Patrik Sund

Comparison of Color LCD and Medical-grade Monochrome LCD Displays in Diagnostic Radiology

In diagnostic radiology, medical-grade monochrome displays are usually recommended because of their higher luminance. Standard color displays can be used as a less expensive alternative, but have a lower luminance. The aim of the present study was to compare image quality for these two types of displays. Images of a CDRAD contrast-detail phantom were read by four radiologists using a 2-megapixel (MP) color display (143xa0cd/m2 maximum luminance) as well as 2-MP (295xa0cd/m2) and 3-MP monochrome displays. Thirty lumbar spine radiographs were also read by four radiologists using the color and the 2-MP monochrome display in a visual grading analysis (VGA). Very small differences were found between the displays when reading the CDRAD images. The VGA scores were −0.28 for the color and −0.25 for the monochrome display (pu2009=u20090.24; NS). It thus seems possible to use color displays in diagnostic radiology provided that grayscale adjustment is used.

Evaluation of lumbar spine images with added pathology

Optimization of radiographic procedures require solid tools for evaluation of the image quality in order to ensure that it is sufficient to answer the clinical question at the lowest possible absorbed dose to the patient. Lumbar spine radiography is an examination giving a relatively high dose and good methods for evaluation of image quality as well as dose are needed. We have developed and used a method for the addition of artificial pathological structures into clinical images. The new images were evaluated in a study of detectability (free-response forced error experiment). The results from the study showed that the methodology can be used to detect differences in the screen-film systems used to produce the images, indicating that the method can be used in a study of image quality. The results of the study of detectability were compared with the outcome of a visual grading analysis based on the structures mentioned in the European Quality Criteria. The comparison indicated that a linear correlation exists between the two methods. This means that the simple VGA can be used in the evaluation of clinical image quality.

Method for determining the two-dimensional presampling modulation transfer function in digital radiography

In digital radiography, radial asymmetry may be present. The use of a one-dimensional representation of the resolution properties can therefore be questioned. Although measurements are often done in two orthogonal directions, there may be a need for a more detailed description. A method of measuring the two-dimensional presampling modulation transfer function (MTF) has therefore been developed. A finely sampled disk spread function is obtained by imaging an aperture mask, consisting of N2 circular holes arranged in an NxN manner in an opaque material, in such a way that each hole is positioned at a different phase relative to the sampling coordinates of the detector system. This spread function is resampled, extrapolated, Fourier transformed, and finally corrected for the finite hole size in order to obtain the presampling MTF. The method was tested on a computed radiography (CR) system through measurements with a prototype mask, consisting of 100 holes of radius 0.2 mm drilled in a lead alloy. The results were compared with measurements using the slit method, and were found to be consistent. Problems associated with the method, e.g. errors due to incorrect alignment of the holes in the aperture mask with the beam, and limitations due to the finite hole size, are discussed.

Evaluation of displays for medical x-ray applications using observer performance

A physical and clinical evaluation of four different display systems intended for the presentation of medical x-ray images was performed. State-of-the-art b/w display devices were studied as well as a low-cost color display. The systems tested were: a) CRT 21 b/w 1K, b) CRT 21 b/w, 2K, c) CRT 21 color, 1K, d) LCD 20.8 b/w, 1.5K. All displays were, as far as possible, adjusted to conform to DICOM 3.0 part 14. The physical evaluation included quantities such as resolution, flickering and uniformity. The clinical evaluation was performed by 15 radiologists using visual grading analysis of one phantom chest image and 12 clinical images of the chest and small bones. One subtle pathological structure and one anatomical structure were rated. The CRT b/w 1K display was used as the reference display system. All displays were evaluated at two different luminance levels (160 and 320 cd/m2) and viewed under two different ambient light conditions (10 and 40 lux). The LCD 1.5K display was rated best and the color CRT display was rated worst for both luminance levels. The result for the color CRT display - unable to produce more than 120 cd/m2 - at the high ambient light setting was very poor.

Demonstration of correlations between physical and clinical image quality measures in chest and lumbar spine radiography

Clinical and physical assessments of image quality are compared and the correlation between the two derived. Clinical assessment has been made by a group of expert radiologists who evaluated the fulfillment of the European Image Criteria for chest and lumbar spine radiography; yielding the so-called Image Criteria Score, ICS. Physical measures of image quality were calculated using a Monte Carlo model of the complete imaging system. This model includes a voxelised male anatomy and calculates contrast and signal-to-noise ratio of various anatomical details and a measure of useful dynamic range. Correlations between the ICS and the physical image quality measures were sought. Four lumbar spine and 16 chest imaging systems were evaluated and simulated with the model. The most useful physical quantities for chest radiography were the dynamic range and contrast of blood vessels in the retro-cardiac area. In lumbar spine, it was the signal-to-noise ratio of trabecular structures. The significant correlation is encouraging and shows that clinical image quality can be predicted provided the imaging conditions are well known and that relevant measures of physical image quality are used to assess the quality of the image.

