Trends In Medical Displays - Planar Systems - Adi Abileah

Trends in Medical Displays Adi Abileah Chief Scientist, Technology Group Beaverton, OR, USA

Outline

Trends in Medical Imaging

Types of Medical Displays

AMLCD Challenges for D.I.

Future hospitals and Displays

New DI and 3D Displays

Summary

Trends in Medical Imaging Trend Display Imaging PACS Archiving

Trends in Medical imaging MR MR CT NM US US Digital Computer CT

Imaging Modalities XR – X-Ray ( CR, DR ) CT – Computer Tomography Fluoroscopy MR – Magnetic Resonance NM – Nuclear Medicine PET – Positron Emission Tomography SPECT – Single Photon Emission Computer Tomography US – Ultra Sound Using tomography (3D slices) Mammography X-ray Magnet Isotopes Ultra Sound Type of radiation used

Evolution of X-ray DR-Digital Radiography CR-Computerized Rad. XR (X-Ray) CT, MR, NM, PET, US, FL, Mammo, PACS Archive PACS Work station DIGITAL DIGITAL DR, CR FILM

Evolution of X-ray DR-Digital Radiography CR-Computerized Rad. XR (X-Ray) CT, MR, NM, PET, US, FL, Mammo, PACS Archive PACS Work station DIGITAL DIGITAL DR, CR

Medical Sensor Resolution and Grayscale Depth

Displays - Sensors matching CT MR CR, DR Mammo NM US Which Display? Mono , or C o l o r ?

DISPLAY Resolution / Grayscale Today

DISPLAY Resolution / Grayscale Soon

DISPLAY Resolution / Grayscale Future

Outline

Summary

1. Embedded Displays

(Instruments)

Example – EL 

EL = Electro-Luminescence

Rigid,

Wide temperature

TFEL  ( C o l o r )

2. Referral Displays

(Informative)

Example – AMLCD 

AMLCD = Active Matrix Liquid Crystal Display

Information,

Instrument signals,

Referral images

Typical Informative displays Medical Monitors Documentation Class Systems Diagnostic class Point of Care

3. Diagnostic Displays (Imaging)

High resolution AMLCDs (Close to film) Calibrated gray levels (DICOM – see below) Meet Film Quality

Imaging (Diagnostic) Displays

DUAL Diagnostic Medical Displays Most radiologist prefer 2 x (3 MP) displays

Outline

AMLCD Challenges for D.I. (Digital Imaging)

Summary

Medical Imaging Displays should have:

Very high resolution (130 DPI, ~190 μm pixels)

High Brightness (~300 cd/m2; >500 mono)

At Least 10 bits (1024) separable gray levels

DICOM GSDF gray levels

Good Viewing angles (CR (+/- 85  H,V) >> 10:1; Little loss of gray levels; No inversion)

Transition to AMLCDs

What makes the AMLCDs compete with CRTs as the displays for digital imaging?

?

AMLCDs are the Dominant Technology Laptops Desktops LCD-TV Medical displays Manufacturing infrastructure Market trend

Improved resolution Exponential Trend…! Medical Diagnostic

Improved Viewing Angles IPS, FFS, MVA, PVA – Liquid Crystal (LC) technologies

DICOM Standard

Standard for:

Communication

Archiving

Displays

DICOM –

D igital I maging and Co mmunication in M edicine

http://medical.nema.org/

Meeting The Gray Levels Criteria

Medical displays must support high # of gray levels

DICOM - Gray Scale Display Function http://medical.nema.org/dicom/2003.html DICOM GSDF

DICOM Gray Levels Calibration

Reasons for DICOM Calibration

Have same image over time

Same image in different locations ( e.g. Beijing and Shanghai )

Differentiate image details

2001 2006

Planar’s Method to Achieve More Gray Levels Display Driver Chips – 8 bits Sub-pixels Dithering – 1.5 bits Temporal Dithering – 2 bits Total = 11.5 bits Planar: 11.5bits /3061 gray levels Sub-pixels

Meeting DICOM Standard Gray levels A ccuracy Brightness Control LUT – Look up tables (> 10 bits) - stable Backlight Sensor (center) Better Front Sensor (corner) Need adjustment

Driving The Displays Sensor 12 bits

CPU

Image Buffer

Compression

Image Proc.

8 bits

Graphic Card

Memory

Video Conversion

DVI

Display

De-Compression

Calibration - (LUT)

11.5 bits

AMLCD glass

Row / Column drivers

Grey Level Brightness vs Horizontal Viewing Angle IPS

Normalized Gray Level Each curve at different viewing angle; NO INVERSION

Meeting Medical Standards (*) - Mandatory AAPM-TG18 DIN-6868 -57 EUREF JIS-Z4752-2 USA, Americas, R.O.W. Germany (*) , Switzerland, Austria Europe (EC) Japan

Planar’s architecture is already 12 bits

We use our own display controller

It is tightly coupled with our display

The limitation is the operating system (Windows) – Changing to new soon ( 2007 )

PACS viewer software is also 8 bits

Medical Displays - Summary

Unique displays

Diagnostic workstations need bright, high resolution and high gray levels

Trend: Color Diagnostic displays

Soon launching 2, 3, 4 MP color DICOM calibrated , 1768 shades of gray

Outline

Summary

Future UCLA medical center (2005)

Imaging Work Station – Center Location

High Resolution Displays (x2)

Low Ambient illumination (no glare)

Color monitor

Departments User Information Access

Infotainment = Information + Entertainment Patient medical Info TV, Web, Emails Secure Paid

Hospital Staff Want Mobility and Connectivity Wireless (Secure) This is evolving technology Patient Information Pharmacy Physician Ref. book Schedules & Emails Images

Future Operating Room (OR) Presented by Dr. Falk at the UCLA-2004 conference

Displays Trend Map Embedded Displays (EL, LCD) Referral (1~2 MP) Desktops, Carts, Vital Screen, Digital Imaging (3, 5, 16 MP), Carts, Mammography, OR- Multi-function Video, ~20”, split screen, touch, washable, OR- Wall Displays >30”, Plasma, AMLCDs Observation Suite >30”, Video Infotainment ~19”, Video, referral, web 3D-stereo High resolution,

Outline

Summary

Typical Displays for DI – Digital Imaging

Typical Medical displays for Digital Imaging: 2, 3, 5 MP – monochrome & Color

Dimensions: 20 ~ 21 inch diameter

Mostly used: pair of 3 MP (mono)

Last two years: 4 MP color / 30” – for two side by side images (2x 2MP)

2 MP 3 MP 5 MP 4 MP / 30”

New products (at RSNA-2007)

Planar-Dome: 16 MP mono / 30” (200 dpi)–

For: mammography, radiology, multi-modalities

production coming soon

Barco: 6.7 MP color / 30” (127 dpi)–

For: Radiology (2x 3MP images), multi-modalities

made by Hitachi (s-IPS)

Planar-Dome: Stereo-3D SD2320:

For: CT, MR, other volume imaging (3Mensio software)

For: surgery planning, and education

Planar-Dome: Stereo-3D prototype:

Mammography study at Emory Hospital

3D Stereo –Planar products

Improves detection of 3D images

Clinical trials of mammography

Stereo-Mirror (3D) - Concept

RSNA Show – Stereo Displays (3D) CT images Processed w. 3Mensio Software Planar - - SD2320 3D display Mammo Study at Emory U. Planar - - prototype 5MP-stereo

Stereo-5 MP – Mammography study