IEC 62563-1:2009

IEC 62563-1 ®
Edition 1.1 2016-03
CONSOLIDATED VERSION
INTERNATIONAL
STANDARD
NORME
INTERNATIONALE
colour
inside
Medical electrical equipment – Medical image display systems –
Part 1: Evaluation methods
Appareils électromédicaux – Systèmes d’imagerie médicale –
Partie 1: Méthodes d’évaluation

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IEC 62563-1 ®
Edition 1.1 2016-03
CONSOLIDATED VERSION
INTERNATIONAL
STANDARD
NORME
INTERNATIONALE
colour
inside
Medical electrical equipment – Medical image display systems –

Part 1: Evaluation methods
Appareils électromédicaux – Systèmes d’imagerie médicale –

Partie 1: Méthodes d’évaluation

INTERNATIONAL
ELECTROTECHNICAL
COMMISSION
COMMISSION
ELECTROTECHNIQUE
INTERNATIONALE
ICS 11.040.55 ISBN 978-2-8322-3270-5

IEC 62563-1 ®
Edition 1.1 2016-03
CONSOLIDATED VERSION
REDLINE VERSION
VERSION REDLINE
colour
inside
Medical electrical equipment – Medical image display systems –
Part 1: Evaluation methods
Appareils électromédicaux – Systèmes d’imagerie médicale –
Partie 1: Méthodes d’évaluation

– 2 – IEC 62563-1:2009+AMD1:2016 CSV
 IEC 2016
CONTENTS
FOREWORD. 4
INTRODUCTION . 6
INTRODUCTION to Amendment 1 . 7
1 Scope . 8
2 Normative references . 8
3 Terms, definitions, symbols and abbreviations . 8
3.1 Terms and definitions . 8
3.2 Symbols . 11
3.3 Abbreviations . 12
4 General . 12
5 Prerequisites . 12
6 Equipment and tools . 13
6.1 LUMINANCE meter . 13
6.2 ILLUMINANCE meter . 13
6.3 Colour meter . 13
6.4 TEST PATTERNS . 14
7 Evaluation methods . 15
7.1 General . 15
7.2 Evaluation method table overview . 15
7.3 Visual evaluation methods . 17
7.3.1 General . 17
7.3.2 Overall image quality evaluation . 17
7.3.3 Greyscale resolution evaluation . 18
7.3.4 LUMINANCE response evaluation . 19
7.3.5 LUMINANCE uniformity evaluation . 20
7.3.6 Chromaticity evaluation . 20
7.3.7 Pixel faults evaluation . 20
7.3.8 VEILING GLARE evaluation . 21
7.3.9 Geometrical image evaluation . 21
7.3.10 Angular viewing evaluation . 22
7.3.11 Clinical evaluation . 23
7.4 Quantitative evaluation methods . 23
7.4.1 Basic LUMINANCE evaluation . 23
7.4.2 Basic LUMINANCE evaluation without ambient light . 24
7.4.3 LUMINANCE response evaluation . 24
7.4.4 LUMINANCE evaluation of multiple displays . 27
7.4.5 Chromaticity uniformity evaluation . 27
7.4.6 Chromaticity evaluation of across multiple displays . 27
7.4.7 LUMINANCE uniformity evaluation . 27
7.4.8 Viewing angle evaluation . 28
7.4.9 Greyscale chromaticity evaluation . 28
Annex A (informative) Sample test reports . 29
Annex B (informative) LUMINANCE measurement methods . 48
Annex C (informative) Description of TEST PATTERNS . 51
Bibliography . 60

