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Accessories: Nuance PowerMic II / Keyboard & Wireless Mouse
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JVC CL-S300 3MP 21" Color LED General Radiology Diagnostic Display Monitors (CL-S300)
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Barco Coronis MDCG-3221 3MP 21" Grayscale LED General Radiology Diagnostic Display (K9301366A)
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Barco Coronis MDCG-3120 3MP 21" Grayscale General Radiology Diagnostic Display (K9601662)
JVC CL-S500 5MP 21" Color LED Mammo 3D-DBT Breast Imaging Display (CL-S500)
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JVC CL-S1200 12MP 31" Fusion Tomo Color LED Mammo 3D DBT PACS Display (CL-S1200)
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Barco Coronis MDMG-5221 5MP 21" Grayscale Tomosynthesis LED 3D-DBT Mammography Display (K9602004)
Barco Nio MDNC-6121 5MP 21" Color LED Mammo 3D-DBT Breast Imaging Display (K9300360A)
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Barco Eonis MDRC-2324 SNIB 2MP 24" Clinical Review LED Monitor (K9350055)
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Barco Eonis MDRC-2221 2MP 21" Color LED Clinical Review Display Monitor (K9301880A)
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Why You Need a 5MP (or Higher) Diagnostic Display to Read Mammograms
Why Radiologists Should Use Medical Diagnostic Displays to Read X-Rays?
How to Choose the Right Diagnostic Display and PACS Workstation
Barco MXRT-5600 4GB Quad Head 4DP Medical Graphic Card (K9306043)
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Radiologists need a high concentration level to ensure they get everything right when reading images. As a radiologist, you sit in front of a medical monitor for hours every day, reading images. This can wreak havoc on your body. This is especially true if you stay in the same position for hours. Given the conditions radiologists work in, the lack of variation in movement can cause back pain, headaches, tension, and tightness in your back, neck, and shoulders. There are ways to combat this sedentary dilemma for a Rad that, by its nature, requires prolonged screen time. Studies show that regular stretching can help reduce neck and shoulder pain. Plus, frequent breaks to stand and stretch increase productivity. Flexibility breaks allow your eyes to rest and your entire body to feel more comfortable. The following are some stretches for radiologists when attempting to reduce prolonged sedentary time and stiffness. Hold each stretch for 10-15 seconds. Avoid any exercises that cause pain or discomfort. Stretch 1: Chest Stretch Radiologists spend most of their time stooped forward at their reading station, so taking regular breaks to stretch your chest and shoulders is one of the best exercises to alleviate back tension and help with sitting up straight. How to: In either a sitting or standing position, put your arms behind you and hold your hands together with your fingers interlaced. Then straighten your arms and slowly lift your hands a few inches, or until you can’t lift them anymore. You should feel a stretch in your chest. Hold this for stretch for 10-15 seconds. It’s recommended to avoid this move if you have shoulder problems. Stretch 2: Shoulder Shrug Reading images on a diagnostic monitor for long periods can cause shoulder and neck tension. The trapezius muscle is often tight with hunching because you don't notice how much extra weight your shoulders take on when typing or clicking away in front of a screen all day! Relieve tension from the shoulders and traps with shrugs. How To: Seated or standing, lift your shoulders towards your ears and squeeze them as far as possible for 1 to 2 seconds before relaxing and rolling your shoulders back and down to a resting position. Repeat this 8 to 10 times, then do the following again but roll the shoulders forward this time. Stretch 3: Upper Back Stretch While shoulder shrugs will help get the circulation going, this upper back move will stretch all the muscles between the shoulder blades, traps, and shoulders. After stimulating blood circulation from shoulder shrugs, perform this upper back move to stretch all of the back muscles between the shoulder blades and the traps and shoulders. How To: Either sitting or standing, straighten your arms and stretch them out in front of you, rotating the hands, so your palms face away from each other. Form a twist by simply moving your arms together until they cross, pressing your palms together once crossed. If twisting the arms is uncomfortable, you can just lace the fingers together. Now contract the abs, round the back as if curving over an imaginary ball, and relax the head down while keeping your arms stretched out in front of you. Hold this position for 10-30 seconds. Stretch 4: Spinal Twist Radiologists sit for long periods, which can cause the lower back to become tight and achy. Gently twisting the spine can help reduce that tension, but you don’t want to over-rotate this stretch: a little goes a long way. How To: Remain seated with feet flat on the floor. Contract the abs and slowly rotate the torso to the right. It may be helpful to leverage an armrest or the seat of a chair to deepen the stretch further. Remember your limits, and only twist as far as you comfortably can while keeping the back straight and hips square. Hold for 10 to 15 seconds. Repeat the stretch on the other side as well. Stretch 5: Torso Stretch Good posture is an essential part of maintaining a healthy back. Still, when you get lost in reading images, you may subconsciously slump back to a hunched position, causing unwanted backaches. With this easy move, you can prevent distracting back pain that helps stretch and loosen all the back, sides, and arms muscles. How To: Either sitting or standing, lace your fingers together and stretch your arms up and over your head, reaching toward the ceiling. Breathe deeply and stretch up as high as you can, feeling the back expand. Exhale while opening your arms and lowering them down. Repeat this stretch 8 to 10 times. Stretch 6: Forearm Stretch Forearms and wrists suffer a lot of wear from typing and clicking. This elementary move helps soothe the muscle tension and prevent repetitive soreness of the wrist and forearms. How To: Either seated or standing, stretch the right arm out with palms facing the floor. Press your left hand against the upper palm of your right hand and gently pull the fingers of your right hand towards you. You should feel a stretch in the forearm. Hold for 10 to 15 seconds, then repeat on the other hand. Stretch 7: Neck Stretch When working on a computer all day long, many