title: Cost-effective handling of digital medical images in the telemedicine environment.
abstract: BACKGROUND
  This paper concentrates on strategies for less costly handling of medical images. Aspects of digitization using conventional digital cameras, lossy compression with good diagnostic quality, and visualization through less costly monitors are discussed.
  
  
  METHODS
  For digitization of film-based media, subjective evaluation of the suitability of digital cameras as an alternative to the digitizer was undertaken. To save on storage, bandwidth and transmission time, the acceptable degree of compression with diagnostically no loss of important data was studied through randomized double-blind tests of the subjective image quality when compression noise was kept lower than the inherent noise. A diagnostic experiment was undertaken to evaluate normal low cost computer monitors as viable viewing displays for clinicians.
  
  
  RESULTS
  The results show that conventional digital camera images of X-ray images were diagnostically similar to the expensive digitizer. Lossy compression, when used moderately with the imaging noise to compression noise ratio (ICR) greater than four, can bring about image improvement with better diagnostic quality than the original image. Statistical analysis shows that there is no diagnostic difference between expensive high quality monitors and conventional computer monitors.
  
  
  CONCLUSIONS
  The results presented show good potential in implementing the proposed strategies to promote widespread cost-effective telemedicine and digital medical environments.
authors.affiliation: Faculty of Engineering, Multimedia University, 63100 Cyberjaya, Malaysia.
authors.forename: Miew Keen
authors.initials: MK
authors.lastname: Choong
authors.forename: Rajasvaran
authors.initials: R
authors.lastname: Logeswaran
authors.forename: Michel
authors.initials: M
authors.lastname: Bister
mesh_terms: D003362:Cost-Benefit Analysis; D044962:Data Compression / Q000191:economics* / Q000379:methods*; D008296:Malaysia; D011856:Radiographic Image Enhancement / Q000191:economics* / Q000379:methods*; D011873:Radiology Information Systems / Q000191:economics*; D019112:Teleradiology / Q000191:economics* / Q000379:methods*