KaVo 3D eXam User manual

K990400 16 April 2008
Cone Beam Volumetric Tomography and
Panoramic Dental Imaging System
Operators’ Manual

K990400 16 April 2008
Published by KaVo
KaVo reserves the right to make changes to both this Manual and to
the products it describes. Equipment specifications are subject to
change without notice. Nothing contained within this manual is
intended as any offer, warranty, promise or contractual condition,
and must not be taken as such.
This document may not, in whole or in Part, be copied, photocopied,
reproduced, translated, or reduced to any electronic medium or
machine-readable form without prior consent in writing from KaVo.
3D eXam® is a registered trademark KaVo. Other names may be
trademarks of their respective owners.
For more information or an original version of documentation on the
KaVo 3D eXam®, please write, call, or fax to KaVo. This
documentation has been drafted, approved & supplied in the English
Language. KaVo will make available under request any component
parts, calibration instruments, circuit diagrams, etc.
No part of this document may be reproduced or transmitted in any
form or by any means, electronic or mechanical, for any purpose,
without prior written permission of KaVo. The information in this
document and the product it describes are subject to change without
notice. Names and data used in examples herein are fictitious unless
otherwise noted. The software program described in this document
is provided to its users pursuant to a license or nondisclosure
agreement. Such software program may only be used, copied, or
reproduced pursuant to the terms of such agreement. This manual
does not contain or represent any commitment of any kind on the
part of KaVo.

K990400 16 April 2008
1-1
What’s New in this Release
Change Description Link to Topic
Quality Control Frames added to
help access quality of captured scan.
First and last frames of a scan can be
compared to determine if patient
moved during the scan.
Using Quality Control Frames on
page 7-3
Study Date drop-down added to
enable filtering by study dates.
Patient Information on page 5-1
Two new options, Reset Window/
Level and Reset All Window/
Levels, added to reset brightness and
contrast to original settings if they
were changed.
Adjusting Brightness and
Contrast on page 7-9
Filter setting Smooth removed.
New filter setting Sharpen Mild
added.
Filter Settings on page 7-11
Preview frames can be viewed for
raw patient images.
Viewing and Reconstructing Raw
Patient Scans on page 7-23
Level Up menu option changed to
Screen option. Screen option
enables selection of any detail
screen without having to access the
Preview screen.
Preview Screen on page 8-1
3D Model view added to the Implant
Planning screen.
To Use the 3D Model View on
page 8-6
New feature added to enable
marking of estimated nerve canal for
left, right, or both canals.
Estimate the Nerve Canal on
page 8-7

Kavo 3D eXam ® Operators’ Manual
K990400 16 April 2008
1-2
Gridlines added to MPR screen. MPR Screen on page 8-14
Scroll wheel on mouse is activated
to enable scrolling through slices on
Implant Planning and MPR screens.
Implant Planning Screen on page
8-2
MPR Screen on page 8-14
Use Lossy Compression option
added to DICOM Export Properties
and CD Burner Speed dialogs. This
compression type can be used when
exporting patient data across a
network or when creating a CD.
Export DICOM on page 9-2
Create CD on page 9-3
Networking support feature added to
facilitate customer setup of
networked VisionQ and Vision
computers.
Networking Support Setup on
page 14-1
New features added to: 1) enable
import of patient data from a
DICOM worklist or Patient
Management system, and 2) enable
export of DICOM images to a
remote system such as a Picture
Archive and Communications
System.
Remote System Import and
Export on page 15-1
Keyboard shortcuts added to access
top-level menu items from the
keyboard.
Keyboard Shortcuts on page C-2
Calibration separated from VisionQ
application and is accessed from
Calibration icon on the desktop.
Calibration on page 10-1
Change Description Link to Topic

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Table of Contents
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What’s New in this Release .............................................................................1-1
Chapter 1 - Introduction
System Description ...........................................................................................1-1
Major System Items ..........................................................................................1-2
About the Operators’ Manual .........................................................................1-3
Conventions Used in the User Manual .................................................................................. 1-3
Standard Limited Warranty .............................................................................1-4
Chapter 2 - Safety Items
Important Safety Information .........................................................................2-1
Warnings, Cautions, and Notes .............................................................................................. 2-1
Safety Precautions .................................................................................................................. 2-2
Electrical Fire Hazard ............................................................................................................ 2-2
Mechanical Hazards ............................................................................................................... 2-3
Laser Beam Hazards ............................................................................................................... 2-3
Radiation Safety ...................................................................................................................... 2-3
System Safety Devices ......................................................................................2-4
Emergency Stops ..................................................................................................................... 2-4
Warning System ...................................................................................................................... 2-4
Interlock System ...................................................................................................................... 2-4
Sample Site Plan ..............................................................................................2-5
Interlock and Warning System Schematic ............................................................................. 2-6
System Labels ...................................................................................................2-7
Chapter 3 - System Controls and Indicators
Operator Control Box ......................................................................................3-1
Patient Emergency Stop Control .....................................................................3-2
Patient Alignment Panel ..................................................................................3-2
System Status Indicators ..................................................................................3-2
TABLE OF CONTENTS

