- Select the Image:
- Click the Export Icon found in the navigation menu on the left
- Read the Warning in the Export DICOM window
- Click CANCEL or DOWNLOAD

- From the IMAGES page:
- Select DICOM from the IMPORT dropdown

Drag and Drop or Click BROWSE FILES

CT (Computer Tomography aka 3D)
MRI and PET – may be imported; but it is not recommended
- Once the image is passed to MediaWeb PACS, the following scree is displayed
- Click USE DENTAL4WEB PATIENT DETAILS for D4Web details to be used
- Click USE DICOM PATIENT DETAILS to display Patient, Gender and DOB

- Patient, Gender and DOB details can be overwritten
- The Study date cannot be altered
- If multiple images are imported the above window is repeated for each image
3D Import
3D (CBCT) volumes can be imported into MediaWeb PACS (MWP), and viewed using the Multi Planar Reconstruction (MPR) Viewer.
Before initiating the import ensure you are in the correct patient to receive the 3D volume.
- From the IMAGES page:
- Select 3D from the IMPORT dropdown

The following is displayed

- Click BROWSE FILES
- Browse to appropriate location that holds the slices that for the volume to be imported.
- Select all the slices; and click Open

As the slices are imported they are validated

When the import is completed the following is displayed…

- Click USE DENTAL4WEBPATIENT DETAILS or USE DICOM PATIENT DETAILS

The following is displayed when the volume is loaded/opened…

- Once the study is loaded, the following is displayed:
- Click 2D MPR to open the MPR viewer

The MPR Viewer will be displayed…

- The following options are available on the right hand side…

Image / Video Selection
When the mouse hovers over an image / video, 4 options are displayed
- Click the tooth icon to display the image properties


- Charting information – this can be modified
- Date/time taken
- Dentist
- ID
- Colour depth
- DICOM modality
- Notes – this can be modified
- The arrows (< and >) allow scrolling through the images
- Click the 3 dots for dropdown, select to Print, Download Copy, Delete the single image


- Images are downloaded to Browser’s download folder
- Click on VIEW to open the image in Editor for examination and/or enhancement


- Click on the selection circle to select multi images


- Open in Editor, Printing or Downloading is selected by clicking the appropriate icon
- By clicking on “x” it will revert to the Images page with the selections cleared
Hover mouse over image to enable VIEW
- Click VIEW

- When an image is opened, the following editor is displayed, the toolbar has been highlighted

Double click on the image to alternate between the normal view and maximised view

Only Annotations can be saved for an image, see list below. Other changes to an image are not saved
Three tools are active when an image is opened, before any clicks: Zoom, Pan and Levels. (Levels is the default tool)
Zoom
- Use the mouse wheel to zoom in or out of an image, this function is always active
Zoomed in

Zoomed out

Pan
“Pan” enables zoomed images to be navigated
- Click and hold the right mouse button down
- Drag the mouse, with the right mouse button down, to navigate the image
- Release mouse button when finished
After Zooming

After Panning

Levels
(The default tool) Changes window Level and window Width values, i.e., Brightness and Contrast
- Click the tool
- Hold the left mouse button down and move the cursor up/down and/or left/right to adjust the changes window Level and window Width values
- The changes are reflected in the changes window Level and window Width shown in the bottom right of the display
- Deselect the tool
Before

After

An image can be manipulated by using the tools in the Toolbar
Fit the Frame
Click the Fit the Frame tool to immediately restore the whole image to be visible and fill the display window, i.e., as it was initially displayed
Before
After
Invert
Click the Invert tool to immediately invert or reverse the image, clicking again will revert the image to how it was previously
Before

After

The Sharp tool is double edged; used correctly in can be very useful in “improving” an image, if used too aggressively it can remove detail and make the image less useful. It is advised to only use the least amount of sharpening necessary
When the Sharpening tool is selected is displays the following dialogue:
- Radius is the aggressiveness of the sharpening, the higher the number the more aggressive or more impact the sharpening will have on the image
- Strength is amount of sharpening to be applied at the given Radius

Before sharpening

Select & adjust Sharpening

After Sharpening

Rotate
- Rotate Right : Each click of the Rotate Right tool will immediately rotate the image 90 degrees to the right (clockwise
- Rotate Left: Each click of the Rotate Left tool will immediately rotate the image 90 degrees to the left (anti-clockwise)
Before

