Need help? If you need training, upgrade, or renew your support license, please contact our Table Support team at tableapplication@anatomage.com or call us directly at 1-408-885-1474 ext. 2. 

7 Introduction TxSTUDIO Imaging Software A natomage, Inc. is a medical imaging company composed of a cross functional team consisting of the most elite researchers, mathematicians, engineers, software developers, business analysts, industry leaders, academic faculty, and dental specialists. We believe that TxSTUDIO software will enable the profession to initiate a revolution of unimaginable scope and magnitude. Ultimately, our mission is dedicated to developing software specially designed for dentists to be simple and refined, yet utilizing the most advanced cutting edge software and technology to better serve their patients. With TxSTUDIO software, doctors can create 3D volume renderings on their own computers, get cross-sections, trace nerves, place implants, print images, save images, and many more functions. The software is designed to reconstruct these 3D volume renderings from DICOM files generated by CBCT, Medical CT, and MRI radiography machines. TxSTUDIO is intended for use as a planning and simulation software in the placement of dental implants, orthodontics and surgical treatment. T his manual is intended to provide supplementary information to your direct training with a support representative. For correct and safe use, it is highly recommended that prospective users seek TxSTUDIO training from their support representative. In this document, TxSTUDIO refers to the latest version of the Anatomage TxSTUDIO software. For more information about the TxSTUDIO Reference Manual, please contact the Anatomage customer support team at info@anatomage.com. ANA003 Rev A 7 Mar 2014 Page 7 of 144 UM-TXS-ENG-53A


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33 HU Measurement: Allows for a calculation of the HU value of an area within a bounding box. The user can create multiple HU measurements on a single image. Measurement information is displayed next to the defined measurement area that the user creates, and the text can be repositioned by clicking and dragging the text box with the left-mouse button. The font color and size of the measurement text can be changed using the preference settings from the File menu. The HU measurement will also display the calculated area and standard deviation for the region chosen. Warning: Any measurement that is incorrect can lead to surgical complications if diagnosis, treatment plans and/or actual treatment is based off of the incorrect measurements. It is critical for the end user to learn how to preform measurements correctly and employ proper usage of all measurement tools. Measurement accuracy depends on the image data and the hardware scanner that generated the image data. The measurement cannot be more precise than the resolution of the image. Software reports the value based on user-picked points. Due to the nature of the medical imaging, the boundary is not always well-defined. The apparent boundary depends on the current brightness and contrast setting. The boundary may shift as the user makes adjustments to brightness and contrast. The user must understand the limitation of the measurement value before applying to the patient. If you notice any inconsistencies or software problems with measurements, or have further questions or concerns about using measurement tools correctly, please contact us at (408) or us at info@anatomage.com ANA003 Rev A 11 Mar 2014 Page 33 of 144 UM-TXS-ENG-53A

35 Ner ve Pathway: A nerve pathway can be created manually or by using the Automatic Nerve feature: Manually Create Nerve Creating a Nerve Pathway (e.g. Inferior Alveolar by following the mandibular canal to its exit). Click New. Left click the mouse where you want the nerve to start. Move the mouse to the next point along your path and left click again. Repeat this procedure for the entire length of the nerve. 2.0mm is the default diameter of the nerve pathway, but you may adjust it for your preference. Press Done to finish. Deleting a Nerve Pathway The Delete tab can be used if a point was plotted in the wrong spot; it will delete the last point added. Picking the nerve and pressing the Delete key will delete the nerve that was traced if you want to get rid of it. Visibility will turn the nerve on or off from view. Create Automatic Nerve Click Pick Seed Points. Pick at least two points with the left mouse click on the axial, cross section, or pano (Slice or Xray) view. Click Delete Last Point to remove the most recently placed seed point. Click Cancel to cancel nerve creation. Click Preview to preview the nerve tracing. Clicking Finish will complete the nerve tracing. Click Modify Points to remove points. Deleting a Nerve Pathway Picking the nerve and pressing the Delete key on the keyboard will delete the nerve that was traced if you want to get rid of it. Visibility will turn the nerve on or off from view. HU Shape: The shape of the HU measurements can set to Rectangle, Circle, or Ellipse. Each shape is defined by two leftmouse clicks and allows adjustments to the size to be made by first left-clicking to select the image and then left-clicking and dragging the red dots to adjust the position or size. Save View Settings Saves the current 2D View settings to be reloaded upon opening any case. See the Display Preferences section in Preferences for more information on which settings are saved for this specific tab. Warning: Any nerve that is traced in a way that does not conform to the actual pathway of the nerve can lead to surgical complications if diagnosis, treatment plans and/or actual treatment is based off of the incorrect tracing. It is critical for the end user to learn how to properly preform nerve tracings correctly. If you notice any inconsistencies or software problem with nerve tracing or have further questions or concerns about nerve tracing, please contact Anatomage support at (408) or us at info@anatomage.com ANA003 Rev A 11 Mar 2014 Page 35 of 144 UM-TXS-ENG-53A