 IEC 2016
Index of defined terms . 62

Figure 1 – Overall image quality evaluation using the TG18-QC TEST PATTERN . 17
Figure 2 – Overall image quality evaluation using the TG18-OIQ TEST PATTERN . 18
Figure 3 – Magnified view of TG18-MP TEST PATTERN showing the 8-bit and 10-bit
markers . 19
Figure 4 – A close-up of the TG18-CT TEST PATTERN . 20
Figure 5 – The TG18-GV TEST PATTERN is displayed (left), a close-up of the centre of
the TEST PATTERN when covered with a mask (right) . 21
Figure 6 – Geometrical evaluation using the GD pattern . 22
Figure 7 – Visual evaluation of viewing angle response . 23
Figure 8 – Example of the measured LUMINANCE in relation to the standard LUMINANCE
response function according to GREYSCALE STANDARD DISPLAY FUNCTION (GSDF) . 26
Figure 9 – An example of the CONTRAST response computed from 18 grey levels as
related to the expected CONTRAST response associated with the DICOM 3.14 [2]
standard LUMINANCE response with a given tolerance limit (e.g. 15 %) [10] . 26
Figure B.1 – Method A, telescopic method . 48
Figure B.2 – Method B, near-range LUMINANCE meter in combination with an
ILLUMINANCE meter . 49
Figure B.3 – Method C, frontal integrated LUMINANCE meter in combination with
ILLUMINANCE meter . 49
Figure B.4 – Method D, back integrated LUMINANCE meter in combination with
ILLUMINANCE meter . 50
Figure C.1 – Example of TG-18 QC pattern for a matrix size of 1536 × 2048 . 59

Table 1 – Overview to the definitions of physical parameters . 11
Table 2 – TEST PATTERNS used for display testing . 14
Table 3 – List of the evaluation methods that can be used for testing medical IMAGE
DISPLAY SYSTEMS . 16
Table A.1 – Acceptance test sample report of a diagnostic display . 30
Table A.2 – Constancy test sample report of a diagnostic display . 35
Table A.3 – Acceptance test sample report of a monochrome reviewing display . 38
Table A.4 – Constancy test sample report of a monochrome reviewing display . 40
Table A.5 – Acceptance test sample report of a colour reviewing display . 42
Table A.6 – Constancy test sample report of a colour reviewing display . 45
Table C.1 – Description of multi-purpose TEST PATTERNS . 52
Table C.2 – TG18-QC pattern: LUMINANCE levels with 8-bit and [12-bit] pixel values
and CX ratings . 55
Table C.3 – The blurring characteristics of the CX reference set utilized in TG18-QC
TEST PATTERNS [16] . 56
Table C.4 – Evaluation criteria for the examples of the CLINICAL REFERENCE IMAGES . 57
Table C.5 – Example description of TG-18 QC pattern for a matrix size of 1536 × 2048 . 58

– 4 – IEC 62563-1:2009+AMD1:2016 CSV
 IEC 2016
INTERNATIONAL ELECTROTECHNICAL COMMISSION
____________
MEDICAL ELECTRICAL EQUIPMENT –
MEDICAL IMAGE DISPLAY SYSTEMS –
Part 1: Evaluation methods
FOREWORD
1) The International Electrotechnical Commission (IEC) is a worldwide organization for standardization comprising
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8) Attention is drawn to the Normative references cited in this publication. Use of the referenced publications is
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9) Attention is drawn to the possibility that some of the elements of this IEC Publication may be the subject of
patent rights. IEC shall not be held responsible for identifying any or all such patent rights.
This consolidated version of the official IEC Standard and its amendment has been prepared
for user convenience.
IEC 62563-1 edition 1.1 contains the first edition (2009-12) [documents 62B/743/CDV and
62B/768/RVC] and its amendment 1 (2016-03) [documents 62B/983/CDV and 62B/995/RVC].
In this Redline version, a vertical line in the margin shows where the technical content is
modified by amendment 1. Additions are in green text, deletions are in strikethrough red text.
A separate Final version with all changes accepted is available in this publication.

