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46TH  ANNUAL  CONGRESS  OF  THE  SAEVA        SKUKUZA      16-­‐20  FEBRUARY  2014   135     per 2–3MP monitor so that the information displayed on the screen most accurately depicts the information stored in the digital matrix. Stated in another way, ‘‘squeezing’’ a large image on to a small monitor will result in the loss of diagnostic information. The image review software functions of window, level, and zoom should always be used because they increase diagnostic accuracy.4,9,25 Cropping tools or automatic collimation detection should be used at the time of image production to minimize white areas surrounding the exposed portion because this reduces excessive back lighting. Features that improve the clinical utility of software programs include the hanging protocol, the default image resolution, and the user interface. Hanging protocols require that specific keywords be incorporated into the DICOM header information so the software can recognize them and hang or display the radiographs or other images in a specified order and orientation. Having an appropriate hanging protocol can greatly increase radiologists’ productivity. The default resolution should be as high as possible because important diagnostic decisions are made very rapidly upon first seeing a radiograph. The user interface is a key feature in increased or decreased radiologist productivity. A radiologist should be able to use the image viewing system with little or no training and the system should be user friendly.29 In one study, the reviewers’ eyes were fixed on the menu options of a software program for 20% of the total time spent reviewing bone radiographs.32 Software options that either stack the remaining images or display the remaining images in a thumbnail format can greatly aid in study evaluation.27 The user interface differs between software programs and this is an important point of comparison in purchasing decisions.   References 1. 2. Ballance D. DICOM and the network. Vet Rad Ultrasound 2008;49:S29–S32. Wright M, Ballance D, Robertson ID, et al. Introduction to DICOM for the practicing veterinarian. Vet Rad Ultrasound 2008;49:S14–S18. 3. A.C.R. American College of Radiology. ACR technical standards for teleradiology: American College of Radiology, Reston, VA, 2002. 4. Bacher K, Smeets P, De Hauwere A, et al. Image quality performance of liquid crystal display systems: influence of display resolution, magnification and window settings on contrast-detail detection. Eur J Radiol 5. 2006; 58:471–479. 6. Badano A. PACS equipment overview: display systems. RadioGraphics 7. 2004; 24:879–889. 8. Balassy C, Prokop M, Weber M, et al. Flat-panel display (LCD) versus high-resolution grayscale display (CRT) for chest radiography: an observer preference study. Am J Roentgenol 2005; 184:752–756. 9. Batchelor J. Monitor choice impacts diagnostic accuracy and throughput. Auntminnie.com May 4, 2002. http://www.auntminnie.com/index.asp? Sec1/4rca&Sub1/4scar_2002&pag1/4dis&ItemId1/453236 (accessed September 11, 2007) 10. Doyle AJ, Le Fevre J, Anderson GD. Personal computer vers us workstation display: observer performance in detection of wrist fractures on digital radiographs. Radiology 2005; 237:872– 877. 11. Graf B, Simon U, Eickmeyer F, et al. 1K versus 2K monitor: a clinical alternative freeresponse receiver operating characteristic study of observer performance using pulmonary nodules. Am J Roentgenol 2000; 174:1067–1074.   135