"skipMainNavigation"
closeDrawerMenuopenDrawerMenu
Search
Quick Search in Journals
Quick Search anywhere
Advanced Search
RadioGraphics
Menu
  • Information
    • Previous
    Next
    Imaging Physics

    Medical Imaging Displays and Their Use in Image Interpretation

    Published Online:Jan 1 2013https://doi.org/10.1148/rg.331125096

    Abstract

    Display technology, the configuration and maintenance of displays for optimal medical image viewing, and viewing strategies to improve diagnostic performance are discussed.

    The adequate and repeatable performance of the image display system is a key element of information technology platforms in a modern radiology department. However, despite the wide availability of high-end computing platforms and advanced color and gray-scale monitors, the quality and properties of the final displayed medical image may often be inadequate for diagnostic purposes if the displays are not configured and maintained properly. In this article—an expanded version of the Radiological Society of North America educational module “Image Display”—the authors discuss fundamentals of image display hardware, quality control and quality assurance processes for optimal image interpretation settings, and parameters of the viewing environment that influence reader performance. Radiologists, medical physicists, and other allied professionals should strive to understand the role of display technology and proper usage for a quality radiology practice. The display settings and display quality control and quality assurance processes described in this article can help ensure high standards of perceived image quality and image interpretation accuracy.

