DICOM Viewer

Click and drag to move the image within any viewport.

• Left-click + drag to pan the view.
• Works in all MPR viewports (axial, coronal, sagittal) and 3D.
• Use mouse wheel to scroll through slices.

Magnify or reduce the image in the active viewport.

• Left-click + drag up/down to zoom in/out.
• Mouse wheel can also be used for zoom when this tool is active.
• Double-click to reset zoom to fit.

Adjust brightness (level) and contrast (window) of the CT image to optimize visualization of different tissues.

• Left-click + drag horizontally to change window (contrast).
• Left-click + drag vertically to change level (brightness).
• Use presets (Cardiac, Abdomen, Lung, Bone) for common ranges.
• Cardiac preset is recommended for TAVI planning.

Measure point-to-point distance in any MPR viewport. Results appear in the Measurements panel on the right.

• Click to place the first point, then click again for the second point.
• Distance is displayed in millimeters based on DICOM pixel spacing.
• Measurements are saved in the right panel under Manual MPR measurements.
• Multiple measurements can coexist on the same viewport.

Measure the angle between two lines in any MPR viewport.

• Click 3 points to define two rays sharing a common vertex.
• Angle is displayed in degrees.
• Useful for assessing aortic angulation and implant trajectories.

Add text annotations and markers to MPR viewports.

• Click on the viewport to place an annotation marker.
• Type a label for the annotation in the prompt.
• Annotations are visible on screen and can be included in report exports.

Draw a polygon on an MPR slice to measure enclosed area and perimeter (annulus planimetry, calcification ROIs, or any cross-section).

• Click to place each vertex; double-click or click the first vertex (release without dragging) to close.
• Drag a vertex (grab cursor) to reposition after placement, including on a saved ROI on the same slice.
• After roughly three-quarters of the contour is traced, the tool may auto-complete the remaining arc.
• Esc cancels vertex drag or clears an in-progress polygon.
• Measured values: area (mm²), perimeter (mm); results sync to the list below and the report pipeline.

Place markers at the coronary artery ostia (RCA and LCA) for coronary clearance assessment.

• Click in MPR at the lower border of each coronary ostium.
• Markers are displayed in the 3D viewport and used for height calculations.
• Pair with the Aortic Root Workflow for complete annulus-to-ostium distance.

3-step workflow to measure the perpendicular height from the annulus plane to each coronary ostium.

1. Step 1 - Annulus: Click in MPR at the level of the annulus plane.
2. Step 2 - RCA: Click at the lower border of the RCA ostium.
3. Step 3 - LCA: Click at the lower border of the LCA ostium.

• Heights < 10 mm trigger a warning (coronary obstruction risk).
• Results are saved to the report and visible in Clinical Summary.

Run a virtual valve deployment simulation based on annulus measurements and selected prosthesis.

• Select a valve model and size in the right panel.
• Adjust depth and rotation sliders for optimal positioning.
• Click Run Simulation to compute oversizing %, PVL risk, and contact metrics.
• Advanced controls allow fine-tuning of offset and tilt in all axes.

Manually place a valve prosthesis mesh in the 3D viewport for visual assessment.

• The valve is positioned at the annulus plane derived from the Aortic Root Workflow.
• Drag in 3D to reposition; use sliders for fine adjustments.
• Use Remove Valve to clear the placed model.

Central hub for all measurements in the DICOM viewer. Shows QC status, AI-derived report measurements, live workflow measurements, and manual MPR measurements.

• QC Status - automated quality control checks (PASS/FAIL/WARNING).
• Report measurements - AI-extracted values from the analysis pipeline.
• Live workflow measurements - values from the active workflow (root, cusps).
• Editable AI areas - click to override AI landmarks (annulus, ostia, SoV, STJ, LVOT, calcification ROIs).
• Manual MPR measurements - distance/angle/ROI measurements placed by hand.
• Use Edit report measurements to open the full measurement editor.

Measure minimum vessel diameters for transfemoral access route evaluation (right and left sides).

• Measure Common Iliac, External Iliac, and Common Femoral arteries.
• Click Measure next to each vessel, then click in the MPR at the narrowest point.
• Switch between RIGHT and LEFT tabs.
• Check Access route not in scan if the scan does not cover the femoral vessels.
• Minimum diameters are summarized in the Clinical Summary panel.

Computed angiographic projection angles for optimal C-arm positioning during TAVI.

• LAO/RAO and Cranial/Caudal angles derived from the annulus plane normal.
• Alternative views are listed when available.
• Enable Show beam plane in 3D to visualize the projection in the 3D viewport.
• Angles are only available after annulus QC passes.

Anatomical level navigator for the aortic root. Click any level to navigate the MPR cursor to that position.