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K990400 16 April 2008
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Chapter 4 - System Startup and Shutdown
System Startup ..................................................................................................4-1
System Shutdown .............................................................................................4-1
Chapter 5 - Managing Patient Data
Patient Information .........................................................................................5-1
Hide/Display Study List ...................................................................................5-3
Delete Patient Scans ........................................................................................5-3
Add New Patient ...............................................................................................5-4
Edit Patient Details ..........................................................................................5-5
Access Patient Data ..........................................................................................5-7
Delete a Patient ................................................................................................5-7
Chapter 6 - Acquisitioning (Scanning)
Patient Positioning ...........................................................................................6-1
Acquisitioning ..................................................................................................6-3
Preview, Dry Run, and Capture Scans ................................................................................... 6-5
Quick Picks .............................................................................................................................. 6-9
PAN Scan (Optional) .....................................................................................6-11
Chapter 7 - Reconstruction of Anatomy
Preview Screen .................................................................................................7-1
Using Quality Control Frames ............................................................................................... 7-3
Adjusting the Panoramic View ............................................................................................... 7-5
Contourline Setup ................................................................................................................... 7-5
Removing Circumference Artifacts ........................................................................................ 7-7
Adjusting MIP, Centerline and Image Type .......................................................................... 7-8
Selecting MIP or Radiograph Display ................................................................................... 7-9
Adjusting Brightness and Contrast ........................................................................................ 7-9
Pan Feature ........................................................................................................................... 7-10
Rotation Feature ................................................................................................................... 7-10
Zoom Feature ........................................................................................................................ 7-10
Back Tool .............................................................................................................................. 7-10
Filter Settings ........................................................................................................................ 7-11
Taking Measurements ...................................................................................7-13
Hounsfield Units ................................................................................................................... 7-13
Distance ................................................................................................................................. 7-15

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Rotating Views ...............................................................................................7-18
Saving Views as JPEG Image Files ..............................................................7-19
Saving and Loading Workups .......................................................................7-19
Save a Workup ...................................................................................................................... 7-19
Load an Existing Workup ..................................................................................................... 7-21
Delete an Existing Workup ................................................................................................... 7-22
Viewing and Reconstructing Raw Patient Scans ..........................................7-23
Chapter 8 - Detail Screens
Preview Screen .................................................................................................8-1
Implant Planning Screen .................................................................................8-2
Estimate the Nerve Canal .......................................................................................................8-7
Ceph Screen ...................................................................................................8-12
MPR Screen ...................................................................................................8-14
TMJ Screen ....................................................................................................8-18
Chapter 9 - Tools
DICOM Database and DICOM Export Setup ................................................9-1
Check Read/Write Access to Image Database ................................................9-2
Export DICOM .................................................................................................9-2
Create CD .........................................................................................................9-3
Erase CD-RW .......................................................................................................................... 9-5
Output to Folder ...................................................................................................................... 9-5
Reporting ..........................................................................................................9-6
Run Report .............................................................................................................................. 9-6
Create New Report .................................................................................................................. 9-7
Modify Existing Report .........................................................................................................9-11
Chapter 10 - Calibration
Panel Calibration ...........................................................................................10-1
Collimators Calibration .................................................................................10-3
Geometry Calibration .....................................................................................10-4
Chapter 11 - Quality Assurance
QA Phantom Test ...........................................................................................11-1
Line Pair Evaluation ............................................................................................................. 11-5
Distance Measurement Test ................................................................................................. 11-6

