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Image Viewing Solution

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Lock Icon - DS Logon Required Apps for Health Care Professionals that display a lock icon require VistA account credentials because they connect to the VA Electronic Health Record (EHR). 

The Image Viewing Solution (IVS) App allows VA clinicians and other relevant staff to search for and view patients’ x-rays, radiology images, and other stored images in Veterans Health Information Systems and Technology Architecture (VistA) Imaging. The app aggregates images from all VA medical facilities, offering easily accessible diagnostic-grade images, capabilities to work with images (e.g., zooming, rotating, changing viewpoints, measuring) and a tool to collaborate with other clinical staff.

The IVS App protects Personally Identifiable Information (PII) and Protected Health Information (PHI) as well as the fidelity of the image, ensuring IVS usage is HIPPA compliant and that images cannot be manipulated.

Please Note: The training materials found on this page are based on an earlier version of the IVS App. The materials are being updated to reflect the current version accessible from this page.

Features:

  • Find patient’s by searching specific archives or all of VA’s databases
  • View and work with images in the IVS Study Browser
  • Collaborate with other health care professionals
  • View images from different perspectives (e.g., 2D, MIP/MPR, 3D)
  • Work with images in a variety of ways, such as zooming, flipping, highlighting and measuring on an image

Videos:

  • Image Viewing Solution Session 1 – Login

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  • Image Viewing Solution Session 2 – About 2D View Mode: Interacting with Images

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  • Image Viewing Solution Session 3 – Changing Main Viewer 2D Layouts

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  • Image Viewing Solution Session 4 – Related Studies

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  • Image Viewing Solution Session 5 – 2D Image Linked Scrolling Actions

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  • Image Viewing Solution Session 6 – View Metadata

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  • Image Viewing Solution Session 7 – Cine Mode Example

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  • Image Viewing Solution Session 8 – Magnifying Glass Lens Tool

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  • Image Viewing Solution Session 9 – 2D View Mode Angular and Linear Measurements

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  • Image Viewing Solution Session 10 – 2D View Mode Point and Region of Interest (ROI) Measurements

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  • Image Viewing Solution Session 11 – 2D View Mode Markups and Annotations

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  • Image Viewing Solution Session 12 – 2D View Mode Working with Presets

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  • Image Viewing Solution Session 13 – Working with the MIP-MPR View Mode – Manipulating Planes

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  • Image Viewing Solution Session 14 – MIP-MPR View Mode – Using Curved MPR

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  • Image Viewing Solution Session 15 – MIP-MPR View Mode Working with Volume Measurement

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  • Image Viewing Solution Session 16 – Manipulating an Image in the 3D View

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  • Image Viewing Solution Session 17 – Magnifying a Part of a Volume with the Lens Tool

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  • Image Viewing Solution Session 18 – Using the Clipping Tool to Remove Obscurity

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  • Image Viewing Solution Session 19 – Using Bone Segmentation

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  • Image Viewing Solution Session 20 – Using the Scalpel Tool

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  • Image Viewing Solution Session 21 – Working with 3D Measurements

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  • Image Viewing Solution Session 22 – The 3D View Working with Presets

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  • Image Viewing Solution Session 23 – Using Collaboration

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  • Image Viewing Solution Session 24 – Manipulating Images Displayed in the 2D View Mode

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  • Image Viewing Solution Session 25 – Upper Left and Upper Right Toggle Pull Down Options

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  • Image Viewing Solution Session 26 – 3D Image Manipulation Operations

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  • Image Viewing Solution Session 27 – Working with Presets

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  • Image Viewing Solution Session 28 – Using the Lens Tool

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  • Image Viewing Solution Session 29 – Orthogonal Planes

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  • Search for Patients’ Images

    Easily search for and find a patient’s images by using either a simple search or an advanced search. You can search specific archives or all of VA’s databases.

  • View Images in 2D

    The 2D view allows you to see and interact with up to four 2D images at one time. Special features including auto-scrolling through images.

  • View Images in MIP/MPR

    The MIP/MPR (maximum-intensity projection/multiplanar reconstruction) view allows you to see and interact with cross sections of 2D images. Special features include creating a curved MPR and measuring volume.

