study rows. Study row templates is "[Patient Name],[Patient ID],[Accession Number]". To find study - type required text in the "Search" field on the top. Select entire action as shown in the image above or single study, check its details in the panel below and click "Open selected item" to load files.
If a DICOM file contains embedded video – the viewer displays it in the built-in video player (if possible), or in system Video player. Embedded PDF will be opened in system PDF viewer, SR report - in built-in HTML viewer.
Up to four (4) studies can be displayed side by side simultaneously using the split options in the toolbar.
convert
Different study might be opened in each part. To do it user needs to select required part by clicking on its area (selected part is marked by red border) and open study using usual ways ("Open files"/"Open folder"/"History" buttons). Another option is drag-drop file/folder from Windows explorer onto required part which will be selected automatically.
Clicking on each area automatically loads its study into series/images thumbnails panels:
MODALIZER+ comes with a predefined contrast presets, you can open this list by clicking "Contrast presets" tool button:
Select required presets to change WC/WW values of the currently opened image.
New custom preset can be added by filling Name/WC/WW values in the bottom line and clicking "Add" button.
You can delete existing preset or edit it in the pop-up window:
If an image contains one or more VOI LUT (Values of Interest Lookup Tables) their values will be added to the list of contrast presets.
When opening an image with VOI LUT the first pair is automatically applied.
You can measure distance on the image (in mm for calibrated images, in pixels for others), calculate optical density in any selected point (for CT images) and measure angle between three points. To start drawing/moving click on "Distance"/"Optical Density" / "Angle" tool button:
To exit the tool click on the button again. If measurement tool is not active, all existing measurements remain visible but you cannot move or delete them.
To start "Distance" drawing, click the left mouse button within the image panel. Start point will be marked as cross and dashed line will appear. Move mouse pointer to another place and left-click again to mark end point. Measured distance will be displayed on mouse move.
To start "Angle" drawing, click the left mouse button within the image panel. Start point will be marked as cross and dashed line will appear. Move mouse pointer to another place and left-click again to mark second (angle peak) point, repeat this to define end point. Measured angle will be displayed on mouse move (after peak point was created)
To calculate optical density click left mouse button once on the selected spot:
To change an existing measurement, select start/end cross or entire line (enter mouse pointer), press mouse left button and move pointer holding left-button pressed to required place and release mouse.
To delete a distance line select any part of the line and click on "Delete" button on the keyboard. You can save measurement lines / point as Grayscale Softcopy Presentation State module file under a new series (about viewing of GSPS modules - see 4.7). When user closes a study, returns from Viewer screen or exits application, and there are one or more new distance measurements, one of the following pop-up screens will be displayed:
(Opened study is not part of LocalArchive)
(Opened study is part of LocalArchive)
(Opened study was retrieved from PACS)
MODALIZER+ can display DICOM 12 Lead ECG Instances.
Use the ECG Display Settings tab in the configuration screen to select the graph formats (click "Setting" button from the Viewer, select required parameters and click "Back" on Settings screen. New display parameters are immediately applied.
To start/stop any of these tools click the tool button. When the tool is active the button background is set to red and the mouse pointer changes to the tool mouse icon:
To change image zoom/contrast, move zoomed image inside viewer panel (Pan Tool) or scroll frames - press left mouse button and move pointer holding left button pressed.
Available actions: Flip Vertically, Flip Horizontally, Rotate 90 Clockwise, Rotate 90 Counterclockwise. All measurements on the current image will be changed accordingly
Before:
After:
If DICOM file contains multi-frame image CINE mode is enabled and the cine buttons can be used.
To Pause/Start CINE - click button.
To Stop CINE and close CINE panel - click button
To go to the first/last frame - click buttons
You can change CINE frame rate and loop mode:
MODALIZER+ can display graphic and text annotations stored in DICOM Presentation State objects (GSPS). When a user opens a study, the application selects all such files, loads their data (relations between annotations and study instances/frames, annotations types/positions etc.) and converts it to graphic objects drawn on the corresponding images.
Every GSPS module (series with PR modality) is displayed as a separate thumbnail in the left panel like any other series.
When a user clicks a PR series thumbnail is highlighted, the graphic objects in the GSPS module are displayed as separate image thumbnails in the bottom panel and first of them is displayed in the main area on the image and frame it is referencing.
