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AIM: The digital transformation of the pathology laboratory is being continuously sustained by the introduction of innovative technologies promoting whole slide image (WSI)-based primary diagnosis. Here, we proposed a real-life benchmark of a pathology-dedicated medical monitor for the primary diagnosis of renal biopsies, evaluating the concordance between the 'traditional' microscope and commercial monitors using WSI from different scanners. METHODS: The College of American Pathologists WSI validation guidelines were used on 60 consecutive renal biopsies from three scanners (Aperio, 3DHISTECH and Hamamatsu) using pathology-dedicated medical grade (MG), professional grade (PG) and consumer-off-the-shelf (COTS) monitors, comparing results with the microscope diagnosis after a 2-week washout period. RESULTS: MG monitor was faster (1090 vs 1159 vs 1181 min, delta of 6-8%, p<0.01), with slightly better performances on the detection of concurrent diseases compared with COTS (κ=1 vs 0.96, 95% CI=0.87 to 1), but equal concordance to the commercial monitors on main diagnosis (κ=1). Minor discrepancies were noted on specific scores/classifications, with MG and PG monitors closer to the reference report (r=0.98, 95% CI=0.83 to 1 vs 0.98, 95% CI=0.83 to 1 vs 0.91, 95% CI=0.76 to 1, κ=0.93, 95% CI=077 to 1 vs 0.93, 95% CI=0.77 to 1 vs 0.86, 95% CI=0.64 to 1, κ=1 vs 0.50, 95% CI=0 to 1 vs 0.50, 95% CI=0 to 1, for IgA, antineutrophilic cytoplasmic antibody and lupus nephritis, respectively). Streamlined Pipeline for Amyloid detection through congo red fluorescence Digital Analysis detected amyloidosis on both monitors (4 of 30, 13% cases), allowing detection of minimal interstitial deposits with slight overestimation of the Amyloid Score (average 6 vs 7). CONCLUSIONS: The digital transformation needs careful assessment of the hardware component to support a smart and safe diagnostic process. Choosing the display for WSI is critical in the process and requires adequate planning.

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PURPOSE: Color images are visualized on medical monitors that are adjusted by a grayscale standard display function (GSDF) or γ2.2. Although the GSDF is visually displayed as a linear graded grayscale, it does not specify how color medical images should be presented. On the other hand, the usual gamma setting for color images is γ2.2, but it has not been standardized. The color standard display function (CSDF) has recently been proposed as a standardized gamma setting for color medical monitors. However, the influence of various gamma settings on image characteristics should be determined. The present study aimed to identify differences in color-scale characteristics on nuclear medicine images displayed on medical monitors adjusted by CSDF, GSDF, and γ2.2. METHODS: Transverse normal (n = 1) and abnormal (n = 5) brain perfusion images were generated using a mathematical digital phantom. Transverse phantom and clinical brain images are shown using the clinically applied eight-color scale. Five nuclear medicine experts visually assessed phantom and clinical images using a defect severity scale that ranged from zero (no defect) to four (defect). Receiver operating characteristic curves were created and areas under the curves (AUCs) were analyzed. Defect scores for the clinical study were evaluated in the nine segments on basal ganglia slice, and defect scores were summed for each patient. RESULTS: The average defect score for color A significantly differed in multiple comparison tests, but not in post hoc tests. The ranges of AUC for CSDF, GSDF, and γ2.2 were 0.86-0.94, 0.82-0.94, and 0.88-0.97, respectively. The AUCs of CSDF in all color scales did not significantly differ from other gamma settings. The summed defect scores of CSDF were similar to those of other gamma settings. CONCLUSION: Nuclear medicine images were equally valid when adjusted by CSDF even at various gamma settings. Nuclear medicine images can be evaluated equally using any gamma setting. Nonetheless, the color gamma setting for medical monitors should be standardized.

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PURPOSE: The use of tablet terminals has been explored in various medical settings; however, caution should be exercised when performing image diagnosis using this technology. The present study examined the characteristics of an iPad Air™ monitor and assessed radiographic image interpretations to verify the reliability of the telediagnosis of acute cerebral infarction based on magnetic resonance imaging (MRI) using a tablet terminal. MATERIALS AND METHODS: The luminance of the iPad Air™ was measured using a UA-10 analyzer, and radiographic image interpretation experiments were performed in 100 patients who underwent MRI within 6 h of symptom onset. Ten physicians viewed the images on the iPad Air™ and a medical monitor, with an interval of 2 months between each interpretation. RESULTS: When the iPad Air™ screen was pure white, the contour lines revealed nonuniform luminance distribution. In the reading experiment, the areas under the curve of the medical monitor and the iPad Air™ were 0.9311 and 0.9431, respectively. No significant difference was observed between the medical monitor and the iPad Air™ (p = 0.113). CONCLUSION: The results of the observer performance studies for detecting acute ischemic cerebrovascular disorders on an iPad Air™ were found to be similar to those on a medical monitor.

