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Part 1 - basic system

1. Introduction - basic properties and structure of
the OSTNUCLINE system

1.1. OSTNUCLINE system concept

One of the implementation outputs of research and development work carried out at the Department of Nuclear Medicine of the University Hospital in Ostrava in the field of physical-mathematical aspects of scintigraphy is the OSTNUCLINE system ( OST RAVA NUC LEAR LINE ) for mathematical analysis and complex evaluation of scintigraphic studies on PC. . This system provides fast, comprehensive and exact evaluation of a wide range of scintigraphic studies (especially dynamic ones). The system was built at the Ostrava workplace in team cooperation and implemented gradually on the evaluation device CLINCOM, GAMMA-11, Amiga-Microsegams and finally a PC. Proven in clinical intensive operation in the evaluation of many thousands of scintigraphic studies, both on the author's work and a number of other institutions in our country and n and several offices abroad. The main effort in building this system was to achieve maximum flexibility , generality and complexity of evaluation of scintigraphic studies, with the greatest possible elegance , unpretentiousness. and ease of use for the operator.

Evaluation with the OSTNUCLINE system is created in a new way with a concept that is significantly different from other company systems. Already at its launch, we can observe a much more efficient way of searching and playing scintigraphic studies compared to most systems. While browsing the directories of patient studies, scintigraphic images are displayed to us (in the form of a thumbnail view) and we can view each study immediately (statically and dynamically) without actually opening it. Without the need to constantly switch between different menus, we can call up the required study from any directory very quickly and easily and immediately. The whole "arsenal" of commands for processing and displaying scintigraphic studies is constantly available in a compact form, including the possibility of their verbal description, commenting, and printing to the printer. The basic menu of commands is displayed by icons at the top of the screen. We choose the corresponding commands in the usual way mice (mice use the left button) appropriate procedures to execute a system with e back to the basic menu. Some more complex procedures (eg "ROI", "Slice", "Curve") have their own menu (submenu), which is displayed in the appropriate place on the screen and with which the mouse we run the individual commands controlling the operation of the procedure; after the end of the procedure, this submenu disappears and the basic menu is displayed together with the result of the completed procedure.

Scintigraphic studies can in principle be evaluated either manually or automatically using complex programs. A typical type of manual processing can be roughly described as follows: We call up a scintigraphic study (from the appropriate directory), while its first image is displayed. We can see how many frames this study contains, in what matrix, what were the storage times of individual frames, whether the study is static or dynamic; in addition, we can read a possible (previously inserted) verbal comment and edit this comment, add, delete, insert a new one, etc. (the commentary modified in this way remains permanently written together with the study). In addition to images, text data and various graphic marks (eg description of images, markings and description of interesting structures in images) can also be entered into images.

Individual images for photography and visual or quantitative evaluation can be processed "manually" using a number of procedures contained in the menu. Above all, we can use the mouse to enlarge , reduce and move images in any direction on the screen while maintaining the usual rules of Windows. Furthermore, we can adjust the lower and upper level (LT / UT) of the image and adjust the contrast of the image to best see the desired structures. We achieve a visual improvement in image quality by interpolating it . If statistical fluctuations appear disturbing in the image, they can be suppressed by smoothingimage "S9" (see, however, the warning note in the relevant description of the procedure). You can select the optimal color or black and white scale *) for the display. Images created on the screen can be graphically printed to a black and white or color printer
at any time . ^*) Black and white imaging can be especially recommended for photography or printing, as it guarantees an objective relationship between the distribution of radioactivity and the blackening density of a given area of film or paper. Black and white imaging can also help to objectify visual evaluation where excessive contrasts between adjacent colors can artificially emphasize insignificant details caused by, for example, statistical fluctuations.

Quantitative data on the distribution of radioactivity are often needed . For detailed assessment of detail image can cause sections of different width and direction and display (in the form of curves) and cyano tifikovat profiles of radioactivity distribution image. It is very important to mark the areas of interest " ROI " ( R egion O f I nterest) on the pictures and to determine the relative amount of radioactivity in the appropriate places.

If a scintigraphic study contains several images (multistatic or dynamic study), we can perform the respective operations with individual images separately or simultaneously with multiple images. We can sum up more images, which can be useful, for example, when adding two or more different images to display multiple structures in one image, or when adding a larger number of sequential dynamic study images to obtain a statistically better image of the radioactivity distribution. In multistatic or dynamic studies, it is advantageous to simultaneously display a larger number of images on the screen and to simultaneously adjust, evaluate and photograph them.

In sequential dynamic studies, the creation of curves of the time course of the distribution of radioactivity in certain places of the image is a very important task . To do this, after preselecting the appropriate step and summing the images, we first run the "ROI" procedure, in which we draw the relevant areas of interest on appropriately stepped images.. Then, using the appropriate procedure, we create our own curves of the time course of radioactivity in these places, which are written to the disk in the appropriate SAVE AREA (see below). These curves can be displayed and further quantified and processed using curve procedures - individual curves can be displayed either separately or together with other curves, we can interpolate, smooth, expand or compress them, perform various arithmetic operations with them, derive and integrate them, interpolate by least squares of linear and exponential functions, etc. We can also determine the coordinates of individual points, or modify these points or insert new points. Modified curves can be written to disk in the appropriate SAVE AREA (see below) and recalled and manipulated at any time. Pom oThese operations, we can display the curves in a graphically optimal form for visual evaluation, and we can obtain some parameters quantifying the dynamics of the studied process. E.g. derivative vs. time curve is obtained radioactivity curve instantaneous rate of leakage of radioactivity or gain, fitting with a linear or exponential function can specify the rate coefficients or half- dynamic process and the like. All of these and many other operations are not precisely in the form and contained in a proper sequence of complex programs.

Another aspect characteristic of the OSTNUCLINE system are the so-called storage areas - SAVE AREA . These are certain defined memory areas on the disk in which images (possibly with marked areas of interest) and curves can be stored . SAVE AREA areas are numbered. If we have an image on the display that we want to keep (eg for later comparison with other images, or it is a specially edited image), we can write it from and write to some SAVE AREA (whose number we choose from the list), including its relevant identification data. This image can then be called up at any time from the relevant SAVE AREA, displayed, further processed and compared with other images from the same or from another withtudie or from some SA. After the necessary manipulations, we can then save it to the same or another SAVE AREA. At the same time as the images, the curves are read and written to the SAVE AREA, if these curves are created. Suitably modified curve (possibly. Complementary n Ene a new curve - eg. The results of differentiation, integration and algebraic operations between curves, graphs interspersed with linear or exponential functions, etc.). Then we can again be saved in the same or another SAVE AREA.

