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Mastering Hanging Protocols

Overview​

TThe Hanging Protocols Configuration Screen in OmegaAI is a comprehensive interface designed to help users configure and customize how medical imaging studies are displayed. It enables radiologists and technologists to create tailored viewing layouts that align with clinical workflows and preferences. The screen is organized into three main sections, each supporting a different part of the configuration process.

Configuration Screen Layout​

The Configuration Screen Layout provides a visual workspace where you define how images are arranged, assigned, and displayed within the viewer. This screen is divided into intuitive panels that guide you through setting up viewports, assigning view codes and modifiers, and managing rules for each viewport.

1. Viewport Setup​

Location: Top-left panel Purpose: Allows you to configure the structure and organization of viewports within the imaging viewer.

  • The Viewport Setup area displays the grid where you can define the number and arrangement of viewports (e.g., 1×1, 2×2, 3×1).

  • A single left-click on the Viewport Setup area opens the Select a layout option, where you can choose their preferred viewport grid.

    • Click on the grid cells to assign active viewports (highlighted in blue).

Resetting the Layout​

  • To restore the default layout, click the Reset button located in the top-right corner of the Viewport Setup panel.

  • From the dropdown, select Reset Viewport.

  • This action clears all assigned layouts and configurations and returns the workspace to the default single-viewport setup.

2. View Codes and Modifiers Panel**​

Location: Bottom-left panel
Purpose: Provides a searchable list of predefined View Codes and MG Modifiers used to accurately assign images to the correct viewports.

View Codes​

View codes represent specific imaging orientations, projections, or series types. They help the system determine which images should be placed into each viewport when a hanging protocol is executed. By selecting the appropriate View Code, you ensure that the correct image type populates the corresponding viewport during the protocol setup.

Examples include:

  • AP (Anteroposterior)

  • PA (Posteroanterior)

  • LAT (Lateral)

  • OBLIQUE

  • CT: AXIAL

  • CT: CORONAL

  • ANY X-RAY

MG Modifiers​

Modifiers provide additional descriptors specific to mammography, capturing variations in breast positioning, orientation, or specialized imaging techniques. These are essential for exams involving modified projections.

Examples include:

  • ID -- Implant Displaced

  • RM -- Right Mediolateral

  • RI -- Right Inferior

  • RS -- Right Superior

  • RL -- Right Lateral

  • NP -- Nipple in Profile

How View Codes and MG Modifiers Are Used​

  • Users drag and drop View Codes or MG Modifiers into the desired viewport within the layout.

  • The system then uses these assignments to automatically load the correct image series or orientation when a study is opened.

  • This ensures consistent, accurate, and predictable image placement according to modality, orientation, and exam type.

Search Functionality​

  • A search icon is available in the top-right corner of the View codes panel.

  • It allows you to quickly find specific View Codes or MG Modifiers by typing relevant keywords or abbreviations.

3. Hanging Protocol Rules Panel:​

Location: Right side of the configuration screen. Purpose: Defines how each viewport behaves when a hanging protocol is applied.

The Hanging Protocol Rules Panel provides a comprehensive set of configuration options that control how images behave, appear, and are selected within each viewport when a hanging protocol is executed. These rules allow you to fine-tune the viewing experience, ensuring that images are displayed consistently and in alignment with clinical workflow requirements.

Each rule applies specifically to the selected viewport, and together they determine everything from visual behavior and image sizing to windowing, orientation, and metadata-driven image selection. The Rules Panel includes the following categories:

  • Click on the viewport name (e.g., Viewport 1) to select it.
    Click the "+" button to add a new rule configuration.
    After clicking "+", options appear around the button, such as

    a. Toggles

    b. Conditions

    c. Scaling

    d. Window Presets

    e. Orientation

Select the desired rule type to configure how images are displayed and interact with in the selected viewport.

a. Toggles​

The Toggles option allows you to enable or disable specific viewing features for the selected viewport. These settings define which tools, visual elements, and interaction behaviors are active when the hanging protocol loads.

