Doctor, doctor give me the news

March 20, 2006

My love of color goes back to my childhood, when the neighbors had color TV and my family didn’t. I’d go over to friends’ houses and watch NBC, whose peacock mascot’s tail feathers would unfold and then burst into all kinds of reds and greens and blues and yellows. When asked why we didn’t have a color set, my father explained that color television was just not worth it. After a couple weeks, he told me, color would look just like black and white.

My love of color goes back to my childhood, when the neighbors had color TV and my family didn't. I'd go over to friends' houses and watch NBC, whose peacock mascot's tail feathers would unfold and then burst into all kinds of reds and greens and blues and yellows. When asked why we didn't have a color set, my father explained that color television was just not worth it. After a couple weeks, he told me, color would look just like black and white.

The medical imaging community today is about where I was back then. Some people have color PACS monitors. Some don't. You can make the argument that, with only a few exceptions (Doppler and nuc med), you can see as much in gray scale as in color. But my gut tells me those with color monitors are better off.

PET/CTs look great in color. So do cardiac CTs. Fiber tracts on diffusion tensor imaging seem like they would be a lot easier to follow in red and yellow. And, let's face it, they look really cool. I saw one seem to lift up in 3D from a planar slice of the brain - kind of a neurological analog to NBC's bird of yesteryear. Ditto for lesions on breast MR identified using CAD software.

While there once was a good case for staying with gray scale, that case is beginning to spring leaks. Early color monitors could produce only a few hundred hues. The next generation did a lot better, like several thousand. And the latest models are in the tens of thousands, which - as with the tens of thousands of shades of gray coming from black-and-white monitors - are more shades than the eye and brain can process.

Problems persist, however. The biggest are resolution and brightness. Color monitors typically don't do as well as gray-scale displays on either score, although this is changing. Several vendors have come out with very capable products. Barco, Planar, Eizo Nanao, and NEC make high-grade color monitors up to 3 MP. Quest International and U.S. Electronics distribute various 2-MP and 3-MP color monitors. Distributor Sonoma Health says Sony has the best medical-grade color LCDs on the market, at least in surgery or as an add-on to an ultrasound workstation, according to the company. (And it's slashing prices - $5250 $2625!)

Monitors have to be matched to the job, whether it's ultrasound or mammography. But these are two extremes of a very broad soft-copy spectrum, with plenty of potential in between for the future adoption of color monitors.

The use of color in fusion imaging, CAD, and other clinical applications, buoyed by vendors' growing propensity for color in graphical user interfaces - buttons and the like - make it all but inevitable that medical monitors capable of displaying these data in all their Technicolor splendor are going to pop up more and more.

The final days of gray-scale dominance may come when healthcare IT systems become truly integrated and medical images are displayed routinely on flat screens showing vital signs. And those days are coming.