A detailed description of the use of commands from the PROCESSING menu is in §3.2.

For dynamic and functional scintigraphic studies, we usually do not suffice with manual processing using a sequence of commands called from the menu, but we use automatic evaluation using complex programs . These complex programs, containing all manipulations and algorithms for processing images and curves according to the relevant mathematical models of the studied process, are created in advance and written on disk under a given name. By running the "Complex program" command in the PROCESSING main menu, we can select the required complex program, which will start and return to the default PROCESSING menu after the evaluation is completed . Detailed description of complex mathematical evaluation withcintigraphic studies using complex programs is the content of the second part of this book ("Complex programs").

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1.2. Structure and installation of the OSTNUCLINE system

The OSTNUCLINE system consists of a number of programs and subroutines . It is based on systems and subroutines for basic system control, for communication with data structures of scintigraphic studies, for creating and displaying images and curves and for their mathematical analysis, for manipulating text and numerical files, etc. These subroutines are concentrated in the GAMLIB library . and the structure will be described in the programming manual.

Using this library, the PROCESSING system is created , consisting of a number of programs for individual manipulations with images, text curves, etc. The individual programs are started with the mouse by selecting the appropriate assigned icon in the menu. These procedures are also used in all complex programs for the evaluation of specific types of scintigraphic studies.

All program parts of the OSTNUCLINE system are loaded on the disk in the VG11 directory and its subdirectories. Auxiliary files, SAVE AREA, color tables, etc. are in the OSTGAM directory (or OST2000) and its subdirectories.

The installation of the OSTNUCLINE 2000 system is performed using the installation CD , which contains all programs, texts, color tables, setting tools, templates, demonstration studies, etc. After starting this installation CD, the dialog tables will start first (Fig.1.2.1-3), with which we choose individual aspects of the installation - names, paths, directories, editors, language, demo-studies, etc. Here it is also possible to decide whether we want a primary installation of the entire Ostnucline 2000, or just a reinstallation of a new version or broken files. According to these default aspects, the installation program then automatically copies all the necessary files (Fig.1.2.3), sets the paths and prepares the system for use.

During installation, or at any time during the actual use (see also §3.1.2), it is possible to enter the name of the workplace (printed on the result protocol) and also the language in which the system will communicate; so far, Czech and English are used as standard, any other language can be implemented by adding dictionaries of used terms - text files * .lan for program communication and default verbal evaluations * .txt for result protocols (eg rendyn.txt in Czech and rendyn_1.txt in English add rendyn_2.txt (in Spanish). The possibility of the OSTNUCLINE system working in different languages ??is important not only for its use in different countries, but also for the preparation of lecture materials, eg in English for international symposia.

Before the actual use of the OSTNUCLINE system, we recommend that it be tested and practiced on several demonstration scintigraphic studies supplied during installation with the system.

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1.3. System hardware requirements

The OSTNUCLINE system works on any compatible PC that has sufficient memory capacity and graphics capabilities. The minimum hardware configuration is as follows:

RAM 4 Mb
disk 40 Mb
graphics Super VGA
mouse
graphics printer (eg HP DeskJet 870-990)

The OSTNUCLINE system works after the Windows 95-98 operating system (we recommend Windows 98), or Windows 2000 or NT.

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2. Acquisition of scintigraphic studies

Scintigraphic data from the cameras in  digital form (using ADC or directly to digital cameras), reap through an acquisition for gram memory evaluation computer and write to the disk drive unit - there scintigraphic studies containing the descriptor (which stores the relevant information about the study) and private accumulated images .

The OSTNUCLINE system is able to evaluate both scintigraphic studies taken from the gamma camera on the PC device itself (acquisition program DIAG) and through the conversion subroutine also studies taken on other evaluation devices, while data can be transmitted over a network or diskette. In addition to the default directory of studies on your own PC (Mediso-DIAG), other directories can be selected - Amiga, InterFile, Picker (if necessary, these options can be supplemented by other systems, such as Elscint, Sopha, ...). Scintigafic studies from various devices can therefore be evaluated on a PC with the OSTNUCLINE system (after the appropriate connection has been made) . We can mainly use the complexity of programs for mathematical analysis and evaluation of functional scintigraphic studies, including cheap printing of quality and complex protocols .

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3. Evaluation of scintigraphic studies

3.1. Choice of scintigraphic studies from directories

Before evaluating a scintigraphic study itself (either using a sequence of manually invoked commands or using a complex program), you must first select and open the desired study written on a disk or diskette.

The basic menu of the OSTNUCLINE system is used to search for scintigraphic studies and select them for their own evaluation (Fig.3.1.1). By launching the "File" icon, we select the device (disk) from which we want to select studies, eg in  network operation . Launching the "Study" icon will display a list of all scintigraphic studies of the selected directory. Using the "Selection" column, studies can be sorted and a list of studies can be selected according to either the date of acquisition (Today, Date), static, dynamic and gated studies (ECG) - Fig.3.1.2. In addition, studies can be selected from the directories of other devices ("Other camera type" command), as mentioned above.

The individual lines of the list of studies are viewed with the mouse, while the first image of the study is automatically displayed on the right (Fig.3.1.1). With the cursor below this image we can view all images of the study very elegantly (statically or dynamically - "cinematographically") . This makes it very easy to find your way around the number of uploaded studies - when you search the directory, we can immediately see which study it is, whether it is normal or pathological, successful or unsuccessful, and so on. Use the "Select ü " command or double-click the mouse button to definitively open the relevant study . The first image of the selected study is displayed on the screen together with the menu of commands for processing the study (§4.2).

If we want to simultaneously evaluate several studies at once , we use the command “Further studies - > ” repeatedly and always select the next required study - the list of these selected studies is displayed in the lower frame. Once we have all the required studies preselected, we run “Select ü ” and the relevant studies open for us , merge them together, and we can evaluate them simultaneously as a single study.

After evaluating the study, we can run the "Study" icon again, which will return us to the selected directory and we can select another study, or choose another directory (“File”) .

3.1.1 Transfer, archive, delete, protect and send studies

The submenu of the “Service” command is used for these system manipulations with scintigraphic studies (Fig.3.1.3). Using the “ Transfer Studies ” command, we transfer (copy) selected scintigraphic studies recorded on the selected “Input Disk” or directory (left in Fig.3.1.3) to the selected “Output Disk” or directory (right). The input and output "disk" or directory can be on the same computer or on any other computer on the network.

