Observer performance using virtual pathology slides: Impact of LCD color reproduction accuracy

Elizabeth A. Krupinski, Louis D. Silverstein, Syed F. Hashmi, Anna R. Graham, Ronald S. Weinstein, Hans Roehrig

Research output: Contribution to journalArticlepeer-review

34 Scopus citations


The use of color LCDs in medical imaging is growing as more clinical specialties use digital images as a resource in diagnosis and treatment decisions. Telemedicine applications such as telepathology, teledermatology, and teleophthalmology rely heavily on color images. However, standard methods for calibrating, characterizing, and profiling color displays do not exist, resulting in inconsistent presentation. To address this, we developed a calibration, characterization, and profiling protocol for color-critical medical imaging applications. Physical characterization of displays calibrated with and without the protocol revealed high color reproduction accuracy with the protocol. The present study assessed the impact of this protocol on observer performance. A set of 250 breast biopsy virtual slide regions of interest (half malignant, half benign) were shown to six pathologists, once using the calibration protocol and once using the same display in its "native" off-the-shelf uncalibrated state. Diagnostic accuracy and time to render a decision were measured. In terms of ROC performance, Az (area under the curve) calibrated00.8570 and Az uncalibrated00.8488. No statistically significant difference (p00.4112) was observed. In terms of interpretation speed, mean calibrated04.895 s; mean uncalibrated06.304 s which is statistically significant (p00.0460). Early results suggest a slight advantage diagnostically for a properly calibrated and color-managed display and a significant potential advantage in terms of improved workflow. Future work should be conducted using different types of color images that may be more dependent on accurate color rendering and a wider range of LCDs with varying characteristics.

Original languageEnglish (US)
Pages (from-to)738-743
Number of pages6
JournalJournal of Digital Imaging
Issue number6
StatePublished - Dec 2012


  • Color calibration
  • Color displays
  • Color management
  • Diagnostic accuracy
  • Pathology

ASJC Scopus subject areas

  • Radiological and Ultrasound Technology
  • Radiology Nuclear Medicine and imaging
  • Computer Science Applications


Dive into the research topics of 'Observer performance using virtual pathology slides: Impact of LCD color reproduction accuracy'. Together they form a unique fingerprint.

Cite this