of us drop our heads forward, putting extra tension on the neck. Heads can weigh up to 11 pounds, which can put an immense amount of stress on the relatively thin anatomy of the neck. Weighing up to 11 pounds, the head can No Radiologist wants to feel the dreaded pangs of neck pain creeping in, especially when accompanied by headache and upper back tension. Neck stretches are great for relieving stress on your neck muscles and avoiding discomfort. How To: Remain seated for this stretch. Grab the side of your chair with the right hand and gently pull while tilting your head to the left. You should feel a stretch down the right side of the neck and shoulder. Hold this position for 10-30 seconds, then repeat on the other side. Stretch 8: Hip Flexor Stretch Even those with perfect posture can experience muscle tightness in the lower body due to sitting too much. We can understand how sitting causes tension by looking at the anatomy: the glutes stretch while the hip flexors are shortened when you sit. Stretching the hips alleviates tightness and gets you up and moving to offer some immediate relief. How To: Stand up and move the right leg back a few feet, bending the back knee like you’re doing a lunge. Lower both knees until you feel a stretch in the front of the right hip. Deepen the stretch by flexing the glutes of the back leg. Hold for 10-30 seconds and repeat on the other side. Stretch 9: Seated Hip Stretch Release the tension of a long day with this simple hip stretch. The hips and glutes are home to a complex series of muscles, making this stretch an excellent choice for targeting several muscle groups. How To: In a seated position, cross the right ankle over the left knee and straighten the back, sitting up tall. Keep your back straight, and gently lean forward until you feel a stretch in the right glute and hip. Deepen the stretch further by pushing down on the right knee. Hold this position for 10-30 seconds, and repeat on the other side. Please remember to avoid this move if it causes pain in the knees. Stretch 10: Inner Thigh Stretch Building on the previous stretch, this variation is geared towards the inner thighs, hips, and groin and targets unwanted lower body tightness. How To: Sitting down, position the legs wide, toes pointing out, and lean forward while resting your elbows on the thighs. Keep your spine straight and abs contracted, and gently lean forward while pushing the thighs out with your elbows until you feel a stretch in the inner thighs. Hold for 10-30 seconds and repeat as many times as is needed.
Home reading can be a challenge, but mastering the art of an efficient reading environment and setup at home may free up more time for you to spend with family and friends. We've compiled a list of tips from fellow rads that will help make home radiology reading more manageable and more efficient. Tip 1: Improve the Ergonomics of Your Reading Station Ergonomics is a big deal to productivity for a radiologist, so you must take the time and effort to create your own comfortable space. The first thing we often neglect when starting our workday is ergonomic considerations; specifically, what effects will lighting have on my readings? How am I sitting right now? Is the desk height correct for me, or does it need adjusting? There are many things to consider, both short-term and long-term, but they can all be taken care of by being mindful about how comfortable you are in your space. Tip 2: Ensure Your Internet Is Up to Speed Nothing makes you want to toss your keyboard across the room than opening a case that takes forever to load. Save yourself the pain and ensure you have a good, reliable internet connection. Preferably, always connect via ethernet wired connection instead of wi-fi because it is typically three times faster. You should only use wi-fi if there is no possibility to make a wire connection to your workstation. Have family members who like hogging the bandwidth with online streaming services and games? Make sure to make arrangements to leave enough room for you to work with access to sufficient bandwidth. Tip 3: Hardware VPN Connectivity Accessing cloud PACS is easier than ever, but it can still be tricky. The IT department at your hospital or imaging center will know exactly how you must access images remotely while working from home. Make sure that images are transferred safely and securely by using a hardware VPN (Virtual Private Network). A hardware VPN is configured within your router, and it is always on. It is more reliable than software VPN, which may get disconnected frequently, and establishing the connection may be required each time you restart your workstation. A reliable VPN connection allows more fluent processing of large images, which can help you fortify your reading workflow. Tip 4: Invest in a High-Quality Diagnostic Monitor and Workstation A diagnostic display is necessary to interpret diagnostic images at home without sacrificing quality or accessibility. International guidelines describe many requirements that need to be met for viewing and reading images reliably. We have a plethora of displays that meet ACR and FDA standards! Read our article on how to choose the right diagnostic display monitor and workstation so you can learn more about all the different options and differences between them. Tip 5: Assure Your Display’s Calibration and Compliance Are in Check Medical diagnostic monitors make use of built-in front sensors to perform calibration and compliance tests. Without one, you will need an external USB sensor that accomplishes this task in addition to compensating for environmental changes and tracking calibration measurements over the lifetime of your equipment. Setting up the schedule on your QC software to perform these tasks regularly will ensure the highest level of diagnostic accuracy and legal compliance. IT departments in a hospital typically handle these processes, but if you are an independent radiologist or working from home, you may be responsible for compliance with your diagnostic monitors. You can always reach out to Monitors.com’s technical support, and we will assist you with configuring your calibration and compliance software for you. Tip 6: Take a Break and Stretch It is important to keep your physical health strong. We can feel stiff muscles and stinging eyes when we work for long hours, which is bound to be distracting and uncomfortable when you’re trying to do your reading, and always remember to drink enough water! Set the alarm to take a break to avoid physical discomforts such as stiff muscles or stinging eyes. A little exercise will help you stretch out those tight muscles while getting your blood flowing again.