 IEC 2016
International Standard IEC 62563-1 has been prepared by subcommittee 62B: Diagnostic
imaging equipment of technical committee 62: Electrical equipment in medical practice.
This publication has been drafted in accordance with the ISO/IEC Directives, Part 2.
In this standard, the following print types are used:
– requirements and definitions: roman type;
– informative material appearing outside of tables, such as notes, examples and references: in smaller type.
Normative text of tables is also in a smaller type;
– TERMS DEFINED IN CLAUSE 3 OF THIS INTERNATIONAL STANDARD, OR AS NOTED: SMALL
CAPITALS.
A list of all parts of the IEC 62563 series, published under the general title Medical electrical
equipment – Medical image display systems, can be found on the IEC website.
The committee has decided that the contents of the base publication and its amendment will
remain unchanged until the stability date indicated on the IEC web site under
"http://webstore.iec.ch" in the data related to the specific publication. At this date, the
publication will be
• reconfirmed,
• withdrawn,
• replaced by a revised edition, or
• amended.
IMPORTANT – The 'colour inside' logo on the cover page of this publication indicates
that it contains colours which are considered to be useful for the correct
understanding of its contents. Users should therefore print this document using a
colour printer.
– 6 – IEC 62563-1:2009+AMD1:2016 CSV
 IEC 2016
INTRODUCTION
This International Standard provides evaluation methods for testing IMAGE DISPLAY SYSTEMS
used in MEDICAL ELECTRICAL EQUIPMENT and medical electrical systems for diagnostic imaging.
On site or after installation, two types of testing can be carried out. An acceptance test is
carried out after a new IMAGE DISPLAY SYSTEM has been installed, or major modifications have
been made to the existing IMAGE DISPLAY SYSTEM. Since an IMAGE DISPLAY SYSTEM may
degrade over time, the constancy test is carried out by the user in a periodic cycle to verify
that the performance is maintained for the intended use.
The standard describes various evaluation methods without dictating what particular tests
shall be used for acceptance and/or constancy tests.
Rather, it is the intention of this standard to be a reference for other standards and guidelines
specific to each modality or to be defined by national authorities who will refer to the
evaluation methods of this standard and mention limiting values and frequencies for
acceptance and constancy tests. Annex A shows sample reports of such a reference.
To maintain the homogeneity in the IEC standards for MEDICAL ELECTRICAL EQUIPMENT,
IEC 61223-2-5, Evaluation and routine testing in medical imaging departments – Part 2-5:
Constancy tests – Image display devices should be reviewed.

 IEC 2016
INTRODUCTION to Amendment 1
This amendment is published to introduce colour measurement.
Since publication of IEC 62563-1:2009, IEC 61223-2-5, Evaluation and routine testing in
medical imaging departments Part 2-5: Constancy tests – Image display devices has been
reviewed and withdrawn.
– 8 – IEC 62563-1:2009+AMD1:2016 CSV
 IEC 2016
MEDICAL ELECTRICAL EQUIPMENT –
MEDICAL IMAGE DISPLAY SYSTEMS –

Part 1: Evaluation methods
1 Scope
This part of IEC 62563 describes the evaluation methods for testing medical IMAGE DISPLAY
SYSTEMS.
The scope of this International Standard is directed to practical tests that can be visually
evaluated or measured using basic test equipment. More advanced or more quantitative
measurements can be performed on these devices, but these are beyond the scope of this
document.
This standard applies to medical IMAGE DISPLAY SYSTEMS, which can display monochrome
image information in the form of greyscale values on colour and on greyscale and colour
IMAGE DISPLAY SYSTEMS (e.g. CATHODE RAY TUBE (CRT) monitors, FLAT PANEL DISPLAYS,
PROJECTION SYSTEM). This standard applies to medical IMAGE DISPLAY SYSTEMS used for
diagnostic (interpretation of medical images toward rendering clinical diagnosis) or viewing
(viewing medical images for medical purposes other than for providing a medical
interpretation) purposes and therefore having specific requirements in terms of image quality.
Head mounted IMAGE DISPLAY SYSTEMS and IMAGE DISPLAY SYSTEMS used for confirming
positioning and for operation of the system are not covered by this standard. Handheld IMAGE
DISPLAY SYSTEMS might require additional or modified versions of the procedures described in
this standard.
It is not in the scope of this standard to define the requirements of acceptance and constancy
tests nor the frequencies of constancy tests.
2 Normative references
The following referenced documents are indispensable for the application of this document.
For dated references, only the edition cited applies. For undated references, the latest edition
of the referenced document (including any amendments) applies.
IEC 60788:2004, Medical electrical equipment – Glossary of defined terms
ISO 11664-1:2007, Colorimetry – Part 1: CIE standard colorimetric observers
CIE S 010/E:2004 Photometry – The CIE system of physical photometry
3 Terms, definitions, symbols and abbreviations
3.1 Terms and definitions
For the purpose of this document, the terms and definitions given in IEC 60788:2004 and the
following apply.
3.1.1
accuracy
closeness of agreement between a test result and the accepted reference value