Click on each image thumbnail loads corresponding image/frame and graphic objects into main area.
When user clicks a non-PR series (images), the annotations are hidden.
When the PR series is selected and user chooses "Show header" - the tags of the PR are displayed ("Edit" for PR files is not allowed)
To view all tags containing in the current DICOM file - right-click on the image and select "Show header" or press Ctrl-H .
Hierarchical tree view will be opened so that sequences might be opened/closed by user.
NOTE: By default all private tags are displayed with "?" name, but you have an option to use dicom.dic file (located in the installation folder) to define name of any private tag. Format of the dicom.dic tag line is:
# Tag VR Name VM Version
(0027,0000) UL SamplePrivateGrpLength 1 RZDCX
All columns MUST be separated by "Tab".
Dicom.dic file from the installation package contains few lines as example. If you don't need them - open file in Notepad and delete unnecessary lines or just delete dicom.dic from the installation folder.
To start editing - select "Show header" and click "Edit" button:
DICOM Object Editor Screen allows user to:
A new instance is generated from the original and updated according to the DICOM standard:
1. New series created
2. Referenced instance sequence (0008,114A) with reference to the original series/instance inserted into the new instance
New instance will be opened for editing:
To add tag - use "Search and add tag" options. When user click "Add" button - tag will be inserted on main level or inside selected sequence
User can copy entire sequence, delete it or add tag into it. To select one of the options - right-click on sequence row to open contest menu.
To change tag value - double-click on its row
To delete tag - right-click on its row and select "Delete tag"
On closing study user will be suggested with several option concerning new instance:
If user decides to save new instance - Rejection Notes KOS Document will be created as new series.
From the context menu select “Image Info” to show the displayed image meta information (size, compression method, color space).
The following shortcut keys are available in the DICOM viewer.
Ctrl + H | Show/Hide text overlay |
Ctrl + O | Open File |
Ctrl+Shift+H | Show History |
F11 | Full screen mode |
Esc | Exit full screen mode |
Select the “New Patient” option from the main menu:
Click "..." button to show/hide Prefix, Middle Name and Suffix fields:
Enter patient’s data (not required), then click “Next”.
Compose the study with images and report as explained in the Create a new Study section then click “Next”.
Create formatted PDF report (optionally) as explained in Writing a Report
Notes:
1. Click button to change the style of the presentation (thumbnails/list).
2. Click on "Patient name..." strip to view full details about procedure
The “Convert” screen consists of three panels:
DICOM files are typically stored in a PACS. This allows accessing them from other DICOM applications.
After acquiring the study images the “Convert” screen is displayed. Select an option “Convert and send to PACS”. If a PACS wasn’t defined yet click “Settings” and configure it. Then click “Next”.
Click “Send to”.
How to send the same study to multiple destinations
In order to use the Modality Worklist Service configure a Worklist Server.
Click “Modality Worklist” in the main menu:
The basic search is done by the patient name or by patient ID. If you are not sure in patient’s name spelling you can use wildcard characters “?” and “*”. “?” is used to represent a single character and “*” represents any number of characters. Click “Advanced Search“ to present additional search options like a range of days when the study has been created or by the accession number. Clicking “Search” with no search parameter set will list all the existing studies. This is not recommended and it may take a very long time.
Search also can be started by pressing "Enter" in any text box in the Advanced Search area.
A default search filter can be set in the settings screen for “today” and for a specific scheduled AE title. To enable this mark the appropriate check-boxes in the “Worklist Server” settings panel.
On screen opening query will be sent to the default MWL server (one currently selected in the settings screen) but you can switch to another server by selecting it from the list located under search panel.
MODALIZER+ uses the attributes received from the MWL Query in the new study Images and report.
Double click on the row from the list of results or clicking the “Next” button will lead you to document the study by creating images and adding a report.
NOTE: If "Two step verification" option on the "Worklist Servers" section of the settings screen is selected - all the data from the selected MWL entry will be displayed in a popup modal windows before starting the procedure:
Right click on the row opens menu allowing to copy/print patient and study info or execute some custom action using selected data ("test" in the below image):
How to configure Customs Actions.
Query/Retrieve (Q/R) is a DICOM Service that allows to search for DICOM objects in a PACS using search criteria (patient name, date of creation of the images, modality etc.) and retrieve them for viewing or other purposes. To use Q/R you configure a Storage Server.