The “ Mail ” command works in a similar way , with the appropriate e-mail table in place of the output “disk” , where the study is automatically inserted and the user just enters the e-mail address of a colleague on the remote computer to which the study is sent. It is possible to send the whole scintigraphic study with or without the result protocol, or result protocol only. This submitted study is then automatically opened to the recipient together with the OSTNUCLINE 2000 system and can be immediately evaluated, copied, sent, etc. (see also section “Telenuclear medicine”).

Use the “ Cancel Studies ” command to remove (delete) unnecessary scintigraphic studies from disks . After starting it, we will mark the relevant studies in the directory of the selected disk for deletion, we will confirm them, after which their list will be displayed again with the question whether we really want to delete them; only after a positive answer are these studies deleted (for Ostnucline 2000 via “Trash”).

To protect (protect) studies from accidental deletion, use the “ Protect studies ” command , which will provide the selected studies with a protection attribute. If you try to delete such a protected study, a warning will appear and the study will not be deleted; Such studies can only be deleted after their previous protection by repeated use of the "Study protection" command.

Manipulation with one study / multiple studies simultaneously : All system manipulations with cintigraphic studies described above can work in two modes:

• If we have a specific scintigraphic study open , the relevant manipulation will be performed only with this given one study .

• If we call up the desired system operation rather than from the study, but the  directory e scintigraphic studies of this directory can choose any number of studies with which this manipulation is then done collectively .

3.1.2 OSTNUCLINE system settings

To set some common aspects of the OSTNUCLINE system operation, use the “ Settings ” panel containing the basic submenu according to Fig.3.1.4. Here you can set background colors and screen size, text editing method and graphic drawing into images, templates for graphical presentation of result protocols. Furthermore, we can choose the language in which OSTNUCLINE will work - of course, provided that the text files * .lan have a translation of the terms used into the language (as well as translation of relevant standard texts * .txt visual evaluation and conclusion) - see also § 1.2.

The Ostnucline system can work on computers connected in a local or system-wide network, including connection to the Internet. Here is a schematic illustration of the connection of such a computer network at the author's workplace.

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3.2. Description of the operation of individual commands

The evaluation of scintigraphic studies is performed using a series of commands for manipulating images and curves, for their editing and quantification. The menu of these commands (Fig.3.2.1) is displayed in the form of icons at the top of the screen, the commands are executed using the left mouse button. The following section of the manual briefly describes the operation of these commands .

EXIT - completion of processing of scintigraphic studies

Use the EXIT command or the cross at the top right to end the processing of the scintigraphic study and exit the PROCESSING mode to the introductory menu.

File - device (disk) selection for study selection

Here we choose from where we will take scintigraphic studies for evaluation - from which computer in the network, or from which directory e or disk. The evaluation then takes the form of sharing the relevant scintigraphic study, without the need for study transfers.

Study - selection of a new scintigraphic study from the directory

Use the "Study" command to end the processing of the existing scintigraphic study and display the list of studies of the last selected directory. From this directory we can select another study for evaluation.

Complex programs - evaluation using complex programs

After running the "Complex program" command, the menu of individual programs for complex mathematical evaluation of scintigraphic studies is first offered. From this list of mice, select the appropriate program, which will start and return to the PROCESSING mode after running. The use of complex programs and the way of their inclusion in the menu are written in Part 2.

T ext - work with texts

The “Text” command contains a submenu of three commands:

• Commentary - text description of the study

• Use the "Comment" command to open a box in which we can write any text and verbal description (comment) for the study. We can freely insert and edit the comment. After the “OK” command, the box is closed and the text is written to the study ; it can be called up and edited by running the "Comment" command again. The commentary together with the study data can be printed on a printer.

• Free text - description by text on the screen

• After running the "Free text" command, we can type text descriptions from the keyboard anywhere on the screen selected by the mouse. The cursor appears in the selected place and we can type. Texts can be deleted and corrected using the keyboard and mouse. The "TE" command is mainly used to describe the various parts and structures of images and curves, followed by photography or printing. Using the mouse and the left button can describe curves different images or graphics, or symbols (e.g. arrows indicating the lesion) in arbitrary m í hundred screen. By pressing the right mouse button, a submenu will appear, with which we can choose various sizes, colors and fonts for the description. Exit the text entry mode with the "key"

• Program results - the resulting protocol from a complex programs
• If a given scintigraphic study has been evaluated by a complex program, the resulting protocol of this evaluation is stored in the scintigraphic study. We can display it on the screen with the command "Program results", view and edit it, event. use the “Print” command to print to the printer. In this mode, graphical intermediate results saved with the “Save screen” command in the “Print” command menu can also be called up.

LT, UT - lower and upper level of cutting

Use the "LT / UT" (Lower Threshold / Upper Threshold) command to set the lower and upper level of the image display. After invoking the command, two line scales marked LT and UT will appear on the lower left of the display. On these mouse scales, we choose the value of the lower and upper level in% of the maximum in the image. The default value at first with p uštìní LT = 0, UT = 100th The procedure responds immediately, so if we move on the scales with the mouse with the left button pressed, the image modulation changes continuously. The current LT and UT value is displayed in the left field. If we see multiple giant of U (e.g. command DI), the LT / UT operate either one selected image or to all images (in the "Picture" is chosen either "one" or "All"). Exit the procedure with "OK".

The "IT" (InTerpolate) command is used to visually refine the image matrix using interpolation. The 64x64 image is interpolated to the 128x128 matrix, the 128x128 image to the 256x256 matrix. Using linear interpolation, 4 interpolated “intermediate points” are generated and displayed for each point of the initial matrix. We will cancel the interpolation of the image by selecting "IT" again.

S9 - 9-point image smoothing

The "S9" (Smooth 9-point) command smooths the existing image in order to suppress statistical fluctuations of values ??in individual parts of the image. A convolution filter with weight coefficients given by the matrix is used

1 2 1
2 4 2
1 2 1,

i.e. the given midpoint multiplied by a factor of 4 is added to the surrounding eight points multiplied by the respective weighting factors, the result is divided by the sum of the weights (16) and stored at the original point. This procedure is performed for all points of the image matrix. Stronger smoothing can be achieved by repeated use of the S9 procedure.