Did you know? 70% of diagnostic errors result from radiologists not seeing abnormalities within images. Breast cancer is the most commonly missed diagnosis for radiologists. Mammograms can be challenging to read because evidence of breast cancers—subtle masses and calcifications, and slight changes in tissue density—can often blend into surrounding healthy tissue. As radiologists can attest, dense breast tissue appears white on a mammogram—but, unfortunately, so do cancers. The denser the patient’s breast tissue naturally is, the greater the challenge in identifying these indicators. Abnormalities need to be clearly visible to achieve earlier diagnoses and better patient outcomes. As with all imaging modalities, the effectiveness of mammograms comes down to image quality and what radiologists are able to see. The Importance of Screen Resolution Alongside display brightness, screen resolution is the most important factor influencing the quality of breast images, the ability for radiologists to detect subtle abnormalities earlier in the development of medical conditions, and the accuracy of diagnostic interpretation. Screen resolution impacts the sharpness and clarity of the image and, therefore, how many minute details can be seen. What is resolution, exactly? Resolution is defined in megapixels. A single megapixel represents one million pixels. To break it down, a pixel is simply the smallest part of an image—one dot. When combined, all the millions of individual pixels in an image form a complete picture. You can calculate total megapixels by multiplying the number of individual vertical pixels by the number of individual horizontal pixels, and then dividing that figure by one million. Remember: The higher the resolution, the more elements are contained within an image and the more details are visible on the screen. Why 5MP (or higher) The American College of Radiology (ACR) and other industry organizations around the world recommend that the resolution of mammography displays should closely—if not precisely—match the resolution of the imaging system that captured the image under analysis. Because the resolution of breast imaging is so high, radiologists need at least 5MP—five million pixels—to reproduce them accurately on a screen and be able to view them 1:1, or at 100%, in full resolution. If the mammography display lacks sufficient resolution, which means that there are more elements in the breast image than available pixels on the screen, radiologists have to manipulate the image to view it at full-size resolution. This could involve panning, zooming, scaling, or windowing to achieve the best view of an image for analysis. This takes up a lot of time for radiologists. And, in the process, critical details within the image could be lost, which would have a negative impact on radiologists’ decisions and, ultimately, patient care. But with a mammography display that’s 5MP per screen or higher, radiologists can fit more of the mammogram within the display and see more detail with little to no image manipulation necessary. For radiologists who study about 40 images per day on average, this saves time and increases productivity. Mammography displays that meet these requirements also provide ergonomic benefits that enhance radiologists’ comfort and ability to read images for longer periods. Legal Requirements Under the Mammography Quality Standards Act (MQSA) Clearly, higher-resolution mammography displays lead to more accurate diagnoses at earlier stages of disease progression, improve patient care and health outcomes, and enable a more comfortable, productive reading experience for radiologists. For these reasons, industry groups such as the ACR have set guidelines recommending displays of 5MP or higher. But radiologists are also required by law to read cases on equipment that meets certain minimum standards. Alongside other region-specific laws passed by governments around the world, one of the most prominent and stringent pieces of legislation is the MQSA. Passed by Congress in 1992 and overseen and enforced by the U.S. Food and Drug Administration (FDA), the MQSA establishes standards for image presentation on monitor screens. Part of this law mandates that each monitor in the typical dual-head display set-up have a screen size of 21 inches and a resolution of 5MP. (If you opt for a single fusion display, these monitors go up to 12MP and have screen sizes between 30 to 33 inches.) Additionally, the MQSA requires mammography display monitors to undergo strict quality-assurance (QA) tests by qualified medical physicists as part of regular FDA inspections of mammography facilities. These QA tests focus on screen resolution, brightness, and contrast, and require that minimum standards for each be present in mammography display monitors. Facilities must preserve the test results.
We get this question all the time: Why should I pay thousands of dollars for a medical-grade monitor to interpret medical images if I can buy a very nice-looking commercial-grade, off-the-shelf (COTS) monitor at the local computer store? We’ve boiled this argument down to six important reasons based on critical arguments that are hopefully simple to understand and explain to your fellow radiologists or administrators who have little technical background. A commercial-grade monitor doesn't show all of the critical anatomical information radiologists need to diagnose medical conditions with the greatest accuracy and confidence. As the name implies, COTS monitors are intended for office automation, to display documents to appear like a printed page. Therefore, performance attributes are weighted heavily to being as bright as possible so that text is easily resolved with minimal eyestrain. Commercial displays attain maximum luminance long before the graphic card input reaches its maximum input value. Remember that a typical graphics card can display 256 different input values, each representing a distinct piece of valuable diagnostic information. COTS monitors have been observed to max out on brightness at an input value as low as 200, which means that values 201 to 255 are mapped to the same luminance value. As a result, 20 percent of all the data is cropped or simply eliminated. By contrast, medical-grade monitors are calibrated to map each individual distinct pixel into something you can detect rather than following the natural response of a graphics card output. Unfortunately, it’s normal for the natural COTS monitor response—uncorrected to the Digital Imaging and Communications in Medicine (DICOM) standard—to yield the same luminance value (measured) for multiple sequential values. For example, flat spots in the response curve are especially obvious in the low range of input values, such as the first 160 of 256 values. What’s the impact of a flat response? Let’s take, as an example with a COTS monitor, the pixel values of 101, 102, 103, 104, and 105. These could be mapped into a single luminance value on the screen. If a patient has a slight nodule, which would otherwise be identified by a difference in input value between 102 and 105, it will disappear on a COTS monitor because there is no distinction between these values on the screen. Note: Since the majority of the clinical information from imaging modalities is in the lower 50 percent of the luminance range, this means that these pixel values are in the most critical areas in which the ability to resolve pixels at different luminance values is compromised. In conclusion, the potential to miss critical diagnostic information both at high luminance and because of flat spots in the response is the most important reason to not even consider a COTS monitor. The first requirement for diagnostic display monitors is to insist on a monitor that’s calibrated to the DICOM standard, which truly maps each of the different pixel values into a luminance value on the screen that’s detectable to the human eye as noticeably different. It’s best to have the manufacturer calibrate the monitor to enable optimal mapping of the three RGB channels into the DICOM-compliant curve. Many COTS monitors don’t have the required