Propagate annotations and measurements

For cross-sectional images, you can propagate an annotation or measurement across all images in the series.

1. Add an annotation or measurement to a cross-sectional image.
2. Right-click (or touch and hold) the annotation or measurement, then select Propagate.

Note that when an annotation or measurement is applied to a multiframe image while a cine is playing, the annotation or measurement is automatically propagated across all images in the series. If a propagated measurement cannot be calculated for all images in the series, the measurement value will be ***.

Arrow

Add a arrow pointing to a feature of the image.

1. Click (or tap) and drag to add an arrow.
2. Add a note, then select OK. Select Cancel if you do not want to add a note.

To adjust an arrow:

• To move the arrow, drag the arrow to a new position.
• To adjust the arrow length, drag at either end of the arrow.
• To move the note, hover over the note until appears, then drag the note to a new position.
• To edit the note, click (or tap) the note. Edit the text, then select OK.

Text

Add a note to an image.

1. Click (or tap) where you want to add the note.
2. Add text and select OK.

To adjust the note:

• To move the note, hover over the note until appears, then drag the note to a new position.
• To edit the note, click (or tap) the note. Edit the text, then select OK.

Plumbline

Add plumblines to an image. The angle where the lines intersect is shown.

1. To create vertical lines, click (or tap) and drag up or down.
2. To create horizontal lines, click (or tap) and drag left or right.

To adjust a line:

• Drag a line to move it to a new position.

Curvature

Measure the radius between two points.

1. Click (or tap) and drag to draw a line between two points.
2. Move the mouse to define the curve radius, then click (or tap) to set the radius.

To adjust the curve:

• To adjust the curve radius, drag in the center or on an end of the curve.
• Drag the curve to move it to a new position.

Spine Labels

Label spinal vertebrae in an image.

1. Click (or tap) on the first spinal vertebra, then select a label.
2. Click (or tap) on the remaining vertebrae to apply consecutive labels. When done, right-click + beside a label, then select Complete Labeling.
3. To display the labels across all views of this body location in the current study, select Study. Select Not Shared to display the labels on the current viewport only.
4. If sharing labels across views, set the Display Threshold to indicate how many neighboring slices the label should be displayed on. Labels are displayed on consecutive slices up to the Display Threshold (in mm).

To adjust the labels:

• To change a label, right-click + beside the label, then select Edit.
• To delete a label, right-click + beside the label, then select Delete. To delete the last label added to the image, select Delete Last. To delete all labels, select Delete Annotation.

Grease Pen

Highlight a region of interest using a freeform shape. No measurements are shown.

1. Click (or tap) and drag to create a shape.
2. Drag the shape to move it to a new position.

Cursor

Click (or tap) to display a point intensity measurement. The value is shown in measurement units appropriate for the study type. You can also choose to show the cursor position.

Ruler

Click (or tap) and drag to create a linear measurement. After the line is drawn, the line length is calculated and displayed. Measurements are not shown on uncalibrated images.

If two lines intersect, the angle between the lines is shown. You can turn off the angle measurement.

Contour

Click (or tap) and drag to create a free hand curve and measure its length. Measurements are not shown on uncalibrated images.

Polyline

Use to create a multi-segment line.

• Click (or tap) to create each point in the line. Right-click (or touch and hold) after creating the final point.
• Drag on a point to move the point to a new position.

Ratio

Use to measure the ratio between two lines. Two ratios are shown: from the shorter line to the longer line, and from the longer line to the shorter line.

1. Click (or tap) and drag to draw the first line.
2. Drag to draw the second line. The ratio is shown between the lines.

To adjust the lines:

• Drag at the end of a line to adjust a line’s length.
• Drag in the center of a line to adjust the line’s position.
• Drag the dashed connecting line to move the entire measurement to a new position.

Calibrate

Enabled for images that need to be calibrated due to missing size attributes in the image (for example, an analog image that has been scanned). The Calibrate tool should only be used when a scale or an object of known size is present on the image.

Drag to draw a line between scale marks on the image or to cover a known object, then enter the distance. After this calibration, the measurement tools are available for the image.

ROI-Free

Create a border around a region of interest using a freehand shape. Statistics for the area are shown as appropriate for the study type (for example: average intensity, standard deviation, area and main diameters).

• Click (or tap) and drag to create a border around the region of interest.

To adjust the measurement:

• Drag a to move the measurement to a new position.
• To increase the measurement area, click (or tap) anywhere on the border (do not select ). Draw a line outside the border that connects to another point on the border. This area is added to the measurement.
• To decrease the measurement area, click (or tap) anywhere on the border (do not select ). Draw a line inside the border that connects to another point on the border. This area is removed from the measurement.

Note
To increase or decrease the measurement area, the ROI-Free tool must be selected.