Note: The secondary undesirable consequence of extermination is that along with the disturbing statistical fluctuations can be smoothed and actual finer structures in the image (secondary deterioration of resolution). We therefore recommend the careful and prudent use of the S9 procedure.

Color - color display scales

The "Color" command controls the color display on the screen. After launching it, a list of color scales will be displayed in the right part of the display (Fig.3.2.2), from which we will select the desired scale with the mouse, which from now on will determine the color distribution, until the next selection using Color. We can also choose black and white scales here. A special program is used to create and edit color tables.

Image - image manipulation

The “Image” command contains a submenu of commands for some image manipulations (Fig.3.2.2).

Use the " AD " command to enter the number of AD frames that will be swept forward to the current frame frm and displayed. So if we have on the screen, for example, the image frm = 1 and we insert AD 2, then we get the sum of the frames 1 + 2 + 3. When moving the arrow one frame forward, the summation of frames 4 + 5 + 6, etc. is then performed. By adding several consecutive frames of the dynamic study, the statistical quality of the images on the display is improved. For repeated SPU br CLEANING "AD" is the summation performed in the same position (the same image); move the image number with the arrows or the slider below the image.

After invoking the " Step " command, we enter the numerical value of the step, after which the images in the sequential scintigraphic study are moved forward and backward by stepping. The default value is Step = 1. The Step value also changes when selecting the sum of consecutive images (with the "AD" command); however, with the "Step" command we can then enter any step regardless of the amount of sum and ce of the images. This allows both a quick overview of the dynamic study of a large number of images (enter more value Step) without summation images, on the other hand allows to improve visual perception cinematic viewing using the "Play" (enter the larger h odnotu AD and little value Step, so that each summation images are will overlap in time and when "Play"

® ~ ¬ arrows and cursor below the image - stepping the images in the study

Use the arrows and sliders from the ones shown below the image matrix to move (step) back and forth consecutive images in the study and display them. Use the arrow keys to move by Step-frames and the sum of (AD + 1) -secutive images. When the default values Step 1 = AD = 0 s e kvenènì nudges individual images. For example, if frm = 2, AD = 3, Step = 8, when you start ® , the pointer moves to frm = 10 and frames 9 + 10 + 11 + 12 are displayed. The slider (cursor) is used to quickly "go through" the scintigraphic study. We remind you that if we do not want to use the default value Step = AD + 1, we must enter the required Step value only after applying the "AD" command. After starting instruction "FA" enter the serial number (frm) image that appears and becomes the default for jogging and display p onby the power of arrows, or "AD". By applying the "FA" command, the default values ??Step = 1 and AD = 0 are set.

BE - return to start of study

The "BE" (BEgin) command returns the display to the first frame of the study and restores the default defaults (LT = 0, UT = 100, AD = 1, Step = 1, cancels smoothing, interpolation, shift, etc.).

ZOOM - continuously zooming in and out of the image

The "ZOOM" command allows you to continuously change the size of the image section, ie the "zoom" in a given frame. On the scale of this command, use the mouse to indicate the degree of magnification (zoom) of the image in the given frame. The procedure responds immediately, so if we move along the scale of the mouse with the left button pressed, the corresponding size of the image zoom will change continuously.

SIZE - image size

Using the “Size” scale, we change the geometric size of the "frame" of the entire image.

TR - image shift

Use the "TR" (TRanslate) command to move the existing image along the surface of the frame in any direction by any distance (matrix of dimension dim by maximum -dim / 2 to dim / 2 pixels). There are two scales for horizontal (TH) and vertical (TV) direction to move the image. At the end of the procedure, the image remains shifted to its current position. The procedure can be repeated as desired.

ROI - areas of interest

The "ROI" (Region Of Interest) command is used to start the procedure for defining areas of interest on scintigraphic images. After starting it, the following submenu will be displayed (Fig.3.2.3):

• ROI 1 2 3 4 5 .... - selection of the ROI serial number (boxes on the top right)
• By selecting individual fields, we determine the serial number of the assigned area of ??interest, which we will draw. After starting the "ROI" procedure from the main menu, ROI No. 1 is implicitly selected. When marking and recording ("Mark") individual areas, the serial number of the ROI is automatically increased by 1. in a different order than sequential, or we need to correct one of the already marked and recorded ROIs. The field of the selected ROI is marked in dark.

• IR - drawing of irregular ROIs
• After selecting the "IR" function, we can use the mouse and the left button pressed to draw an area of ??interest of any shape and size. If the curve drawn in this way is not closed, only the marked points are taken as ROI, with a closed curve the whole interior is taken as ROI. Drawing (marking new points) takes place when we hold down the left mouse button. To delete already marked points, press the right mouse button. After drawing the area of ??interest, we run the "Mark" command, which writes this area of ??interest under the marked ROI number. The ROI number increases by 1 and we can continue to draw another ROI.
•  
• RI - quadrangular ROI
• The "RI" function is used to define rectangular areas of interest . When the left mouse button is pressed, we move diagonally , which draws a rectangular ROI.
•  
• IC - isocontour as ROI
• If the "IC" mode is selected, the area of ??interest is created using an isocontour guided by the point to which we move the mouse and press the left button. The program draws this ROI, which can be written with the "Mark" command under the given number. To obtain a sufficiently smooth and continuous ROI by the isocontour method, we recommend smoothing the image first.
•  
• Erase - erase ROI
• Use the "Erase" command to delete the area of ??interest, the number of which is preset.
•  
• Mark - ROI notation
• Use the "Mark" command to write the drawn area of ??interest to the memory under the given ROI number. In the upper right corner, the relevant field displays data about this ROI, including its serial number, the number of marked points and the integral of the numerical content of the cells in the ROI. At the same time, the Pointer of the ROI sequence number increases by 1.
•  
• ® ~ ¬ arrows and cursor below the image - stepping the images in the study
• Use the arrows and the slider below the image to step through the display of images from the study forwards and backwards (Respecting Step and AD), analogous to the main menu. We can gradually display those images from the study, in which the structures needed to mark individual ROIs are best seen. The rapid Play á tion and the time shifts are used in the study cursor ~ under the image - is particularly suited to visual inspection, whether we appropriate structures in the body during the study "run away" from the displayed ROI (patient movements, respiratory movements, etc.)..
•  
• LT / UT - change of upper and lower image threshold
• The cursors in the “LT / UT” table allow you to continuously change the lower and upper level of cropping in brightness and color modulation of the image in the same menu. By this adjustment of the image modulation, we can operatively achieve a better visual resolution of the structures needed to accurately mark the ROI.