After Rotate Right

After Rotate Left

Flip
- Flip Horizontally: Each click of the Flip Horizontal tool will immediately horizontally flip (mirror image) the image
- Flip Vertically: Each click of the Flip Vertical tool will immediately vertically flip (mirror image) the image
Before

After Flip Horizontally

After Flip Vertically

Measure Annotations
When the measurement tool icon is clicked, the following options are displayed

- Measure straight line – measure a single segment line
- Select the tool
- Single left click on the starting point
- Move to the end point of the measurement and single left click
- The measurement will be shown
- Repeats steps 1b to 1d if any further measurements are needed
- When finished de-select the tool

- Measure polyline – measure a multi-segment line
- Select the tool
- Single left click the starting point
- Move the mouse to each intermediate point and single left click
- At the last point double left click
- The measurement will be shown
- Repeat steps 2b to 2e if any further measurements are needed
- When finished de-select the tool

- Calibrate by line – allows an images resolution to be set (if necessary), requires something of known length to be used as the basis for the resolution
N.B. – the result will only be as accurate as the calibration - Select the tool
- Single left click at the starting point of the known measurement

- Move the mouse to the end of the known measurement and single left click
- Enter the known length of the line drawn to calibrate the image
- The following is the result using the new resolution
- This is entering the length of the line drawn to set the calibration i.e. 4mm

- This shows the line used for calibration

- Calibrate by Polyline - measures a multi-segment line and allows an images resolution to be set (if necessary)
- Measure angle – measures a simple angle
- Select the tool
- This requires three single left mouse clicks to reach the end point
- The first is at the end of one the legs that defines the angle
- The second is at the apex of the two legs i.e. the point of the angle
- At the last point double left click

- Repeat step for and subsequent angles, if needed
Text
The Text annotation allows a single line of text to added to the image
To Add Text:
- Select the Text tool
- Click where on the image the text is needed
- Enter the text
- Click the Tick to confirm or x to cancel

- If the tick is clicked, the text is visible at the selected spot on image

- When finished de-select the Text tool
To Format Text:
- Change colour of text
- Click on the text
- Click on the colour icon and select from the available colours

- Change the font size
- To select font size, click and select from the options in the drop list

- Lock the text
- Click the lock icon
- Click again to unlock

- Delete the text
- Click the Delete (bin) icon
- Note: There is no warning & deletion is not reversable

- Change multiple settings at once
- To change multiple setting at once, click on the Cog
- Change colour, font size, font style, add and remove text

- Click CANCEL or CONFIRM

Draw Shapes
When the Draw Shape Annotation tool is selected the following options are displayed

- Draw a line – draws free hand shapes
- Select the tool
- Move mouse to the starting position
- Click and hold the left mouse button down
- With left mouse button down draw shape using mouse
- When finished release left mouse button
- Repeat steps 1b to 1e if further lines are required
When finished de-select the tool
- Draw an arrow – draws an arrow
- Select the tool
- Move mouse to where the arrowhead is to be located
- Click and hold the left mouse button down
- With left mouse button down draw the arrow using mouse
- When finished release left mouse button
- Repeat steps 2b to 2e if further arrows are required
When finished de-select the tool
- Draw an Ellipse - draws ellipses (ovals, circles)
- Select the tool
- Move mouse to the starting point of the shape
- Click and hold the left mouse button down
- With left mouse button down draw the required shape
- When finished release left mouse button
- Area is the area of the shape – this uses the images resolution, so accuracy is dependent on the accuracy of the resolution
- Mean is mean or average Hounsfield Units for the area
- Std Dev. is Standard Deviation of the Hounsfield Units for the area
- See https://radiopaedia.org/articles/hounsfield-unit for Hounsfield Unit information
- Repeat steps 3b. to 3e. if further ellipses are required
When finished de-select the tool
- Draw a rectangle - Used to draw rectangular shapes
- Select the tool
- Move mouse to the starting point of the shape
- Click and hold the left mouse button down
- With left mouse button down draw the required shape
- When finished release left mouse button
- Area: the area of the shape – this uses the images resolution, so accuracy is dependent on the accuracy of the resolution
- Mean is mean or average Hounsfield Units for the area
- Std Dev. is Standard Deviation of the Hounsfield Units for the area
- See https://radiopaedia.org/articles/hounsfield-unit for Hounsfield Unit information
- Repeat steps 4b to 4e if further rectangles are required
When finished de-select the tool
When a shape annotation has been selected, the attributes of the new annotations can be changed
Reset
The Reset tool will restore the image to how it opened in this session, i.e., remove all changes made in this session
Filter
The Filter tool allows pre-defined filters to be applied to an image and/or create new filters.
Probe
Displays the tissue density in Relative Density
- Click the tool to enable it
- Move the mouse over the image to the Relative Density at the selected area
- Click the tool to deselect it
Flashlight
Enables zoom mode to just a small part of the image as if it’s spotted by a flashlight
- Click and hold the left mouse button and navigate over the image to display a magnified view
- When finished release the left mouse button

