DISCLAIMER Medical physicists, investigators, vendors, or other users can utilize the authentic copyrighted TG18 patterns supplied in conjunction with this report for any professional, investigational, educational, or commercial purposes. However, the patterns may not be altered in any form or fashion, and their labels may not be removed. Alternatively, with the aid of the descriptions provided in section 3 and appendix III and with the exception of anatomical test patterns, the users may generate patterns similar to the TG18 patterns. To do so, four requirements should be observed: 1. The original reference should be acknowledged. 2. The generated pattern may not duplicate the original TG18 label. 3. The generated pattern should include a label indicating that it is a synthetic pattern based on the description provided in the TG18 report. 4. If the pattern is scaled (e.g., a new 1.5k × 2k pattern versus the original 1k and 2k patterns), all the specified elements of the original pattern should be present, and the label should indicate that it is a scaled pattern. In using the patterns, for most patterns, it is essential to have a one‐on‐one relationship between the image pixels and the display pixels, unless indicated otherwise in the test procedures in section 4. Patterns in DICOM and 16‐bit TIFF formats should be displayed with a window and level set to cover the range from 0 to 4095 (WW = 4096, WL = 2048), except for the TG18‐PQC, TG18‐LN, and TG18‐AFC patterns, where a WW of 4080 and WL of 2040 should be used. For 8‐bit patterns, the displayed range should be from 0 to 255 (WW = 256, WL = 128). AAPM ON-LINE REPORT NO. 03 ASSESSMENT OF DISPLAY PERFORMANCE FOR MEDICAL IMAGING SYSTEMS DISCLAIMER: This publication is based on sources and information believed to be reliable, but the AAPM and the editors disclaim any warranty or liability based on or relating to the contents of this publication. The AAPM does not endorse any products, manufacturers, or suppliers. Nothing in this publication should be interpreted as implying such endorsement. © 2005 by American Association of Physicists in Medicine One Physics Ellipse College Park, MD 20740-3846 AAPM ON-LINE REPORT NO. 03 ASSESSMENT OF DISPLAY PERFORMANCE FOR MEDICAL IMAGING SYSTEMS April 2005 American Association of Physicists in Medicine Task Group 18 Imaging Informatics Subcommittee Chairman: Ehsan Samei Duke University Medical Center Main Contributors: Aldo Badano FDA, CDRH Dev Chakraborty University of Pennsylvania (currently with University of Pittsburgh) Ken Compton Clinton Electronics (currently with National Display Systems) Craig Cornelius Eastman Kodak Company (currently a consultant) Kevin Corrigan Loyola University Michael J. Flynn Henry Ford Health system Brad Hemminger University of North Carolina, Chapel Hill Nick Hangiandreou Mayo Clinic, Rochester Jeff Johnson Sarnoff Corp, NIDL (currently with Siemens Corporate Research, USA) Donna M. Moxley-Stevens University of Texas, Houston, M.D. Anderson Cancer Center William Pavlicek Mayo Clinic, Scottsdale Hans Roehrig University of Arizona Lois Rutz Gammex/RMI Ehsan Samei Duke University Medical Center S. Jeff Shepard University of Texas, Houston, M.D. Anderson Cancer Center Robert A. Uzenoff Fujifilm Medical Systems USA Jihong Wa ng University of Texas, Southwestern Medical Center (currently with University of Texas, Houston) Charles E. Willis Baylor University, Houston, Texas Children’s Hospital (currently with University of Texas, Houston) Acknowledgments: Jay Baker (Duke University Medical Center), Michael Brill (Sarnoff Corp, NIDL), Geert Carrein (Barco), Mary Couwenhoven (Eastman Kodak Company), William Eyler (Henry Ford Hospital), Miha Fuderer (Philips), Nikolaos Gkanatsios (Lorad), Joel Gray (Lorad), Michael Grote (Sarnoff Corp, NIDL), Mikio Hasegawa (Totoku), Jerzy Kanicki (University of Michigan), Andrew Karellas (University of Massachusetts), Kevin Kohm (Eastman Kodak Company), Wa lter Kupper (Siemens), Peter Scharl (Siemens, DIN), George Scott (Siemens), Rich Van Metter (Eastman Kodak Company), Marta Volbrecht (Imaging Systems). CONTENTS Preface ................................................................................... vii How To Use This Report ................................................................. viii 1 INTRODUCTION ................................................................... 1 1.1 Background ................................................................... 1 1.2 Existing Display Performance Evaluation Standards.......................... 2 1.2.1 SMPTE RP 133-1991 ................................................. 2 1.2.2 NEMA-DICOM Standard (PS 3)....................................... 2 1.2.3 DIN V 6868-57 ....................................................... 