<H3>Special Instructions</H3> This tests focus on the requirements for display of FFDM images.  Rendering of images and Mammography CAD SRs is tested in MAMMO_MOD_EC_Display. <p> When entering results for this test in Kudu, the Image Display should initiate an instance of this test <b>when the results are complete</b>.  This allows you to also give credit to the Acquisition Modality which supplied the images without locking that system out of other testing while the Image Display is working on the rendering. </p> A clinical expert will evaluate this test.  The representative of the Image Display system is responsible for arranging a time for him/her to do the evaluation with you. <H3>Description</H3> The MAMMO_MOD_Display test is used to determine if the Acquisition Modality is entering the proper data in the DICOM FFDM images, and to determine if the Image Display is rendering the images properly. Several types of datasets will be produced for this test.  <p> The Image Display can retrieve sample images which the Modality stored to the Connectathon CENTRAL_ARCHIVE in test MAMMO_MOD_Store. Alternatively, the Modality can send images directly to the workstation (DICOM C-Store, though not an IHE transaction). </p> <p>Image Display please use the <em><a href=system_con_object.php>Objects Information</a></em> page to find out what your peers have uploaded on the central archive </p> <H3>Evaluation</H3> Project Managers may find it helpful to dump the DICOM header in the images when evaluating this test.  Use Image Display to dump DICOM headers and to display images. If the Image Display cannot dump the DICOM header, we will find another method to check attribute values. <p> (1) The Image Display will demonstrate that: </p> <ul> <li>E44: it can display simultaneously a set of current and prior conventional four view screening mammography images (left and right CC and MLO views) <li>E45: it allows the user to adjust the grayscale contrast.  The Evaluator ensures that grayscale contrast adjusts smoothly and continuously without sudden discontinuities or loss of quality in the very dark or light regions. <li>E46: when contrast is adjusted or the image is inverted, the air outside the breast tissue remains uniformly black when conditional there is pixel padding (0028,0120) or Pixel Padding Value Range (0028,0tbd) is encoded in the image header <li>E47: the initial display of the images is the correct orientation and justification, without the user needing to flip or rotate into achieve the correct orientation <p><i>(Note the following from RAD TF-2:4.16.4.2.2.1.1.2:  "...images are normally displayed such that the axilla is towards the top of the viewport, except for cleavage views (which contain two axillas)."</i></p> <li>E48: it allows the user to select or configure hanging protocols defining: <ul> <li>the placement of images relative to one another  <li>the required orientation of the images <li>the display of current and prior images <li>the sequence of layouts displayed  </ul> <li>E49: it can justify the image horizontally to the left or right side of the viewport rather than centering it, to avoid displaying any unnecessary padding between the adjacent chest walls of back to back images <li>E50: does not display excessive window decoration (such as scroll bars) between back to back viewports <li>E51: it can display multiple images such that all images are at the <b>same relative physical size</b>,  <p><i>(Note the following from RAD TF-2:4.16.4.2.2.1.1.3.1: " For example, a user reviewing a four-view screening mammogram together with a four-view prior mammogram might want to display eight viewports, each showing one view, such that the each view is at the same relative physical size, even if the images were obtained on detectors with different sized pixels. This allows the user to compare features in the prior and current images to visually assess whether or not they have changed in size.)"</i></p> <li>E52: it can display multiple images such that <b>all images are true size</b> <p><i>(Note the following from RAD TF-2:4.16.4.2.2.1.1.3.2:  "True size is defined as the display of an image such that an object in the image when measured with a hand-held ruler on the surface of the display measures as closely as possible to the true physical size of the object if located on the front face of the detector housing. This mode of display is not intended for geometrically magnified views, since the geometrically magnified view would then be displayed too small.)"</i></p> <li>E53: it can display multiple images such that each encoded pixel occupies one display pixel in the viewport. If the size of the pixel data exceeds the size of the viewport, it may not be possible to display all of the encoded pixels at once, in which case some form of pan or quadrant navigation functionality is provided.  (Since there is no minification or magnification, images with different pixel physical size will be displayed in this mode such that the physical size in the patient will appear different.) <li>E54: it provides the user with the ability to select amongst the window and VOI LUT choices available in the image object. Subsequent to the initial application of the chosen contrast transformation, the Image Display actor allows the user to adjust the contrast without reverting to a purely linear transformation. <p><i>(Note the following from RAD TF-2:4.16.4.2.2.1.1.3.4:  "...If the chosen contrast transformation is a lookup table, then the Image Display shall allow the input value of the lookup table to be stretched and translated so as to give the affect of adjusting contrast and brightness whilst applying the same general shape as the curve encoded in the lookup table. To provide feedback to the user, the "window width" can be reported as the adjusted range of input values to the LUT, and the "window center" can be reported as the center value of that range."</i></p>  <li>E55: To test "accidental reading of prior studies", the Image Display will demonstrate that it can display a warning to the use if none of the studies being displayed is within a user-configurable period from the current real time.  The Image Display will demonstrate how this time period can be configured.   (It may be necessary to reconfigure this value on the image display, or to edit a DICOM header to change the Acquistion Date (0008,0022) in order to test this condition. <li>E56: To test that the Image Display is able to conform to local, regional or national regulatory requirements for luminance settings, the Image Display will demonstrate that the minimum and maximum luminance for the display is configurable. </ul>