dynamic range of brightness. The maximum light output of a monitor is specified using the unit of candela per square meter (cd/m2). A good-quality commercial display can achieve 300 cd/m2, sometimes more if you’re lucky. This maximum value of 300 cd/m2 is at the low end of what any medical-grade monitor can achieve—these might be able to go up to 2000 cd/m2 or higher. Why do we need this much luminance? When a display is calibrated to DICOM, a percentage of the response is lost in the mapping process. At 300 cd/m2 and after applying DICOM corrections, the maximum luminance value can be expected to decrease by about 10 to 20 percent. The human eye has a 250:1 contrast ratio at the ambient conditions of the viewing environment. Assuming the commercial display was DICOM compliant with aftermarket software, the luminance ratio of the display and the eye would be very close. However, ambient light detracts from the ability to see low-contrast information. This particular example would need to be in a low-light room to achieve a 250:1 luminance ratio that accounts for ambient light. Diagnostic displays operate between 400 and 600 cd/m2, as corrected to DICOM, with reserve luminance potential for extended life at those levels. Even if a monitor is calibrated, if there aren’t enough points in which to map the pixel data, you clip off part of the information. For example, if you want to map 256 grayscale pixel values but you have only 200 points available, you’ll lose that information. The required dynamic range depends on where you use the monitor. The lighter and brighter the room light, the more information you’ll lose in the dark because you simply won’t be able to distinguish details. There’s a simple fix for this. Calibration takes into account the room light and maps the lowest pixel value into something you can detect. The whole range is shifted, which is important when using it in a light area such as an ER or ICU. Also, it’s beneficial to have some slack at the dynamic range, which medical monitors provide because the light source of the monitor will decrease over time. Therefore, the maximum brightness to facilitate mapping the whole data range should be about 350 cd/m2, assuming you use the monitor in a dark environment. If you use it in a bright area or if you want to ensure you have some slack to facilitate the decrease of monitor output over a period of several years, you might want to opt for a maximum luminance of 450 to 500 cd/m2. A medical-grade monitor typically adjusts light output to compensate for start-up variations in output. With COTS monitors, the light output of a monitor varies as the temperature needs to stabilize for about 30 to 60 minutes after the equipment’s turned on. You can leave the monitor on day and night, or switch it on automatically one hour before use. However, either method will drastically reduce the lifetime of the monitor. High-quality medical-grade monitors typically have a built-in feedback mechanism that measures light output and adjusts the electrical current to the light source to create the same output. Therefore, the third requirement is to have a medical-grade monitor with a light output stabilizer. A medical-grade monitor can perform automatic calibration, QA, and maintain calibration records. Why are these records so critical? Two words: Liability reduction. Using a medical-grade monitor and, as a result, being able to continually measure and adjust values on the monitor and record these incidences of calibration, help you do your job properly on an ongoing basis and provide an umbrella of protection over your professional career. Using a COTS monitor simply exposes you, your livelihood, and the money you’ve invested in your medical education and career to too much risk. In addition, you need access to these records on a regular basis, regardless, to ensure that the monitor is still operating within the acceptable range. Many radiologists seem to replace their monitors after five years or so. If the monitor is still within calibration, there’s no reason to do that. Therefore, the fourth requirement for a medical-grade monitor is to make sure that you can retrieve and store calibration records. A medical-grade monitor is typically certified. The American College of Radiology (ACR) provides recommendations for medical monitors as a standard and baseline for image-display performance. They are somewhat technical and, in our opinion, not worded strongly enough. Also, most manufacturers of medical-grade monitors are FDA approved, which is actually only a requirement if you’re reading digital mammography. If your monitor meets the ACR requirements referenced above, you should be OK—but FDA approval doesn’t hurt. You can check the FDA website and look up monitor manufacturers to confirm if they’ve been approved. All medical displays offered by Monitors.com are FDA approved for medical use. The fifth (optional) requirement is to be FDA approved. Your monitor needs to have the right spatial resolution to see individual details. In addition to being able to see all of the grayscale, which is characterized by the contrast resolution, you also need to be able to distinguish between the different pixels. For example, let’s take a typical computed radiography (CR) chest image, which may have a matrix size of 2,000 x 2,500 pixels. This results in five million pixels, or 5MP. The standard configuration for a diagnostic monitor to look at medical images is 3MP because a physician has the capability to zoom or use an electric loupe to see a one-to-one mapping of each image pixel element on the screen. One could argue that you can use a 2MP monitor as well. Yes, that’s correct as long as you realize that it will take more time to interpret images and make a diagnosis. If you’re cost-sensitive, a 2MP configuration will do. But, assuming your time is more valuable than the cost of the monitor, the sixth requirement is to have a 3MP monitor configuration for general radiology reading where CR cases are being interpreted. Yes, diagnostic display technology of at least 3MP costs more than their lower-resolution counterparts and certainly commercial displays. Even if you’re cost-sensitive about monitors, look at it this way: As you know, radiologists get paid per case they read. Diagnostic monitors of at least 3MP give you more detail within the image and reduce zooming, panning, and time spent focusing on a particular area. If you can read faster and more comfortably, and with more confidence, how much more money can you be earning? How many more cases could you read with the extra time you save each day? Isn’t it possible that the diagnostic display monitor—the superior albeit more expensive technology—pays for itself pretty quickly? Is it worth it to spend more on the best-quality image? Simply put, a medical-grade monitor is a professional tool that delivers professional results. Chief among these results are improving diagnostic accuracy and timeliness—what your reputation is based on. But being able to increase your earning potential is certainly attractive, too. Conclusion Does this mean that you can’t use a COTS monitor? It depends. Are you willing to manually calibrate the monitor on a regular basis by running a calibration check and ensuring this can be applied by the monitor? Will you take care of warm-up time? Do you have a monitor that meets minimum brightness requirements? Do you have a means of keeping your calibration records? Are you certain that, in case of a legal dispute, the plaintiff doesn’t have enough expertise to challenge you about using sub-standard components that may impact patient care? It’s up to you. But we would think twice about it—especially as the price difference between a good-quality medical-grade monitor and commercial-grade monitors is not that great, compared with the overall cost of a picture archiving and communication system (PACS), to justify the risks. Interested in buying a diagnostic display monitor? Now that you understand why you need this superior technology, please review the wide selection of general radiology and mammography displays from Monitors.com.
