MIM USER GUIDELINES - TROG Cancer Research · MIM USER GUIDELINES FOR CONTOUR REVIEW Version 5 May 2015 Page 6 of 29 3.2.1 Citrix Troubleshooting The first time you login into Citrix,

MIM USER GUIDELINES

FOR TROG QUALITY ASSURANCE CONTOUR REVIEW

Version 5 May 2015

MIM USER GUIDELINES FOR CONTOUR REVIEW

Version 5 May 2015 Page 2 of 29

Contents

1 Welcome ......................................................................................................................................... 4

2 TROG QA Support ........................................................................................................................... 4

3 Opening MIM .................................................................................................................................. 4

3.1 Access to CQMS ...................................................................................................................... 4

3.2 Access to MIM via Citrix .......................................................................................................... 5

3.2.1 Citrix Troubleshooting ..................................................................................................... 6

3.3 Open MIM ............................................................................................................................... 7

3.3.1 Firewall Issues ................................................................................................................. 8

3.4 Log in to MIM .......................................................................................................................... 8

4 Opening the Patient ........................................................................................................................ 9

4.1 Patient List .............................................................................................................................. 9

4.2 QA Review Saved Sessions ...................................................................................................... 9

5 Navigating MIM ............................................................................................................................. 11

5.1 Menu Sidebars ...................................................................................................................... 11

5.2 Changing the Display ............................................................................................................. 11

5.3 Contour Sidebar .................................................................................................................... 12

5.3.1 Contour Display ............................................................................................................. 13

5.3.2 The ‘Create’ Toolbar...................................................................................................... 13

5.3.3 Contour Menu ............................................................................................................... 14

5.4 Radial Menu and Tools .......................................................................................................... 14

5.5 Keyboard shortcuts ............................................................................................................... 16

5.6 Creating Annotations ............................................................................................................ 16

5.7 Using the Image Grid ............................................................................................................ 16

5.8 Dose Sidebar ......................................................................................................................... 19

5.8.1 Dose Display .................................................................................................................. 19

5.8.2 Dose Volume Constraints .............................................................................................. 19

5.8.3 Dose Volume Histogram ............................................................................................... 20

6 Saving in MIM ............................................................................................................................... 22

7 Creating a Structured Report ........................................................................................................ 23

7.1 Preparation for Creating a Structured Report ...................................................................... 23

7.2 Creating the Structured Report ............................................................................................ 23

7.3 Adding Screen Captures ........................................................................................................ 25

7.4 Adding Comments ................................................................................................................. 26



7.5 Saving a Structured Report ................................................................................................... 26

8 Exiting MIM ................................................................................................................................... 27

9 Complete CQMS audit form .......................................................................................................... 27



1 Welcome

Welcome to the TROG user guidelines for MIM. These guidelines contain an overview of the TROG

QA review process using MIM software.

These guidelines are not intended to provide a complete overview of the features of MIM, but

rather an outline of how MIM should be used to conduct TROG QA technical reviews.

2 TROG QA Support

Please do not hesitate to contact the QA office for further training and assistance:

Phone: +61 (0)2 40143914

Email: [email protected]

3 Opening MIM

MIM is accessed through the TROG Citrix platform via CQMS

3.1 Access to CQMS

CQMS is accessed via a secure log-in on the TROG website www.trog.com.au

Click on the link at the top of the TROG homepage to access the CQMS log-in page

mailto:[email protected]

http://www.trog.com.au/



Enter your CQMS login details into the specified fields

If you do not have a login or have any issues please contact the Helpdesk ([email protected])

3.2 Access to MIM via Citrix

Click on the Citrix (CRG) icon, which will take you to the Citrix log-in page

Enter your username and password into the specified fields

mailto:[email protected]



3.2.1 Citrix Troubleshooting

The first time you login into Citrix, your computer may not have the correct client software installed.

Follow the instructions on the page to install the software

There may be workplace network restrictions in place and you will need your IT person to

complete the installation

To install, click on “Run”, or “Save” if you need IT to load the file

You may need to also install and add-on (Wfica from Citrix Systems)



To allow this to happen you may need to enable “ActiveX Control”

3.3 Open MIM

Click on the “MIM” icon



The MIM icon may not be able to be visualised and you might need to go back by selecting the “Up” icon

The “Up” icon lets you move up through the file/folder tree.

Refresh your page

Clicking on the key allows you to change your password.