    References

    • 1 Kagadis GC, Walz-Flannigan A, Krupinski EA, et al.. Image Display, from the AAPM/RSNA Physics Online Modules. http://physics.rsna.org/section/default.asp?id=PHYS0910. Accessed March 1, 2012. Google Scholar
    • 2 Fetterly KA, Blume HR, Flynn MJ, Samei E. Introduction to grayscale calibration and related aspects of medical imaging grade liquid crystal displays. J Digit Imaging 2008;21(2):193–207. Crossref, Medline, Google Scholar
    • 3 Roehrig H, Krupinski EA, Chawla AS, et al.. Noise of LCD display systems. International Congress Series 2003; 168. Google Scholar
    • 4 Samei E. AAPM/RSNA physics tutorial for residents: technological and psychophysical considerations for digital mammographic displays. RadioGraphics 2005;25(2):491–501. Link, Google Scholar
    • 5 Barten P. Physical model for the contrast sensitivity of the human eye. SPIE Human Vision, Visual Processing and Digital Display III 1992; 57–72. Google Scholar
    • 6 Barten P. Spatio-temporal model for the contrast sensitivity of the human eye and its temporal aspects. SPIE Human Vision, Visual Processing and Digital Display IV 1992; 2–14. Google Scholar
    • 7 Flynn MJ, Kanicki J, Badano A, Eyler WR. High-fidelity electronic display of digital radiographs. RadioGraphics 1999;19(6):1653–1669. Link, Google Scholar
    • 8 Samei E, Badano A, Chakraborty D, et al.. Assessment of display performance for medical imaging systems: report of the American Association of Physicists in Medicine (AAPM) Task Group 18. College Park, Md: American Association of Physicists in Medicine, 2005. Google Scholar
    • 9 Digital Imaging and Communications in Medicine (DICOM). Part 14: Grayscale standard display Function. Rosslyn, Va: National Electrical Manufacturers Association, 2004. Google Scholar
    • 10 Samei E, Badano A, Chakraborty D, et al.. Assessment of display performance for medical imaging systems: executive summary of AAPM TG18 report. Med Phys 2005;32(4):1205–1225. Crossref, Medline, Google Scholar
    • 11 ACR-AAPM-SIIM Technical Standard for Electronic Practice of Medical Imaginghttp://www.acr.org/~/media/ACR/Documents/PGTS/standards/ElectronicPracticeMedImg.pdf. Accessed October 15, 2012. Google Scholar
    • 12 Apple iPhone 4 LCD Display Shoot-Out. 2012. http://www.displaymate.com/iPhone_4_ShootOut.htm. Accessed March 1, 2012. Google Scholar
    • 13 FDA. FDA clears first diagnostic radiology application for mobile devices. U.S. Food and Drug Administration; 2011. http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm242295.htm. Accessed March 1, 2012. Google Scholar
    • 14 MIM. Mobile MIM. http://www.mimsoftware.com/markets/mobile/. Accessed March 1, 2012. Google Scholar
    • 15 SMPTE RP133. Specifications for medical diagnostic imaging test pattern for television monitors and hard-copy recording cameras. White Plains, NY: Society of Motion Picture & Television Engineers, 1991. Google Scholar
    • 16 Committee on Patient Safety and Quality Improvement. ACOG committee opinion number 398, February 2008: fatigue and patient safety. Obstet Gynecol 2008;111(2 Pt 1):471–474. Medline, Google Scholar
    • 17 Higginson JD. Perspective: limiting resident work hours is a moral concern. Acad Med 2009;84(3): 310–314. Crossref, Medline, Google Scholar
    • 18 LeBlanc VR. The effects of acute stress on performance: implications for health professions education. Acad Med 2009;84(10 suppl):S25–S33. Crossref, Medline, Google Scholar
    • 19 Lindfors PM, Heponiemi T, Meretoja OA, Leino TJ, Elovainio MJ. Mitigating on-call symptoms through organizational justice and job control: a cross-sectional study among Finnish anesthesiologists. Acta Anaesthesiol Scand 2009;53(9):1138–1144. Crossref, Medline, Google Scholar
    • 20 Riad W, Mansour A, Moussa A. Anesthesiologists work-related exhaustion: a comparison study with other hospital employees. Saudi J Anaesth 2011;5(3):244–247. Crossref, Medline, Google Scholar
    • 21 Scott LD, Hofmeister N, Rogness N, Rogers AE. Implementing a fatigue countermeasures program for nurses: a focus group analysis. J Nurs Adm 2010; 40(5):233–240. Crossref, Medline, Google Scholar
    • 22 Bhargavan M, Sunshine JH. Utilization of radiology services in the United States: levels and trends in modalities, regions, and populations. Radiology 2005;234(3):824–832. Link, Google Scholar
    • 23 DiPiro PJ, vanSonnenberg E, Tumeh SS, Ros PR. Volume and impact of second-opinion consultations by radiologists at a tertiary care cancer center: data. Acad Radiol 2002;9(12):1430–1433. Crossref, Medline, Google Scholar
    • 24 Ebbert TL, Meghea C, Iturbe S, Forman HP, Bhargavan M, Sunshine JH. The state of teleradiology in 2003 and changes since 1999. AJR Am J Roentgenol 2007;188(2):W103–W112. Crossref, Medline, Google Scholar
    • 25 Lu Y, Zhao S, Chu PW, Arenson RL. An update survey of academic radiologists’ clinical productivity. J Am Coll Radiol 2008;5(7):817–826. Crossref, Medline, Google Scholar
    • 26 Meghea C, Sunshine JH. Determinants of radiologists’ desired workloads. J Am Coll Radiol 2007;4(3):166–170. Crossref, Medline, Google Scholar
    • 27 Mukerji N, Wallace D, Mitra D. Audit of the change in the on-call practices in neuroradiology and factors affecting it. BMC Med Imaging 2006;6:13. Crossref, Medline, Google Scholar
