Do NOT uninstall QCT Pro.
This error may occur immediately after installing QCT Pro. If this is your situation, insert the QCT Pro installation CD, start the AutoRun application on the CD if it does not start automatically, and click on the option to "Upgrade" QCT Pro. The upgrade process detects and installs missing components.
If QCT Pro has been operating in a normal manner, but now this error occurs when starting QCT Pro, then it is likely that the QCT Pro database is locked by another QCT Pro application. The QCT Pro Database Dump utility is often the culprit since it locks the QCT Pro database when the application is opened. To resolve this issue, make sure that all other QCT Pro applications that make use of the QCT Pro database are closed before starting the main QCT Pro application.
DICOM licenses are licenses to allow receipt of DICOM images from different CT scanners. Images can be transferred from a CT scanner, PACS, or other media. CliniQCT licenses are linked to the CT scanner and enable processing CT images acquired without a patient phantom from CT scanners with an assigned CliniQCT license. If you wish to perform QCT analyses on images from more CT scanners, you can purchases additional CliniQCT licenses.
First ensure that you still have the images on your CT scanner. Then click on the "bridge" icon (left-most icon) on the QCT Pro toolbar. Click on the "Select" button in the lower-left cornter of the file translation dialog. This displays a file-open dialog. Find the folder or folders with names matching the patient name. Right-click on such a folder and select the option to "delete" the folder. Confirm deletion of the folder. This action deletes the DIOCM images previously sent to QCT Pro for the patient. Now resend from your CT scanner just the series of interest for the patient.
You can find the Port number for transferring images to QCT Pro by opening the "QCT Pro Server Monitor" in the system tray. A port number is listed in the top left hand corner under QCT PRO DICOM Server.
The default AE Title for QCT Pro is "QCTPRO" The AE Title changed by opening Tools → PACS Configuration… within QCT Pro. View/change the AE title. Save any changes you make to the AE title.
The IP address of the computer you are using to run QCT Pro can be found by opening a Command Window (Windows button, search for "cmd") and typing "ipconfig" on the command line followed by hitting the enter key.
The IP address of the computer you are using to run QCT Pro can be found by opening a Command Window (Windows button, search for "cmd") and typing "ipconfig" on the command line followed by hitting the enter key.
Open QCT Pro and then click on Tools → PACS Configuration… to open the PACS configuration dialog. The AE Title for QCT Pro can be viewed and changed from this dialog. Additionally, the AE Title, IP address and port number for one or more PACS destinations can be defined through this configuration dialog.
There are three primary purposes behind the Mindways quality assurance process. First, the QA process is used to establish the operational integrity of a QCT Pro or CliniQCT system. The QA process involves CT scanning, image transfer, data processing and reporting. If all of these steps can be completed in the intended manner, then the system should be ready for patient scanning. Second, the QA process is used to monitor the long-term stability (calibration) of your CT scanner. Third, and specifically in the context of CliniQCT, the QA process is the source of calibration information used to measure bone mineral density from CT scans acquired without a calibration phantom imaged with the patient.
QA analyses should be performed monthly
For CliniQCT, when the system is first used with a new CT scanner a QA should be done for every kVp and SFOV pair used to acquire patient images. After this initial calibration analysis, a monthly QA need only be done at one kVp and SFOV in order to monitor CT scanner performance. If significant performance change is found, new QAs should be done for all kVp and SFOV pairs.
For example, if you scan all patients at an SFOV of 500 mm and with a kVp of 120 for normal patients and 140 for obese patients, your QA schedule should look like this:
kVp and SFOV affect the calibration, and as such must match between patient scans and the QA scan. In routine clinical use with a set protocol, changes to kVp or SFOV should be avoided if possible. If the settings must be changed (e.g., increasing kVp for an obese patient), a QA scan should be done at the new settings.