When a toggle rule is added, you can choose from the following options:

• Linking

Synchronizes scrolling, planning, zooming, and slice navigation across linked viewports.

• Scroll Between Series

It allows you to scroll through multiple series within the same viewport.

• Show Annotations

Displays system-generated or user-created annotations within the viewport.

• Show CAD Findings

Shows computer-aided detection (CAD) markers when available for the study.

• Show Overlay

Enables DICOM or system overlays such as patient demographics, study metadata, and acquisition details.

• Show Reference Lines

Displays cross-reference (scout) lines between linked viewports.

• Show Scout Image Overlay

Displays scout (topo-gram) locator lines on CT images when scrolling through slices.

  • Each toggle can be set to Active or Inactive, giving users complete control over how the selected viewport behaves and what visual elements are displayed.

b. Scaling​

The scaling option defines how images are sized and displayed within the selected viewport when the hanging protocol is applied. These settings ensure consistent zoom behavior and image fit across different studies and series.

Users can configure the following:

  • Zoom (%) Zoom applies a fixed zoom level to the image, allowing precise control over magnification.

  • Fit Type Determines how the image fits within the viewport:

  • Viewport---Fits the entire image within the viewport while maintaining aspect ratio.

  • Fill---Fills the viewport completely, which may crop parts of the image.

  • Use scaling settings to maintain a uniform viewing experience, particularly when comparing multiple series, modalities, or orientations.

c. Window Presets​

The Window Presets option allows you to define the window level (WL) and window width (WW) that will be applied to the selected viewport when the hanging protocol is loaded. This ensures consistent brightness and contrast settings across studies.

You can either:

  • Select Custom and enter WL/WW values, or

  • Select from predefined imaging presets, such as

  • Brain (70/30)

  • Bone (2000/500)

  • Abdomen (400/40)

  • Soft Tissue (350/50)

  • Liver (160/60)

  • Lung (1500/600)

  • Mediastinum (500/50)

  • Window presets help standardize image appearance and streamline review across body regions and modalities.

  • The Window Level Preset Sync feature in OmegaAI ensures any presets created using the Window Level Tool are automatically available for use in Hanging Protocols.

  • Any hanging protocol saved with a specific window level configuration will also be listed under the available window presets, allowing for easy reuse and consistency across studies.

d. Conditions​

  • The Conditions option lets you set rules that decide when a viewport configuration should be applied.

  • These rules are based on DICOM tags, so the system can match images using specific metadata.

    Each condition includes:

  • DICOM Tag -- The attribute you want to check (example: 0008,103e -- Series Description).

  • Operator---How the value should be compared:

    • Equal -- Value must match exactly.

    • Not equal --- Value must be different.

    • Includes---Value must contain the text you enter.

    • Not include---Value must not contain the text you enter.

  • Value---The text or number you want to match (example: LUNG 1.25 MM).

Purpose:
Conditions help the system select the correct images for each viewport based on modality, series description, body part, or any other DICOM header tag.

e. Orientation​

The Orientation option allows you to control how images are flipped, rotated, or aligned within the selected viewport when the hanging protocol is applied. These settings ensure that images always appear in consistent and clinically appropriate orientation.

You can configure:

  • Flip---Flip the image horizontally or vertically.

  • Rotate---Rotate the image clockwise or counterclockwise.

  • Align---Align the image to a specific side of the viewport:

    • Top

    • Bottom

    • Right

    • Left

Orientation rules help standardize image presentation across different studies and modalities.

Hanging Protocol Stages Management​

Hanging Protocol Stages Management allows you to organize and control how images are displayed across multiple stages within a hanging protocol. Each stage represents a specific viewing layout or configuration tailored for different parts of the interpretation workflow---such as localizer views, core series review, or comparison studies.

