Frequency and impact of high-resolution monitor failure in a filmless imaging department

The purpose of this study was to assess the image quality and the rate of f ailure of the high-resolution (2,048 x 1536 pixel) monitors used for primar y diagnosis in a firmless radiology department and to analyze the type of p roblems encountered as well as the action taken to repair the monitors. Dat a were collected from Picture Archival and Communication System (PACS) serv ice logs to determine rates of monitor adjustment and replacement, the symp toms reported, and the action taken. Additionally, random surveys of the hi gh-resolution monitors were performed using a standard test pattern to asse ss spatial and contrast resolution in the center and outer corners of the m onitors. Analysis of monitor service records showed a high rate of monitor replacement (41% per year) resulting in a relatively short "life expectancy " (defined as average time required before replacement) of 2.4 years. Rando m surveys of monitor quality using a standard test pattern showed suboptima l image quality in approximately 54% of the monitors with moderate image qu ality degradation present in at least one region of 27% of the high-resolut ion monitors, despite our vendor's quality control program. The results of this study support our subjective impression and those of other colleagues in the PACS community of an unacceptably high monitor failure rate and pers istent image quality problems with 2,000 pixel monitors used for primary di agnosis. The relatively high incidence of suboptimal quality monitors sugge sts that more frequent quality control should be performed using a test pat tern particularly given the fact that radiologists often are unable to disc ern degradation of monitor performance using clinical images. The high inci dence of problems with image quality on high-resolution monitors indicates that vendors need to develop better quality control in monitor design and t esting. Radiologists should review briefly a test pattern on each monitor a t the beginning of each day. A computer program should be incorporated into the PACS, which asks radiologists to evaluate a test pattern and records t he results in a central database, which is communicated to the service engi neers. Further studies should be evaluated to determine the clinical impact of monitor image degradation, which is relatively easily seen using a test pattern but may be difficult to discern on clinical images. Requests for p roposals (RFPs) for PACS and service contracts must specify carefully requi rements for monitor image quality and conditions under which the vendor is required to replace these monitors. Copyright (C) 2000 by W.B. Saunders Com pany.