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Image display devices

CT

Quality Assurance
Image display devices

Acceptance testing for image display devices

10351301
07740769
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08872017
08379492
08377520
08098951
07734713
07543106
07543015
07407039
07407013
07393114
07114023
07005502
04806118
03815490
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03804890

© Siemens AG 2006
The reproduction, transmission or use
of this document or its contents is not
permitted without express written
authority. Offenders will be liable for
damages. All rights, including rights
created by patent grant or registration
of a utility model or design, are
reserved.

Print No.: CT00-000.820.04.01.02 English

Replaces: CT00-000.820.01.03.02 Doc. Gen. Date: 04.06
2 Revision / Disclaimer
1Revision / Disclaimer

Document revision level

The document corresponds to the version/revision level effective at the time of system
delivery. Revisions to hardcopy documentation are not automatically distributed.
Please contact your local Siemens office to order current revision levels.

Disclaimer
The installation and service of equipment described herein is to be performed by qualified
personnel who are employed by Siemens or one of its affiliates or who are otherwise
authorized by Siemens or one of its affiliates to provide such services.
Assemblers and other persons who are not employed by or otherwise directly affiliated
with or authorized by Siemens or one of its affiliates are directed to contact one of the
local offices of Siemens or one of its affiliates before attempting installation or service pro-
cedures.

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Table of Contents 3
0Table of Contents

1 _______ General remarks ________________________________________________ 4

General remarks regarding these instructions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4

Remarks regarding the acceptance testing . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4
Notes regarding filling out the acceptance test protocol . . . . . . . . . . . . . . . . . . . . . . . 4
Application category of image display devices . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4
Identifying reporting monitors . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5

2 _______ Measurement and test tools required _______________________________ 6

Luminance meter . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6
Devices recommended: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6

3 _______ Scope of testing_________________________________________________ 9

Items to be tested . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10
Ambient lighting . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10
Viewing conditions at the operating location . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10

4 _______ Measurement requirements ______________________________________ 11

Luminance density measurements, determining the maximum contrast . . . . . . . . . . . . 11

Veiling luminance (Ls) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11
Maximum contrast. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11

5 _______ Grayscale display: ______________________________________________ 12

6 _______ Spatial and contrast resolution ___________________________________ 13

7 _______ Homogeneity of image brightness_________________________________ 14

8 _______ Geometrical image properties ____________________________________ 15

9 _______ Visual image evaluation _________________________________________ 16

10 ______ Visual evaluation of clinical reference images _______________________ 17

Clinical reference images . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17

Visual check of the clinical reference image. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18

11 ______ Characteristics and reference values for the constancy test ___________ 19

12 ______ Changes to previous version _____________________________________ 20

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4 General remarks
1-
General remarks regarding these instructions
1General remarks

These instructions refer to the following test protocols:

"Quality assurance (acceptance test protocol for image display devices, monitor print no.
CT000-820.02...)

Remarks regarding the acceptance testing 0

An acceptance test in accord with § 16 RöV has to be performed:

• Prior to start-up,
• after changes to the operating mode which affects image quality, e.g. after repairs,
replacements, modifications or new adjustments.

NOTICE Please adhere to the safety regulations.

¹ In particular to the regulations for radiation protection

Notes regarding filling out the acceptance test protocol 0

• On each page of the protocol, the report number has to be stated. The report number
comprises the order number and the date of the last test. This ensures explicit alloca-
tion of each protocol sheet. In place of the order number, you may want to provide the
KS number (master customer number).
• The completed protocol cannot contain empty fields. Fields that do not require an input
have to be identified with n.a. (not applicable) and/or crossed out.
• Do not fill out protocols using a pencil or use white-out to correct errors. Incorrect
entries need to be crossed out. The correct values have to be entered including the date
and the initials of the person performing the correction.
• The starting values for the constancy test determined and documented during the tests
have to be documented in a separate test protocol.
• The operator receives the original and a copy of the test protocol.
• The completed acceptance test protocol has to be signed on page 1-1 by the person
who performed the test (including name, date, and signature).