    • 28 Nakajima Y, Yamada K, Imamura K, Kobayashi K. Radiologist supply and workload: international comparison—Working Group of Japanese College of Radiology. Radiat Med 2008;26(8):455–465. Crossref, Medline, Google Scholar
    • 29 Sunshine JH, Maynard CD. Update on the diagnostic radiology employment market: findings through 2007-2008. J Am Coll Radiol 2008;5(7):827–833. Crossref, Medline, Google Scholar
    • 30 McCall I. Workload and manpower in clinical radiology. London, England: Royal College of Radiologists, 1999; 5. Google Scholar
    • 31 Risk management in radiology in Europe IV. Vienna, Austria: European Society of Radiology, 2004. Google Scholar
    • 32 Bechtold RE, Chen MY, Ott DJ, et al.. Interpretation of abdominal CT: analysis of errors and their causes. J Comput Assist Tomogr 1997;21(5): 681–685. Crossref, Medline, Google Scholar
    • 33 Berlin L. Liability of interpreting too many radiographs. AJR Am J Roentgenol 2000;175(1):17–22. Crossref, Medline, Google Scholar
    • 34 Fitzgerald R. Error in radiology. Clin Radiol 2001; 56(12):938–946. Crossref, Medline, Google Scholar
    • 35 Krupinski EA, Berbaum KS. Measurement of visual strain in radiologists. Acad Radiol 2009;16(8): 947–950. Crossref, Medline, Google Scholar
    • 36 Krupinski EA, Berbaum KS, Caldwell RT, Schartz KM, Kim J. Long radiology workdays reduce detection and accommodation accuracy. J Am Coll Radiol 2010;7(9):698–704. Crossref, Medline, Google Scholar
    • 37 Krupinski EA, Berbaum KS, Caldwell RT, Schartz KM, Madsen MT, Kramer DJ. Do long radiology workdays affect nodule detection in dynamic CT interpretation? J Am Coll Radiol 2012;9(3):191–198. Crossref, Medline, Google Scholar
    • 38 Oestmann JW, Greene R, Kushner DC, Bourgouin PM, Linetsky L, Llewellyn HJ. Lung lesions: correlation between viewing time and detection. Radiology 1988;166(2):451–453. Link, Google Scholar
    • 39 Krupinski EA, Kallergi M. Choosing a radiology workstation: technical and clinical considerations. Radiology 2007;242(3):671–682. Link, Google Scholar
    • 40 Occupational Safety & Health Administration. Computer workstationshttp://www.osha.gov/SLTC/etools/computerworkstations/. Accessed February 28, 2012. Google Scholar
    • 41 Brennan PC, Ryan J, Evanoff M, et al.. The impact of acoustic noise found within clinical departments on radiology performance. Acad Radiol 2008;15(4): 472–476. Crossref, Medline, Google Scholar
    • 42 Kohn LTCorrigan JMDonaldson MS, eds. To err is human: building a safer health care system. Washington, DC: Institute of Medicine, 1999. Google Scholar
    • 43 Report to the President. Doing what counts for patient safety: federal actions to reduce medical errors and their impact. Washington, DC: Quality Interagency Coordination Task Force, 2000. Google Scholar
    • 44 Berlin L. Reporting the “missed” radiologic diagnosis: medicolegal and ethical considerations. Radiology 1994;192(1):183–187. Link, Google Scholar
    • 45 Berlin L. Malpractice issues in radiology: perceptual errors. AJR Am J Roentgenol 1996;167(3):587–590. Crossref, Medline, Google Scholar
    • 46 Berlin L, Berlin JW. Malpractice and radiologists in Cook County, IL: trends in 20 years of litigation. AJR Am J Roentgenol 1995;165(4):781–788. Crossref, Medline, Google Scholar
    • 47 Berlin L, Hendrix RW. Perceptual errors and negligence. AJR Am J Roentgenol 1998;170(4):863–867. Crossref, Medline, Google Scholar
    • 48 Forrester JV, Dick AD, McMenamin PG, Lee WR. The eye: basic sciences in practice. Philadelphia, Pa: Saunders, 1996. Google Scholar
    • 49 Carmody DP, Nodine CF, Kundel HL. An analysis of perceptual and cognitive factors in radiographic interpretation. Perception 1980;9(3):339–344. Crossref, Medline, Google Scholar
    • 50 Kundel HL. Perception errors in chest radiography. Semin Respir Med 1989;10(3):203–210. Crossref, Google Scholar
    • 51 Kundel HL. Peripheral vision, structured noise and film reader error. Radiology 1975;114(2):269–273. Link, Google Scholar
    • 52 Kundel HL, Nodine CF, Carmody D. Visual scanning, pattern recognition and decision-making in pulmonary nodule detection. Invest Radiol 1978;13(3):175–181. Crossref, Medline, Google Scholar
    • 53 Kundel HL, Nodine CF, Krupinski EA. Searching for lung nodules: visual dwell indicates locations of false-positive and false-negative decisions. Invest Radiol 1989;24(6):472–478. Crossref, Medline, Google Scholar
    • 54 Berbaum K, Franken E, Caldwell R, Schartz K. Satisfaction of search in traditional radiographic imaging. In: Samei EKrupinski EA, eds. The handbook of medical image perception and techniques. New York, NY: Cambridge University Press, 2010; 107–138. Google Scholar
    • 55 Nodine C, Mello-Thoms C. The role of expertise in radiologic image interpretation. In: Samei EKrupinski EA, eds. The handbook of medical image perception and techniques. New York, NY: Cambridge University Press, 2010; 139–156. Google Scholar

    Article History

    Received: May 4 2012
    Revision requested: May 31 2012
    Revision received: July 18 2012
    Accepted: July 31 2012
    Published online: Jan 1 2013
    Published in print: Jan 2013