Go back to checking on your client software

Help

3.3.1 Firewall Issues

If there are issues with the firewall at your site, this becomes obvious at the MIM loading stage. If

you have issues at this stage your IT person will need to allow access to:

https://citrix.trog.com.au/Citrix/AccessPlatform/site/default.aspx

3.4 Log in to MIM

Log in to MIM using your CQMS/Citrix username and password

https://citrix.trog.com.au/Citrix/AccessPlatform/site/default.aspx



4 Opening the Patient

4.1 Patient List

Patient data is stored in trial-specific MIMPacs folders

You will only have access to the specific trials you require.

Double click on the trial folder of interest

From the patient list, click once on the appropriate patient for review

Available data for each patient is listed on the right hand side of the screen (i.e. the radiotherapy

treatment planning data including the CT dataset, dose, planning, and structure file/s).

Stored data might also include diagnostic CT datasets, PET datasets and Cone Beam CTs.

4.2 QA Review Saved Sessions

For each review, the TROG QA office will set up a saved ‘SESSION’ for you to access. This session

will include:

o Trial specific dose volume constraints

o Trial specific reporting templates

o Standardised contour naming conventions

o Relevant isodose values



o Pre-set displays to optimise and streamline the review process

If multiple sessions are saved, a + icon will precede the session file, with the latest version

displayed. To reveal previously saved sessions, select the + symbol

The session to be used for review will be named “INITIAL REVIEW”

Highlight the “INITIAL REVIEW” session and select “Open”

The patient for review will now open



5 Navigating MIM

5.1 Menu Sidebars

Menu sidebars are located along the left hand side of the screen and can be accessed by clicking

on the sidebar of interest

5.2 Changing the Display

Select the desired display window

The display will appear on the computer screen

Add each view (axial, sagittal, coronal) to the windows of the computer screen by a single left

mouse click

Select the “Create” tab to populate



Each time a new display is created, it is added as a window at the top of the screen in red. Click

to view previous displays

5.3 Contour Sidebar

To access, edit and create contours, select the Contour sidebar



5.3.1 Contour Display

Use the eye icon to turn structures ‘on’ and ‘off’

To adjust the contour line and width click on an individual structure and use the tools at the

bottom of the contour list

Double click on contours for contour statistics

Contours for review have been renamed according to TROG protocol naming conventions. This

will ensure that the trial-specific dose-volume constraint templates will automatically populate.

5.3.2 The ‘Create’ Toolbar

Before you use the ‘Create’ toolbar functions, you must first create a new contour by selecting

the ‘+’ icon at the top of the contour list

Please ensure you rename your structure to include your name (initials) and a clear description

i.e. TL SUGGESTED PTV

To rename, right mouse click on the newly created structure in the contour list



5.3.3 Contour Menu

To access the contour menu, right mouse click on individual structures

5.4 Radial Menu and Tools

Tools can be accessed at the of the page or via the radial menu

To access the Radial Menu right click and then select the shaded quarter of the oval



Icon Function Notes

Save Session Use at end of review – save your session as: INITIALS_CONTOUR REVIEW

Structured Report To provide feedback to sites. Add screen captures and comments

Measure

Capture viewport Take a screen capture of the active window

Rotate view

Contrast

Pan

Zoom

Annotate To provide contouring feedback

3D Brush 3D Brush+ Right click and pan - Increase or decrease brush diameter

2D Brush 2D Brush+ Right click and pan- Increase or decrease brush diameter

Image Grid To show multiple slices in consecutive order (for the purposes of creating a screen capture)



5.5 Keyboard shortcuts

Keyboard Function Notes

1,2,3 Zoom Zooms display by factor of 1,2,3

E Localise Enter Dicom co-ordinates

Access MIM tools – See below

Add tools to the toolbar, search for additional tools

Type keywords in the textbox at the top of the drop down menu to search for tools

5.6 Creating Annotations

To Provide feedback annotations can be added

Select the ‘Annotations’ tool

Click and draw a line where you would like the annotation to point to

Enter feedback in the text box, adjust the font size and select ‘OK’

Select drop down menu to use recently accessed annotations

5.7 Using the Image Grid

The ‘Image Grid’ feature can be used to show multiple slices in consecutive order (for the

purposes of creating a screen capture)



For optimal use, first create a ‘Full’ screen axial view

o Select the ‘Display’ sidebar

o Click on the ‘Full’ screen option

o Select the axial view

o To generate the view, click ‘Create’



Select the ‘Image Grid’ feature

Click on the axial window

Click on the notifications bar

Enter desired rows and columns (for optimal visualisation it is recommended not to exceed 3

columns and 3 rows)

Scroll through to the desired slices showing relevant annotations, measurements and contouring

suggestions. Ensure an appropriate zoom level.