 IEC 2016
[ISO 5725-1:1994, definition 3.6]
3.1.2
brightness
LUMINANCE as perceived by the human visual system
3.1.3
cathode ray tube
CRT
picture tube
component of an IMAGE DISPLAY SYSTEM in which images defined via electrical signals are
visualized by means of an electron beam striking a phosphor
3.1.4
clinical reference image
specific medical image typical for the intended use of the IMAGE DISPLAY SYSTEM
NOTE The anatomical patterns reported in Annex C are examples of CLINICAL REFERENCE IMAGE.
3.1.5
clock artefact
artefact in form of distorted vertical bars or stripes, visible on the screens of fixed-pixel type
IMAGE DISPLAY DEVICES (e.g. LCD), when the frequency of the internal dot clock is different
from that of the incoming analogue signal
3.1.6
contrast
ratio of the difference of the LUMINANCE of two image areas, L - L ,
1 2
divided by the average of the two LUMINANCE values:
.
CONTRAST = 2 (L - L )/(L + L )
1 2 1 2
3.1.7
digital driving level
DDL
digital value given as input to an IMAGE DISPLAY SYSTEM producing a LUMINANCE
3.1.8
display controller
electronic component of an IMAGE DISPLAY SYSTEM that provides the analogue or digital
interface between the computer hardware and the IMAGE DISPLAY DEVICE
3.1.9
flat panel display
IMAGE DISPLAY DEVICE that is flat and thin
NOTE E.g. liquid crystal display (LCD), plasma display (PDP), field emission display (FED), surface-conduction
electron-emitter display (SED), carbon-nano-tube display (CNT), organic light-emitting display (OLED).
3.1.10
flicker
perception of unintentional fluctuations of the LUMINANCE over time
3.1.11
greyscale standard display function
GSDF
mathematically defined mapping of input, DIGITAL DRIVING LEVEL (DDL) to LUMINANCE values
based on the Barten model
– 10 – IEC 62563-1:2009+AMD1:2016 CSV
 IEC 2016
1)
[Source: DICOM PS 3.14:2007, see [2] ]
3.1.12
illuminance
measurement of the luminous flux incident on a surface per unit area (unit: Lux (lx),
lx = lm/m )
3.1.13
image display device
monitor
specific hardware/medium used to display images presented through an analogue or digital
interface
3.1.14
image display system
workstation consisting of an IMAGE DISPLAY DEVICE, DISPLAY CONTROLLER and computer
hardware and software, capable of displaying images
3.1.15
luminance
ratio of luminous flux penetrating (impinging on) a surface area in a specified direction to the
product of the irradiated solid angle and the projection of the surface area onto a plane
perpendicular to the viewing direction (unit: candela per square meter (cd/m ))
NOTE This definition has been derived from the term in DIN 5031-3:1982-03 [18] and is equivalent to the
definition in the International Electrotechnical Vocabulary (IEV).
3.1.16
phase artefact
artefact in form of blurred edges of displayed objects (letters, lines, etc.), visible on the
screens of fixed-pixel type IMAGE DISPLAY DEVICES (e.g. LCD), when the phase setting of the
internal dot clock is different from that of the incoming analogue signal
3.1.17
precision
closeness of agreement between independent test results obtained under stipulated
conditions
[ISO 5725-1:1994, definition 3.12]
3.1.18
projection system
large-screen IMAGE DISPLAY DEVICE which enlarges the small image generated on a plane by
central projection to a second plane
3.1.19
resolution addressability ratio
RAR
measured pixel at 50 % point of LUMINANCE at peak or nominal rating expressed as a
percentage of addressable space available
3.1.20
spatial resolution
measure of the ability of an IMAGE DISPLAY SYSTEM to distinguish spatial features of interest
within an image
—————————
1)
Figures in square brackets refer to the Bibliography.

