On 23 Jun, Detlef Grittner wrote:
>>For specific examples of how this can be used, see  
>>http://medical.nema.org/dicom/2001.html/01_14PU.PDF  or Barten's book
>>Contrast Sensitivity of the Human Eye and Its Effects on Image Quality
>>
>>Then follow the references to track down other major researchers on this
>>topic.
>>
>>R Horn
> 
> I found the correct link at http://medical.nema.org/dicom/2001/01_14PU.PDF 
> 
> Thank you for the information. As I'm working on medical viewers people often ask me 
>how many gray scales are needed.
> Some people even doubt that more than 8 Bit (256) gray scales are necessary.
> But typical radiological images often come with 10 Bit (1024) gray scales.
> If you have a display and a video card that can display distinguishable 1024 grays 
>that would be invaluable.

Sorry about the typo.  If you are working in medical you must also take
a look at  http://www.rsna.org/IHE/tf/ihe_tf_index.shtml

In particular, it is becoming a market necessary to comply with the
Consistent Presentation of Images (CPI) profile.  At present it only
applies to greyscale images.  Calibrating color monitor presentation to
comply with the greyscale standard makes a significant improvement to
the quality of a color presentation.  The further work on color space
calibration remains in committee.  This came up very briefly at last
weeks DICOM WG-6 meeting, mostly as a question regarding when was the
color standard going to be ready, with a response of "Don't know".  One
of the issues is the weakness of the scientific literature regarding the
diagnostic requirement for color consistency.  

The minimum realistic requirement for medical work is a high quality
monitor and a 10-bit DAC.  This lets you adjust the output LUT so that
you can comply with the display standard while using 8-bit data.
Assuming that there is compliance with the CPI profile, you can degrade
10-bit to 8-bit image data with a minimum loss of utility.

There are a number of vendors for medical quality displays.  These are
all quite expensive because they provide both 10-bit input and 12+bit
DAC controls so that they can both calibrate the system to comply with
the display standard and convey 10-bit image data.  They also
incorporate the very high luminance required to achieve 10-bit
viewability.  Unfortunately from an XFree perspective, most of the
medical vendors will not disclose the programming information for the
display controllers.

The actual requirement for resolution depends on the imaging modality
and the purpose of viewing.  For many purposes, an 8-bit display that
meets the display standard will be sufficient.  For other purposes it
will not.  I would never consider doing general radiographic diagnosis
of a chest with anything under 10-bit.  I would never consider doing it
in without controlled ambient lighting and the very high brightness of a
radiology oriented monitor.  These are the norm in any reading room. But
for ultrasound an 8-bit display with calibration and proper lighting
should suffice.  

There is also a big difference between diagnosis and other uses.

Further, just a warning about safety regulations.  The FDA regulates
medical devices under the Safe Medical Device Act.  You might be an
unwitting manufacturer. The definitions of device and manufacturer are
very broad. So check whether these safety laws apply to you. It is a
very serious crime to ship a medical device without a serious effort to
comply with the laws. It is a far less serious crime to make mistakes in
compliance. The website at http://www.fda.gov/cdrh/overview.html is a
good starting point.  FDA regulations include efficacy rules, and
questions about necessary display quality might be an efficacy question.

R Horn 

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