• LVOT - Left Ventricular Outflow Tract (funnel/trapezoid shape).
• Annulus - Aortic Valve Base (elliptical cross-section).
• SOV - Sinuses of Valsalva (Mercedes-Benz / cloverleaf shape with coronary origins).
• STJ - Sinotubular Junction (perfect circle; upper boundary for valve calcification).
• Ascending Aorta - Tubular aorta above STJ (uniform circle).

The calcification tagging guide below shows how to identify boundaries for accurate calcium scoring.

Configure and run virtual valve deployment. Results include oversizing, PVL risk, and contact assessment.

• Valve Model - select prosthesis type from the catalog.
• Size - pick from available sizes for the selected model.
• Depth / Rotation - adjust implant depth and rotational orientation.
• Advanced - fine-tune model axis, offset (X/Y/Z), and tilt (X/Y/Z).
• Run Simulation computes oversizing %, paravalvular leak risk, and contact metrics.
• Reset Position returns all sliders to defaults.

Curved Planar Reformation (CPR) shows the aorta straightened along its centerline for diameter and length assessment.

• Lock to centerline - keeps the CPR slice synchronized with the MPR cursor position.
• Thickness slider - adjust the CPR slab thickness (1-20 mm).
• Edit offset - manually adjust the centerline path.
• Save / Reset - persist or discard centerline edits.
• If CPR is not available, click Generate CPR Views for server-side computation.

Single source of truth for all clinical data. Aggregates QC status, key measurements, access assessment, C-arm angles, and CPR information.

• QC & Measurements - quality control status, confidence level, and key report measurements.
• Access Assessment - minimum vessel diameters (right/left) and feasibility.
• C-Arm Guidance - recommended projection angles.
• CPR - centerline distance summary.
• Series - loaded DICOM series information.

This panel is always visible regardless of the active tool. Use it as the primary reference during clinical review.

Paint directly on MPR views to correct the aorta segmentation mask. Use this when the AI segmentation includes non-aorta structures (e.g., LV, PA) or misses aorta regions.

• Correction mode — select Mask in the switcher at the top of the right panel.
• Mode: add / remove — paint voxels into the mask (green) or erase them (red). Clicking this button activates correction mode.
• Brush slider — adjust brush radius (1–20 px on screen). Moving the slider auto-activates correction mode.
• Counter — number of modified voxels. Each stroke records individual voxel changes.
• Save & re-run — sends corrections to the server, merges them into the original NIfTI mask, and re-runs the pipeline (centerline + measurements + safety firewall) in the background.
• After re-run — a banner appears with Back to Decision. Return to Decision to confirm readiness before signing off.
• Cancel — exits correction mode and discards unsaved changes.
• Clear — clears pending corrections without exiting correction mode.

Brush strokes show as green for added voxels and red for removed voxels.

Tip: Zoom in for precise boundary corrections. The pipeline re-run is asynchronous — use the completion banner or reload when notified.

Drag contour control points on the MPR slice to correct the AI-detected lumen boundary at Annulus, SoV, or STJ. Use when the landmark position is acceptable but the drawn shape is wrong.

• Correction mode — select Contour in the switcher at the top of the right panel.
• Level selector — choose Annulus, SoV, or STJ.
• Activate — enter contour editing mode. Contour points appear as draggable circles on the MPR view.
• Drag points — click and drag any contour point. The point follows the cursor in the plane.
• Save & re-run — sends corrected points to the server, recomputes metrics (area, perimeter, diameters), and re-runs the measurement pipeline.
• After re-run — use Back to Decision in the banner to re-check readiness.
• Cancel — exits contour correction mode and discards changes.

All corrections are stored with provenance (source: human_contour_rescue) and appear in the audit trail.

The Correct portal is for spatial fixes on MPR images. Choose one mode at a time — only the active panel is shown.

• Mask — paint voxels to fix aorta segmentation (wrong LV/PA inclusion, missing lumen).
• Contour — drag control points at Annulus, SoV, or STJ when the plane is right but the outline is wrong.
• Centerline — pick proximal (seed) and distal points when the centerline fails or is too short.

After Save & re-run (or Re-run for centerline), wait for the completion banner and click Back to Decision to confirm case readiness before report sign-off.

Manual numeric override (collapsed below) is secondary — use only when spatial correction is not sufficient.

Use when the safety firewall reports a missing or too-short centerline, or when root landmarks cannot be computed.

• Correction mode — select Centerline in the switcher.
• Pick seed — click the proximal aorta at annulus level in any MPR view.
• Pick distal — click a point downstream in the ascending aorta (enables after seed).
• Re-run — recomputes the centerline and full measurement pipeline from your picks.
• Cancel — clears picks and exits rescue mode.

If the centerline still fails, check segmentation with Mask mode first. After a successful re-run, use Back to Decision to verify readiness.