 IEC 2016
NOTE Systems designed with adequate SPATIAL RESOLUTION characteristics are necessary to assure that spatial
details of interest are preserved when a medical image is displayed. Portraying image data on a IMAGE DISPLAY
DEVICE with insufficient resolution will compromise the ACCURACY of the radiological interpretation.
3.1.21
test image
test pattern
image for testing or verifying the IMAGE DISPLAY SYSTEMS
3.1.22
veiling glare
enhancement of the LUMINANCE measurable on the IMAGE DISPLAY DEVICE caused by internal
scatter processes
NOTE The value of the LUMINANCE enhancement is dependent on the illuminated portion of the image displayed.
3.1.23
window setting
display of a subset of the pixel values existing in the digital image
NOTE The WINDOW SETTING is determined by the window width and level (centre) and serves for CONTRAST
enhancement.
3.2 Symbols
The symbols of physical parameters used in this standard are listed in Table 1. All
measurements referred to in Table 1 are in the centre of the IMAGE DISPLAY DEVICE. Note that
LUMINANCE may also be measured at other locations according to the methodologies
described in this document.
Table 1 – Overview to the definitions of physical parameters
Abbreviation Mathematically derived Definition and explanation
L LUMINANCE generated by the ambient light on the surface of an
amb
IMAGE DISPLAY DEVICE when the IMAGE DISPLAY DEVICE is off.
L Minimum LUMINANCE generated by a IMAGE DISPLAY DEVICE at
min
DIGITAL DRIVING LEVEL (DDL) = 0 measured at the centre of the
screen. It includes VEILING GLARE specific to TEST PATTERN used for
measurement. It is measured with ambient light totally switched off
(in the dark).
L Maximum LUMINANCE generated by a IMAGE DISPLAY DEVICE at
max
DIGITAL DRIVING LEVEL (DDL) = max measured at the centre of the
screen. It includes VEILING GLARE specific to TEST PATTERN used for
measurement. It is measured with ambient light totally switched off
(in the dark).
L′ L + L LUMINANCE that will be perceived by the human eye at the centre of
min min amb
the screen at DIGITAL DRIVING LEVEL (DDL) = 0. It contains VEILING
GLARE and L
amb
L′ L + L LUMINANCE produced by the IMAGE DISPLAY DEVICE at the maximum
max max amb
DIGITAL DRIVING LEVEL (DDL) measured at the centre of the screen.
It contains VEILING GLARE and L
amb.
R Diffuse reflection coefficient (provided by manufacturer with a
d
specific measurement method, ideally following the methods
described in Reference [10] using a CIE standard illuminant A and
an aperture size 20 to 30 % larger than the diameter of the
LUMINANCE meter).
r' LUMINANCE ratio of an IMAGE DISPLAY DEVICE containing VEILING
L′ /L′
max min
GLARE and ambient LUMINANCE.
E ILLUMINANCE.
a L /L′ Safety factor.
amb min
– 12 – IEC 62563-1:2009+AMD1:2016 CSV
 IEC 2016
Abbreviation Mathematically derived Definition and explanation
a L /L Alternative safety factor. This factor is defined to provide
R amb min
consistency with other relevant documents (e.g. ACR–AAPM–SIIM
Technical Standard For Electronic Practice Of Medical Imaging,
Amended 2014, Resolution 39).
2 2 1/2
((u ’-u ’) + (v ’-v ’) ) Maximum Distance in u'-v' space.
Δu'v'
1 2 1 2
3.3 Abbreviations
The following abbreviations are used in this standard.
CRT cathode ray tube
CT computed tomography
DDL digital driving level
DICOM digital imaging and communication in medicine
LCD liquid crystal display
MR magnetic resonance
4 General
In IMAGE DISPLAY SYSTEMS, every individual component can limit or reduce the image quality of
the system. Therefore it is necessary to adopt suitable measures for quality monitoring. If
IMAGE DISPLAY SYSTEMS are correctly adjusted and maintained, these devices can consistently
generate similar images.
Simple test equipment is used (LUMINANCE meter, TEST IMAGES) with PRECISION appropriate for
the purpose of a test. Before a test, all test equipment shall be checked for its functioning
according to the manufacturer’s specifications.
The manufacturer's data (e.g. requirements on operating voltage, humidity etc.) are required
for the correct setting of the IMAGE DISPLAY SYSTEM and for correct installation. The
manufacturer's data shall be enclosed with the technical documentation of the IMAGE DISPLAY
SYSTEM.