It’s a question that we get asked on a near-daily basis by radiologists, healthcare IT professionals, buyers for medical groups, and hospital administrators: Why should I pay a premium for medical-grade displays when there are attractive, seemingly high-quality consumer-grade options on the market that cost less? With all the advances in commercial off-the-shelf display technology, is there really that much of a difference between the two options? Although it may appear, superficially, that consumer-grade display technologies have closed the gap, the answer to whether there’s still a meaningful difference is a resounding yes. Here’s a simple, less technical explanation for why higher-end, higher-cost medical-grade displays are superior in diagnostic applications, and why your hospital or radiology practice should choose them: 1. Better patient outcomes What’s best for patients is paramount. Consumer-grade displays are intended for a wide variety of applications in our everyday lives and standard office environments—in other words, activities that don’t require the best visualization capabilities and highest level of detail. However, medical-grade displays were designed and built specifically for the clinical environment—where quality, consistency, and accuracy are, literally, matters of life and death. For radiologists, their work is all about what they can see, so the smallest details have to be visible. Radiologists’ interpretations impact courses of treatment. Sub-standard technology can result in misdiagnoses and have a negative effect on patient outcomes. Way too much is at stake to gamble on a consumer-grade product that was never intended for diagnostic applications. 2. Improved image quality and, as a result, increased radiologist efficiency and precision, and diagnostic accuracy Colors Medical-grade displays show a much broader spectrum of colors—about 1 billion colors compared to the 16 million in consumer-grade displays. This helps radiologists to see even the smallest variations quickly and easily. Screen resolution Standard consumer monitors simply don’t offer a high enough screen resolution to see critical anatomical details. The higher the number of pixels, the sharper, crisper, clearer, and more detailed the image is. Additionally, no panning or zooming in and out is necessary, which saves radiologists time when interpreting images. Brightness The brighter the screen, the more you can see. With a standard consumer monitor, typical brightness is around 300 candela/square meter (cd/m2). Unfortunately, this level of brightness naturally degrades over time. Medical monitors range between 600 to 2,000 cd/m2, and maintain a continuous level of brightness throughout their lifespan—even adjusting light output to compensate for the surrounding lighting and the variations in brightness that happen as monitors power up and the temperature stabilizes. Contrast Contrast—seeing all of the grayscale and having all the details really pop out—is equally important as brightness in detecting abnormalities. While consumer-grade displays typically have a contrast ratio of between 500:1 to 700:1, medical-grade displays have a contrast ratio of up to 2,000:1. Uniformity In consumer monitors, which weren’t designed for such a high degree of precision, it’s expected that variances in the amount of light emanating from LCD monitors can cause inconsistencies in how images are presented by anywhere from 25 to 35 percent. This means that some parts of the screen could appear well lit while other areas look dim. If a user turned up the brightness level as an attempted fix, the grayscale would become washed out and visualization would worsen. In diagnostic applications, that’s unacceptable. It’s important that images are presented consistently over time across individual screens, entire displays, and even enterprises—in any location, from remote teleradiology workstations to various sites within multi-hospital systems—so radiologists don’t miss any crucial detail. That’s why medical-grade displays have integrated quality-assurance tools such as uniform luminance technology (ULT), which improve the consistency of brightness levels and enhance grayscale presentation. Compliance with medical standards Consumer monitors aren’t calibrated to digital imaging and communications in medicine (DICOM) standards for brightness and contrast. (DICOM standards dictate how images must be presented on medical displays.) Nor do they meet the growing body of medical standards and regulations from Mammography Quality Standards Act (MQSA), American Association of Physicists in Medicine (AAPM), or the American College of Radiology (ACR), to name a few. Users of consumer-grade technology in a medical environment have to manually calibrate the monitors and frequently check on their status. This is not only an unnecessary distraction for radiologists, but also time consuming and introduces the possibility for human error. And, if the consumer display doesn’t have the range to view images properly and the means to maintain consistency, these instabilities can invalidate calibration efforts and cause detail in the images to be lost. Medical-grade displays are calibrated to DICOM standards and comply other medical standards and regulations. Using front-of-screen sensors and other quality-assurance tools, they automatically make real-time adjustments to compensate for external conditions. These displays also have the capability to store and track calibration measurements over the lifetime of the equipment. These records can serve as a useful defense in the event of a legal dispute. This gives radiologists more confidence that they’re operating in compliance 24/7 and producing accurate diagnoses based on best image quality. 3. Longevity and cost-effectiveness A consumer-grade display may have a lower upfront expense, but the cost of technology is never just about the initial investment. There’s also the cost of ongoing maintenance and repairs, more frequent replacement, and, possibly, additional equipment. Medical-grade displays cost more to obtain because they incorporate the latest and greatest technology. This includes higher-quality components and features that not only improve image quality but also make them more durable, such as light stabilization and their innate heat resistance. They also are able to maintain calibration with DICOM and other standards. For these reasons, medical displays typically have a life span that’s up to four times longer than their consumer-grade counterparts. Furthermore, medical displays are compatible with medical workstations out of the box and don’t require additional costs to become fully operational. Many of these displays also enable multi-modality imaging on a single screen, eliminating the need to purchase several monitors per desk. The superior performance and longevity of medical displays quickly negates any perceived cost savings of consumer displays. Actually, they will be less expensive and have a higher return on investment over the long term. 4. Extended warranties In most cases, manufacturers of medical-grade displays provide longer, more competitive warranties than manufacturers of consumer products—usually up to five years.