Application category of image display devices 0

NOTICE Monitors for CT devices are subject to application category B

¹ Refer also to DIN 6868-57

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General remarks 5

• Application category A These image display devices have to meet especially high
demands regarding image quality: Application category A: This application category
includes all image display devices for the diagnosis of digital images and for which high
spatial and contrast resolution are required. Image displaye devices of application cate-
gory A: have to display images in the diagnostically required format and with the diag-
nostically required number of image pixels, that is, at least 1000 x 1000 image pixels.
• Application category B Application category B includes all image display devices for
image diagnosis which are not classified in application category A and allocate the
image display devices for image viewing. The spatial and contrast resolution required
for individual application has to be ensured.
• Application category C: Image displaye devices of Application category C: cannot be
used for diagnosing or viewing medical images. They serve, for instance, as control
monitors for patient monitoring or as image display devices for displaying operating pro-
cedures.

Identifying reporting monitors 0

• Prior to the test it needs to be determined which monitors are used for reporting (as dis-
cussed with customer). They have to be identified with a label.

Fig. 1: Label for report monitor

• Enter application category A or B by hand
• Order the required labels through:

Siemens AG
ATD TD LC Werkzeuglogistik
Siemensstr. 33
D 71254 Ditzingen

Tel. 0711-137-6510/6513
Fax 0711-137-6550/6531
E-mail: [email protected]

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6 Measurement and test tools required
2-
Luminance meter
2Measurement and test tools required

Specifications: Class B (DIN 5032-7) with valid calibration date

Range from 0.05 cd/m2 - 1000 cd/m2

Devices recommended: 0

MAVO - monitor with SPOT meter: SIEMENS S# (for CRT monitors)

Spotmeter SMfit ACT, Mat# 077 52 848 (for LCD monitors)

Test pattern generator

Phantom according to DIN 6868-4

Devices recommended: AR TD Part 3 Norm 384

Test image
a) digital or analog test images
b) clinical reference images

Souces for test images

Sources for test images for image display devices are imaging devices of medical engi-
neering. These devices can be classified according to the following two groups:

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Measurement and test tools required 7
Tab. 1 Souces for test images

a) Medical imaging devices with access to permanently stored

test images, for examples devices for:
• Computed tomography (CT)
• Magnetic resonance tomography (MR)
• Digital Radiography (DR)
• Digital fluoroscopy
• Digital subtraction angiography (DSA)
• Sonography (US)
• Nuclear medicine (NM)
• Picture Archiving and Communication Systems (PACS)
b) Medical imaging devices without access to permanently
stored test images, for examples devices for:
• Fluoroscopy
• Digital subtraction angiography (in some cases)
• Sonography (in some cases)
• Nuclear medicine (in some cases)

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8 Measurement and test tools required

Fig. 2: Examples of test images

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Scope of testing 9
3Scope of testing 3-

Tab. 2 Items to be tested

Items to be tested Test images required

Environmental and viewing conditions
Luminance density measurement (Image 2 or 6)
Grayscale display: (Image 2 or 6)
Spatial and contrast resolution (Image 5 or 6)
Homogeneity of image brightness (Image 3 or 6)
Geometrical image properties (Image 3 or 4)
Visual image evaluation (Image 3 or 4)
Clinical reference image

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10 Scope of testing

Items to be tested 3.1

Ambient lighting 0

It is recommended to allow for adjustment of the general lighting so that the values deter-
mined from table 1 can be obtained.. If this is not possible, please change the location of
the monitor or install diaphragms.

NOTICE The criteria for the constancy test have to be observed.

¹ It must be possible to set the brightness to a certain,

reproducible value.