The tests listed in this International Standard are a compilation of all the evaluation methods
that may be used for testing an IMAGE DISPLAY SYSTEM. A subset of these test items or test
methods may be selected and applied in any order depending on the intended purpose of the
IMAGE DISPLAY SYSTEM.
For mobile systems, a fixed location for these tests shall be determined and used so that it is
representative for the locations where such mobile systems may be used. Care should be
taken to ensure that the ambient lighting in these areas can be adequately controlled.
5 Prerequisites
Prior to testing an IMAGE DISPLAY SYSTEM, the following shall be considered:
a) The testing of an IMAGE DISPLAY SYSTEM shall include the complete system including
software, hardware and settings involved in image handling.
b) For all IMAGE DISPLAY SYSTEMS to be tested, all components including computer, IMAGE
DISPLAY DEVICE, display card, display software, and software version shall be traceable.
c) The TEST IMAGES and the clinical images shall be presented in the same way on the IMAGE
DISPLAY SYSTEM.
 IEC 2016
d) Before starting the tests, the front surface of the IMAGE DISPLAY DEVICE shall be cleaned
according to the instructions for use.
e) It shall be ensured that no prior nominal settings have been changed.
f) Room lights, windows, viewing devices etc. shall not cause any disturbing reflections on
the IMAGE DISPLAY DEVICE. Methods to prevent reflections are described in the standards
ISO 9241-302, ISO 9241-303, ISO 9241-305 and ISO 9241-307.
g) The ambient lighting in the room shall be maintained at normally used conditions.
h) Before initiating a test, the IMAGE DISPLAY SYSTEM shall be installed and started up
according to the manufacturer’s recommendations; to ensure stable performance, the
IMAGE DISPLAY DEVICE shall be switched on before the test for a period as specified by the
manufacturer (e.g. 30 min). The IMAGE DISPLAY SYSTEM should be set to the desired display
function. The GREYSCALE STANDARD DISPLAY FUNCTION (GSDF) is recommended and is a
necessary prerequisite for some tests.
6 Equipment and tools
6.1 LUMINANCE meter
A LUMINANCE meter shall have the following specifications. The range of the LUMINANCE meter
shall cover at least the range of LUMINANCE of the IMAGE DISPLAY SYSTEM with a PRECISION of at
most 5 % (repeatability), and an ACCURACY of at most 10 %, with a calibration traceable to a
primary standards laboratory. The manufacturer of the meter shall provide a clear calibration
program. The aperture angle shall not exceed 5°. The relative spectral sensitivity shall
correspond to the BRIGHTNESS CIE standard photopic spectral response (CIE S 010/E:2004).
The influence of the photopic response shall be within the overall ±10 % ACCURACY described
in this paragraph.
For near range LUMINANCE meters, a predefined angle and distance of measurement result in
a defined measurement field size. During a measurement, the area to be measured shall be
displayed by a field (or patch) that is significantly bigger than the defined measurement field
size.
A LUMINANCE meter can be integrated into the IMAGE DISPLAY SYSTEM or be a stand-alone
device.
6.2 ILLUMINANCE meter
An ILLUMINANCE meter may be required for testing IMAGE DISPLAY SYSTEMS with a range of 1 to
1 000 lux with an ACCURACY of at most 10 % and a PRECISION of at most 5 % (repeatability).
The device calibration shall be traceable to a primary standards laboratory and shall have a
clear calibration program. It shall have a uniform response to a Lambertian light source.
In measurement method B, C and D (described in Annex B), the ILLUMINANCE meter is ideally
located at the centre of the screen facing outward. Side locations will also be acceptable as
long as they provide similar measured values.
6.3 Colour meter
A colour meter may be required for testing IMAGE DISPLAY SYSTEMS. The meter shall be able to
evaluate the CIE-specified (ISO11664-1:2007) colour coordinate with better than ±0,004
ACCURACY in the u’,v’ space (0,007 in the x,y space) for a standard illuminant, within the
LUMINANCE range of the IMAGE DISPLAY SYSTEM. The device calibration shall be traceable to a
primary measurement standard and shall have a clear calibration program.