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Hounsfield Unit (HU) Measurements .................................................................................. 11-7
QA Water Phantom Test ................................................................................11-9
Noise Level Test .................................................................................................................. 11-13
Uniformity Test ................................................................................................................... 11-14
PAN Phantom Test ......................................................................................11-16
Radiation Output Test ..................................................................................11-19
Measured Dose .................................................................................................................... 11-19
Interpretation ...................................................................................................................... 11-20
Declaration of Conformity ...........................................................................11-21
Equipment Class Determination .................................................................11-22
Chapter 12 - Radiation Environment Survey
Conditions of Operation – 8.9 and 26.9 Second Scans ................................12-2
Scatter Measurements for 8.9 Second Scans ................................................12-2
Landscape 8.9 Second Scan ................................................................................................. 12-3
Portrait 8.9 Second Scan ...................................................................................................... 12-4
Scatter Measurements for 26.9 Second Scan ................................................12-5
Landscape 26.9 Second Scan ............................................................................................... 12-5
Portrait 26.9 Second Scan .................................................................................................... 12-6
Scatter Measurements for PAN Scan ............................................................12-7
Drywall Attenuation .......................................................................................12-8
Recommended Operating Requirements .......................................................12-8
Dose and Imaging Performance Information ..............................................12-9
Conditions of Operation ....................................................................................................... 12-9
Measurements ..................................................................................................................... 12-10
X-ray Tube Assembly ...................................................................................12-11
Chapter 13 - Product Information
Technical Specifications ................................................................................13-1
Power Requirements ......................................................................................13-2
Power Cords ...................................................................................................13-2
Environmental Specifications .......................................................................13-3
Operating ............................................................................................................................... 13-3
Transportation and Storage .................................................................................................. 13-3
Acquisition Computer ....................................................................................13-3
Patient Support Chair ....................................................................................13-4

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Disposal ..........................................................................................................13-4
Extension Cords .............................................................................................13-4
External Item .................................................................................................13-4
Cleaning .........................................................................................................13-4
Electromagnetic or other Interference
(Emissions and Immunity) ............................................................................13-5
Equipment Standards .....................................................................................13-7
Equipment Class ............................................................................................13-7
Preventive Maintenance Schedule - for Owner / User .................................13-8
Planned Maintenance - 12 Month Schedule ................................................13-8
Cleaning ................................................................................................................................ 13-9
Planned Maintenance Checklist ........................................................................................... 13-9
Replaceable Parts - Reference List .............................................................13-11
Accessories ...................................................................................................13-12
System Gantry Dimensions ..........................................................................13-14
Chapter 14 - Networking Support Setup
Networking Support Overview .......................................................................14-1
Networking Data Flow ...................................................................................14-1
Network Support Installation/Setup ..............................................................14-2
Provide Network Storage ...................................................................................................... 14-2
Install Sweeper Service ......................................................................................................... 14-2
Configure Sweeper Service ................................................................................................... 14-3
Migrate from Standalone to Server ...................................................................................... 14-4
Change Image Root Folder .................................................................................................. 14-5
Start the Sweeper ................................................................................................................... 14-5
Sweeper Service ..............................................................................................14-6
Sweeper Controller ................................................................................................................ 14-6
Network Failures ...........................................................................................14-7
No Network Access at Startup .............................................................................................. 14-7
Network Fails During Operations ........................................................................................ 14-8
Limitations of Networking Support ...............................................................14-9
Chapter 15 - Remote System Import and Export
Remote System Import and Export Overview ...............................................15-1
Remote System Import ...................................................................................15-1

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Import Installation and Setup .......................................................................15-2
Set Up DICOM Worklist Interface ....................................................................................... 15-2
Set Up Practice Management Interface ............................................................................... 15-4
Import Patient Data .......................................................................................15-5
Remote System Export ...................................................................................15-6
Export Installation and Setup .......................................................................15-6
RSSM Log ......................................................................................................15-8
Send Patient Data to a Remote System .........................................................15-9
Appendix A - eXamVision Installation
eXamVision .....................................................................................................A-1
Laptop Minimum Requirements .............................................................................................A-2
Workstation Minimum Requirements ....................................................................................A-2
File Structure Setup ................................................................................................................A-2
Install eXamVision ..................................................................................................................A-3
eXamVision Setup ...................................................................................................................A-3
Appendix B - Three Dimensional Volume Rendering (3DVR)
Open Database ................................................................................................B-1
Axial Functions ...............................................................................................B-3
Paging ......................................................................................................................................B-3
W/L (Window/Level) ...............................................................................................................B-3
ROI (Region of Interest) .........................................................................................................B-4
Distance ...................................................................................................................................B-5
Identify .....................................................................................................................................B-6
Remove Object .........................................................................................................................B-7
Hounsfield Unit Calibration Offset ........................................................................................B-8
View Volume ...................................................................................................B-9
Projection Type .....................................................................................................................B-10
Volume Edit ...........................................................................................................................B-11
VR Functions ........................................................................................................................B-12
Pop Up Menu ........................................................................................................................B-15
View Full Screen ...................................................................................................................B-16
Appendix C - eXamVision Quick Reference
Navigating the eXamVision Interface ............................................................C-1
Tools for Viewing this Image .................................................................................................C-1
Suggestions for Adjusting Panoramic Map ...........................................................................C-2