Select “Query Retrieve” from the main screen.
Once the search criteria are set click “Search”. Clicking “Search” with no search parameter set will list all the existing studies. This is not recommended and it may take a very long time.
Search also can be started by pressing "Enter" in any text box in the Advanced Search area.
On screen opening query will be sent to the default Storage server (one currently selected in the settings screen) but you can switch to another server by selecting it from the list located under search panel
Double click on the row from the list of results or select the row and click “Next” –the matching DICOM files will be stored in the destination folder and then displayed in the DICOM viewer.
Right click on the row opens menu allowing to copy/print patient and study info, add a new series to an existing study or execute some custom action using selected data ("Query action" in the below image):
How to configure Customs Actions.
MODALIZER+ can create portable medical records with specific studies and reports, and an embedded DICOM Viewer.
Select “Export” from the main screen.
In order to prepare a Standard DICOM Media, MODALIZER+ prepares the media files using standard filenames in Patient-Study-Series-Image hierarchy and creates a DICOMDIR file.
The “Export” screen consists of two areas:
Select the appropriate option from the list:
Notes:
Click “Next”. Select the drive for the media to be burn. Click “Burn to disc” option.
MODALIZER+ features two options for creating reports:
Formatted Report Templates automates the process of filling the report with case attributes such as patient identification (e.g. Name, ID, Birth Date and Sex), study information and other attributes.
A report template is saved as RTF Document with placeholders for values that are automatically filled while following the new patient wizard. You can create your own templates and select from multiple templates depending on the performed procedure.
The special ‘$’ surrounded placeholders are automatically replaced by the actual attributes values for every new report. The following attributes can be used:
Patient Name | $PatientName$ |
Patient ID | $PatientID$ |
Patient Sex | $PatientSex$ |
Patient Birth Date | $PatientBirthdate$ |
Accession Number | $AccessionNumber$ |
Study Date | $StudyDate$ |
Study Time | $StudyTime$ |
Modality | $Modality$ |
Requested Procedure Description | $RequestedProcedureDescription$ |
Scheduled Procedure Step Description | $ScheduledProcedureStepDescription$ |
Station Name | $StationName$ |
Referring Physicians Name | $ReferringPhysiciansName$ |
Read more about how to configure the report templates.
Create a DICOM Structured Report by typing text in the report text panel on "Acquisition" screen and selecting the "DICOM SR" option in the "Create report as" section on "Convert to DICOM" screen. DICOM file containing SR will be added to a destination folder automatically as a separate series. You can load the report to the Viewer where it will be displayed.
The Local Archive is a built-in SQLite database and hierarchically structured storage place (Root folder/Study folder/Series folder/DICOM files). All converted/retrieved from PACS DICOM files are stored in this storage place if "Use local archive" option is marked in Settings screen. You are able to search, view, export, delete stored files and add new DICOM files to an existing study using "Local Archive" screen.
See in “Settings” how to configure the Local Archive.
Select “Local Archive” from the main screen:
Default sorting of the result grid is by study date descending.
Additional search fields are available on opening expander:
Once the search criteria are set click “Search”. Double click on the row from the list of results or clicking the “Next” button will lead you to Viewer screen displaying images of the selected study.
You can import DICOM files from the folder by your selection. To do it click "Import files" and select required folder. This folder will be scanned, valid files will be copied to archive folder and found studies will be entered into DB.
Right click on the row opens menu allowing to export/send to PACS/delete selected study or add a new series to it:
Click on "Export' opens next screen:
Here you can store images as DICOMDIR on external media (as DVD or Flash drive) or in some folder on your computer (about building DICOMDIRs see Creating Standard DICOM CD/DVD Exports )
You can open the “Settings” screen by clicking the “Settings” link in the main menu or by clicking the “Settings” button in the bottom left corner of any screen. Here you can set the Listener, Storage and Worklist servers, configure Local Archive, Formatted report templates and Custom Actions, change the conversion process configuration and define how to display ECG files in the Viewer
The DICOM nodes (workstations, PACS systems) can communicate if they know each other. That means, each system must know the AE Title, the IP address or hostname and the IP port of the other system. After setting these parameters you will be able to use Storage, Modality Worklist and Query/Retrieve.
