Agnosco DICOM Viewer: A Complete User GuideAgnosco DICOM Viewer is a medical imaging application designed to open, view, and analyze DICOM (Digital Imaging and Communications in Medicine) files. This guide walks through installation, core features, advanced tools, workflow tips, troubleshooting, and best practices for radiologists, clinicians, researchers, and technical users. Wherever possible, practical examples and step‑by‑step instructions are provided to help you get the most from Agnosco.
What is Agnosco DICOM Viewer?
Agnosco DICOM Viewer is a software tool for displaying DICOM images (CT, MRI, ultrasound, PET, digital X‑ray) and supporting associated metadata. It aims to combine an intuitive interface with advanced image manipulation, measurements, and export capabilities suitable for clinical review, teaching, and research.
Installation & Setup
System requirements
- Operating systems: Windows ⁄11, macOS (latest two versions), and commonly Linux distributions.
- Recommended hardware: multi‑core CPU, 8+ GB RAM (16+ GB for large studies), GPU acceleration for 3D rendering where available, 500+ GB disk for local archives.
- Display: Full HD (1920×1080) minimum; calibrated medical monitors recommended for diagnostic reading.
Download & installation steps
- Obtain the installer from the official Agnosco website or an authorized distributor.
- Run the installer and follow on‑screen prompts (accept license, choose installation folder).
- On first run, configure patient data privacy settings and specify default DICOM directories.
- Optionally register the application or connect to a PACS server (see next section).
Connecting to PACS and network configuration
- To connect to a PACS (DICOM store), you’ll need the PACS AE Title, IP address, port, and transfer capabilities (C‑STORE, C‑GET, C‑MOVE).
- In Agnosco: Settings → DICOM Network → Add Server. Enter AE Title, Host, Port, and preferred transfer syntax.
- Test association using the built‑in DICOM Echo (C‑ECHO) tool.
- For secure connections, enable TLS and import the PACS certificate if required by your institution.
Basic Workflow
Opening studies
- Drag & drop a DICOM folder or DICOMDIR file onto the app window.
- File → Open → choose single DICOM file, directory, or compressed archive (.zip/.tar).
- To fetch from PACS, use Retrieve → Query/Retrieve: enter patient/study criteria, select results, then Retrieve (C‑GET/C‑MOVE).
Study layout & navigation
- Study list (left pane) shows patients, studies, and series. Click to load a series into the viewer.
- Viewer supports multi‑panel layouts (1×1, 1×2, 2×2, 3×3). Use layout controls to compare series side‑by‑side.
- Scroll through slices with mouse wheel, touch gestures, or keyboard arrows. Use play/loop controls for cine/studies with time series.
Windowing, contrast, and brightness
- Window/Level tools: click‑and‑drag in the image area (horizontal for window width, vertical for level) to adjust contrast/brightness.
- Preset windowing modes (e.g., Bone, Lung, Soft Tissue) are available from a toolbar menu.
Measurement & Annotation Tools
Linear and curved measurements
- Linear ruler: click start and end points to measure distance (display units: mm).
- Curved/segmental ruler: place multiple control points along a curved structure to measure path length.
Angle, area, and ROI
- Angle tool: select three points (vertex and two endpoints) to calculate angles.
- Polygonal and elliptical ROI: draw regions of interest to measure area, mean/median pixel intensity, and standard deviation within ROI.
Annotations & reporting
- Text annotations: place labels on images; customizable font size, color, and opacity.
- Snapshot and export: capture annotated images to PNG/JPEG or export DICOM Secondary Capture.
- Report generation: create quick measurement reports including thumbnails, measurement values, patient/study metadata. Export as PDF or HL7‑compatible formats depending on your setup.
Advanced Imaging Features
Multiplanar reconstruction (MPR)
- Create orthogonal views (axial, sagittal, coronal) from isotropic volumes. Synchronized cursors let you navigate through planes consistently.