Curves - create curves

The "Curves" command is used to create time curves for the distribution of radioactivity in a given dynamic scintigraphic study in the marked areas of interest. We usually use the command immediately after defining these areas of interest in the ROI procedure. The program plays a dynamic study individual frames from disk to memory, each of which counts both surface integrals of the picture, both from individual ý s ROI and the resulting values stored in the memory (SA 0). After completion of the process, these values are entered in the form of curves, where the horizontal axis is the serial frame number (indicates the time from the beginning of the study), the vertical axis is the value of the number of pulses of the empirical nastro din all pixels of the given ROI. Curves can be saved in the selected SAVE AREA and can be processed in the "Curves" subroutine (see below) or other programs.

• Exit - end of ROI delimitation

Use the "Exit" command to end marking and all manipulations with ROI, leave this subroutine and return to the basic menu "PROCESSING". The image together with the marked ROIs can then be written to the SAVE AREA (command "SM" - see below), or these ROIs can be used to create time curves of radioactivity.

DI - displays the selected number of frames

After running the "DI" command, we select the number (1,2,3,4,6,8,15 ....) of consecutive images of the scintigraphic study, which are simultaneously displayed on the screen in such a size and arrangement that they optimally fill desktop area. The Step step, the number of summed AD frames, the set LT / UT values, the color table, possible image intertpolation (only relevant for D1-D4) and smoothing with the "S9" command are respected . Used to display either individual projections of a multistatic study simultaneously or to display the time sequence of images in a dynamic study. The command "Inf." the images describe the names of the projections for the multistatic study (if they were defined at the time of acquisition), or the relevant time data for the dynamic study.

With face - profiles (sections) of the image

The "Slice" command is used to start the procedure for creating sections (profiles) with a scintigraphic image. After running this command in the main menu, the following submenu will be displayed (Fig.3.2.4):

•  
• Slice 1 2 3 4 - serial number of the profile
• By selecting the appropriate column in the table with the mouse, select the serial number of the profile. Up to 7 profiles can be displayed simultaneously in each direction. When starting the "Slice" procedure, profile no. 1 is set by default.

• Hor. / Vert. - horizontal / vertical section
• By marking "Hor." or "Vert." we choose whether to perform in horizontal or vertical section of the image. The place in the image that we want to make the cut is marked with the mouse, or we can move it with the arrow keys on the keyboard. The corresponding section is displayed as a distribution profile curve radio indicator. In Ostnucline 3.3, the curve of the horizontal profile is displayed at the bottom below the image and the vertical profile is displayed to the right of the image, in Ostnucline 2000, both profiles are displayed at the top next to each other. At the same time, a maximum of 7 profiles can be displayed in each direction with curves of different colors. These sections are used for the image of detailed analysis of the distribution of radioactivity in various places image (e.g. when assessing the homogeneity of the field of view of the scintillation and mers, when comparing the asymmetry of paired organs, and the like.).
•  
• Width - width of the cut
• For each section we enter the width "Width" of the section in pixels. With a default width of 1, a profile of one row or stack is created, with a width of eg 5, the contents of 5 rows or columns of the image matrix are added arithmetically. With a larger cutting width, we can achieve a higher number of pulses in the profile curve and thus a reduction in statistical fluctuations - a smoother profile.
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• IC - isotrophic section
• Using the "IC" (IsoConture) command, we can make a section of the image that corresponds to the intersection of this image in an isometric view with a horizontal plane at the appropriate height. We define the place where we want to lead the isocontouration with the mouse. The program displays, both in its own image and separately below, the isotonto corresponding to the numerical content of the point marked by the mouse. Several isocontours for different "heights" can be displayed simultaneously. To ensure that the isocontours are smooth and continuous, we recommend smoothing the image properly beforehand. Isocontours can be usefully s at a more detailed assessment of the shape of the various organs and structures in the image.
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• ” ¬ - step the image forward / backward
• Using the arrows and the slider below the image, we can step through the individual images in the study (Step and AD are respected), for which the respective default profiles are created and displayed immediately. We can thus monitor the rearrangement of the radioactivity distribution in more detail during the dynamic study.
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• R / W - read / write coordinates of profile curve points
• After running the "R / W" (Read / Write) command, a cursor will appear on the profile curve, which can be moved with the mouse. For each cursor position, the x and y coordinates of the respective point of the profile curve are displayed in the table (we read the coordinates of the points). By pressing the "W" key we can modify the existing point: on the query "new value =" we enter the required value of the vertical coordinate (ie the accumulated number of pulses), which will be written to this point. If this is the profile width of 1, write the corresponding value at the same time in the appropriate bo dfor the image matrix. In this way we can modify scintigraphic images. Where the incurrence e.g. artifical in a certain place of the image enormously high operating distracting, these points can be modified afterwards (Reset the vat or to replace the appropriate value).
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• Exit - end of profile manipulation
• The "Exit" command ends all manipulations with profiles and the program goes to the main menu. If necessary, the printing of profile curves, including the image (as an intermediate result protocol), must be done before the end of the “Slice” procedure.

SA - recall image, ROI and curves from SAVE AREA

After running the "SA" (Save Area) command, a list of all Save Areas will be displayed, together with study (patient) identifiers, of which images or curves are always stored in the given Save Area. By selecting the appropriate Save Area with the mouse, the image, ROI and curves contained in it will be displayed in a reduced size as a preview. Double-clicking this SA opens, images, ROIs and curves are played back in memory ; the image is displayed directly, the curves can be displayed and processed by the “Curves” menu tool. At the same time, the relevant scintigraphic study from which the image or curves in the SA originate opens - so you can step through the images of this study, display and process it. (Note: If the study belonging to the called SAVE AREA has already been deleted, the corresponding message will appear on the monitor and the default study in which we were before entering the "SA" command) remains open to us.

SM - write images and curves to SAVE AREA

Use the "Save - SM" (Save Matrix) command to write the current image displayed on the screen to the SAVE AREA, the number of which is selected from the list that appears. Use "SM" to the individual can enter the SAVE AREA Scintigraphic images, the ROI and the curve (whether native, n ebo suitably adapted). With the help of "SA" we can then call them up, compare or quantify them. The SAVE AREA number can range from 1 to 50.

CA - adds a number to the image

Using the "CA" (Constant Add) command, a number is added to the content of all image points, the value of which is entered from the keyboard. If we want to subtract a suitable number (eg the average background / cell value), we enter its negative value.