  • View Images in 3D

    3D view allows you to see and interact with images as they would seem in real life. Special features include segmenting an image and adjusting the pixels of the image.

  • Use the Menu to Work with Images

    Depending whether you are viewing an image in 2D, MIP/MPR or 3D, the menu options may differ slightly, but most options include: Flip /Rotate, Layout, Markup, Options, Presets and Measure.

  • Collaborate with Colleagues

    The Collaboration tool allows multiple physicians to view a patient’s images simultaneously and offer feedback.

The Image Viewing Solution (IVS) mobile application (app) allows U.S. Department of Veterans Affairs (VA) clinicians and other relevant staff to search for and view patients’ x-rays, radiology images, and other stored images in Veterans Health Information Systems and Technology Architecture (VistA) Imaging. The app aggregates images from all VA medical facilities, offering easily accessible diagnostic-grade images, capabilities to work with images (e.g., zooming, rotating, changing viewpoints, measuring) and a tool to collaborate with other VA and non-VA clinical staff. The app protects Personally Identifiable Information (PII) and Protected Health Information (PHI) as well as the fidelity of the image, ensuring app usage is HIPPA compliant and that images cannot be manipulated. (NOTE: The app should NOT be used for mammography images.)
To use the Image Viewing Solution App, you must be a VA health care provider with Veterans Health Information Systems and Technology Architecture (VistA) credentials. You will be required to enter your credentials in order to log in to the app.
You can find a patient using either a simple or advanced search. For a simple search, fill out any or all of the criteria: Patient Name, Time Frame and/or Modality (type of image captured). For an Advanced Search, you can add more information: Patient ID, Accession, Study Description, Referring Physicians, Date Range and Archives. Click Search, and a list will appear of patients whose information matches your search criteria.
To work with an image, you must first search for a patient in the Study Browser and then select the image(s) to add to the Viewer. Click the checkbox in the selected column of the image(s) you would like to view, and then click Load Data in the upper right corner of the screen (or double click on the Preview/Series Description). You will go to the Viewer screen, which shows you the full-size images and provides you with different ways to view them. You can view up to four 2D images at the same time (in a 1x1, 1x2, 2x1 or 2x2 layout), or view in maximum-intensity projection/multiplanar reconstruction (MIP/MPR) or 3D.
There are three ways to view a patient’s images: 2D, MIP/MPR and 3D. The 2D view allows you to see and interact with up to four 2D images at one time. The MIP/MPR view allows you to see and interact with cross sections of 2D images. The 3D view allows you to see and interact with images as they would seem in real life.
Right click on an image to bring up the radial menu. From the menu you can access 2D (2x2, 2x1, 1x2, 1x1), MIP/MPR and 3D views. Depending on whether you are viewing an image in 2D, MIP/MPR or 3D, the menu options may differ slightly, but most options include: Flip /Rotate, Markup, Options, Presets and Measure.
Right click on the image to bring up the radial menu, and then click either 2x2, 2x1 or 1x2. Left click on the series of images on the left side of the screen, and drag it into the open spaces in the 1x2, 2x1 or 2x2 layout on the right side of the screen.
Right click on the image to bring up the radial menu, and click Layout. The wedges of the menu will change, and then click either MIP/MPR or 3D.
In MIP/MPR view, your will see three small images in a vertical strip on the left, and one large image on the right. The larger image will be a close up of one of the smaller images. If you click on a small image, the big image will change to be the close up of the one on which you clicked. Any changes or mark-ups made to one image will be reflected in the other images of the series being viewed.
The small images on the left show three perspectives (orthogonal planes) and are color coded: • Green = slices taken from left to right (sagittal) • Blue = slices taken from front to back (coronal) • Red = slices taken from top to bottom (axial) The larger image will be a close up of one of the smaller images, and to emphasize from which perspective you are viewing the larger image, the outline will match the color (green, blue or red) of the small image it duplicates.
To manipulate planes or rotate the image, move the two perpendicular positional lines in each of the smaller images, which represent the cross sections or slices you are viewing. To move a plane perpendicularly or in parallel (orthogonally), click on any solid part of the perpendicular positional lines over the image, and hold down and drag up, down, right or left to reposition. To rotate a plane, click on any dashed end of the perpendicular positional lines over the image, and hold down and drag clockwise or counterclockwise to reposition.
