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Soft-copy environment provides dynamic ways to view image data
By: Merlina Trevino
The transition to filmless operation is forcing radiologists to move away from static hard-copy methods and toward a more dynamic mode of interpretation, according to research conducted at the VA Medical Center in Baltimore.
Traditionally, radiologists worked with what is termed the "single best" image. They located and diagnosed from the single film image that best presented the area in question. But with advanced modalities providing more dynamic displays of data, this single best image concept may be obsolete, said Dr. Bruce Reiner, director of radiology research at the Baltimore facility.
"Image processing techniques provide the potential to improve image quality and diagnostic accuracy," he said.
To assess the impact of image processing techniques at the Baltimore VA center, Reiner and colleagues studied how nine readers examining both normal and subtle fracture exams were affected by image processing techniques, including manufacturer's default, edge enhancement, multifrequency processing, and gray-scale inversion.
The nine readers examined 100 exams. They reported their perception of image quality and their fatigue level. They also considered the readers' interpretation time and use of workstation tools.
Reiner and colleagues reported that not only did the readers overwhelmingly choose multifrequency processing and gray-scale inversion as their image processing tools of choice, but these two techniques also had better accuracy in diagnosing the subtle fractures.
While gray-scale inversion exhibited the highest accuracy of the different techniques, it also increased the time to complete the interpretation. Because this advanced image processing technique provides the user with more workstation tools to manipulate the data, the radiologists used the tools more frequently, Reiner said. The radiologists reported that the manufacturer's default resulted in the greatest fatigue. Multifrequency processing improved diagnostic accuracy without the increased interpretation time of gray-scale inversion and may serve as the preferred replacement for default processing.
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