Viewing conditions at the operating location 0

The ambient light influences the luminance density of the image display device.
The required minimum value of the relationship between white luminance density and veil-
ing luminance for application category A and B is listed in the table

Application category A > 100

Monitors, application category B > 40

Lmax/ Ls has to be larger than 40 (CT monitors belong to application class B).
¹ Lmax is the measured value of the white box of the test image. (Distance 40-60
cm).
¹ Lmin is the measured value of the black box of the test image (distance 40-60
cm).
¹ LS is the measured value in the center of the switched off monitor (distance
40-60 cm).

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Measurement requirements 11
4-
Luminance density measurements, determining the maximum
4Measurement requirements

contrast 0

Veiling luminance (Ls) 0

• The room lighting is adjusted to the operating conditions (it may be necessary to ask the
user) using a dimmer with a scale.
• When the image display device is switched off, the luminance density device is used to
measure and document the veiling luminance Ls in the center of the screen. The lumi-
nance density measurement device is located at the distance (40-60 cm) specified by
the manufacturer.

Maximum contrast 0

• While the monitor is switched on, the luminance density measurement device mea-
sures the minimum and maximum luminance.
• For test image 2, the two squares for the minimum gray value (L min.) and the maximum
gray value (L max, bright field) are used.
• For test image 6, the squares 0 % are used for L min. and 100 % for L max.
• The luminance density measurement device is kept at the conventional viewing dis-
tance (40-60 cm) from the image display device.
The ratio L max /L min is computed as the maximum contrast MK.
For image display devices of application category A, the ratio has to be L max./ L min. >
100.
For image display devices of application category B, the ratio has to be L max./ L min. > 40.

NOTICE A simple means of increasing the contrast is to reduce the ambi-

ent illumination. At the same time, required visual work (e.g. read-
ing, writing) has to be factored in.

¹ Darkening the room through curtains, jalousies or dim-

ming the room lighting.

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12 Grayscale display:
5Grayscale display: 5-
• Test image 2 or 6 is displayed on the image display device. The visual impression of the
difference in contrast at the lower or upper end of the grayscale staircase is evaluated.
• For test image 2, the three darkest and the three lightest grayscales have to be seen in
full and at the same distance of one another.
• For test image 6, the 5% and 95% take-off has to be clearly differentiated from the envi-
ronment (0% or 100%). All grayscale steps have to be equidistant.

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Spatial and contrast resolution 13
6Spatial and contrast resolution 6-
• The test image (image 5 or 6) has to be displayed on the monitor for testing the visual
resolution.
• Bar patterns with 100 % high contrast modulation will be visually checked in the four
corners and in the center of the displayed image matrix.
• It has to be possible to detect the lines of the bar patterns across most of the overall
length.
• If available, vertical and horizontal bar patterns with low contrast NK (modulation of
25% and 6.25% for test image 5 or modulation of 5% and 3% for a SMPTE test image)
have to undergo visual resolution.

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14 Homogeneity of image brightness
7Homogeneity of image brightness 7-
• Use test image 3 or 6 to measure the luminance density within an image. Measure the
luminance density offset by one measurement point from the center (Lcenter)and at the
four measurement points in the corners (Lcorner).
• Use the luminance density measurement device to measure according to distance as
describe under item 4. The five measurement points have to located in regions with a
uniform grayscale value, corresponding to 50% of the maximum signal value.
• The measurement values have to be documented.
• Limit deviations of the luminance densities in the four corners are listed in the table
shown below.

Permissible deviations from the luminance density

Cathode X-ray tube Flat screen
Application category A ± 30 % of Lcenter ± 15 % of Lcenter
Application category B ± 35 % of Lcenter ± 20 % of Lcenter

Calculation: Difference in % = Lcenter - Lcor- X 100

ner

Lcenter

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Geometrical image properties 15
8Geometrical image properties 8-
• The test image required for geometrical display characteristics (refer to image3, 4 or 6)
is shown on the monitor.
• It needs to be visually tested to determine whether the outer limit lines on top (O), at the
bottom (U), to the right (R) are visible and if the lengths of lines O, U and/or L, R are the
same.
• It will be checked to see if:
- no image shift or image rotation exists
- the complete image is visible and not cut off.
- no distortions or warps are shown.