While the MIP/MPR view is generally used to show images at right angles to each other, you can create a Curved MPR (CMPR), which is a series of 2D images that follow the curvature of a specified part of anatomy. When viewed together, they present a continuous (elongated) depiction of the entire anatomical structure in a single plan. You must first enable CMPR by right clicking to display the radial menu and clicking Manual CMPR. Use your cursor to draw and define a centerline. Points will appear on the line as you draw, and the line will be reflected in the other three images.
Clipping panes slide into the volume to cut away slices of the image. Position the box around the area of the image by clicking and dragging an edge or corner of the box. To slice away material, click and drag the floating dots on the middle of the box.
The scalpel manually cuts away obscuring anatomy and allows for a greater degree of precision than clipping planes. Click Scalpel, left click, hold and drag the scalpel around the part of the image you would like to cut away. Release your mouse, and hover your mouse over the outlined area so that it is highlighted. Press the Delete key.
Bone segmentation allows you to remove selected materials from the image. Click Keep, and click on the material(s) within the image that you would like to keep, click Remove, and click on the material(s) within the image you would like to remove, and finally click Segment. Once you have segmented the image, you can see a shadow of the materials you removed by sliding the triangle along the Opacity bar.
Yes, you can work with images using your keyboard. Depending whether you are viewing an image in 2D, MIP/MPR or 3D, each view has its own set of keystrokes that control each view’s features. The legend for each view’s keystroke shortcuts can be viewed by clicking the question mark icon in the upper right of your screen and clicking User Guide. However, with all views, these keystrokes allow you to:
Key StrokeAction
HOMEreset view
-zoom out
=zoom in
DELETEreset view
IAction: invert intensifies (change light to dark and dark to light)
Otoggle magnifying glass
Right click on the image you are viewing to bring up the radial menu, and click Markup (“A” icon). To type a note, click Annotate and place the cursor where you would like to add your comments. To draw or write in your own script, click Freehand and use the pencil icon that appears.
No, any annotations you make either with Annotate or Freehand will not be saved.
You can take linear (distance), region of interest (ROI), point, angle and volume measurements. NOTE: The Volume measurement feature is only available in MIP/MPR view.
The app allows collaboration and allows multiple physicians to view a patient’s images simultaneously and offer feedback. As a collaboration host, you can email invitations to a session. During a session, you can check the boxes in the Collaboration Session box to choose which participants can interact with or point to images. You can remove a participant by clicking on the participant’s name and clicking Remove. NOTE: Once you start a Collaboration, patient confidential information is automatically hidden. To show this information, check the box next to “Show confidential patient information.”
In order to participate in a collaboration session, you must have received an emailed invitation for the session. Open the emailed invite, and click the link. Type your name and email in the Participant Info pop-up box, and click Join.
The app offers a built-in User Guide, Hotkeys (keyboard shortcuts) legend and an About background information, which can be accessed by right clicking on an image to display the circular pop-up menu, and then clicking Options. The User Guide is also accessible by clicking the question mark icon in the upper right corner of your screen. An additional Quick Start Guide, Slideshow and User Manual for the Image Viewing Solution App are available at mobile.va.gov/training. If you need assistance with the IVS App, contact the app training point of contact at your local VA Medical Center or dial 1-844-482-6624 to speak with a VA representative. The Help Desk is open weekdays from 7 a.m. to 7 p.m. CT. For TTY assistance, dial 711.
Additional information about other available VA apps can be found on mobile.va.gov/appstore as well as mobile.va.gov in VA’s Mobile Apps General FAQs.


Help Desk
VA Care Teams: (844) 482-6624
Veterans: (877) 470-5947
Weekdays 7 a.m.-7 p.m. (CT)

Correspondence Address
VA Mobile Health
VHA Office of Connected Care (10P8), 375AA
U.S. Department of Veterans Affairs
810 Vermont Avenue, NW
Washington, DC 20420