Detection of low contrast test patterns on an LCD with different luminance and illuminance settings

The DICOM part 14 grayscale standard display function provides one way of harmonizing image appearance under different monitor luminance settings. This function is based on ideal observer conditions where the eye is always adapted to the target luminance and thereby also at peak contrast sensitivity. Clinical workstations are however often exposed to variations in ambient light due to a sub-optimal reading room light environment. Also, clinical images are inhomogeneous and low-contrast patterns must be detected even at luminance levels that differ from the eye adaptation level. All deviations from ideal luminance conditions cause the observer to detect patterns with reduced eye sensitivity but the magnitude of this reduction is unclear. The purpose of this paper was to quantify the effect different luminance settings have on the contrast threshold. A method to display well-defined sinusoidal low-contrast test patterns on an LCD has previously been developed and was used in this study. The observers were exposed to light from three different areas: 1) A small sinusoidal test pattern. 2) The remaining of the display surface. 3) Ambient light from outside the display area covering most of the observers field of view. By adjusting the luminance from each of these three areas, two major effects could be quantified. The first effect was similar to Bartens f-factor where the target luminance differs from the observers adaptation level while the second effect concerned the influence of areas outside the display surface. When a luminance range of 1-350 cd/m2 was used, the contrast needed to detect a dark object in a gray surrounding was almost doubled compared to a dark object in a dark surrounding. Ambient light from outside the display area has a moderate effect on the contrast threshold, except for the combination of high ambient light and dark objects where the contrast threshold increased considerably.

Development and evaluation of a method of calibrating medical displays based on fixed adaptation

PURPOSEnThe purpose of this work was to develop and evaluate a new method for calibration of medical displays that includes the effect of fixed adaptation and by using equipment and luminance levels typical for a modern radiology department.nnnMETHODSnLow contrast sinusoidal test patterns were derived at nine luminance levels from 2 to 600 cd/m(2) and used in a two alternative forced choice observer study, where the adaptation level was fixed at the logarithmic average of 35 cd/m(2). The contrast sensitivity at each luminance level was derived by establishing a linear relationship between the ten pattern contrast levels used at every luminance level and a detectability index (d) calculated from the fraction of correct responses. A Gaussian function was fitted to the data and normalized to the adaptation level. The corresponding equation was used in a display calibration method that included the grayscale standard display function (GSDF) but compensated for fixed adaptation. In the evaluation study, the contrast of circular objects with a fixed pixel contrast was displayed using both calibration methods and was rated on a five-grade scale. Results were calculated using a visual grading characteristics method. Error estimations in both observer studies were derived using a bootstrap method.nnnRESULTSnThe contrast sensitivities for the darkest and brightest patterns compared to the contrast sensitivity at the adaptation luminance were 37% and 56%, respectively. The obtained Gaussian fit corresponded well with similar studies. The evaluation study showed a higher degree of equally distributed contrast throughout the luminance range with the calibration method compensated for fixed adaptation than for the GSDF. The two lowest scores for the GSDF were obtained for the darkest and brightest patterns. These scores were significantly lower than the lowest score obtained for the compensated GSDF. For the GSDF, the scores for all luminance levels were statistically separated from the average value; three were lower and two were higher. For the compensated GSDF, three of the scores could not be separated from the average value.nnnCONCLUSIONSnAn observer study using clinically relevant displays and luminance settings has demonstrated that the calibration of displays according to the GSDF causes the perceived contrast to be unevenly distributed when using displays with a high luminance range. As the luminance range increases, the perceived contrast in the dark and bright regions will be significantly lower than the perceived contrast in the middle of the luminance range. A new calibration method that includes the effect of fixed adaptation was developed and evaluated in an observer study and was found to distribute the contrast of the display more evenly throughout the grayscale than the GSDF.

Investigation of parameters concerning the modulation transfer function in digital radiography

The effects of the design of a radiographic system on the modulation transfer function (MTF) are studied with a specially developed computer program. The program simulates a digital radiographic system by using three parameters: sampling distance, sampling aperture, and the spread of the signal in the detector due to the interaction processes of the incoming photons. The signal spread is approximated by Gaussian distributions. The influence of the three parameters is studied on the presampling MTF and on the two extreme cases of the digital MTF: the maximum MTF and the minimum MTF. From theoretical data on the interaction processes, the resolution properties of an amorphous selenium flat-panel detector are simulated. The program is also used to simulate a measurement of the presampling MTF with the slit method, and the effect of the slit width on the measured presampling MTF is examined.