CM - multiply the image by a number

Using the "CM" (Constant Multiply) command, we multiply the entire image (the content of each point) by a number, the value of which we enter from the keyboard. This operation is used, for example, when mutually normalizing images to the same maximum, etc.

SA + - *: - arithmetic operations between images

The "SA + - *:" procedure is used to perform the appropriate arithmetic operations between two images stored in the Save Area. After selecting one of these characters, the relevant arithmetic rule is displayed in the lower left part of the display, eg for "+" FRM_ + FRM_, where we insert the SA serial numbers with the respective images via the flashing cursor from the keyboard: enter the SA number of the first image first and then the SA number of the second image. The program performs the appropriate algebraic operation between the two images (ie between the values ??themselves o corresponding dots - pixels) and display the resulting image on the screen. Example: if we want to subtract the image from Save Area No.3 from the image in Save Area No.2, select the sign "-" and insert the numbers 2 and 3 into the flashing algebraic expression FRM_ - FRM_. The operation FRM (SA2) - FRM (SA3), the resulting image is displayed and ready for the event. further manipulation. Note: Both images for arithmetic operations must have the same dimension of the image matrix (64x64 or 128x128)! This whole procedure will be generalized to the form of an image calculator.

Curves - manipulation with curves

The set of subroutines invoked by the "Curves" command is used for manual mathematical processing of radioactivity time course curves in the ROI contained in the Save Area (these curves can be generated either by the "Curves" command in the "ROI" menu or by a complex program). The curves that we want to display and process are called from the appropriate SAVE AREA using the "SA" command, while entering the SAVE AREA number in which the curves are stored (they were stored there either during their generation in the "ROI" menu or after processing in the " Curves "with the" SM "command, or with a complex program). The curves are read into memory, shown on the display and are ready for processing. After running the “Curves” command from zh lIn the main menu, all curves are displayed, a table containing in each column the number of the curve, the maximum and minimum value of the points of the respective curve and a submenu with tools for processing curves (Fig.3.2.5). The “Curve” command has the following submenu:

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• Crv T 1 2 3 ... 12 - curve selection fields for display and processing
• By selecting individual fields in the table with the mouse, we determine the serial number of the curve that we want to display or process; the T (Total) curve represents the time course of radioactivity in the whole field of view, the numbers of other curves correspond to the serial numbers of the ROI for which the curves were created. If you want to display all curves simultaneously, select the "ALL" field (after the initial start of "Curves", "ALL" is selected by default). Otherwise, they are of the Brazen only those curves whose serial number is on the table preselected. The sequence number field of the curve that is selected for display and processing is marked ü. In this way, we can display, visually compare, photograph, etc. together. two or more curves. The verticalization of the display scale in the vertical direction is set according to the largest of the maxima of the displayed curves. Note: For optimal display of multiple curves, it is advantageous to use their multiplication by suitable constants using the command "* " in the submenu "Operation".
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• Operations - submenu for mathematical operations with curves
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• * - multiplication of the curve by a number
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• The "CM" (Constant Multiply) command multiplies the numerical content of each point of the selected curve by a constant, the value of which is entered after selecting "CM". The command is used for various modifications of curves, eg multiply a too "low" curve by a number greater than 1 so that it is comparable to other curves when displayed, or, conversely, multiply a too "high" curve by a number less than 1.
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• CA - adding a number to a curve
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• Using the "CA" (Constant Add) command, we add a constant to the numerical content of each point of the selected curve, the value of which we enter after selecting "CA". If we enter a negative number, the corresponding value is subtracted - it is used, for example, when subtracting a constant background value.
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• + - *: - addition, subtraction, multiplication, division of two curves
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• The commands "+", "-", "*", ":" are used to perform the respective arithmetic operations between two curves. After selecting one of these characters, enter the sequence numbers of the curves in the fields: enter the number of the first curve in column C1, the number of the second curve in C2 and finally the number of the resulting curve in the “Result” field. The program performs the appropriate algebraic operation between the two curves (ie between the values ??of the corresponding points) from boxes C1 and C2 and writes the resulting curve under the sequence number given in the “Result” box. Example: if we want to subtract curve No. 3 from curve No. 2 and save the result as curve No. 5, column C1 number 2, in field C2 number 3 and in field “Result” number 5. Operation C2 - C3 is performed = C5,

