Review and manage images

Estimated reading: 11 minutes

Update, review, and delete images. Learn about keyboard shortcuts and tools for enhancing and annotating images.

Before you start

Security

Important!

  • Use IDEXX – PACS or IDEXX Web PACS for capturing digital radiographs and other diagnostic digital imaging, and for tasks related to diagnostic radiographs. This includes:
    • Comparing diagnostic images to each other or to images you import into the software
    • Sharing images by patient CD, email, DICOM send, and telemedicine
    • Reassigning diagnostic images to a different patient or client
    • Using DICOM features (DICOM send, import, query/retrieve)
    • Using telemedicine features to submit diagnostic images, track case status, and receive reports

Searching images

The Image Explorer provides access to non-DICOM images only. To work with diagnostic (DICOM) images, use the IDEXX-PACS Image Viewer.

Navigate to Toolbar > Image Explorer.

  1. Click the Quick Search or Advanced Search tab.
    • Quick Search: Search for client or patient by name or ID and/or date or species.
    • Advanced search: Search for client and patient by client/patient name or ID, location, species, keywords, date range, and/or type of modality (ultrasound, endoscope, etc.).
  2. Click Search. Search results are displayed in the Summary list on the left side of the Image Explorer window.
  3. Select the patient from the Summary list. Thumbnail images are displayed for the selected patient.
  4. Click Clear to remove search criteria from all fields, and start a new search if needed.

Updating an image record

The Image Explorer provides access to non-DICOM images only. To work with diagnostic (DICOM) images, use the IDEXX-PACS Image Viewer.

In the image record, you can change the image study date, image title, source, modality, and veterinarian. In addition, you can add, change, or delete comments and keywords.

To update images navigate using one of the following:

  • Toolbar > Image Explorer
  • Patient Clipboard > Search for and select a patient > Right Click on a patient > Imaging > Image Explorer
  1. Search for and select the client and patient, if needed.
  2. Click the image you want to update.
  3. Click Review or double-click the image. The image is displayed in the Image Viewer.
  4. Click Edit Image Details.
  5. Edit existing information and comments as needed.
  6. Click OK to close the Image Details dialog box.
  7. Click Save.

Notes:

  • You can also update an image from the Patient File window by double-clicking on the desired image line.
  • If you use IDEXX Digital Radiography, you can update diagnostic imaging records by opening the IDEXX-PACS Software or the IDEXX Web PACS Software. If you have an IDEXX Web PACS Software subscription, images open in IDEXX Web PACS instead of in the IDEXX-PACS Software.

Using the Cornerstone image viewer

Use the toolbar buttons at the top of the window to enhance, edit, or annotate nondiagnostic images.

Tip: On the Image Viewer, in addition to the toolbar buttons (below), keyboard and mouse shortcuts can be used to manipulate images.

For DICOM images, use IDEXX-PACS or IDEXX Web PACS.

Tool nameIcon Description
OpenCapture frames, import file, import graphic from multi-TWAIN or single-TWAIN device.
SaveSave images to a file.
PrintPrint the selected image.
Edit Image DetailsOpens the Image Details window, where you can view and update details about the image.
Rotate and FlipRotate clockwise, rotate counterclockwise, flip horizontal or flip vertical.
Window/Level (Contrast and Brightness)Manipulate the contrast and brightness of a graphic. Click and the drag cursor:
To the right to increase contrast
To the left to decrease contrast
Up to increase brightness
Down to decrease brightness
AnnotationsOpens the annotation tools menu: Arrow, ellipse, straight line, text, ect.
Note: Although advanced tools like the Vertebral Heart Score tool are available in Cornerstone when Cornerstone is integrated with IDEXX-PACS or another imaging system, we recommend using these tools on DICOM images in IDEXX-PACS/IDEXX Web PACS, or other diagnostic imaging software.
MagnifyOpens a set of tools (magnify, customize magnification, zoom) that can be used to enlarge a portion of the image.
InvertReverse light and dark values.
CropSelect Crop tool, click and drag the crop border so that it contains the part of the image you want to keep. Right-click inside the border and select Apply Crop.
Restore OriginalSelect Crop tool, click and drag the crop border to contain the part of the image you want to keep. Right-click inside the border and select Apply Crop.
Lock When viewing multiple images side by side in the Image Viewer, synchronize images within one series to images in other series to compare the images in different series. Click the Lock tool, scroll through one series and images in the other series move in sync. Note: This feature is for IDEXX-PACS and Diagnostic Imaging only.
ConfigurationOpens a set of tools that you can use to change how images are displayed. It includes an option to select or deselect which toolbar buttons appear on the Image Viewer toolbar.

Image keyboard and mouse shortcuts

The following keyboard and mouse shortcuts are available when viewing nondiagnostic images in the Cornerstone Image Viewer.

Note: Shortcuts need to be activated in the Staff defaults.