List
This is multi-function tool
- Will display all annotations created for all images for this patient

- Click Save Annotations to save any unsaved annotations, a confirmation message will appear
- Clicking an annotation gives the option to delete it
- Clicking an annotation on another image will open that image, after clicking annotation for Image 2

Once shapes (lines, arrows, ellipse, rectangles) have been added, the user is able to move, delete, lock and format.
- Move an annotation’s shape
- Once an annotation is drawn, move the mouse (+ & o) to the drawn shape
- Click and hold the left muse and drag to new position
- Unclick the left mouse when in correct position

- Delete an annotation
- Move the mouse to the annotation and click
- Click the Delete icon

- Lock an annotation
- Move the mouse to the annotation and click
- Click the Lock icon
- Repeat to unlock

- Format (Colour, font size line width) an annotation
- Move the mouse to the annotation and click
- To select colour, click and select from the available colours

- To select font size, click and select from the options in the drop list

- To select line type, click and select from the drop list

Recovery Page
Once an Image is deleted from IMAGES, they are moved to the Recovery Page automatically.
Within the recovery page the selected image can be recovered
- Select the Recovery Page from the toolbar

- When the Recovery page is opened the following message is displayed (bottom right)

- Click the circle at the top right corner of the images / videos to be recovered.
- Click RECOVER SELECTED

- The recovered image is now found back in the IMAGES page
Note: Images / Videos added to the Recovery page and recovered to the IMAGES page are always dated as per the original date of the Image / Video
Downloading & Printing
Single Images
Single images can be selected for Printing or Downloading.
- The 3 dots appear when you hover mouse over the image.
- Click either Download or Print

Download
- When Download is selected, the following displayed
- Gives the option to:
- Set the filename of the downloaded file (this could include the Study date inf needed)
- Change the file type from JPG (default) to PNG
- Add the following as text on the image:
- Patient name
- Patient ID – Dental4Web card number
- Patient DOB
- Study Date
- Text options – Colour, Size, Bold, Italic, Position (Schema)
- Click CANCEL to quit the download process or
- Click DOWNLOAD

- When DOWNLOAD is clicked, the file will be downloaded to the Browser’s download folder
- This gives the options:
- If Open with is selected, choose the relevant application and the image will opened in the specified software
- If Save File is selected, the image is saved in the selected folder
- Click OK

- If Save File was selected above, click Save

- Once the image is saved, control is passed back to previous window
Click
Cancel
Print
- When the Print option is selected the following is displayed
- This shows a Print Preview and print options
- Once the options are selected, click Print
If Cancel
is selected it reverts to the previous window
- If the print using the system dialogue... was selected, the following is displayed

Multi-Select Images
Multiple images can be selected for downloading or printing
- Hover mouse over the image and click the circle in top right corner of the thumbnail

- When multiple images have been selected a band appears at the bottom of the window
This will de-select the images and revert to the previous window
Displays how many images have been selected
Download – see below for details
Open the images in the viewer / editor
Print – see below for details
Multiple download
When downloading multiple images, they are downloaded in JPEG format in a ZIP file
- When selected, the following 'Windows' window is displayed

- If Open with is selected, the Zip file is displayed

- If Save File is selected, the explorer is displayed, this allows the file to be renamed and saved where needed
- Click OK
Multiple printing
When the Print option is selected the following is displayed
- Tick the circled windows to be printed. 1 to 4 images allowed to be printed per page

- This widget defines the number of the columns printed per page

- Drag your mouse over the squares to select more
- Click when required numbered are selected
- The following is displayed
- Once the options are selected:
- Click Print
- If Cancel is clicked, it reverts to the previous window

- If the print using the system dialogue... is selected the following is displayed
