Comparison of the Commercial Color LCD and the Medical Monochrome LCD Using Randomized Object Test Patterns

Workstations and electronic display devices in a picture archiving and communication system (PACS) provide a convenient and efficient platform for medical diagnosis. The performance of display devices has to be verified to ensure that image quality is not degraded. In this study, we designed a set of randomized object test patterns (ROTPs) consisting of randomly located spheres with various image characteristics to evaluate the performance of a 2.5 mega-pixel (MP) commercial color LCD and a 3 MP diagnostic monochrome LCD in several aspects, including the contrast, resolution, point spread effect, and noise. The ROTPs were then merged into 120 abdominal CT images. Five radiologists were invited to review the CT images, and receiver operating characteristic (ROC) analysis was carried out using a five-point rating scale. In the high background patterns of ROTPs, the sensitivity performance was comparable between both monitors in terms of contrast and resolution, whereas, in the low background patterns, the performance of the commercial color LCD was significantly poorer than that of the diagnostic monochrome LCD in all aspects. The average area under the ROC curve (AUC) for reviewing abdominal CT images was 0.717±0.0200 and 0.740±0.0195 for the color monitor and the diagnostic monitor, respectively. The observation time (OT) was 145±27.6 min and 127±19.3 min, respectively. No significant differences appeared in AUC (p = 0.265) and OT (p = 0.07). The overall results indicate that ROTPs can be implemented as a quality control tool to evaluate the intrinsic characteristics of display devices. Although there is still a gap in technology between different types of LCDs, commercial color LCDs could replace diagnostic monochrome LCDs as a platform for reviewing abdominal CT images after monitor calibration

Digital Radiography with Computerized Conventional Monitors Compared to Medical Monitors in Vertical Root Fracture Diagnosis

Introduction: Vertical root fracture (VRF) is a complication which is chiefly diagnosed radiographically. Recently, film-based radiography has been substituted with digital radiography. At the moment, there is a wide range of monitors available in the market for viewing digital images. The present study aims to compare the diagnostic accuracy, sensitivity and specificity of medical and conventional monitors in detection of vertical root fractures. Material and Methods: In this in vitro study 228 extracted single-rooted human teeth were endodontically treated. Vertical root fractures were induced in 114 samples. The teeth were imaged by a digital charge-coupled device radiography using parallel technique. The images were evaluated by a radiologist and an endodontist on two medical and conventional liquid-crystal display (LCD) monitors twice. Z-test was used to analyze the sensitivity, accuracy and specificity of each monitor. Significance level was set at 0.05. Inter and intra observer agreements were calculated by Cohen’s kappa. Results: Accuracy, specificity and sensitivity for conventional monitor were calculated as 67.5%, 72%, 62.5% respectively; and data for medical grade monitor were 67.5%, 66.5% and 68% respectively. Statistical analysis showed no significant differences in detecting VRF between the two techniques. Inter-observer agreement for conventional and medical monitor was 0.47 and 0.55 respectively (moderate). Intra-observer agreement was 0.78 for medical monitor and 0.87 for conventional one (substantial). Conclusion The type of monitor does not influence diagnosis of vertical root fractures

Initial clinical evaluation of observer performance using a tablet computer with a 4K high-resolution display for detection of breast cancer by digital mammography

Purpose:To compare observer performance using medical‐purpose 5‐megapixel liquid crystal display monitors (5‐MP LCDs) and a tablet PC with a 4K high‐resolution display for detection of breast cancer by digital mammography. Materials and methods: Mammograms from 40 patients with primary breast cancer (18 mass, 16 microcalcifications, 3 artificial distortions, and 3 focal asymmetries) and 60 control patients were consecutively collected. Four experienced radiologists assessed 100 mammograms to rate using the BI‐RADS lexicon. The BI‐RADS assessments were subjected to receiver operating characteristic (ROC) curve analysis. Also, the observers assessed the image quality in terms of brightness, contrast, sharpness, and noise using 5‐step Likert scale. Results: The average under the curve (AUC) values for use of the 5‐MP LCDs and 4K monitors were 0.921 and 0.936; the difference between them was small and not significant. In terms of image quality, the 4K was rated better for brightness, contrast, and sharpness. Conclusion: Observer performance for detecting breast cancer on a 4K tablet PC with a high‐resolution display is similar to that using a 5‐MP LCD. This appears adequate for displaying mammograms of diagnostic quality and could be useful for patient consultations, clinical demonstrations, or educational and teaching purposes

Medical Grade Displays in Radiation Oncology

In modern day medicine medical images are an integral part of clinical care. They are used in almost every clinical department from diagnosis to treatment and beyond. Medical images are viewed using electronic displays of various sizes, shapes, hardware, and software. Some clinical departments, like diagnostic radiology, require electronic displays with a large dynamic range, high contrast and high resolution. Other departments do not have any requirements and will use any commercially available display in their clinical workflow. Viewing the same medical image on different electronic displays with different hardware, software or calibration setup could influence how observers perceive and analyze these images. This occurs often when a patient is referred from diagnostic radiology to another clinical specialty department such as radiation oncology. In this case, the patient’s tumor would be diagnosed using a high-performance display while their treatment will be planned and delivered using a commercially available display. In this dissertation, at first, an experiment was design to examine and verify the visual contrast sensitivity of observers using the two types of displays used in the clinic. Observers were tasked with detecting a modulating bar pattern using each display under different background luminance levels and ambient room illumination. The luminance response of each display was also measured for proper comparison. Second, a set of visual experiments compared the image quality of both displays in the different sections of the radiation oncology workflow. Observers were tasked with comparing medical images viewed on both displays and ranking them on a rating scale. As part of the workflow, the observers used both displays to contour tumor and healthy tissue volumes, analyze and fuse two sets of images, verify and adjust patient’s treatment position in three degrees of motion. The results show a clear presence for the high-performance display over the commercial grade display in every step of the radiation oncology workflow. It was shown that better visualization of medical images can improve the accuracy and precision of treatment plan and treatment delivery of radiation oncology patients