Right click and use “Capture Viewport” from the radial menu

Please rename your screen capture appropriately in the image description text box.



All screen captures are saved and listed in the capture gallery

5.8 Dose Sidebar

5.8.1 Dose Display

A trial-specific pre-set selection of isodose values will be prepared and saved by TROG QA

To add isodose values select the ‘+’ icon

All isodose values should be in absolute dose (Gy)

Colourwash can also be used

Turn isodose values ‘on’ and ‘off’ select the eye icon

Turn phases ‘on’ and ‘off’ – select the eye icon next to each phase and un-check the tick box

5.8.2 Dose Volume Constraints

Trial specific dose constraints are displayed

A green tick indicates that protocol requirements have been met



A red circle indicates that protocol requirements have not been met

o These values are automatically populated to aid review, however all reviewers must use

this ONLY as a supplement to the overall assessment of dose constraints. It is your

responsibility to ensure the correct volumes are selected and assessed

5.8.3 Dose Volume Histogram

The DVH can be calculated by selecting the DVH icon

Please ensure you only select the DVH icon next to the phase of interest



Choose the structures to display on the MIM-Generated DVH

The generated DVH will open in a new window

Points of interest on the DVH can be located using the annotation tool

o Highlight the structure of interest (a red outline will appear around the structure)

o Select ‘Add Annotation’ and define the dose or volume value that you wish to view



The annotation will now appear as shown below

6 Saving in MIM

Please Note: MIM and Citrix will time out if left idle. SAVE your work in a session for easy retrieval.

All edits and changes made for the purpose of review, including contours, annotations,

measurements and screen captures will need to be saved in a CONTOUR REVIEW session

To identify sessions, please use the naming convention YOUR INITIALS_CONTOUR REVIEW

If you exit MIM and continue your review at a later time, select your saved session and then

“Open”

All additional changes/edits will need to be saved each time in a new session

When the review is complete, please be aware only the most recent ‘CONTOUR REVIEW’

session will be kept. Previous saved sessions with the same name will be deleted by TROG

QA.



7 Creating a Structured Report

A Structured Report can be created in MIM and used as feedback together with the QA Case Report

generated through CQMS. Screen captures and comments can be entered into this report, which

TROG QA will then export as PDF.

7.1 Preparation for Creating a Structured Report

Prior to completing the structured report, please create any relevant:

o Annotations

o Measurements

o Contours

o Screen captures

7.2 Creating the Structured Report

Select the ‘Findings’ tab and the report icon at bottom



Select the ‘Empty Template’ and then ‘OK’

New report window will opened showing options of data to include in the report

Select Patient information as header

Screen captures and comments can now be added



7.3 Adding Screen Captures

To add screen captures, select ‘Captures’

Insert screen captures to the Structured Report by selecting the green ‘+’. To remove them, select the red ‘-‘.



7.4 Adding Comments

To add comments, select ‘Text Editor’ and type in the comments box

7.5 Saving a Structured Report

Saved the Structured Report by selecting ‘Save SR’ at the top left. This will save in Dicom format

and will appear in the list of files in the patient folder as ‘SR’



8 Exiting MIM

When you wish to exit MIM or close the session:

o Select “Sessions”

o Click on the red cross

o MIM will prompt you with “Really?”, click on the red cross again

o Select ‘No’ when asked to perform final save of contours

9 Complete CQMS audit form

An Audit Form will be allocated to you in CQMS. This Audit Form contains the review questions that

will be used as feedback to the treating clinician in the form of a QA Case Report.

Please log in to CQMS via the TROG website: www.trog.com.au

Click on the blue Audit Form link, located under ‘Audit’

http://www.trog.com.au/



When you click on the link you will be taken to the form for that patient

Expand each section of the form by clicking on “Expand All”

The audit form contains a listing of the files that have been uploaded from the site

All JPEG images, word and PDF documents will be listed under the “Files” tab

To view a document or image, simply click on the file name and the image or document will

open in a new window



Please complete the questions in the relevant sections

Once you have completed the review select “Yes; form complete” in the “REVIEW COMPLETE”

section at the bottom of the page

Enter your name, date of the review (dd/mm/yyyy) and any comments you wish to have relayed

to the treating clinician

Select “Save”

This will remove the audit form from your CQMS desktop

Documents

MIM USER GUIDELINES - TROG Cancer Research · MIM USER GUIDELINES FOR CONTOUR REVIEW Version 5 May 2015 Page 6 of 29 3.2.1 Citrix Troubleshooting The first time you login into Citrix,