Interpretation time efficiency with radiographs: a comparison study between standard 6 and 12 MP high-resolution display monitors.

Purpose: The purpose of this study is to compare interpretation efficiency of radiologists reading radiographs on 6 megapixel (MP) versus 12 MP monitors. Approach: Our method compares two sets of monitors in two phases: in phase I, radiologists interpreted using a 6 MP, 30.4 in. (Barco Coronis Fusion) and in phase II, a 12 MP, 30.9 in. (Barco Nio Fusion). Nine chest and three musculoskeletal radiologists each batch interpreted an average of 115 radiographs in phase I and 115 radiographs in phase II as a part of routine clinical work. Radiologists were blinded to monitor resolution. Results: Interpretation times per radiograph were noted from dictation logs. Interpretation time was significantly decreased utilizing a 12 MP monitor by 6.88 s ( p = 0.002 ) and 6.76 s (8.7%) ( p < 0.001 ) for chest radiographs only and combined chest and musculoskeletal radiographs, respectively. When evaluating musculoskeletal radiographs alone, the improvement in reading times with 12 MP monitor was 6.76 s, however, this difference was not statistically significant ( p = 0.111 ). Interpretation of radiographs on 12 MP monitors was 8.7% faster than on 6 MP monitors. Conclusion: Higher resolution diagnostic displays can enable radiologists to interpret radiographs more efficiently.

A Practical Guide to Whole Slide Imaging: A White Paper From the Digital Pathology Association.

CONTEXT.­: Whole slide imaging (WSI) represents a paradigm shift in pathology, serving as a necessary first step for a wide array of digital tools to enter the field. Its basic function is to digitize glass slides, but its impact on pathology workflows, reproducibility, dissemination of educational material, expansion of service to underprivileged areas, and intrainstitutional and interinstitutional collaboration exemplifies a significant innovative movement with far-reaching effects. Although the benefits of WSI to pathology practices, academic centers, and research institutions are many, the complexities of implementation remain an obstacle to widespread adoption. In the wake of the first regulatory clearance of WSI for primary diagnosis in the United States, some barriers to adoption have fallen. Nevertheless, implementation of WSI remains a difficult prospect for many institutions, especially those with stakeholders unfamiliar with the technologies necessary to implement a system or who cannot effectively communicate to executive leadership and sponsors the benefits of a technology that may lack clear and immediate reimbursement opportunity. OBJECTIVES.­: To present an overview of WSI technology-present and future-and to demonstrate several immediate applications of WSI that support pathology practice, medical education, research, and collaboration. DATA SOURCES.­: Peer-reviewed literature was reviewed by pathologists, scientists, and technologists who have practical knowledge of and experience with WSI. CONCLUSIONS.­: Implementation of WSI is a multifaceted and inherently multidisciplinary endeavor requiring contributions from pathologists, technologists, and executive leadership. Improved understanding of the current challenges to implementation, as well as the benefits and successes of the technology, can help prospective users identify the best path for success.

Color standard display function: A proposed extension of DICOM GSDF.

PURPOSE: Color images are being used more in medical imaging for a broad range of modalities and applications. While in the past, color was mostly used for annotations, today color is also widely being used for diagnostic purposes. Surprisingly enough, there is no agreed upon standard yet that describes how color medical images need to be visualized and how calibration and quality assurance of color medical displays need to be performed. This paper proposes color standard display function (CSDF) which is an extension of the DICOM GSDF standard toward color. CSDF defines how color medical displays need to be calibrated and how QA can be performed to obtain perceptually linear behavior not only for grayscale but also for color. METHODS: The proposed CSDF algorithm uses DICOM GSDF calibration as a starting point and subsequently uses a color visual difference metric to redistribute colors in order to obtain perceptual linearity not only for the grayscale behavior but also for the color behavior. A clear calibration and quality assurance algorithm is defined and is validated on a wide range of different display systems. RESULTS: A detailed description of the proposed CSDF calibration and quality assurance algorithms is provided. These algorithms have been tested extensively on three types of display systems: consumer displays, professional displays, and medical grade displays. Test results are reported both for the calibration algorithm as well as for the quantitative and visual quality assurance methods. The tests confirm that the described algorithm generates consistent results and is able to increase perceptual linearity for color and grayscale visualization. Moreover the proposed algorithms are working well on a wide range of display systems. CONCLUSIONS: CSDF has been proposed as an extension of the DICOM GSDF standard toward color. Calibration and QA algorithms for CSDF have been described in detail. The proposed algorithms have been tested on several types of display systems and the results confirm that CSDF largely increases the perceptual linearity of visualized colors, while at the same time remaining compliant with DICOM GSDF.

Solution for nonuniformities and spatial noise in medical LCD displays by using pixel-based correction.

Liquid crystal displays (LCD) are rapidly replacing cathode ray tube displays (CRT) for medical imaging. LCD technology has improved significantly in the last few years and has important advantages over CRT. However, there are still some aspects of LCD that raise questions as to the usefulness of liquid crystal displays for very subtle clinical diagnosis such as mammography. One drawback of modern LCD displays is the existence of spatial noise expressed as measurable stationary differences in the behavior of individual pixels. This type of noise can be described as a random stationary image superposed on top of the medical image being displayed. It is obvious that this noise image can make subtle structures invisible or add nonexistent patterns to the medical image. In the first case, subtle abnormalities in the medical image could remain undetected, whereas in the second case, it could result into a false positive. This paper describes a method to characterize the spatial noise present in high-resolution medical displays and a technique to solve the problem. A medical display with built-in compensation for the spatial noise at pixel level was developed and improved image quality is demonstrated.

The evolution of display technologies in PACS applications.

Picture archiving and communications systems (PACS) systems have been around for over a decade now. The most visible components in a PACS system are the PACS workstations. Most of the clinical users of PACS only interact with the display hardware/software pieces and never truly think about the archival and communications that occur behind the scenes. This paper discusses the evolution of PACS display technology in the past 16 yr, which can roughly be divided into three phases and will also discuss future emerging trends.