– 14 – IEC 62563-1:2009+AMD1:2016 CSV
 IEC 2016
6.4 TEST PATTERNS
Table 2 – TEST PATTERNS used for display testing

TG18-QC for overall
testing CATHODE RAY TUBE
OIQ for overall testing
(CRT and LCD)
TG18-MP for LUMINANCE
(LCD) TG18-LN8-01 for
resolution
LUMINANCE
TG18-LN8-18 for TG18-UN10 for LUMINANCE TG18-UN80 for LUMINANCE TG18-CT for LUMINANCE
LUMINANCE
uniformity uniformity response

ANG for angular response GD for geometrical TG18-UNL80 for TG18-GVN for VEILING
properties LUMINANCE uniformity GLARE

TG18-GV for VEILING GLARE
TG18-MM1 as example
TG18-CH as example TG18-KN as example
mammogram
chest radiograph extremity radiograph

 IEC 2016
TG18-MM2 as example BN01 for LUMINANCE (LCD) BN18 for LUMINANCE (LCD)
mammogram
A subset of these examples or elements from these examples may be used to form composite
TEST PATTERNS depending on the intended use of each modality being tested (see Annex C for
more information).
7 Evaluation methods
7.1 General
This clause describes a number of evaluation methods (tests) that can be used for testing
medical IMAGE DISPLAY SYSTEMS. The number and order of these evaluation methods are not
mandatory; a modality standard can refer to a subset of these tests in any order with a
preference for limiting values and evaluation criteria.
7.2 Evaluation method table overview
Table 3 shows an overview of all evaluation methods described in this standard. Not all of
these tests may be required or be appropriate for a specific IMAGE DISPLAY SYSTEM. A subset
of test items or test methods to be performed can be chosen from these lists that are relevant
to a particular IMAGE DISPLAY SYSTEM. These tests can be performed in any appropriate order.

– 16 – IEC 62563-1:2009+AMD1:2016 CSV
 IEC 2016
Table 3 – List of the evaluation methods that can be used
for testing medical IMAGE DISPLAY SYSTEMS
Evaluation method Equipment, tools
Visual evaluation methods
Overall image quality evaluation TG18-QC TEST PATTERN
– Verify overall performance.
Greyscale resolution evaluation TG18-MP TEST PATTERN
– Verify sufficient greyscale resolution based on 8-
and 10-bit markers
LUMINANCE response evaluation (more complete TG18-CT TEST PATTERN
solution than overall image quality evaluation)

LUMINANCE uniformity evaluation TG18-UN80 TEST PATTERN
– Look for non-uniformities
Chromaticity evaluation TG18-UN80 TEST PATTERN
– Verify colour uniformity
Pixel faults evaluation TG18-UN10 and TG18-UN80 TEST PATTERN
– Look for dark (TG18-UN80) and bright (TG18-UN10)
pixel defects
VEILING GLARE evaluation TG18-GVN and TG18-GV TEST PATTERN, mask
– Look for low CONTRAST objects on 2 TEST PATTERNS
Geometrical image evaluation GD TEST PATTERN, ruler (CATHODE RAY TUBE (CRT) only)
– Verify geometry, phase/clock correction, clipping
Angular viewing evaluation ANG TEST PATTERN
– Verify viewing angle
Clinical evaluation Clinical TEST PATTERNS (examples see TG18-CH, TG18-
KN, TG18-MM1 and TG18-MM2)
Quantitative evaluation methods
Basic LUMINANCE evaluation LUMINANCE meter, ILLUMINANCE meter
Basic LUMINANCE evaluation without ambient light LUMINANCE meter
LUMINANCE response evaluation LUMINANCE meter, ILLUMINANCE meter
The GREYSCALE STANDARD DISPLAY FUNCTION (GSDF) is
prerequisite for this test
LUMINANCE evaluation of multiple displays LUMINANCE meter
Chromaticity uniformity evaluation Colour meter
Chromaticity evaluation of across multiple displays Colour meter
LUMINANCE uniformity evaluation LUMINANCE meter
Viewing angle evaluation (Provided by manufacturer)
Greyscale chromaticity evaluation Colour meter

