The Big Picture: Medical Displays for Cardiac Images


 The University of Mississippi Medical Center in Jackson, Miss., has invested in 27 workstations that utilize a combination of grayscale and color displays from Barco.

In the realm of diagnostic displays, the line between color and grayscale is starting to blur. Many facilities are embracing such a merge—presenting a variety of color and grayscale medical images along with other critical patient information in comprehensive displays with multiple monitors to review studies across different modalities.

The challenge for many facilities in choosing displays to view cardiac and cardiovascular images is to find solutions that work for the diverse array of procedures such as cardiac catheterization, echocardiography, nuclear medicine, and cardiac CT and MRI.

“Medical displays are like football linemen—you don’t notice them unless they do something wrong,” says David Derr, MD, the University of Mississippi Medical Center (UMMC) in Jackson, Miss. Derr reads and reviews 3D cardiac MR, cardiac CT, angiography and fluoroscopy using 2 megapixel (MP) and 3MP color and 3MP grayscale Coronis diagnostic displays from Barco.

“For as long as I can look at my displays, they work, there is no image distortion and the color looks good, I am pretty happy,” he says. “These monitors have not been turned off in almost three years.”

UMMC is a 722-bed, tertiary-care facility with approximately 27,000 inpatient visits and 418,000 outpatient and emergency visits annually. This Level 1 trauma center offers specialized services that include interventional MRI; separate medical, surgical, cardiac, neuroscience and pediatric ICUs; a heart station for diagnosis and treatment of heart disease; a heart failure clinic; heart, kidney, cornea and bone marrow transplant programs; a comprehensive stroke unit; state-of-the-art radiological imaging systems.

David Derr, medical director of radiology informatics and assistant professor of musculoskeletal radiology, University of Mississippi Medical Center 

Three years ago, Derr says that as part of an upgrade, the hospital installed a new PACS from Stentor, and decided to upgrade the facility’s monitors as well. “We were looking for reliability, good luminescence, and remote QA [quality assurance] features,” he says. According to Derr, the 27 workstations have either a two or four-monitor configuration, including a mix of color and grayscale. Consistency across the workstations eliminates the need to move from one workstation to another to switch applications, he says. A user can view both grayscale and color images in one location.

Derr stresses that reliability is key for medical displays, an unobtrusive yet essential part of the entire hospital system. “Displays must be reliable—dead pixels are distracting,” Derr says. “You want good luminescence, good color reproduction and it has to be reliable—you cannot have pixels going out on you. We wanted the best of the best.” He says it doesn’t matter “how good your scanners are, if you don’t have good monitors, you can’t take advantage of them.”

UMMC has top of the line displays, beginning with the 21-inch Coronis Color 2MP with its 1600x1200 resolution for more accurate diagnosis. The 3MP color display offered the good luminescence the hospital was looking for with its Diagnostic Luminance (DL) backlight technology. While color displays can lack the brightness of grayscale monitors, Derr says the 800 cd/m² luminance on the 3MP DL provides “unprecedented brightness and DICOM-accuracy over its entire lifetime.”

The 3MP grayscale display, with a resolution of 1536x2048, offers diagnostic precision and workflow efficiency, he says. All three monitors feature remote calibration to ensure quality at all times. “We calibrate them when we set them up; then remotely and while being used,” Derr says. The hospital auto-calibrates using the sensors on the front of the displays and the MediCal QAWeb softcopy calibration software from Barco.

“We were not really looking for displays suitable for one type of study, we wanted reliability,” says Derr. “You don’t really need high-end monitors for cardiac MR and CT, but cheaper monitors start having problems like burn in and loss of screen resolution. The better the components are, the less likely that is to happen.”

Multi-modality flexibility

Allina Hospitals & Clinics is a not-for-profit family of hospitals, clinics and other care facilities with more than 22,500 employees, 5,000 physicians and 2,500 volunteers delivering healthcare and support services throughout Minnesota and western Wisconsin. In 2006, the hospital system made the transition from grayscale to color with diagnostic displays primarily for the radiology, ICU, ER, and cardiology departments.

According to Systems Administrator Bruce Facile, Allina chose NEC Display Solutions’ 21-inch MultiSync LCD2190UXi 2 MP color systems. The decision to switch to color came down to the requirements by the different modalities to display color.

“We made the move from grayscale to color for the added information and flexibility—more and more modalities are using color in their imaging—MRI, ultrasound, 3D reconstruction—and it makes it more flexible for us to use displays suitable for cardiac imaging,” Facile says. “We like the image quality and the homogeneity of the brightness across the display, and of course the cost.”

More to see

As many facilities look for systems capable of displaying cardiac images from the spectrum of procedures, solutions run the gamut from color and grayscale monitors ideal for radiology, the OR and other subspecialty areas. Deploying a color display can bring an efficiency gain to departments by allowing users to shift from application to application without having to move from one workstation to another.