ROI-Ellipse

Create a border around a region of interest using an elliptical shape. Statistics for the area are shown as appropriate for the study type (for example: average intensity, standard deviation, area and main diameters).

• Click (or tap) and drag to draw an ellipse.

To adjust the measurement:

• Drag the center to move the measurement to a new position.
• Drag an outer to adjust the length of the corresponding axis of the ellipse.

Circle

Create a circular border around a region of interest. Statistics for the area are shown as appropriate for the study type (for example: average intensity, standard deviation, area and main diameters).

• Click (or tap) and drag to draw a circle.

To adjust the measurement:

• Drag an outer to adjust the measurement size.
• Drag the center to move the measurement to a new position. You can also drag anywhere on the circumference of the circle (except on an outer ).

Polygon

Create a border around a region of interest using a polygon shape. Statistics for the area are shown as appropriate for the study type (for example: average intensity, standard deviation, area and main diameters).

1. Click (or tap) to create each point in the line.
2. Right-click (or touch and hold) after creating the final point.

To adjust the measurement:

• Drag a to adjust the measurement size.
• Drag the measurement to move it to a new position.

Square and Rectangle

Create a square or rectangle around a region of interest. Statistics for the area are shown as appropriate for the study type (for example: average intensity, standard deviation, area and main diameters).

1. Click (or tap) to create the first corner of the square or rectangle.
2. Click (or tap) to create the opposite corner.

To adjust the measurement:

• Drag a to adjust the measurement size.
• Drag the measurement border to move it to a new position.
• Drag a circle to rotate the measurement.

ROI - Threshold

Available for PET images. Highlight areas above a certain threshold within a region of interest.

To apply a threshold:

1. Click (or tap) and drag to create a border around a region of interest.
2. Enter a threshold, then select OK. Any areas within the region of interest that are above the threshold are circled.

   Note
   The default threshold is 2.5 SUV.

3. To apply the ROI threshold measurement to all images in the series, right-click (or touch and hold) the measurement, then select Propagate.

To adjust the measurement:

• Drag a to move the measurement to a new position.
• To increase the measurement area, click (or tap) anywhere on the border (do not select ). Draw a line outside the border that connects to another point on the border. This area is added to the measurement.
• To decrease the measurement area, click (or tap) anywhere on the border (do not select ). Draw a line inside the border that connects to another point on the border. This area is removed from the measurement.

Area Ratio

Available for OP images. Measure the area ratio between two regions.

1. Click (or tap) and drag to create a border around the first region.
2. Click (or tap) and drag to create a border around the second region. The area of the two regions are shown. The ratio of the smallest area to the largest area is also shown.

To adjust the measurement:

• Drag to move the measurement to a new position.
• To increase the measurement area, click (or tap) anywhere on the border (do not select ). Draw a line outside the border that connects to another point on the border. This area is added to the measurement.
• To decrease the measurement area, click (or tap) anywhere on the border (do not select ). Draw a line inside the border that connects to another point on the border. This area is removed from the measurement.

Note
To increase or decrease the measurement area, the Area Ratio tool must be selected.

Angle

Click (or tap) and drag to create the first side of the angle (the start of this side will be the vertex). Click (or tap) where you want to place the bottom of the second side of the angle. The two sides are automatically connected. The angle between the two sides is shown.

Cobb Angle

Click (or tap) and drag to create the first side of the Cobb angle, then drag to create the second side. The two sides are automatically connected. The angle between the two sides is shown.

Cobb Multi-Angle

Click (or tap) and drag to create the first line of the Cobb angle, then drag to create each additional line. When done adding lines, right-click (or touch and hold) the image. The angle between each set of lines is shown.

Delete Last, Delete All

Remove the last change or all changes from the current image.

Note
Use Reset to remove changes from all images in the series.

Editing Annotations

You can edit annotations. For example, you can drag to change the annotation’s position or size. You can also double-click (or touch and hold) the text in an arrow or text annotation to modify it.

Deleting Annotations

To remove an annotation, right-click (or touch and hold) the annotation, then select Delete.

Measurements for wide field ophthalmic photography images

NilRead calculates linear and area measurements on wide field ophthalmic photography images. The calculations are done using a 3D geometric model of the eye.

When you apply a linear measurement to a wide field ophthalmic photography image using the ruler tool, the measurement is calculated as the length of the curve representing the line on the 3D surface of the eye. Area measurements are performed on a 3D model of the eye by projecting the 2D shape (ellipse or ROI) from the image to the 3D model. The area measurement is calculated from the enclosed pixels on the 3D model.

If the distance or area cannot be measured, the measurement value will be ***. If you move a linear or area measurement to a different location on the image, the measurement will be recalculated based on the measurement’s new location.