Certificates from the Windows store can be used to secure the DICOM connections to the PACS. Both the Local Machine and the Current User certificate stores can be used (see Microsoft Management Console).
See more detailed explanations about using certificates in Listener configuration and Remote Servers configuration sections.
MODALIZER+ can receive DICOM files sent from other applications if its built-in DICOM Listener is started. Current listener status is displayed in the right upper corner of the Listener tab.
First set your listener AE Title and port. You can always start/stop listener by clicking "Start"/"Stop" button next to status label.
To change folder where listener stores received files - click "Browse" button.
When "Use local archive" on Local Archive configuration tab is selected:
You can decide to start listener each time when MODALIZER+ starts by marking "Start listener when application stars" checkbox.
If listener is running there is an indication on the main application screen:
In case "Use secure network" is not selected indication will be like:
If you want to minimize MODALIZER+ to the tray on closing application by "X" (so that the listener keeps running) - mark "Keep running when listener is on" checkbox. To restore MODALIZER+ to view - right click on tray icon and select "Open". To exit MODALIZER+ which is collapsed to tray - right click on tray icon and select "Exit"
NOTE: If one MODALIZER+ instance is already running, all other instances you'll try to start will be opened in "Viewer only" mode. In such case check for another MODALIZER+ instance collapsed to the system tray.
Checkbox "Use secure network" - if selected enable DICOM TLS Network Security Layer
"Windows Certificate store" area - select required store (Local Machine or Current User)
"MODALIZER+ Certificate" area - click "Browse" to select certificate that identifies MODALIZER+ from Windows store:
If user selects a certificate that doesn't have a private key, an error message will be shown and certificate will not be selected:
Click "Clear" to remove selected certificate from settings.
Checkbox "Certificate Verification" - if checked listener will ask clients to provide a certificate
Checkbox "Request for Client Certificate (Mutual Authentication)" - when disabled the clients are not asked to identify ???
"Approved clients" textbox - list of all certificates belonging to the listener clients. User must get clients certificates as files and import them into Windows Store using Microsoft Management Console.
Click "Add" to select certificate from the list, click "Clear" to remove ALL client certificates.
All converted/retrieved DICOM files can be stored in hierarchically structured storage place (Root folder/Study folder/Series folder/DICOM files); info about these files is stored in built-in SQLite data base. To use this option, mark "Use local archive" checkbox on the "Local Archive Configuration" tab.
To change the root folder where archived studies are stored – click the "Browse" button.
Set required clearing mode by selecting options from "Automatically delete local copy of study after" and "Automatically delete local copy of study only if" lists.
You may need to re-fill DB by info about DICOM files stored in root folder, for example if you want to switch to another storage folder. You can do it by selecting required path and clicking "Rebuild from files" button. Current archive folder will be scanned and found studies inserted into DB.
This operation is executed in separate task with displaying its progress while running. You can stop this operation by clicking "Cancel" button.
Log file RebuildFromFiles.log will be created containing follow data:
- The name of every folder that is scanned
- The name of every file that is opened (full path)
- Whenever new study is added with Study Instance UID.
You can also import DICOM files from the folder by your selection. To do it click "Import files" and select required folder. This folder will be scanned, valid files will be copied to archive folder and found studies will be entered into DB.
Note: You should configure at least one server.
Set the data for your Storage Server. Click the “Echo” button to verify that the settings are correct. If red X icon is displayed, verify that the settings are correct and the server is running. Click “Save” to apply the settings for a new Storage Server or “Cancel” to exit the settings. Check the log file lastEcho.log in MODALIZER+ installation folder (C:\MODALIZERPLUS).
"Retrieve method" combo box allows selection between using C-MOVE and C-GET. The user can select which of the commands to use for retrieving the instances.
"Windows Certificate store" area - select required store (Local Machine or Current User)
Local AE Certificate (optional - user don’t have to select certificate. Not all servers require it) - click "Browse" to select local certificate from Windows store. Click "Clear" to remove selected local certificate.
This certificate verifies MODALIZER+ identity. The remote AE may request for this (mutual authentication)
Remote AE Certificate (optional - user don’t have to select certificate. If not defined MODALIZER+ will not verify the server certificate explicitly) - click "Browse" to select remote certificate from Windows store. Click "Clear" to remove selected remote certificate.