So, you've made the right decision to purchase a diagnostic display monitor for your radiology practice or healthcare facility. This technology is vital in obtaining a medical image of superior quality and maintaining compliance with international medical standards and regulations. However, choosing the optimal medical display monitor for your needs and budget can be a daunting task. There are many makes and models available at varying resolutions, screen sizes, and price points. The display that you ultimately select can significantly improve patient care and long-term outcomes. By delivering a sharp, full-resolution image that visualizes even the most subtle abnormalities, radiologists can diagnose medical conditions earlier and more accurately. Your new display can also have a positive impact on radiologists' workflow. The correct display setup can help a radiologist interpret images faster and more comfortably—with little to no image manipulation necessary, which means fewer clicks, less eye strain, and less overall head, hand, and eye movement. Time-consuming distractions, such as manual calibration, will also be a nuisance of the past. Additionally, before choosing a diagnostic display, it's essential to consider the purchase's financial burden in light of your short-term and long-term business plans. This discussion centers on everything you need to consider when identifying the optimal diagnostic display monitor. Monitor resolution and screen size There are three primary resolutions—measured in megapixels (MP)—for radiologists to consider when choosing a diagnostic display monitor: 2MP, 3MP, and 5MP. All these options are available in both grayscale and color. Diagnostic monitors are also available in single fusion displays in these resolutions: 4MP, 6MP, and 12MP. Typically, a radiologist who reads X-Ray, magnetic resonance (MR), computed tomography (CT), and ultrasound (US) studies would consider 3MP displays as recommended by the American College of Radiology (ACR). 5MP displays are required by law for reading mammography studies, but they can also read general radiology cases. A typical dual-head setup consists of two 21-inch displays with an aspect ratio of 3:4. Fusion displays are essentially a dual-head setup combined into a single large screen. You can configure a fusion 6MP monitor as a single display (3280 x 2048 pixels) or two 3MP monitors (1536 x 2048 pixels x 2). The screen size on a fusion display is often between 30 to 33 inches, depending on resolution and the model, with an aspect ratio of 16:10 on 6MP fusion and 3:2 on 12MP mammography fusion displays. With a fusion monitor, you would still run two video signal cables (DVI or DisplayPort) from your graphics card to the monitor. In this scenario, your picture archiving and communications system (PACS) workstation detects it as a 2 x 3MP monitor under the operating system's display settings. LED or LCD? It's a question we get asked often: What's the difference between LCD and LED monitors? The reality is, it's not an either/or choice. All diagnostic monitors are liquid crystal display (LCD) and manufactured with either LED or CCFL backlight technology as the light source behind the LCD panel. Light Emitting Diode (LED) is simply the light source behind LCD panels. Previously, manufacturers used cold cathode fluorescent lamps (CCFL) as the light source behind LCD panels. With technology advances, LED has become the preferred, obvious choice. Why? LEDs produce much higher brightness. LEDs enable monitor longevity (extending the lifespan by 40% on average), primarily due to having less heat. LEDs consume considerably less energy. LEDs are safer for the environment because they don't contain toxic chemicals such as mercury. If LED backlight displays are within your budget, we recommend them over CCFL displays. Dual-head set-up or a single fusion display? Both options deliver benefits worth considering. That's why we recommend that you choose the system you're more comfortable with. Fusion displays have a few advantages that give them the upper hand compared to a dual-head setup. The elimination of the center bezel present on dual-head plays provides a more comfortable reading experience and reduces distractions when comparing images side by side. Radiologists can read more comfortably, for more extended periods, due to less movement of the neck. Uniformity of light and color temperature across the whole screen lessens radiologists' eye strain. Fusion displays can be converted into a single large display or reverted to a dual-head configuration with a keyboard shortcut. This enables utilizing your diagnostic display for general web browsing and other activities in which a large display is preferred. Research shows that fusion displays increase radiologist productivity by up to 19%.* The main advantage of a dual-head setup is redundancy. In the event of one monitor's failure, you can continue using the second display until a replacement display becomes available. Color or grayscale? A few years ago, color displays had no chance of competing with their grayscale counterparts because of their limited brightness and contrast, and therefore lower-quality grayscale image. This has changed significantly within the last few years as manufacturers have allocated most of their R & D resources to improve color display technology. Today, color displays have the upper hand and produce grayscale images at a higher quality than most grayscale monitors in the market. Eventually, grayscale monitors will be phased out, and all diagnostic display monitors will be offered in color only. If you're considering a renewed option, grayscale monitors are a hot, in-demand choice for radiologists. With a lower price tag and excellent grayscale quality, they deliver great value. Suppose color monitors are within your budget, and you're investing in a long-term solution. In that case, we highly recommend considering color diagnostic display monitors because of their versatility and better resale value. Color displays provide important reading advantages: Not only can radiologists read cases in which color is needed for interpretation (color Doppler studies), but they can get creative and set up a more efficient workflow using color. For example: The hanging protocol can be configured to show the markings or measurements in a different color, so they are easier to read. A prior study can be shown in a different text overlay color, so the cases are easier to distinguish when making a comparison. Radiologists can read faster without needing to re-verify that they're interpreting the correct study. You can utilize color monitors for general web browsing. Color monitors can have their RGB values adjusted to create perfect color matching between a pair of monitors. Grayscale monitors can be color-matched only at the factory level or by professional service centers, such as Monitors.com, which can fine-tune the display using advanced calibration devices for