Due to the extensive growth in the utilization of digital imaging and PACS modalities and the cost-effective viewing methods they provide, non-dedicated image review using standard PCs is being employed at almost every medical imaging facility.

At this time, the ACR guidelines recommend that radiological imaging displays be calibrated to DICOM part 14, however, monitor brightness may not affect DICOM part 14 grayscale display function conformance.

Presenting for Dr. David Hirschorn during the 2008 SIIM meeting in Seattle, Dr. Saman Hazany shines a light on the effect of monitor brightness decay on DICOM performance.

"Compared to a medical industry price of $6000.00, a consumer display might only run you $600.00," says Hazany. Unlike LCD displays of the medical market, consumer LCD displays do not possess a built in brightness stability control circuit and as the backlights age with usage, the brightness of a typical consumer LCD display is known to decay over time.

Dr. Hazany and researchers from the Massachusetts general hospital compiled data from several high brightness consumer displays that have been deployed for up to two years. They also performed a simulation by incrementally decreasing the brightness of the monitor after initial calibration and sequential.

With respect to maximum luminance, it was noted that the decay of the monitor brightness could produce a degradation of the DICOM conformance because the display function is not linear.

"Human response is not linear," added Hazany.

Although brightness stability control is a desirable component of medical imaging displays, researchers concluded, its absence does not preclude a display that is slowly decaying from remaining conformant to the DICOM curve.

"Brightness stability is important, it is not critical. Routine conformance checks are mandatory. Our PACS team performs these checks every three months and any display whose luminance has decayed must be addressed," he says.

The innovation of medical imaging modalities creates daily challenges and evolving roles for many PACS administrators. For the successful management and integration of PACS modalities, it is essential that the PACS imaging professional be actively engaged with the install and support of all PACS modalities and DICOM devices.

"They are accountable for the integrity of the images. Proper prep and installation is the key to success," says Herman Oosterwijk from OTech Inc.

Taking attendees through several steps to ensure a strong and successful PACS installation, Oosterwijk also suggested the same steps and procedures should be followed when modalities are upgraded. "Even if a vendor claims that an upgrade is insignificant, if there is a vendor service engineer onsite never allow them to live unless all validation checks have been performed," he says.

As we approach new frontiers in medical imaging, he adds, "it is important to monitor your devices past install with in-depth testing and heartbeat programs ? the establishment of formal acceptance policies and procedures as well as necessary monitoring tools is a must, there are several free downloadable software options out there, and we need to use them."

Comprised of complex systems and created by multiple vendors, the monitoring of DICOM compliant devices can be daunting to a limited IT infrastructure personnel team.

In this paper, Harshad Puppulwar and colleagues from Citius Tech Inc. presented how recent developments in technologies and healthcare standards can be blended to enable automated discovery, mapping and monitoring of DICOM compliant devices.

Puppulwar noted that recent enhancements in technology as well as DICOM and Networking standards are likely to boost the ability of PACS administrators to better, discover, map and monitor DICOM compliant devices remotely in complex provider environments.

From avoiding device conflicts to ensuring configuration, consistent asset management is a necessity.