OnePacs Forums

We read x-ray cases for quite a few outside facilities. Some of the facilities send directly to our Gateway via a VPN and other are sent to OnePACS via a gateway set up at their site. For one particular clinic the x-ray images need to be windowed and leveled in order to make them look "good"; all the other facilities come across with no window and leveling needed. Any thoughts on why this might be other than poor technique on part of the4 facility? When I went to their facility to look at the images they looked fine on their x-ray monitor but washed out on OnePACS.

The most common cause of this behavior would be the DICOM data containing information regarding recommended window and level for particular images.
The OnePacs workstation applies the recommended window and level to all images if there is a recommendation. Some other viewers do not.
It's possible the modalities are putting bad numbers into the recommended w/l for the images, but it's not noticed on-site because the viewers they use on site dont look for the recommended w/l but rather just show studies at pre-set window/level values.

As a simple workaround you could just define a present window/level for what looks good for their images and hit a key to select that preset when you are looking at their images. Take a look through the DICOM headers to see if they have recommended w/l and also look at what w/l it is that they look good at and what w/l they originally show at on OPW and on the other viewers to investigate further.

John