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Objective To propose a monitor failure diagnosis method based on fault tree theory to decrease maintenance cost and increase efficiency.MethodsBased on fault tree theory and maintenance practices,a typical fault tree analytical model was established on likely faults and possible causes.The model developed was applied to the quantitative analyses of kinds of probability events to determine the causes for the faults.Results The study on some kind of faults proved the accuracy,accessibility and practicability,which facilitated the maintainer to eliminate the fault.Conclusion The method determins the cause and probability of the fault directly,and contributes to rapid and convenient maintenance of the monitor.

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Objective To realize scientific allocation of medical monitors in clinical departments by evaluating quantitatively their social and economic benefits.Methods Analyses were executed on social and economic benefit indexes,including number or times of patients involved,utility time,volatility of utilization rate (VOUR),payback period and investment yield.Results Totally 457 monitors were involved in the study from January to June 2015,and the monitors had the number or times of patients being 20,utility time being 383 h,VOUR lower than 10％ (except that of February),mean payback period being 0.64 a and yearly mean investment yield being 137％.Conclusion The monitor has to be allocated by the equipment division in case of low social benefit.In case of high social benefit while low economic benefit,the monitor manufactured in China gains advantages due to short payback period,high investment yield and long free warranty time.The foreign monitor with specific function has to be selected in case of high social and economic benefits as well as requirements on special function.

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Objective:To do research on quality control and calibration period of medical monitor, to assure that the medical monitor is being its best performance and to provide a stable and consistency medical diagnostic images for doctors.Methods: Based on DICOM and AAPM-TG18 calibration standards and using luminance meter and monitor calibration software, our hospital implemented detection and correction quarterly to nine medical monitors. At the same time we tested the brightness response data of medical monitor continuously for 55 weeks and recorded the various brightness with the change of time, then we did some work in statistic analysis and curve fitting using MATLAB software.Results: The performance parameters of our hospital medical monitors are in AAPM-TG18 specified range and the display characteristics are also consistent with the DICOM standard; The change of brightness quarterly of medical monitor is 0~25cd/m2 which is accorded with the function of DICOM GSDF. Conclusion: In order to ensure the accuracy of the impact of image diagnosis system, it’s reasonable and effective to do medical monitors quarterly testing based on brightness response curve.

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The medical liquid crystal display (LCD) monitor is a conventionally used imaging device for diagnosis and during endoscopic surgery. Recently, a medical organic electroluminescence panel, the organic light-emitting diode (OLED) monitor, was made available commercially. The advantages of the OLED monitor include good color reproducibility, high contrast, and high video responsiveness. In this nonclinical study, we compared the clinical usefulness and image quality of the OLED monitor and those of the LCD monitor using videos of gynecologic endoscopic surgeries. Monitors were set for blind evaluation. Five evaluators with varying experience in endoscopic surgery evaluated 21 surgery videos played simultaneously on an OLED monitor and two LCD monitors for 2 to 3 minutes twice. Evaluators judged 13 clinical usefulness indices and 11 image quality indices using a 5-point scale (1, very good; 5, very poor) for each video. The mean scores of clinical usefulness indices of the OLED monitor and the LCD monitors 1 and 2 were 2.2 to 2.7, 2.1 to 3.3, and 3.0 to 3.2, respectively. Of seven indices measured, five including motion response, the ability to differentiate organs, recognize lesions, and reproduce actual images, and the general impression of picture quality were statistically superior with use of the OLED monitor compared with the LCD monitor 1, and two including ability to distinguish blood vessels and the ureters were statistically superior with use of the LCD monitor 1 compared with the OLED monitor. The mean scores of image quality indices of the OLED monitor and the LCD monitors 1 and 2 were 1.8 to 3.2, 2.6 to 3.6, and 2.8 to 4.0, respectively. Each index of the OLED monitor was superior to or comparable with those of the LCD monitors. We conclude that the OLED monitor is superior to the LCD monitors insofar as several video presentation characteristics required in gynecologic endoscopic surgery. These findings suggest that the OLED monitor is expected to contribute detailed assessment of organs and the operative field.

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As an important device of modern medical treatment,medical monitor is a combination of modern electronics technology,computer technology and medical technology.In this paper,the development of medical monitors in China is summarized,especially the main technique characteristics of medical monitor in Chinese market.The examples of monitors made in China are presented.