Resolution requirements for monitor viewing of digital flat-panel detector radiographs: a contrast detail analysis

Since the introduction of digital flat panel detectors into clinical routine the discussion on monitor specifications for primary soft copy reading has gained new impetus. Major concerns exist for viewing of tiny opacities such as pulmonary nodules. In this study CDRAD phantom images were acquired on a caesium iodid/amorphous silicon detector at varying exposure levels. Images were read three times by three observers on a clinical 1K and 2K monitor workstation. All typical workstation functions such as magnification and window/level setting were applied during image reading. Correct detection ratios were calculated according to the CDRAD evaluation manual. Observer ratings were highest for high dose exposure and 2K monitor reading. No significant difference was detected in the correct detection ratio of observers. However, the difference between the two types of workstations (1K versus 2K monitors) despite less than 3% was significant at a 95% confidence level. This is in good accordance with recently published clinical studies. However, further clinical work will be needed to strengthen this laboratory based impression. Given these subtle differences in low contrast detail detection on 1K and 2K clinical PACS workstation we should probably rethink the recommendations of various national boards for the use of 2K monitors.