Checkbox "Verify Certificate" (enabled only when Remote AE Certificate is blank) . When checked RZDCX will look for the remote certificate in the local user cert store
Important: To complete this step you must also configure your Storage Server (PACS) with Your MODALIZER+ AE Title (the value you set for “Local AE”), the hostname (or IP address) of your computer and the IP port (the value you set for “Local port”).
Note 1: Ask your System/PACS Administrator for the Storage Server parameters.
Note 2: MODALIZER+ is compatible with most DICOM PACS providers. Please advise your PACS software help file about AE configuration of your PACS server or ask your System Administrator.
The Worklist Server must be configured in order to use Modality Worklist query.
Configure the parameters for your Worklist Server. Click the “Echo” button to verify that the settings are correct. If red X icon is presented verify that the settings are correct and the server is running. Click “Save” to apply the settings for a new Storage Server or “Cancel” to exit the settings.
Timeout - The recommendation is to keep the default, if there is known connection problem increase the value.
Two more options in the Worklist Server panel refer to Worklist Query filter. You can define that the search results will present only the studies that scheduled for today and/or for a specific Scheduled AE Title. To do this mark the appropriate check-boxes in the “Worklist Server” panel.
"Two step verification" checkbox: if this option is selected (default is checked) – the user will be asked to review and confirm the data received from the Modality Worklist before starting the procedure.
See "Storage servers configuration " about Remote server and security settings.
Checkbox "Automatic MPPS" - select if you want MPPS to be sent with the completed study.
Note: Don’t check this option if the Worklist Server you work with doesn’t support MPPS.
"Storage server" list allows to select one the remote servers defined in MODALIZER+ as default destination to send study created from the Modality Worklist.
Note: Ask your System Administrator for the Worklist Server parameters.
User has an option to use some external application to acquire images for converting to DICOM. For example - some application receiving images from medical device as CT etc. This application must receive as input parameter path to some "exchange data" file containing patient data (name and ID) and save acquired file in the parent folder of this file.
To use this option, the following parameters must be configured in the settings screen:
In order to use EXAP - select "Use EXAP"
When "Use EXAP" is selected - external application will be started when user clicks "Next" button on "New patient"/ "Modality Worklist" screen or on adding new series to existing study from "Local Archive'/"Query Retrieve" screen.
MODALIZER+ will fill the exchange file with case attributes such as patient identification (e.g. Name, ID, Birth Date and Sex), study information and other attributes.
Template file (located in MODALIZER+ installation folder and named PatientDataTemplate.xml) can be of any text format - XML, txt, json, even RTF. By default it's XML containing ALL available fields:
<?xml version="1.0" encoding="utf-8" ?>
<PatientData>
<PatientName>
$PatientName$
</PatientName>
<PatientId>
$PatientID$
</PatientId>
<PatientSex>
$PatientSex$
</PatientSex>
<PatientBirthdate>
$PatientBirthdate$
</PatientBirthdate>
<AccessionNumber>
$AccessionNumber$
</AccessionNumber>
<StudyInstanceUID>
$StudyInstanceUID$
</StudyInstanceUID>
<StudyId>
$StudyId$
</StudyId>
<StudyDate>
$StudyDate$
</StudyDate>
<StudyTime>
$StudyTime$
</StudyTime>
<Modality>
$Modality$
</Modality>
<RequestedProcedureDescription>
$RequestedProcedureDescription$
</RequestedProcedureDescription>
<ScheduledProcedureStepDescription>
$ScheduledProcedureStepDescription$
</ScheduledProcedureStepDescription>
<StationName>
$StationName$
</StationName>
<ReferringPhysiciansName>
$ReferringPhysiciansName$
</ReferringPhysiciansName>
</PatientData>
Output file is saved as PatientData.xml in the shared folder so your EXAP application is able to load required data from it.
The special ‘$’ surrounded placeholders are automatically replaced by the actual attributes values for every new exchange file.
MODALIZER+ is installed with built-in EXAP application as example:
After user added files and clicked "Done" (or executed custom actions in external application and closed it) - "Acquisition" screen will be opened with acquired files added to the list
About formatted reports structure see Reporting section.