39 Section: Control Panel Layout: Default: Go back to original layout. Change Layout: Click to choose custom layout. Slice Thickness: Select the cumulative thickness of the slices in view. View Control: Brightness & Contrast: Can be adjusted for each of the presets to enhance your image. Rendering Preset (drop down list): The presets either load a brightness/contrast setting that is optimized for a particular tissue type or a color preset o Brightness/Contrast Presets: Dental (custom), Abdomen, Bone, Brain CT, Liver, Lung, Mediastinum, and Grayscale o Color Presets: Allows better visualization of certain anatomic structures, soft tissue profiles, airway, etc. The color rendering is only for visualization. The colors are based on densities but DO NOT represent the density value of the bone. Sharpening Filter: Applies the selected sharpening filter from the dropdown menu to the 2D slice renderers Additional View: 3D Volume: This option allows 3D volume rendering in the fourth corner of the window. Create Custom Section: By clicking two points, a customized section can be created on any cross section to better visualize anatomy along that axis. Delete Custom Section: Removes a custom cross section made in the Rendering Window. Style: The Explorer style allows the user to freehand rotate and move the custom section. By clicking two points, a customized section can be created on any cross section to better visualize anatomy along that axis. The custom section can be navigated by clicking and dragging the arrows to rotate, the endpoints to lengthen, or the center point to freely drag the entire section. The Line style allows the custom section to be dragged along the 2D section renderer back and forth in only a direction perpendicular to the custom section. 3D Volume Clipping: When 3D volume is enabled, this option allows you to clip the volume to see the internal anatomy. The clipping plane will be synchronized with section cursors. ANA003 Rev A 11 Mar 2014 Page 39 of 144 UM-TXS-ENG-53A

44 Volume Render: Toolbar Shown below is the Tool Bar and tools that are loaded with the Volume Render View Tab: Reset View: Resets the Rendering Window to the original view size. Left View: Automatically orients the volume so the patient is facing left sagittal. Left  View: Automatically orients the volume so the patient is facing 45 left sagittal. Front View: Automatically orients the volume so the patient is facing the front. Right  View: Automatically orients the volume so the patient is facing 45 right sagittal. Right View: Automatically orients the volume so the patient is facing right sagittal. Top View: Automatically orients the volume so you are oriented above the patient. Bottom View: Automatically orients the volume so you are oriented below the patient. Back View: Automatically orients the volume to the posterior view. Quick Zoom: Click the zoom icon, then the point on the volume to zoom in. Use Reset icon to go back to normal size. Quick Slice: Once activated, clicking on a point on the volume will open a 2D zoom window in that location. The zoom window can be scrolled through using the mouse wheel and also shows the profile of any implants on that slice. Freehand Sculpture: Allows you to freely outline an area that you want to remove from the volume in a cookie cutter manner. You may remove areas inside or outside the selection by clicking the scissors inside or outside of the area that has been outlined. Polygon Sculpture: Allows you to outline an area (by selecting a series of points) for removal from the volume in a cookie cutter manner. You may remove areas inside or outside the selection by clicking the scissors inside or outside of the area that has been outlined. Note: right click your mouse to indicate that you have marked your last point. Marker: When selected you may mark a point on the volume and X,Y,Z coordinates (Transverse, Sagittal, Vertical) will appear. Clicking on the point and moving the cursor can modify points. Clicking on the point and pressing, Delete, can delete it. View Control features allow the values to be hidden or exported to a report. Distance Measurement: When selected you may mark 2 points on the volume and distance will appear. Clicking on the point and moving the cursor can modify points. Clicking on the point and pressing, Delete, can delete them. View Control features allow the values to be projected to 2D, hidden, or exported to a report. Angle Measurement: When selected you may mark 3 points on the volume and angle between them will appear. Clicking on their control points and moving the cursor can modify measurements. Clicking on the point or line and pressing, Delete, will delete them. View Control features allow ANA003 Rev A 11 Mar 2014 Page 44 of 144 UM-TXS-ENG-53A be457b7860

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