ActionShortcut
Rotate the image 90 degrees counterclockwiseClick the A key.
Rotate the image 90 degrees clockwiseClick the S key.
Move the image aroundRight-click while holding down the M key and moving the mouse. This is the same as using the Pan tool.
ZoomHold down the right mouse button and move the mouse.
Return to original zoom (image fits in window)Double right click.
Move a magnified area around the imageHold down the Shift key, and click the right mouse button. This is the same as using the Magnify tool.
Change the window (brightness) for the imageHold down the left mouse button, and move the mouse left and right.
Change the level (contrast) for the imageHold down the left mouse button, and move the mouse up and down.
Return to the original window/level settingsDouble left click.

Reviewing imaging files

The Image Explorer provides access to non-DICOM images only. To work with diagnostic (DICOM) images, use the IDEXX-PACS Image Viewer.

Cornerstone allows for quickly reviewing and annotating full-sized nondiagnostic images for a selected patient. When reviewing these images, you can access all pages for each image, if applicable.

To review image files navigate using one of the following:

  • Toolbar > Image Explorer
  • Patient Clipboard > Search for and select a patient > Right Click on a patient > Imaging > Image Explorer
  1. Search for and select the client and patient, if needed.
  2. Click the images that you want to review. To select more than one image, press the Ctrl key and click each image to review.
    • If there are several images in a series, click on one of the images in the series and all of the images in the series will be reviewed.
  3. Click Review. The selected images are displayed in the Image Viewer.
  4. To change the image displayed in the Image Viewer’s main window, in the Thumbnails area, double-click the thumbnail for the image you want to display in the main window.

    Note: If you use IDEXX Diagnostic Imaging, you can update diagnostic images by double-clicking the line item on the Patient Clipboard, patient file, and Image Requests and Results window, or by selecting the View image option on those windows. If you have an IDEXX Web PACS Software subscription, images open in IDEXX Web PACS instead of in the IDEXX-PACS Software.

Adding and viewing image details

Add, update, and view additional details about the image, including title, technique information, and comments. You can also mark the image as a key image by checking the Key Image check box.

Note: The following fields cannot be changed: Client, patient, capture date, modified date, and tech name.

  • Study: The word study, and the current date display by default. If needed, replace “Study” with a more meaningful description of the study.
  • Title: The word text displays by default. If needed, change the title.
  • Series Title: Type a meaningful title. The Series Title is displayed in the patient’s history.
  • If this image should be the key image, select the Key Image checkbox.
  • Source: If not already the default, select the capture source from the drop-down list.
  • Modality: If not already the default, select the modality from the drop-down list.
  • Keywords: To sort or search for the images by keyword, select the specific keyword to assign to this image.
  • Veterinarian: From the drop-down list, choose the veterinarian who requested the x-ray.

The Technique Details tab only applies to radiographs. Type technique information (Distance, Exposure, and kVp) used during the image capture.

Delete an image

The Image Explorer provides access to non-DICOM images only. To work with diagnostic (DICOM) images, use the IDEXX-PACS Image Viewer.

The ability to delete images or studies depends on the security settings of the person who is logged in to Cornerstone.

Navigate to Toolbar > Image Explorer.

  1. Search for and select the client and patient.
  2. Click or right-click the image. Click Delete.
  3. Select the level to delete: image, series, or study.
  4. A message displays to confirm the deletion. Click Yes to delete the image.

Notes:

  • Using IDEXX Digital Radiography, you can update diagnostic imaging records by opening the IDEXX-PACS software.
  • If you subscribe to the IDEXX Web PACS Software, images open in IDEXX Web PACS instead of in the IDEXX-PACS Software.

Printing images

The Image Explorer provides access to non-DICOM images only. To work with diagnostic (DICOM) images, use the IDEXX-PACS Image Viewer.

Navigate to Toolbar > Image Explorer.

  1. Search for the client and patient.
  2. Click the image you want to print and click Print.
    • Press the Ctrl key to select multiple images and click each desired image.
    • To select a contiguous range of images, press the Shift key and click the first and last desired images.
  3. Select one of the following:
    • Image: Print only the selected image
    • Series: Print the series to which the selected images belong
    • Study: Print the studies to which the selected images belong
      Note: See Additional Information for details about images, series, and studies.
  4. Select one of the following:
    • Apply Overlays: Print images to contain the overlay information displayed in the Image Viewer.
    • Apply Annotations: Print images to contain the annotations created in the Image Viewer.
  5. Click Select. The Print Preview window displays. The preview includes the image and client and patient information.
  6. Click one of the following to change the page that is displayed in the preview window:
    • First Page
    • Previous Page
    • Next Page
    • Last Page
  7. Click one of the following to change how large the page is displayed:
    • Actual Size: Display the page in actual size.
    • Fit Page: Resize so the entire page is visible.
    • Fit Width: Resize so the page is displayed as wide as the window.
  8. Zoom In and out to display the page larger or smaller. Select a zoom percentage or type a percentage and press enter to resize.
  9. Click Page Setup to adjust how images will be laid out and what information will be printed. Click OK after the options are selected.
    • Small (4 to a page): Check to include up to four small images per page.
    • Header and Footer: This is checked by default. Uncheck if you do not want them included when printing.
    • Comments: Check to include comments typed in the Series Comments or on the Image Details dialog box on the Image Viewer.
    • Include Comments on a Separate Page: Check if you want comments printed on a separate page.
  10. Click Print or to save the information to a file, click Save.

Additional information

Image, series, and study

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