When using CliniQCT to measure bone mineral density from CT scans acquired for other reasons, it is necessary to perform a QA scan on the same scanner at the same kVp and SFOV used to acquire the patient images.
Ideally for the hip exam, yes. Rotating the feet inwards helps prevent the acetabulum from obscuring the femoral neck. In practice, however, some patients will be uncomfortable or unable to inwardly rotate their feet. In such cases, have the patient maintain a comfomfortable foot position, inwardly rotated as much as possible, and be prepared to use a 10 mm femoral neck ROI height when analyzing the hip case to avoid overlap for the femoral neck ROI with acetabulum and/or ischium.
Clothing or hospital gowns without metal are acceptable. Patients should not have any metal items in their pockets, and clothing with metal zippers, buttons or rivets between the patient and calibration phantom should be removed. Small amounts of metal generally is not a problem if located external to the patient and anterior to the spine. Bra clips are generally not an issue.
When imaging the spine, avoid imaging vertebrae with implanted hardware. Up to three levels between T11 and L4 can be used for a QCT spine study. If all six of these levels are affected by hardware, it is likely best to forgo spine imaging.
When imaging the hip, it may be possible to get a good BMD measurement of the contralateral hip (without implanted hardware). Rocking the hips to move the prosthesis more out of the axial planes with the organic hip can help reduce beam-hardening induced errors.
For the spine, L1 and L2 are the preferred measurement sites when neither L1 nor L2 is fractured or otherwise significantly deformed structurally. If L1 and/or L2 are not suitable for measurement, then any two, and up to three, vertebral levels between T11 and L4 is a suitable alternative. In general, the scan range should cover the entire vertebral body for each vertebra intended for analysis.
For the hip, the left hip is typically analyzed unless hardware or other factors suggest analyzing the right hip is preferred. The CT scan should extend from the top of the femoral head to just below (approximately 1 cm) the lesser trochanter of the hip to be analyzed.
The scan extent should be from the top of the femoral head to approximately 1 cm below the bottom edge of the lesser trochanter. Excessive coverage of the femoral shaft and/or ilium may cause the software to lose anatomical landmarks and return an access violation error. Use the SlicePick module to select the appropriate range. If this does not solve the problem, Contact Us.
Open QCT Pro and click on Tools → Backup Database… → Backup. The drive letter associated with the desired backup location can be selected before clicking Backup. Note that Windows Explorer can be used to map a backup destination on the local or a remote computer to a drive letter than can be selected in the QCT Pro backup tool.
Both the clinical and technical reports (without the hip image) for the hip, but only the clinical report for the spine can be printed again from the database. To do so, use the database review tool to find the patient of interest in the database, highlight the exam, click "Select Exam", in the new window click the "Results" tab, and then click "Print Report".
Spine interpretation guidelines are available from the American College of Radiology.
CTXA Hip BMD measurements are intended to be interpreted exactly the same way as DXA hip BMD measurements. This includes application of WHO T-score guidelines as well as the University of Sheffield FRAX® fracture risk calculator.
QCT Spine T-scores provide an accurate reflection of spine fracture risk. Clinical practice guidelines, however, emphasize hip fracture risk mitigation. Most individuals are at significantly increased risk of spine fracture some ten to fifteen years before they are at significant risk of hip fracture. Applying WHO T-score guideslines, intended for use identifying individuals at at significant risk of hip fracture from hip BMD measurements, to QCT Spine T-scores thus results in overcalling osteoporosis relative to commonly used practice guidelines.
The serial comparison section calculates BMD based on the vertebral levels in common for all exams in the comparison, whereas the results section displays values from all levels analyzed in that exam. For example, consider the case: exam from two years ago covered L1+L2, new exam covers L2+L3: results displays (L2+L3) while serial comparison shows only L2.
QCT uses common CT scan protocols, and as such the scan will be very similar to what you have experienced before. The primary difference between QCT and conventional CT studies occurs with how your CT images will be processed after they are acquired.
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