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• S 3 - curve smoothing
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• The "S3" (Smooth 3-point) procedure performs a 3-point smoothing of the preset curve (or with "All" of all curves). For each point, the value of this point, multiplied by a weighting factor of 2, is added to the values ??of the previous and following points, multiplied by a weighting factor of 1, the result is divided by the sum of the weights 4 and stored back at the original point. The "Sx" command performs multipoint (x-point) smoothing, entering the value "x" . Curve smoothing is used to suppress statistical fluctuations in the curves of the time course of radioactivity. The same warning applies to the use of this procedure as for "S9" for images: smoothing
  Although it will improve the smoothness of the curve, together with statistical fluctuations, some factual details of the dynamics of radioactivity distribution may be smoothed out . We therefore recommend the prudent use of smoothing procedures!
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• IT - interpolated curve display
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• The "IT" command performs an interpolated display of the default curve (or all curves), consisting in the fact that the original display with discrete points is replaced by a continuous line display, created by linear interpolation of values ??between individual points. Interpolated views works better visual impression than discrete points, particularly in "thin" waveforms consisting change and the time limit points. In addition, the interpolated display can be used to differentiate and highlight selected curves, such as for photography.
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• R / W - finding and modifying the values ??of the coordinates of the curve points
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• The exact values ??of the coordinates of the individual points of the selected curve are determined (or inserted) using the "R / W" (Read / Write) command. After calling it, we define points on the given curve of the mouse, while the table shows the values ??of the coordinates of these points: its serial number of the point ", time so at the ordinate" time = " = '(indicating the number of pulses accumulated in the respective image in the ROI with the given serial number). mouse you a curve arbitrarily p of range widely and thus detect the coordinates of individual points.By pressing the "W" key we can modify the existing point: at the query "new value =" we enter the required value of the vertical coordinate, which will be written to the given point. It is used, for example, if a point with an obviously incorrect value is present on the curve, which is disturbing during the processing or documentation of the curve. To end the procedure, press the left mouse button or the "ESC" key on the keyboard.
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• NR - normalization of curves to ROI surfaces
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• The "NR" command normalizes the individual curves per unit area of ??the relevant region of interest (ROI) from which the curve originated. While the original curves indicated the time course of the amount of radioactivity in the individual areas of interest, the normalized curves rather express the time course of the "concentration" of radioactivity at the corresponding sites. Standardization curves use eg. If the curve of a ROI we subtract armchair and aged background coming from other ROI on another surface. We return to the original (non-normalized) curves using "Restore" or "RC".
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• EX - expansion of curves
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• Use the "EX" command to widen ("stretch") the curve in the horizontal direction. Each "EX" application horizontally stretches the curve by 10% of its current length. If the points of the curve are distributed too sparsely after multiple use of "EX", an interpolated "IT" display can be used. Typical treatments use "EX" is a better view Comp á Tecno phase dynamic studies, which are generally faster and therefore they are densely packed at the beginning of the curve. With a suitable expansion, we cut off the later slower parts and clearly display the phase capturing the fast dynamics over the entire display.
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• COMP - compression (compression) of curves
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• The "COMP" procedure is the opposite of the "EX" procedure and performs backward compression of the extended curve. The "EX" and "COMP" commands can be repeated and alternated as desired for optimal curve display .
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• LIN - interpolation of a linear function
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• The "LIN" procedure is used to interpolate the linear regression function y = Px + Q points of the selected section of the given curve. After starting it, first mark the start point of the fit on the curve (move it to it with the arrows or the mouse and press the left button) and then the end point of the fit. The program takes the points of the defined section of the curve, interpolates the linear regression function with them using the least squares method, writes the values ??of coefficients P and Q and the value of residual variance S. We can visually assess the adequacy of the interleaving, or. interleaving several times with different curves or different parts mand the same curve. The resulting interpolated functions are equivalent curves (given by their serial number) and we can use them to possibly. further mathematical processing.
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• EXP - interpolation of exponential function
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• The "EXP" procedure is used to interpolate the exponential function y = = Q.exp (Rx) points of the selected section of the given curve. After starting it, first mark the start point of the fit on the curve (move it to it with the arrows or the mouse and press the left button) and then the end point of the fit. Progra m taking off points defined section curve by the least squares fitted by an exponential function by them, writes the values of the coefficients R and Q, and the value of residual variance S. Also, displayed and below the respective number (entered in the column "R esult ”) writes a graph of this exponential function. We can visually assess the adequacy of the interleaving, or. interpolation multiple times with different curves or different parts of the same curve. The resulting interleaved functions are equivalent to the curves (given by their serial number) and we can use them to possibly. further mathematical processing.
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• DIFF - curve derivation
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• The "DIFF" command derives the given curve, entering the serial number in the "Result curve" field, under which the resulting derived curve is written. This curve can then be used for display and other operations. If Zderivujeme vs. time curve of radioactivity, we obtain a curve expressing the waveform or instantaneous leak rate increment radioak t ivity. Since the derivatives highlight the statistical fluctuations of the original curve, we recommend smoothing the curve before the derivation as needed with the "S3" command.
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• INT - curve integration
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• Use the "INT" command to integrate the given curve. The resulting integrated curve is written under the sequence number entered in the "Result curve" field.
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• SUM - determination of the integral (area) under the curve
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• The "SUM" command is used to determine a certain integral of a given curve from the lower limit to the upper limit. This integral is actually the sum of the vertical coordinates of the respective points, i.e. the area under the curve, indicating the total number of pulses accumulated in the respective ROI in the time interval from the lower to the upper limit. After the first run the mouse not b by arrows define lower and upper bounds, then calculates and displays the value of the integral "= int" and the corresponding area under the curve are stained.
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• Restore - restore the curve from SAVE AREA
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• Use the "RESTORE" command to restore (replay) the given curve from the SAVE AREA that is open and from which the curves come. We use the "Restore" command when, for example, incorrect manipulation of a given curve has led to its irreversible changes. The curve whose sequence number is selected in the "Crv" field is transmitted.
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• E nd - end of manipulation with curves
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• Use the "End" command to end all manipulations with curves and exit the "Curves" program to the main menu "Processing". Any printing of the curves, including the results (as an intermediate result protocol), must be done before completing the “Curves” procedure.
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• All curves can be stored (“SM”) in the SAVE AREA of the selected number. Curves are saved as they are after the output of the “Curve” procedure, ie including possible design modifications (smoothing, multiplication, algebraic operations, derivatives, integrations, etc.) and created new curves (eg graphs of fitted functions). The curves prepared in this way can then be called up at any time with the "SA" command and further processed by using the "Curve" procedure again. Can m e and store the result of complex editing and manipulating the curves for further work, photography and so on. Note: Interpolation is not saved, which is not a structural modification of the curve, but only a way of its display.

Play - cinematic representation of the sequence of images

The "Play" command is used for cinematographic (animated) display of a sequence of images of dynamic scintigraphic studies. Before running the "Play" command, first select the initial image in the main menu, from which we want to view the study cinematographically, use "AD" to select the desired summation of images and use "Step" to select the step of moving the images in the study. The smaller the Step value, the smoother and smoother the movement, the higher the AD value, the greater the image overlap and the smaller the statistical fluctuations. The "LT", "UT", "IT", "S9", "Color" commands are also respected when generating the selected frame sequence for playback. After starting "Play", a table with a bar scale will be displayed at the bottom right,Wed cinematic playback. The program then always adds the required number of AD consecutive frames, displays them, shifts by Step-frames, re-adds AD-frames, displays, etc. This cyclic playback of a sequence of images on the screen at a higher speed also gives the visual impression of smooth movement . The projection speed is selected (ranging from 0 to 25 images / sec.) With the mouse on the table scale at the bottom right. Activating the “Stop” icon in the table will stop the projection, the “Play” icon will start again. Cinema playback ends completely with the "Close" icon. The "Play" procedure has both didactic significance and can show the dynamics of the movement of the radio indicator in dynamic scintigraphic studies more clearly and vividly.

Printing - printing an image on a graphics printer

Use the "Print" command to print the contents of the display in graphic mode to a black and white or color printer ; you can select the number of copies. In this way, you can print texts, images, curves or other structures created on the display. Advantageously, it can also be used in complex programs for printing interesting intermediate results - for example, the results of Fourier analysis in ventriculography. The "SaveScr" command can be used to save the contents of the display to a file which is archived for the relevant scintigraphic study ; it is then called up again on the display by the command “File” in the submenu “Text - Program results”. In this way, we can prepare various graphic intermediate results, variously processed images and curves, etc. for subsequent photography, printing, research or publishing activities.