Select required template in the list and click “Edit” to edit the template properties:
You can change templates name which is displayed in the list of templates on "Images" screen, select another RTF file or open RTF file itself to edit its content by clicking "Edit template" button (you can edit the header/footer of the template, edit text and add Logo).
If you want to create a new template - click "Add new" and select path to your custom RTF file.
To delete existing template - select it in the list and click "Delete"
NOTE: At least one template must exist so you cannot delete last one.
"Custom Action" is a some operation you can execute using data from one MWL entry (see Modality Worklist Query) or Query entry (see Query/Retrieve - Searching the PACS)
To create new custom action click "Add new" button:
Select a screen where you want to see new action (Modality Worklist or Query Retrieve), give action a title which will appear in the list and define some command you want to execute - path to some file (as .TXT, .RTF, .EXE or .BAT) .
Mark "Replace parameters" checkbox to make application replace pre-defined parameters inside command file by data from MWL/Query (as in formatted report)
When you select custom action from the row on MWL/QUERY screen - defined file will be opened (with replaced parameters if needed) as separate system process.
To edit existing custom action - select it in the list and click "Edit" button.
To delete existing custom action - select it in the list and click "Delete" button.
You can test your action by clicking "Test" button (parameters will be replaced by some random data).
Types of the custom action:
1.Start EXE without parameters.
2. Open document template , TXT or RTF for example, containing placeholders ( $PatientID$ etc.) to replace (like formatted reports). Place holders will be replaced, files stored in [MyDocuments]\MODALIZERPLUS\ACTIONS folder and opened as separate process (Notepad, Word etc.)
3. Start EXE with parameters. To pass parameters to EXE you need to do follow:
Available parameters are:
$PatientName$
$PatientID$
$PatientSex$
$PatientBirthdate$
$StudyDate$
$AccessionNumber$
$StudyTime$
$Modality$
$RequestedProcedureDescription$
$ScheduledProcedureStepDescription$
$StationName$
$ReferringPhysiciansName$
DICOM attributes are stored in the files that you can edit or replace. In order to use the attributes as they’re defined in the template mark “V” in the check-box “Use Template”.
Application allows to define not only one template common to all converted DICOM files, but also specific templates for each type of such files.
There is combo box "Type" in "Override" section:
"Common" template (if defined) will be inserted into each converted DICOM file.
There are also four other types: Image, PDF, Video and Structure Report templates which will be inserted only to relevant files.
Any of the files can be created/selected separately.
Important! The override attributes are applied after all other conversion steps were made. Make sure not to override any image attributes (group 0028).
To create your own DICOM attributes template click “New”, in the opened window select the file location and give it a name. Click “Save”. The created file will be automatically loaded in MODALIZER+ and you can edit the attributes. You can find the attribute by its name - start typing to get a drop-list of the appropriate attributes or search by the attribute’s tag enumeration. Click “Add” to present the value in the table. Enter the new value in the attribute’s row in the “Value” column. Clicking “X” in the left column will remove the attribute from the template.
If you want to use another DICOM attributes template click “Browse” and select.
At the bottom of the configuration screen there are few additional options:
Create new folder for every run - in this way each study will be stored in separated folder (Recommended).
When Local Archive is disabled the converted images destination folder can be manually set (see New Patient).
When "Create new folder" is enabled, every study is stored in a newly created directory.
When "Use unicode caharcter set" is checked, values of "String" tags (Value Representation SH, LO, ST, LT, UT, PN) will be inserted encoded as Unicode.
When per-user configuration is checked, every user (from the windows operating system) has its own configuration file.
Define key combination to capture image from the currently selected TWAIN/WIA device when in the capture screen
Valid keys:
Enter/Return and Space keys are not recommended as they may interfere with standard UI functionality.
To disable the capture key, click in the text box and then press the delete key.
Default value is "INFO"
MODALIZER+ is a powerful DICOM Workstation that lets you display DICOM Files from your local computer, from CD/DVD/USB and from any PACS.
There are a few ways to present the files - you can Drag-and-drop the items or to click “Open Files” to browse for a folder and select the files to view. In order to present all folder’s content use “Open Folder” button.
DICOMZIER automatically adds a DICOM CD Viewer to every burned CD/DVD so patients and physicians can view their studies and reports anywhere. Double click the DICOM Viewer application in the CD/DVD root folder to view the CD/DVD content.