Preliminary investigation of the clinical usefulness of super-high-resolution LCDs with 9 and 15 mega-sub-pixels: Observation studies with phantoms

金沢大学附属病院放射線部Our purpose in this study was to evaluate the preliminary clinical efficacy of soft-copy reading of digital mammography, for a 15-mega-sub-pixel (MsP) and a 9-MsP super-high-resolution liquid-crystal display (SHR-LCD) by use of an independent sub-pixel driving technology. We performed three kinds of phantom observation studies by six radiological technologists. Detectability of a contrast-detail phantom and simulated small objects (SSOs) resembling microcalcifications (MCLs), and shape discrimination ability of SSOs with round and square shapes, were examined and compared with a 5-MP conventional LCD (5-MP LCD). In each study, four types of display magnification ratio were used. The detectability and the shape discrimination ability of the 15-MsP SHR-LCD were highest among the three LCDs of most of the display magnification ratios. The 9-MsP SHR-LCD indicated a higher or equal performance as compared with the 5-MP LCD in the SSO detection and shape studies. The results of our study demonstrated that the SHR-LCDs had good potential to detect MCLs and to evaluate the shape in high-resolution digital mammography. © 2009 Japanese Society of Radiological Technology and Japan Society of Medical Physics

Methods for the analysis of ordinal response data in medical image quality assessment.

The assessment of image quality in medical imaging often requires observers to rate images for some metric or detectability task. These subjective results are used in optimisation, radiation dose reduction or system comparison studies and may be compared to objective measures from a computer vision algorithm performing the same task. One popular scoring approach is to use a Likert scale, then assign consecutive numbers to the categories. The mean of these response values is then taken and used for comparison with the objective or second subjective response. Agreement is often assessed using correlation coefficients. We highlight a number of weaknesses in this common approach, including inappropriate analyses of ordinal data, and the inability to properly account for correlations caused by repeated images or observers. We suggest alternative data collection and analysis techniques such as amendments to the scale and multilevel proportional odds models. We detail the suitability of each approach depending upon the data structure and demonstrate each method using a medical imaging example. Whilst others have raised some of these issues, we evaluated the entire study from data collection to analysis, suggested sources for software and further reading, and provided a checklist plus flowchart, for use with any ordinal data. We hope that raised awareness of the limitations of the current approaches will encourage greater method consideration and the utilisation of a more appropriate analysis. More accurate comparisons between measures in medical imaging will lead to a more robust contribution to the imaging literature and ultimately improved patient care

The Empirical Foundations of Teleradiology and Related Applications: A Review of the Evidence

Introduction: Radiology was founded on a technological discovery by Wilhelm Roentgen in 1895. Teleradiology also had its roots in technology dating back to 1947 with the successful transmission of radiographic images through telephone lines. Diagnostic radiology has become the eye of medicine in terms of diagnosing and treating injury and disease. This article documents the empirical foundations of teleradiology. Methods: A selective review of the credible literature during the past decade (2005?2015) was conducted, using robust research design and adequate sample size as criteria for inclusion. Findings: The evidence regarding feasibility of teleradiology and related information technology applications has been well documented for several decades. The majority of studies focused on intermediate outcomes, as indicated by comparability between teleradiology and conventional radiology. A consistent trend of concordance between the two modalities was observed in terms of diagnostic accuracy and reliability. Additional benefits include reductions in patient transfer, rehospitalization, and length of stay.Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/140295/1/tmj.2016.0149.pd

TFOS lifestyle: Impact of the digital environment on the ocular surface

Eye strain when performing tasks reliant on a digital environment can cause discomfort, affecting productivity and quality of life. Digital eye strain (the preferred terminology) was defined as “the development or exacerbation of recurrent ocular symptoms and/or signs related specifically to digital device screen viewing”. Digital eye strain prevalence of up to 97% has been reported, due to no previously agreed definition/diagnostic criteria and limitations of current questionnaires which fail to differentiate such symptoms from those arising from non-digital tasks. Objective signs such as blink rate or critical flicker frequency changes are not ‘diagnostic’ of digital eye strain nor validated as sensitive. The mechanisms attributed to ocular surface disease exacerbation are mainly reduced blink rate and completeness, partial/uncorrected refractive error and/or underlying binocular vision anomalies, together with the cognitive demand of the task and differences in position, size, brightness and glare compared to an equivalent non-digital task. In general, interventions are not well established; patients experiencing digital eye strain should be provided with a full refractive correction for the appropriate working distances. Improving blinking, optimizing the work environment and encouraging regular breaks may help. Based on current, best evidence, blue-light blocking interventions do not appear to be an effective management strategy. More and larger clinical trials are needed to assess artificial tear effectiveness for relieving digital eye strain, particularly comparing different constituents; a systematic review within the report identified use of secretagogues and warm compress/humidity goggles/ambient humidifiers as promising strategies, along with nutritional supplementation (such as omega-3 fatty acid supplementation and berry extracts)