Saturday, September 4, 2010

Diagnostic Monitors - Case Study in Kuwait - Part I

Abstract
Kuwait is one of first countries in region to convert medical imaging into digital. Many digital archives were available in mid nineties and full RIS/PACS installations were seen in many places in late nineties. Most Radiography systems are either converted to digital or equipped with CR readers. In principle, Kuwait has one of longest experience in digital radiography. Reporting from films is getting less and less and more soft copies are being seen around Kuwait.


Even though this long time of digital implementation in imaging, Kuwait imaging centers lack Quality control procedure for digital imaging in general and digital monitors specifically. Quality control procedures are still done until the modality monitor or film printer (camera, processor). No action has been taken to extend this QC procedure further to the reporting workstation, where radiologists read their images.


In part I of this article, we start shedding light on status of medical grade monitors or so called diagnostic quality monitors and their existence in imaging departments.


Study



Visiting many hospitals in Kuwait, you will find that majority of diagnostic monitors are off-shelf commercial monitors used regularly in any home/office pc. In exception to few hospitals, imaging departments have mixed brands, dimensions, or resolutions. 


In this study, we visited radiology department of a 600+ bed hospital with fairly large radiology department with ~15 modalities including two MDCT and ~20 radiology PACS Workstations. Furthermore, distribution system is integrated with this setup to facilitate referral inside the hospital. We found out that more than 70% off PACS workstations are equipped with off-shelf non-diagnostic monitors used to report different types of medical images like DR, CT, MRI, and sometimes mammography. See table below





Monitor photo
Click down to enlarge
Manufacture/Model
URL
Specs.



Resolution:     1440 x 900      
Brightness:      250 cd/m²
Contrast ratio: 1000:1

Official use: Business moitor



Resolution  1280 x 1024
Brightness  270 cd/m2
Contrast Ratio 500:1

Official use: Professional (non-medical)



PACSMate MMC – 2201c
Resolution       1600 x 1200
Color depth     16.7M colors
Brightness (cd/m2)      300
Contrast Ratio 800:1(typical)

Official use: Clinical Review (non-diagnostic)



Resolution       1600x1200
Contrast Ratio 1000:1 (typ)
Brightness       300 cd/m2 (typ)

Official Use:  applications and multimedia (non-medical)



Resolution       1680 x 1050
Contrast Ratio 1000:1
Brightness       300 cd/m2

Official use:     Multimedia (non-medical)



Resolution       2048 x 1536(3MP)
Contrast Ratio 600:1
Brightness       500 cd/m²

Official use:     Medical Diagnostic.


Conclusion
Many hospitals in Kuwait are using off-shelf monitors to diagnose different types of digital images. In part II, we will discuss international standards and requirements for monitors used in medical diagnosis.


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7 comments:

Saud said...

I have been saying this for a long time but unfortunately no one would listen. My home desktop monitor is higher in quality than most of these.

Q8PACS said...

International standards like FDA, ACR, DICOM part 14 say a lot about this as we will see (insha Allah) in part II.

unfortunately,

We are way below these standards .. I know some radiologist who are ok with using 1, or 2MP monitors from i.e. Eizo (Diagnostic Quality ones) but i didn't hear any where in the world about a radiology center who uses DELL, SAMSUNG, HP like that center ..

Saud, thank you for stopping by ..

Anonymous said...

Suppliers have high responsibility in selecting components of PACS/RIS project as users (Radiology staff) has limited knowledge.
Unfortunately many suppliers in Kuwait make hefty profits at the expense of Radiology users and Patients.

Q8PACS said...

We in Kuwait make critical decision based on every thing but evidence, or scientific literature.

I encourage every one to read this document by Royal College of Radiologists in UK.

http://www.rcr.ac.uk/docs/radiology/pdf/IT_guidance_PACSApr08.pdf

Anonymous said...

As I know, this model Samsung 206BW was installed by "Q8PACS" in Sabah and Farwaniya also... very funny haaa !!!!!!!!!

Anonymous said...

This is a surprising news!

Mr. Q8PACS, for which company did you work for?

Mr. Anonymous, do you know for which company did Mr. Q8PACS installed these monitors?

Please share your valuable information.

Q8PACS said...

Mr. Anonymous,

Although this looks personal by now, but since it has come to this level, I will then reveal this information.

At that time, I worked for a company Called Advanced Technology Co. (ATC) the biggest supplier of Medical Imaging Equipment in Kuwait.

Even though, international societies have made their words clear, neither ATC nor Ministry of Health had any policy to govern this technology.

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