perfect grayscale matching the displays. Connectivity and Compatibility Diagnostic display monitors are typically equipped with both DVI and DisplayPort. You can use either option to connect the display to your display controller card (graphics card). Most modern graphics cards are equipped with either DisplayPort (DP) or Mini DisplayPort (miniDP). If your monitor's inputs are DVI and you happen to have a graphics card with DisplayPort output, then a simple DisplayPort to DVI adapter can adequately convert the signal for you. All monitors purchased from Monitors.com are bundled with the appropriate graphics card, software, drivers, cables, and all necessary adapters. No additional purchases are required to connect your monitors to your display controller. This information may be necessary in an event where you would like to use your own graphics card or graphics processing unit (GPU), to drive the monitors instead of the card that's bundled with the displays. It's important to know that HDMI isn't a supported connection to medical diagnostic displays. A graphics card with an HDMI output may not display images in full resolution on monitors because of improper signal conversion that happens from HDMI to either DisplayPort or DVI. Monitors.com recommends AMD FirePro, AMD Radeon Pro, and Nvidia Quadro series graphics cards to drive your diagnostic monitors. The Barco MXRT line of graphics cards is recommended for all Barco monitors. However, they aren't necessary because nearly all Barco monitors (except Barco UNITI) are compatible with AMD and Nvidia graphics cards. Calibration and quality-assurance tests Diagnostic displays are pre-calibrated to DICOM part 3.14 at the factory level and therefore are DICOM-compliant out of the box. This guarantees accurate reproduction of grayscale images regardless of the graphic card or workstation sharing a connection with the monitor. All diagnostic displays have a backlight sensor mounted inside the monitor behind the backlight module. This controls the display's brightness and makes adjustments to the backlight to produce a sharp, bright image. Additionally, some monitors have a built-in front sensor that measures image quality from the viewing direction that radiologists see images. To perform compliance tests on any diagnostic monitor, you need a monitor with a built-in front sensor. Otherwise, you'll have to purchase an external USB sensor. DICOM Compliance and QA reporting are mandatory for New York State and New York City Quality Assurance Programs for Primary Diagnostic Monitors, as well as guidelines set forth by the Mammography Quality Standards Act (MQSA) for all 5MP and digital mammography display monitors across the U.S. and Canada. Please check with your healthcare facility to confirm whether submitting a monthly compliance report is necessary. Renewed or New? The main difference between renewed and new monitors is the length of their warranty. For the most part, Monitors.com renewed products consist of open-box and demo models used at trade shows for industry organizations such as the Radiological Society of North America (RSNA) and the Society for Imaging Informatics (SIIM). They are grade A+ in terms of cosmetic condition and are identical to new monitors in terms of image quality. All renewed products are guaranteed to pass all calibration and quality-assurance tests during the standard warranty period of three years. Essentially, renewed products offer buyers of diagnostic display monitors the opportunity to get a like-new product at a reduced cost. New diagnostic monitors come with a five-year warranty. If a new monitor is your preference, we offer great prices and world-class technical support on all our new diagnostic display offerings. Guarantees and Warranties For any vendor with whom you consider doing business, ask about their return policy and a restocking fee to ensure that you have the option to return or exchange display monitors without any penalties. Most sellers charge a minimum 15% restocking fee. Monitors.com is the only company that offers a 30-day, 100%-satisfaction, money-back guarantee and no restocking fee on all items we sell. Additionally, most manufacturers or dealers offer only basic warranty coverage. Anything deemed "additional," such as hot-swap exchanges, carry an extra fee. (A hot-swap exchange is when a replacement monitor is sent immediately in the event of a product failure.) Included with your Monitors.com purchase at no extra charge, our comprehensive standard warranty covers both parts and labor, as well as advanced hot-swap exchanges and loaner coverage. As part of our hot-swap exchange, we'll send you a replacement display in advance of the product return and include a prepaid label for you to return the monitor to us. This significantly reduces your downtime and gets you up and running by the next day if you request overnight delivery. We're the only company in our industry that offers this level of complete coverage. Monitors.com standard warranties for renewed diagnostic monitors include: Three-year full warranty on parts and labor Three years of advance hot-swap exchange. Three years of loaner coverage Guarantee to pass all state and federal compliance requirements (MQSA, ACR) No stuck pixels or imperfections within the viewing area Perfect brightness, uniformity, and image at all times 30-day, money-back, 100%-satisfaction guarantee with no restocking fee Free remote technical support Monitors.com standard warranties for new diagnostic monitors include: Five-year full warranty on parts and labor Five years of advance hot-swap exchange (only offered by Monitors.com at no extra charge) Five years of loaner coverage (only provided by Monitors.com at no additional charge) Guarantee to pass all state and federal compliance requirements (MQSA, ACR) 30-day, money-back, 100%-satisfaction guarantee with no restocking fee (only offered by Monitors.com) Free remote technical support in addition to the manufacturer's technical support (only provided by Monitors.com) If desired, Monitors.com offers extended warranties on both renewed and new monitors. Workstations (PC and CPUs) Workstations As some radiologists refer to them, workstations, or CPUs, are an essential part of a properly configured reading station for radiologists. They do all the hard work of loading images, processing tasks, and sending images to the GPU, so they're displayed on monitor screens for the radiologist to interpret. Investing in a reliable reading workstation has enormous benefits as it delivers a smooth, fast, lag-free experience when it comes to opening and scrolling through cases, as well as all other performance-related tasks. You can either purchase a workstation or have an IT professional build the system for you. Whichever option you choose, we provide technical support. One advantage of buying a workstation from Monitors.com is that we can configure it to match your display setup. Upon delivery, your system will be plug and