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16 Visual image evaluation
9Visual image evaluation 9-
Visual image evaluation with respect to image artifacts.
All test images will be evaluated, if necessary with a magnifying glass.
Tab. 3

-Pairing = Uneven line distances

-Line flyback = Roughly distributed, diagonal white lines
- Incorrect locations = Dot-shaped, dark/bright spots
(pixel errors) = Several superimposed images are shown
- Ghost images = Brighter or darker and/or color contours in
-Overshoots subsequent image area, with sharp
image transitions
= With an uniform image background, checks are frontal
- Flickering and out of the corner of the eye. Image display devices
of application categroy A have to be flicker-free.
-Horizontal/vertical = Horizontal/vertical movements of the
Image motion entire image are determined
-At times geometrical = Do the grid lines remain stable for more than approx.
Distortions one minute?

- Convergence =
When displaying grid lines on the
color monitor

- Color hue = it should not be possible to detect adjacent colored

lines.
No tinted or color-washed zones may occur.

NOTICE The display of the test image cannot show one of the listed errors
in diagnostically important areas.

¹ Visual image evaluation

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Visual evaluation of clinical reference images 17
10-
Clinical reference images
10Visual evaluation of clinical reference images

• At least one clinical reference image should be provided for the acceptance test of the
imaging device. Only the use of a clinical reference image enables testing the image
quality of the clinical images required by the user.
• The clinical reference image serves for the visual test of the grayscale value display, of
the resolution and of the existence of artifacts (specially pseudo-contours).

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18 Visual evaluation of clinical reference images

Visual check of the clinical reference image 10.1

If a clinical reference image is available, it will be displayed at the image display device
and the predefined display parameters will be taken into account. The user has to confirm
the quality of the clinical reference image/reference images. If the quality is not accepted,
the characteristic line may be adjusted to user-specific needs, if required. The final setting
or the look-up table used has to be documented. If the monitor settings are changed, the
respective test positions have to be checked again and documented, if necessary.

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Characteristics and reference values for the constancy
11Characteristics and reference values for the constancy test 11-
General
• If the tests described in chapter B have shown that the image display device satisfies
the requirements of the acceptance test, the reference values will be determined for the
following constancy tests with the test equipment of the operator.
Characteristic values
• Viewing conditions at the site of installation: Lveil
• Grayscale reproduction: Luminances Lmin and Lmax
• Deviation of the luminance within the image: Lcenter, Lcorner LO, Lcorner RO, Lcorner
LU, Lcorner RU.
• Spatial and contrast resolution. The following characateristics are included in the test,
but not explicitly documented.
• Geometrical image properties
• Line structure
• Color-related aspects
• Image instabilities
• Artifacts.
Reference values
• The reference values are determined with the test equipment of the operator. The mea-
surements are performed according to the method as described under items 4, 6 and 7
of the acceptance test.
• The image source for the test image is the imaging device. If it is not possible to select a
test image from the imaging device, the test body according to DIN 6868-4 may be
used.
• The measurement and test results have to be confirmed via date and initials.
Monthly constancy tests.
• The operator has to perform constancy tests at least once a month. The current actual
values have to be determined and entered into the protocol. The values have to located
within the established limits. The respective test result has to be evaluated, the date
has to be entered and the test has to be initialed as confirmation. In case the limit val-
ues are exceeded, the source for error has to be determined immediately and removed.
After repairs or new adjustments, new starting values have to be determined after an
i.e. partial acceptance test.

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20 Changes to previous version
12Changes to previous version 12-

Chapter Change Reason

Consideration conditions at the business
3 Charm: TD00002775
place enlarged
all Conversion into English with a new Variant Charm: TD00003364

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