The Hanging Protocol Stages Management panel is located along the bottom border of the Hanging Protocol Configuration screen. It appears as a horizontal navigation bar below the Viewport Setup and View Codes sections.

Creating a Stage​

  • Click the "+" (Add Stage) icon located at the bottom-left of the stage bar.

  • A new stage will be added to your Hanging Protocol.

  • You can create as many stages as required, depending on your workflow or multi-step reading process.

  • Each stage is represented by a dot indicator on the bar, and each dot is labeled with a unique stage number.

  • Click on any dot indicator to review, configure, or switch between stages.

Deleting a Stage​

  • Click on the stage indicator dot for the stage you want to delete.

  • A trash can icon will appear next to the selected stage.

  • Right-click and hold the trash icon to delete the stage.

  • The stage will be removed, and the remaining stages will automatically be renumbered.

Stage Navigation in the Image Viewer​

Stage navigation in the OmegaAI Image Viewer allows you to move between different stages defined within a Hanging Protocol. Each stage represents a unique layout or configuration designed to guide the reading workflow.

  • In a multi-stage protocol, use Page Up to move to the previous stage and Page Down to move to the next stage.

  • In a single-stage protocol, Page Up/Page Down will load the next series instead of switching stages.

  • Empty stages (stages with no matching images) are automatically skipped during navigation.

Prior Matching Model Configuration in OmegaAI​

The Prior Matching Model Configuration in OmegaAI enables you to define how previous imaging studies are matched to the current study based on specific criteria, ensuring accurate and relevant prior retrieval for diagnostic review.

Accessing the Prior Matching Model​

To access the Prior Matching Model Configuration:

  1. Open the Configuration Drawer, which displays all created matching models, with the active model for the current hanging protocol highlighted.

  2. Identify the Default Model
    Indicates which matching model is automatically applied across all hanging protocols.

Creating and Managing Matching Models​

Adding a New Model

  • Create New Model Initiates the setup of a new matching model for prior study retrieval.

  • Managing Existing Models

The three-dot menu beside each model provides quick management options.

  • Edit---Modify the existing model configuration.

  • Delete---Remove the model permanently.

  • Set as Default -- Assign the model as the default selection for future use.

Configuration Options​

a. Model Name

  • Purpose: Defines a unique and identifiable name for the matching model. Enter a clear and descriptive name in the Query model name field.

b. Body Part

  • Purpose: Ensures prior studies are selected based on the relevant anatomical region.

  • Default: Matches the body part of the current study.

  • Customization: Specify one or more body parts to broaden or refine the matching criteria.

c. Study Date

  • Purpose: Filters prior studies based on how recent they are relative to the current exam.
    Enter the desired range in months (up to 360 months) to identify relevant prior studies.

d. Study Status

  • Purpose: Includes prior studies based on their workflow or completion status.

  • Default: Matches the status of the current study.

  • Custom Options: Select one or more statuses, such as "Completed" or "In Progress"

e. Modality

  • Purpose: Ensures matching is limited to relevant imaging modalities.

  • Default: Matches the modality of the current study.

  • Customization: Select one or more modalities to expand or restrict matching.

f. Laterality

  • Purpose: Matches prior studies based on the anatomical side being scanned.

  • Default: Matches the laterality of the current study.

  • Options: Left, Right, Both, Unpaired.

g. Procedure Code

  • Purpose: Matches prior studies using standardized procedure codes.

  • Default: Uses the current study's procedure code.

  • Expansion: Select additional procedure codes to ensure inclusion of relevant exams.

h. Study Description

  • Purpose: Allows filtering of prior studies based on keywords or phrases within the study description.
    Supports text-based conditions such as "includes," "does not include," "equals," and "does not equal."

Saving the Matching Model

  • Review all configured criteria for accuracy.

  • Click Save to store the newly created or updated matching model.

  • The saved model will appear in the list and can be assigned to viewports during Hanging Protocol configuration.