title: Enhanced displays of medical images: evaluation of the effectiveness of color, motion, and contour for detecting and localizing liver lesions.
abstract: OBJECTIVE
  Many perceptual studies have shown that the detection of large, low-contrast targets is better either in color or in contrast-reversing presentations than in standard gray scale. We determined the value of several new display techniques for viewing liver computed tomography (CT) scans.
  
  
  METHODS
  Eight observers (four radiologists and four nonradiologists) viewed sets of 100 liver CT images (50 with lesions and 50 without) under five display conditions on a Macintosh computer: (1) color (equiluminant color contrast); (2) color-luminance (combined luminance and chromatic contrast); (3) flicker (luminance contrast that reversed polarity at 2 Hz); (4) contour (shaded intensity mapping); and (5) control (conventional gray scale). Receiver operating characteristics (ROC) techniques were used for analysis.
  
  
  RESULTS
  The measured ROC curve areas for the different viewing conditions were as follows: control = 0.77 +/- 0.01 (mean +/- standard error of the mean); color = 0.78 +/- 0.01; color-luminance = 0.82 +/- 0.01; flicker = 0.78 +/- 0.01; and contour = 0.76 +/- 0.01. The percentage of lesions correctly located ranged from 0.82 (color-luminance) to 0.75 (flicker). Performance under the color-luminance condition was significantly better than in the control condition (p = .01), whereas the other experimental conditions were not significantly different from the control condition (p > .21).
  
  
  CONCLUSIONS
  The use of mixed color and luminance displays may have perceptual advantages for radiologists and can improve performance over that of gray-scale viewing.
authors.affiliation: Department of Radiology, Harvard Medical School, Brigham and Women's Hospital, Boston, MA 02115, USA.
authors.forename: S E
authors.initials: SE
authors.lastname: Seltzer
authors.forename: P
authors.initials: P
authors.lastname: Cavanagh
authors.forename: P F
authors.initials: PF
authors.lastname: Judy
authors.forename: R G
authors.initials: RG
authors.lastname: Swensson
authors.forename: L
authors.initials: L
authors.lastname: Scarff
authors.forename: W
authors.initials: W
authors.lastname: Monsky
mesh_terms: D003116:Color; D006801:Humans; D007089:Image Enhancement / Q000379:methods*; D008099:Liver / Q000000981:diagnostic imaging*; D008107:Liver Diseases / Q000000981:diagnostic imaging; D009038:Motion; D015588:Observer Variation; D012372:ROC Curve; D014057:Tomography, X-Ray Computed / Q000379:methods*