The American Association of Physicists in Medicine Task Group 18 (TG18) has recently developed guidelines for objective performance evaluation of medical displays. This paper reports on the first multi-institutional trial focusing on the implementation and clinical verification of the TG18 methodology for performance testing of medical image display devices in use at different clinical centers. A minimum of two newly-installed PACS display devices were tested at each institution. The devices represented a broad spectrum of makes and models of 1-5 megapixel CRT and LCD display devices. They were all either new or in clinical use for primary diagnosis with acceptable performance at the time of testing. The TG18 test patterns were loaded on all the systems. Visual and quantitative tests were performed according to the guidelines for assessing specific display quality characteristics including geometrical distortion, reflection, luminance response, luminance uniformity, resolution, noise, veiling glare, color uniformity, and display artifacts. The results were collected in a common database. For each test, the results and their variability were compared to the recommended acceptance criteria. The findings indicated that TG18 tests and guidelines can easily be implemented in clinical settings. Most recommended criteria were deemed appropriate, while small minor modifications were suggested.
This work will describe the implementation of a highly reliable DICOM print network at our institution. The system was designed to provide DICOM print services to many modalities, allowing customized LUT assignments either by calling AET or by special request from the modality. The system was implemented on a small scale with hardware from three different manufacturers (Agfa/Sterling, Kodak, and Fuji) for evaluation purposes. Our experiences with each system will be presented. The final configuration (Fuji PS551/DPL) was scaled up to meet the needs for hard copy production in our busy (300,000 exams/year) clinical operation. Quality control is accomplished via automatic (chron job) initiation of DICOM print jobs from a Unix-based workstation or by manual initiation from one of several PC's utilizing e-Film'sTM DICOM print capabilities. Print servers are connected to multiple printers and are configured for automatic fail-over on printer error detection. Modalities are configured with dual ('Primary' and 'Secondary') print destinations to allow manual redirection of print activity on print server error detection. As a result, the system provides an extremely high level of dependability. The printers also sort by AET so that the output from any given modality may be directed to a specific sorting bin, significantly reducing the effort needed to sort films and match with paperwork prior to hanging.
Since February 2000, radiologists at the M. D. Anderson Cancer Center have accessed clinical information through an internally developed radiologist's clinical interpretation workstation called RadStation. This project provides a fully integrated digital dictation workstation with clinical data review. RadStation enables the radiologist as an effective clinical consultant with access to pertinent sources of clinical information at the time of dictation. Data sources not only include prior radiology reports from the radiology information system (RIS) but access to pathology data, laboratory data, history and physicals, clinic notes, and operative reports. With integrated clinical information access, a radiologists's interpretation not only comments on morphologic findings but also can enable evaluation of study findings in the context of pertinent clinical presentation and history. Image access is enabled through the integration of an enterprise image archive (Stentor, San Francisco). Database integration is achieved by a combination of real time HL7 messaging and queries to SQL-based legacy databases. A three-tier system architecture accommodates expanding access to additional databases including real-time patient schedule as well as patient medications and allergies.