To extract a PDF from a DICOM Encapsulated PDF file, click PDF icon in the Viewer – the file will be converted to PDF and displayed using your system default PDF viewer.
MODALIZER+ will automatically identify compatible camera or other imaging device connected to your computer. If there are more than one device connected choose the one you’d like to use through the drop-list in the upper left corner of the Image/Report panel.
Capture an image by clicking on the red button. The icon of the captured image will be presented in the panel below the Image/Report panel.
Once an operation is completed you can send a copy of your study to others DICOM applications by using the “Send to” option in the operation completed screen. Select the destination from the drop-list next to the “Send to” button. If the destination DICOM application is not in the list, enter settings and add new Storage Server.
Modality Performed Procedure Step is a complementary service to Modality Worklist.
Once the procedure was started via Modality Worklist Query the modality creates a new MPPS that references the Study.
MPPS has 3 statuses:
MODALIZER+ Log files are stored in the directory: C:\Users\<User>\Documents\ MODALIZERPLUS \LOGS.
MODALIZER+ keeps the last log for every DICOM operation:
When operation fails, message will be displayed with an option to open correspondent Log file:
When launched with specified command line parameters MODALIZER+ will start directly in the Q/R screen and send a query according to the parameters. Query parameters appear in the query screen when results are retrieved from PACS and could be editable for additional query.
Also there is command line parameter allowing to get "snapshot" of the current image from the MODALIZER+ viewer.
Command Line options
-q or -Q | Start MODALIZER+ in the query screen and send a Query. |
-o or -O | Set the output path for Send as references. This option overrides the EXAP shared folder name. |
Query parameters
0 or more query parameters can follow the -Q option. Every parameter should be of the form:
tagName=”value”
Double quotes are optional for cases where the value contains whitespace characters (space).
The allowed tags are all the ones that are displayed in the Q/R screen including the advanced search. The tag names should be according to RZDCX’s DICOM_TAG_ENUM.
Option | Tag Name | Tag | Comments and examples |
patientName | Patient Name | (0010,0010) | |
patientId | Patient ID | (0010,0020) | |
PatientBirthDate | Patient Birth Date | (0010,0030) | Exact date in DICOM format (YYYYMMDD) Example: “20170821” |
PatientSex | Patient Sex | (0010,0040) | Valid Values: M/F/O or Male/Female/Other (both accepted). |
AccessionNumber | Accession Number | (0008,0050) | |
StudyDate | Study Date | (0008,0020) | Exact date in DICOM format (YYYYMMDD) including ranges. When value is a date range double quotes must be used to prevent parsing it as command line option. Examples: “20170821” (exact date) “-20170821” (to date). “20170812” (from date). “20170812-20170911” (date range) |
ModalitiesInStudy | Modalities in Study | (0008,0061) |
Example: MODALIZERPlus.EXE -q patientId=”111” will start the directly to the Q/R string and start a query:
Save as reference button
When the -O command line parameter is used, the Save as reference button will be displayed instead of the three buttons on the left (open file, open folder and history) :
Clicking the "Save as reference" button will save the currently displayed and selected image using the current VOI LUT to the path provided as the value of the option. For example if the MODALIZER+ started with the command: MODALIZERPlus.EXE -O “c:\taken Send as references” then the files will be saved in “c:\taken Send as references” .
The Save as references will be saved in PNG format in the full resolution of the DICOM image (i.e. according to the Rows and Columns tags (0028,0100) and (0028,0101).
Next to the PNG file, the original DICOM file will be saved:
The Send as reference save files will have the following filename pattern:
<destination-folder>\SOP Instance UID.png
<destination-folder>\SOP Instance UID.dcm
<destination-folder> is the value from the -O command line parameter. If -O is not set, application uses the EXAP shared folder from configuration.
If the provided path is not empty, and there is already a file with that name, the file shall be replaced without asking the user.
Start MODALIZER+ with "-help" or "-h" parameter to open popup windows with the description of command line parameters.
© H.R.Z Software Services LTD 2021. All rights reserved.
2014-11-12 Page of MODALIZER+ User Manual.docx
[1] Changing the image format may result in quality loss.
[2] Some PACS May not allow storing JPEG Compressed DICOM Images.
[3] JPEG Compressed Images usually take less disk space and may be faster to store and restore from the PACS but loose some quality compared to uncompressed files..
