DICOM gray-scale standard display function: clinical diagnostic accuracy of chest radiography in medical-grade gray-scale and consumer-grade color displays.

Abstract

The purpose of this study was to compare the diagnostic accuracy achieved with and without the calibration method established by the DICOM standard in both medical-grade gray-scale displays and consumer-grade color displays. This study involved 76 cases, six radiologists, three displays, and two display calibrations for a total of 2736 observations in a multireader-multicase factorial design. The evaluated conditions were interstitial opacities, pneumothorax, and nodules. CT was adopted as the reference standard. One medical-grade gray-scale display and two consumer-grade color displays were evaluated. Analyses of ROC curves, diagnostic accuracy (measured as AUC), accuracy of condition classification, and false-positive and false-negative rate comparisons were performed. The degree of agreement between readers was also evaluated. No significant differences in image quality perception by the readers in the presence or absence of calibration were observed. Similar forms of the ROC curves were observed. No significant differences were detected in the observed variables (diagnostic accuracy, accuracy of condition classification, false-positive rates, false-negative rates, and image-quality perception). Strong agreement between readers was also determined for each display with and without calibration. For the chest conditions and selected observers included in this study, no significant differences were observed between the three evaluated displays with respect to accuracy performance with and without calibration.