- Adjust slab thickness to create thick‑slice reformats for better visualization of structures.
3D volume rendering (VR) and surface rendering
- Volume rendering: transfer function editor for adjusting opacity and color mapping to highlight tissues (bone, vessels, soft tissue).
- Surface rendering: generate isosurfaces (e.g., bone threshold) and apply smoothing and mesh simplification options.
- GPU acceleration: enable in Settings if supported for smoother interactive manipulation.
Fusion and registration
- Multi‑modal fusion: align and overlay PET/CT, PET/MR, or CT/MR series; adjust fusion blend ratio.
- Rigid registration tools and basic landmark‑based registration are built in; automatic registration algorithms may be available depending on the license.
DICOM Structured Reports and SEG support
- Read and export DICOM Structured Reports (SR) and segmentation objects (DICOM SEG). Use SR templates to standardize measurements reporting.
- Import/export of common segmentation formats (NIfTI, NRRD) is often supported for research workflows.
Customization & Automation
Layouts and presets
- Save custom viewer layouts and window/level presets for modality‑specific reading (e.g., CT trauma, MR brain).
- Keyboard shortcuts are configurable for common actions (zoom, pan, window/level, measurements).
Scripting and batch operations
- Some Agnosco versions include a scripting API (Python/JavaScript) for batch DICOM conversions, anonymization, or repetitive measurements.
- Use batch import to process entire folders, convert to other formats (PNG, JPEG, NIfTI), or apply anonymization templates.
Security, Privacy & Anonymization
Patient data handling
- Agnosco supports anonymization profiles to strip or replace PHI from both DICOM metadata and burned‑in annotations before export or sharing.
- Use role‑based access controls and local encryption for stored archives if available.
Audit logging and compliance
- Enable audit logging for user actions (study access, exports) to comply with institutional policies.
- Confirm DICOM TLS and network security settings with your IT/security team for HIPAA and regional compliance.
Troubleshooting & Tips
Common issues and fixes
- Unable to connect to PACS: verify AE Title, IP, port, and firewall rules. Use DICOM Echo for testing.
- Corrupt or incomplete series: check for transfer interruptions; re‑retrieve from PACS or request original media.
- Slow 3D rendering: enable GPU acceleration, reduce volume resolution, or increase system memory.
Performance tips
- Keep local cache size sufficient for recent studies to avoid repeated network fetches.
- Use lossless compression when archiving to save space without diagnostic loss.
- For large volumetric datasets, prefer 16 GB+ RAM and SSD storage for faster load times.
Exporting, Sharing & Interoperability
Export options
- Image export: PNG, JPEG, TIFF, DICOM Secondary Capture.
- Data export: DICOM (full), DICOM RTSTRUCT/RTPLAN (if supported), NIfTI, CSV for measurements.
- Report export: PDF, HTML, or structured DICOM SR.
Sharing with colleagues
- Use secure DICOM Send (C‑STORE) to another PACS or workstation.
- For quick sharing, anonymize and package studies into a ZIP containing a DICOMDIR for portable media or a secure file transfer solution.
Best Practices
- Validate calibration and monitor performance periodically to ensure diagnostic image quality.
- Establish a standard set of windowing presets, measurement protocols, and report templates across your department.
- Regularly update Agnosco to receive bug fixes, security patches, and feature improvements.
- Use anonymization profiles when using images for teaching or external research.
Appendix: Keyboard Shortcuts (example)
- Spacebar: toggle play/stop for cine
- Mouse wheel: scroll through slices
- Left‑click + drag: pan
- Right‑click + drag: zoom
- Middle‑click + drag / Ctrl+drag: window/level (Shortcuts vary by version — check Settings → Shortcuts for exact mappings.)
If you want, I can:
- Produce step‑by‑step screenshots for any section.
- Create a printable quick‑reference cheat sheet for radiologists.
- Write automated scripts for batch anonymization or export (specify OS).
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