IMPAX for Breast Imaging is intended for use by radiologists trained to review and analyze mammography and other relevant medical images. Radiologists use the program to document and record their findings. It is also intended to be used for reviewing purposes. Using a Breast Imaging Radiologist license gives access to all features of IMPAX for Breast Imaging.
When configuring the IMPAX Client for use in breast imaging, the following tasks are often required.
 | CAUTION! Do not use lossy compressed images when dictating mammography. Viewing lossy compressed mammography images should be for reference purposes. Ensure that the client is configured to retrieve original images when dictating mammography studies and that the user is configured to view full fidelity images (Show web images is not selected in the List area). |
1. Modify the field mapping in the Source Manager of the IMPAX Administration Tools
For more details, refer to "Modifying a field mapping" (topic number 8960) in the IMPAX 6.5.1 Server Knowledge Base or contact Agfa Support.
2. Create a demographic layout for breast images
For more details, refer to "Creating a demographic layout" (topic number 8512) in the IMPAX 6.5.1 Server Knowledge Base or contact Agfa Support.
3. Create a breast imaging role
Creating a role simplifies the task of providing all users of the Breast Imaging Radiologist license with the features they need. As a shortcut, use the Breast Imaging Radiologist sub-role under Radiology in the default role hierarchy shipped with IMPAX. This role has default permissions and preferences that make configuration faster.
4. Add users to the breast imaging role
Radiologists who specialize in breast imaging should have this as their primary role, while radiologists who cover breast imaging periodically can have this as their secondary role.
5. Assign the appropriate number of Breast Imaging Radiologist licenses
Assign Breast Imaging Radiologist licenses to the breast imaging role, and ensure that this is the default license for that role. (Also ensure that you have a sufficient number of licenses for the users in this role.)
6. Assign the appropriate permissions to the breast imaging role
The set of default roles in IMPAX also has default permissions appropriate to those roles. You can create different permissions, if required, for your specific workflows. Or, you can edit the permissions shipped with IMPAX. Refer to Permissions: Workflow applications.
A reporting workflow must be created (unless one is inherited from a parent role). You must define:
Options for how worklist studies are initially displayed
What happens after studies are dictated
8. Enable the MG Split and Regroup wizard
Some modality vendors send their MG studies to the PACS system with all the images in only one series. This prevents Breast Imaging radiologists from using the Comparative Review Mode feature in IMPAX. Use the MG Split wizard to split a study into multiple series (as many series as there are images). The wizard then looks for images that represent the same view and groups them in the same series, so they are available for Comparative Review Mode (to view the repeat images, move the mouse wheel).
9. Set up the Comparative Review Sequences: Diagnostic and Screening
Comparative review modes automate the application of screen formats, study view modes, and hanging protocols to the craniocaudal (CC) and mediolateral oblique (MLO) images from current and prior studies. These modes are designed for optimal screening of breast images. Once a sequence is set up, it is applied automatically to MG studies.
10. Add common breast imaging tools to the customizable area of the top toolbar or to the context toolbar
In particular, the Mammography CAD SR, Comparative Review Sequence, and VOI LUT Selection tools should be positioned in the top toolbar so they are always visible and easily available.
Selecting a key combination is often quicker than using a mouse or other pointing device to click a tool button. Therefore, assign custom keyboard shortcuts to the Mammography CAD SR, Presentation State, Comparative Review Mode, Paired Zoom and Pan, 1:1 Navigator, and other tools commonly used for screening breast images.
12. Hide toolbars
Toolbars can be set to be hidden until the pointer moves toward them. You may want to set this as the initial display for breast imaging. Users can quickly change the display as needed.
13. Show the Available Series palette by default but do not embed it (do not select the F12 > User Profile tab > Embed windows option)
We strongly recommend that the unembedded Available Series palette be used when viewing mammography images. Embedding them creates gaps, takes away from the available Image area, and when embedded at the top of the Image area, causes misalignment of breasts in certain CRM views.
14. Configure the diagnostic monitors
You can group the stations used primarily by users assigned the Breast Imaging Radiologist license under one station container in the Configure area - Stations section, then configure them all at once.
 | Note: On stations where radiologists are diagnosing with the features found in the Breast Imaging Radiologist license, only Agfa-validated video cards and monitors should be used. For a complete list, contact your Agfa representative. |