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3.3. Complex programs

Com plex programs used for automatic evaluation of scintigraphic data, especially dynamic and functional studies. These programs contain mathematical algorithms for processing images and curves according to the relevant mathematical models of the studied process, all operationsand manipulation resulting from the methodology, including possibly. printing a results log. Complex programs are created in the "C" language, compiled and linked with the appropriate subroutines from the GAMLIB library. For use in the OSTNUCLINE system, they are included in the “Wedge. Program ”which contains a list of complex programs. If we select the required program in this menu, it is loaded into the operating memory and started, the corresponding complex evaluation will take place and after completion the system returns to the main PROCESSING menu. The operation and use of individual complex programs is described in more detail in Part 2 of the OSTNUCLINE manual - "Complex programs". Creating complex programs using subroutines of the GAMLIB library will be described in the OSTNUCLINE system programming manual.

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4. OSTNUCLINE 2000 system

4.1. Concept of the OSTNUCLINE 2000 system

Despite the significant progress in the style of scintigraphy evaluation that the OSTNUCLINE system has brought, there are several aspects that were desirable to improve and modernize . These are, on the one hand, some minor programming and system errors, which persisted despite the constant improvement of the system, and, on the other hand, the limitations imposed by the programming tool used (C ⁺⁺ Borland language ).

For these reasons, and especially to ensure the perspective of further development of the system in new and future versions of operating systems, the authors have developed a new version of this system called OSTNUCLINE 2000 in the Visual C ⁺⁺ programming language . Compared to the current version, there are a number of improvements, especially in terms of presentation, standardization, reliability. These include the use of a WORD-based editor for entering descriptions and creating final protocols, sending studies and resulting protocols via the Internet, expanding options and to visual matrices up to 512 ´ 512 (with conversion of 1024 ´ 1024), extension and improvement of image and curve processing, possibility of operative stepping in running programs forward and backward, etc.

The following paragraphs briefly list some of the changes and additions made to the OSTNUCLINE 2000 system.

4.2. Viewing and selection of scintigraphic studies

The system for searching, viewing and selecting scintigraphic studies has been improved (Fig.3.1.1-2), including transfer, deletion, protection, archiving and remote sending of studies.

4.3. Manipulation of scintigraphic images

When evaluating multistatic scintigraphic studies (such as skeleton, static kidneys, lungs, etc.) it is sometimes necessary to change the original order in which the images were taken (Fig. 4.3.1a). In the original Ostnucline, the required order of the images was entered numerically. In the OSTNUCLINE 2000 system, we change the order of the images of multistatic studies very elegantly by simply moving the images from the column of the original order with the mouse to the corresponding fields of the new order (Fig. 4.3.1b).

4.3. Areas of interest (ROI)

An improved submenu for defining areas of interest is shown in Fig.3.3.3. During ROI rendering, it is possible not only to "go through" the whole study and change the image modulation (LT / UT), but also to enlarge and reduce the image (zoom), move it, change the orientation, shift the ROI. You can choose colors for ROI rendering.

4.4. Analysis and processing of curves

In the OSTNUCLINE 2000 system, all possibilities of processing curves that were in the OSTGAM system are implemented and improved again (but for capacity reasons they were not completed in the OSTNUCLINE 3.3 and lower system) - see Fig.3.2.5.

4.5. Complex programs

In the field of mathematical analysis and evaluation of scintigraphic studies by complex programs , only minor adjustments and improvements were made, related to the innovated subroutines of the Ostnucline 2000 system.

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4.6. Text descriptions and result protocols

The way of presentation of text descriptions and result protocols has undergone significant improvement in the OSTNUCLINE 2000 system. Using the item “Set” it is possible to choose whether we want to use an internal editor (improved editor similar to Ostnucline 3.3) or a standard WORD editor for the presentation and editing of textual information (visual evaluation, conclusion) and the result protocol . At the same time, we will select a template for the result protocol here.

For routine work, an internal editor can be recommended , which is fast and provides sufficient options for inserting and editing texts in RTF format, including printing and archiving the result report in the same format (improved compared to version 3.3 with the possibility of editing).

If we choose the standard WORD editor, the loading of texts will slow down a bit, but a larger arsenal of editing tools will be available. The result log will then be automatically in the format of a WORD-document (file or type .doc,) according to the default template and will also be archived in this way. This protocol already has all the standard editing options, according to the default template it can contain a logo or image of the workplace, links to internet web pages and e-mail - these links are "clickable" and allow online communication in a computer network "remotely" ( fig.4.6.1). When sent by e-mail, this protocol will be readable on every PC (see “Telenuclear Medicine”). However, the protocol created in the internal editor can also be added to the WORD (.doc) format .

For routine clinical practice, it is recommended to use the internal editor during the evaluation of the scintigraphic study, and only when creating the final protocol by clicking on the item "WORD", if necessary, convert it to WORD (.doc) format.

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4. 7 . Telenuclear medicine - evaluation of remote scintigraphic studies

The main benefit of the development of computer technology for nuclear medicine undoubtedly lies in the possibilities of exact mathematical analysis and comprehensive evaluation of (quantitative o + visual) scintigraphic studies. Furthermore, it is an extension of the possibilities of presenting the results of evaluation of scintigraphic studies (complex result protocols) and archiving of data using databases.

The development of computer networks in recent years offers another step in the direction of flexibility and efficiency in the evaluation of scintigraphic studies - " remote " evaluation .

The most common way of evaluating scintigraphic studies can be described as " local " - directly on the computer of the gamma camera. The interconnection of computers then enables evaluation on other " close " computers in the  local network of the workplace or institute (either by transferring studies or even better by sharing them). Finally, the development of global computer networks also enables the real " remote " evaluation of scintigraphic studies on remote computers in another institute, city or state. In this way, individual workplaces will be able to pass on experience, together in the form of consultations to solve complex and controversial cases, methodically help each other and represent each other.

In the OSTNUCLINE 2000 system for mathematical analysis and complex evaluation of scintigraphic studies, the possibilities of electronic sending of scintigraphic studies as well as result protocols (see §3.1.1) are realized , which allow users to easily and undemandingly evaluate scintigraphic studies "remotely".

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System authors:

OSTNUCLINE - annotation		Part 2. - Comlex programs

Vojtech Ullmann