Societies tackle digital quality and consistency

The digital imaging era promises improved efficiency and accuracy, but it also produces a host of new problems related to consistent image presentation. The American College of Radiology, the American Association of Physicists in Medicine, the RSNA, and SCAR are collaborating to determine achievable standards in image quality in the digital era, according to SCAR chair Dr. J. Anthony Seibert.

Working with manufacturers, regulators, and users, the groups will assemble a panel of experts to discuss the topic. They plan to publish a white paper and request feedback on it within the next three to five months, said Ehsan Samei, Ph.D., director of the advanced imaging laboratories at Duke University.

"Technology overcomes previous obstacles, making it possible to have improved image quality," he said. "However, a poorly designed or operated system can render images suboptimal, impacting the effectiveness of their clinical utility. This flexibility necessitates clear guidelines."

The goal of the multisociety effort is to pave the way for consistent high-quality digital image presentations. Problems persist in this area despite efforts such as the DICOM gray-scale standard display function.

Inconsistent image presentation can particularly affect emerging areas, including digital mammography, said Dr. Margarita Zuley, a breast imager at the Elizabeth Wende Breast Imaging Clinic in Rochester, NY.

Digital mammography involves many new variables, including processing algorithms, soft-copy workstations, and display monitors, which can affect image quality in different ways.

"We still don't know how all of these variables interact in terms of image quality," Zuley said.

While a screen-film mammogram produced in one facility can be transferred easily and with full image integrity to another, digital mammograms can be site- and vendor-specific. They may not be transferable to another facility with a different vendor's soft-copy workstation and PACS.

"The effect that these technical parameters and processes have on the final image quality is not completely known from a clinical perspective," she said. "We really need further refinement and standards for many aspects of the imaging chain."

Each of the components of an imaging system, from acquisition to display, should provide the best possible performance, Samei said.

"The main challenge remains the ability to relate various physics- and engineering-based characteristics to diagnostic quality, a goal that is an active area of research," he said.