4 1.2.4 ISO 9241 and 13406 Series............................................ 5 1.2.5 VESA Flat-Panel Display Measurements (FPDM) Standard............. 5 2 OVERVIEW OF ELECTRONIC DISPLAY TECHNOLOGY ...................... 7 2.1 Electronic Display System Components ....................................... 7 2.1.1 General Purpose Computer ............................................ 7 2.1.2 Operating System Software ............................................ 7 2.1.3 Display Processing Software ........................................... 8 2.1.4 Display Controller ..................................................... 8 2.1.5 Display Device ........................................................ 9 2.1.6 Workstation Application Software..................................... 10 2.2 Photometric Quantities Pertaining To Display Devices....................... 10 2.2.1 Luminance ........................................................... 10 2.2.2 Illuminance .......................................................... 11 2.3 Display Device Technologies ................................................. 11 2.3.1 Cathode-Ray Tubes................................................... 11 2.3.2 Emerging Display Technologies ....................................... 20 2.4 Engineering Specifications for Display Devices .............................. 24 2.4.1 Physical Dimensions.................................................. 26 2.4.2 Power Supply......................................................... 26 2.4.3 Input and Output Signals ............................................. 26 2.4.4 Bandwidth (CRT) .................................................... 26 2.4.5 Environmental Specifications ......................................... 27 2.4.6 Matrix Size .......................................................... 27 2.4.7 Display Area ......................................................... 27 2.4.8 Phosphor Type (CRT) ................................................ 27 2.4.9 Refresh Rate ......................................................... 28 2.4.10 Pixel Size ............................................................ 28 2.4.11 Luminance ........................................................... 29 2.4.12 Luminance Uniformity ............................................... 29 2.4.13 Surface Treatments ................................................... 29 2.4.14 Bit Depth ............................................................ 30 2.4.15 Viewing Angle (LCD) ................................................ 30 2.4.16 Aperture Ratio (LCD) ................................................ 30 2.5 Classification of Display Devices ............................................. 31 iii 3 GENERAL PREREQUISITES FOR DISPLAY ASSESSMENTS .................. 32 3.1 Assessment Instruments ..................................................... 32 3.1.1 Photometric Equipment .............................................. 32 3.1.2 Imaging Equipment .................................................. 35 3.1.3 Light Source and Blocking Devices ................................... 37 3.1.4 Miscellaneous Accessory Devices..................................... 38 3.2 Test Patterns................................................................. 40 3.2.1 Multipurpose Test Patterns ........................................... 40 3.2.2 Luminance Test Patterns.............................................. 46 3.2.3 Resolution Test Patterns .............................................. 51 3.2.4 Noise Test Patterns ................................................... 55 3.2.5 Glare Test Patterns ................................................... 56 3.2.6 Anatomical Test Images .............................................. 58 3.3 Software ..................................................................... 62 3.3.1 Pattern-Generator Software ........................................... 62 3.3.2 Processing Software .................................................. 62 3.3.3 Spreadsheets ......................................................... 62 3.4 Initial Steps for Display Assessment ......................................... 63 3.4.1 Availability of Tools .................................................. 63 3.4.2 Display Placement.................................................... 63 3.4.3 Start-up Procedures .................................................. 63 3.4.4 Ambient Lighting Level .............................................. 64 3.4.5 Minimum and Maximum Luminance Settings ......................... 65 3.4.6 DICOM Grayscale Calibration ........................................ 65 4 ASSESSMENT OF DISPLAY PERFORMANCE .................................. 67 4.1 Geometric Distortions........................................................ 67 4.1.1