Working from home is becoming increasingly popular. The benefits range from spending less time on commuting to a better work-life balance and improved productivity. For radiologists, home working is the perfect way to deal with a growing workload and the strain of being on call. But do they have what it takes to read and report from home?
Guidelines for home reading displays
The American College of Radiology (ACR) recommends a ‘single high professional standard of quality for both teleradiology providers and on-site radiologists’1. It’s why the latest guidelines stipulate clear rules for every medical display, whether on- or off-site, and include standards for display luminance, pixel pitch as well as calibration to the DICOM standard.
According to the ACR-AAPM-SIIM Technical Standard for Electronic Practice of Medical Imaging, a display used for medical imaging should have a luminance of at least 350 cd/m² (450 recommended in the case of mammography)1. This provides radiologists with more visible shades of gray so they can detect subtle details faster. More importantly, the luminance should remain stable over time, meaning luminance output should be measured and controlled, even in a home environment.
Pixel pitch and display size
Pixel pitch is related to display resolution and diagonal size. A larger display with a high resolution will present more data, providing radiologists with the best image for analysis. This reduces the need for panning and zooming and makes reading more efficient. Though some consumer displays feature similar specs compared to medical displays, they are not fit for home reading.
DICOM calibration and quality control
Every display that is used for viewing of medical images must comply with the DICOM Part 14 grayscale standard display function (GSDF), even the ones that are used at home. The ACR recommends that “teleradiology services should be incorporated into the local operations related to safety and quality within the radiology practice, hospital, or imaging center”. Only when 24/7 compliance is guaranteed can radiologists have complete peace of mind about their reading performance. However, manual calibration to the DICOM standard is extremely inefficient, especially in a home-working environment.
Diagnostic displays are a better fit
Diagnostic displays comply with all the required medical standards and guidelines. What’s more, they are engineered for optimal viewing of medical images. A number of well-controlled studies have demonstrated that diagnostic displays improve radiologist performance2. In addition, a diagnostic display system delivers return on investment even after only one year of use as radiologists can come to the correct interpretation more quickly with diagnostic displays3.
There are different types of home reading in radiology. There’s the radiologist who performs occasional reading and reporting of exams, in case of an emergency or request for a second opinion, for example.
However, when processing a high volume of diagnostic exams (one/twice a week or full-time) at home, a diagnostic display that ticks all the boxes (i.e. a high luminance over time, the right pixel pitch and automated, interruption-free DICOM calibration) is required.
1. Ezequiel Silva III et al, ACR White Paper on Teleradiology Practice: A Report From the Task Force on Teleradiology
2. Krupinski EA, Siddiqui K, Siegel E, Shrestha R, Grant E, Roehrig H, Fan J. (2007). Influence of 8-bit vs 11-bit digital
displays on observer performance and visual search: a multi-center evaluation. Proc SPIE Med Imag, 6515, 65150L-1.
5 And Krupinski EA. Medical Grade vs Off-The-Shelf Color Displays: Influence on Observer Performance and Visual Search.
Submitted for review, 2008
3. Image quality performance of liquid crystal display systems: Influence of display resolution, magnification and
window settings on contrast-detail detection. European Journal of Radiology, 2003, Volume 58, Issue 3, Pages 471-
479 K. Bacher, P. Smeets, A. De Hauwere, T. Voet, P. Duyck, K. Verstraete, H. Thierens And Krupinski EA. Medical Grade vs Off-The-Shelf Color Displays: Influence on Observer Performance and Visual Search.
Submitted for review, 2008