play. We do everything for you to configure the display, including installing the graphics card, calibration software, all Microsoft Windows updates, and any required software or hardware upgrades. We deliver a fully turnkey teleradiology PACS reading station. As soon as you receive your system, radiologists can start reading. Additional advantages of purchasing a complete system from Monitors.com are, as previously discussed, our full warranty and hot-swap advance exchange on all our products. We also repair hardware or software issues. In this way, we serve as your one point of contact throughout the lifetime of your equipment. Mobile Workstations (Laptops)Because of recent advances in computer hardware, there are more options and a higher demand for mobile workstations (laptops). These mobile workstations are as powerful as their full-size personal computer (PC) counterparts and offer great functionality for radiologists who want a portable solution. Typically, mobile workstations come with: 15- or 17.3-inch screen DICOM-calibrated, high-luminance display Long battery life Ability to connect up to six external medical displays (up to 5MP each) simultaneously They are perfect for a standalone system to read any stat cases on the go since the display of the laptop itself is DICOM calibrated and meets ACR guidelines for clinical review displays. In scenarios in which laptop monitors are required to be connected to a specific graphics card (GPU), an external GPU enclosure can connect to the mobile workstation to drive the desired display configuration. Gaming PCsWe don't recommend using gaming PCs to set up your radiology reading station. This has to do with limitations that can arise because of the hardware design's nature and the intended functionality. For example, some gaming PCs have limitations on the motherboard: It may not be possible to install more than one graphics card. The gaming graphics card may be missing the lookup table (LUT), which is necessary for proper calibration and storing of quality-assurance data on diagnostic displays. They're also not designed for the full-on, 24/7 performance and stability that workstations offer. Therefore, there's a much higher chance of system failure resulting from heavy usage. When radiologists have to complete readings or attend to stat cases, downtime isn't acceptable. We have seen radiologists use gaming PCs to set up their reading station with success in the configuration. However, we can't confirm gaming PCs' reliability and uptime because they aren't designed precisely for this purpose. iMACs, MACs, and MacBook Pros All displays offered by Monitors.com are compatible with Apple products. You may need to purchase additional adapters to connect your monitors to your iMac or MacBook Pro properly. Please note the calibration software that communicates with the monitors is Microsoft Windows-based for Barco and JVC diagnostic displays. If you need to have a monitor DICOM calibrated, you may have to connect them via USB cable to a Windows PC to perform the necessary calibration and quality assurance. Currently, Eizo and LG are the only manufacturers that offer a MAC-native version of calibration and quality assurance software. Dictation devices and voice-recognition software Typically, radiologists use Philips Speechmikes or Nuance Powermic dictation microphones. There are various available models and can be used with all dictation software, such as Dragon Medical, Epic, or Dolby. Philips offers a variety of microphones, both USB-wired and wireless. Philips Speechmike LFH-3500 and SMP-3700 are among the most popular models. They come in a touch button or center-slider-control style. Suppose you are looking for a wireless option. In that case, we highly recommend Philips SpeechOne dictation headsets (SMP-6500) or Philips SpeechMike Premium Air Wireless handheld dictation microphone (SMP-4000) as they are the industry standards and market leaders in quality and performance. Nuance's best-seller microphones are Powermic II and the newly redesigned and released Powermic III. In terms of functionality, they are identical. Both are fully compatible with the latest voice-recognition software. Improvements to Powermic III have been mostly in ergonomic characteristics. We recommend that radiologists choose the model they are most comfortable with and are currently using with their current workstation. Voice-recognition software isn't included with a microphone purchase. Typically, the PACS/RIS package purchased by healthcare facilities provides this software. If this doesn't apply to your situation and you'd like to buy a voice-recognition software license, please contact Monitors.com for a custom quote. Business and career considerations Medical displays are a significant and vital investment in the professional journey of radiologists. In addition to the technical considerations we've outlined, understanding your long-term goals, and planning accordingly before purchasing a diagnostic display, is essential for maximizing your investment. If you're a radiologist, ask yourself whether either of these two scenarios applies more to you: Are you planning to retire soon? Are you purchasing your system for backup and light usage for stat cases? Or perhaps you're buying a reading station for a second home? In any of these scenarios, we believe renewed diagnostic displays deliver exceptional quality at a great value. Are you planning to practice for at least the next ten years? Are you planning to read from home, for the most part, and therefore teleradiology is your long-term plan? In this scenario, we recommend you consider color LED diagnostic displays since they have more advanced features when paired with a robust workstation. These systems typically last between eight to 10 years and keep their value over time. When you need to upgrade, you'll get excellent trade-in value toward them. Monitors.com offers a buy-back guarantee on most diagnostic displays and workstations that we sell, along with a comprehensive warranty that covers technical support during the full warranty period. Our goal is to assure you of excellent quality products, attentive customer service, and knowledgeable technicians to assist you. Please contact us to discuss your requirements and request a custom quote, and our knowledgeable team will provide you with multiple options to fit any need or budget. You can also shop our large selection of diagnostic displays and workstations, and be sure to sign up to receive the latest deals and promotions delivered to your inbox as we have occasional flash sales exclusive to our email subscribers. -------------------- 1 Influence of Medical Display System on Productivity and Eye Strain of Radiologists, Montefiore Medical Center, Albert Einstein College of Medicine of Yeshiva University, 2012
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7 Considerations When Choosing a Mammography Display
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