The assessment of diagnostic medical images using 10-bit grayscale – fact or myth?

Purpose
The aim of the study was to find tests for verification of 10-bit grayscale support for radiological workstation hardware/operating system and for DICOM viewer. Also, we wanted to perform the tests on available workstations.

Material and methods
The following tests were selected to verify 10-bit grayscale support: workstation hardware and operating system tests using DirectX SDK 10BitScanout10.exe and NEC 10bitdemo.exe programs, DICOM viewer tests using TG18-MP and TG18-QC patterns. The tests were performed on 14 radiological workstations in a local department of radiology and on 4 radiological workstations during the technical exhibition at the ECR (European Congress of Radiology) in 2017.

Results
Only 3 out of 14 local workstations passed the hardware and operating system 10-bit grayscale support test. Only one workstation passed the DICOM viewer 10-bit grayscale support test.

Conclusions
Hardware/operating system and DICOM viewer 10-bit grayscale support should be tested on every radio­logical workstation even if compatibility is stated by the manufacturer. Existing medical diagnostic display quality requirements should be adjusted so that 10-bit support for DICOM viewers is only a desirable option.