 IEC 2016
7.3 Visual evaluation methods
7.3.1 General
All visual tests shall be performed from the customary viewing distance unless specified
differently.
7.3.2 Overall image quality evaluation
The elements in the TG18-QC TEST IMAGE may be used to assess the overall performance of
IMAGE DISPLAY SYSTEMS as described in Figure 1.
Evaluate black-to-
white and white-to-
black transitions
Evaluate the appearance of
Evaluate the
the high CONTRAST line-pair
continuous
patterns at the centre and
appearance of
the four corners of the
ramp bars
pattern (the use of the low
CONTRAST patterns is
optional)
Evaluate the
appearance of all
16 LUMINANCE
patches
Evaluate the
appearance of the
5 % and 95 %
patches
Evaluate the
Evaluate the appearance of the
appearance of the low borders and lines
contrast letters (straight) of the
("quality control") in pattern and the
the 3 areas centring of the
pattern in the active
area of the IMAGE
DISPLAY DEVICE
IEC  2493/09
Figure 1 – Overall image quality evaluation using the TG18-QC TEST PATTERN
For CATHODE RAY TUBES (CRT) the SPATIAL RESOLUTION shall be included: Evaluate the CX
patterns at the centre and corners of the pattern and grade them compared to the reference
score (see Annex C).
As an alternative, the OIQ (overall image quality) TEST IMAGE may be used to assess overall
performance of LCDs as described in Figure 2
...

IEC 62563-1 ®
Edition 1.2 2021-07
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Medical electrical equipment – Medical image display systems –
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Appareils electromedicaux – Systemes d'imagerie medicale –
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IEC 62563-1 ®
Edition 1.2 2021-07
CONSOLIDATED VERSION
INTERNATIONAL
STANDARD
NORME
INTERNATIONALE
colour
inside
Medical electrical equipment – Medical image display systems –
Part 1: Evaluation methods
Appareils electromedicaux – Systemes d'imagerie medicale –
Partie 1: Méthodes d’évaluation
INTERNATIONAL
ELECTROTECHNICAL
COMMISSION
COMMISSION
ELECTROTECHNIQUE
INTERNATIONALE
ICS 11.040.55 ISBN 978-2-8322-5336-6

IEC 62563-1 ®
Edition 1.2 2021-07
CONSOLIDATED VERSION
REDLINE VERSION
VERSION REDLINE
colour
inside
Medical electrical equipment – Medical image display systems –
Part 1: Evaluation methods
Appareils electromedicaux – Systemes d'imagerie medicale –
Partie 1: Méthodes d’évaluation

– 2 – IEC 62563-1:2009+AMD1:2016
+AMD2:2021 CSV  IEC 2021
CONTENTS
FOREWORD. 5
INTRODUCTION . 7
INTRODUCTION to Amendment 1 . 7
INTRODUCTION to Amendment 2 . 7
1 Scope . 8
2 Normative references . 8
3 Terms, definitions, symbols and abbreviations . 8
3.1 Terms and definitions . 8
3.2 Symbols . 11
3.3 Abbreviations . 12
4 General . 12
5 Prerequisites . 12
6 Equipment and tools . 13
6.1 LUMINANCE meter . 13
6.2 ILLUMINANCE meter . 13
6.3 Colour meter . 13
6.4 TEST PATTERNS . 14
7 Evaluation methods . 15
7.1 General . 15
7.2 Evaluation method table overview . 15
7.3 Visual evaluation methods . 17
7.3.1 General . 17
7.3.2 Overall image quality evaluation . 17
7.3.3 Greyscale resolution evaluation . 18
7.3.4 LUMINANCE response evaluation . 19
7.3.5 LUMINANCE uniformity evaluation . 20
7.3.6 Chromaticity evaluation . 20
7.3.7 Pixel faults evaluation . 20
7.3.8 VEILING GLARE evaluation . 21
7.3.9 Geometrical image evaluation . 21
7.3.10 Angular viewing evaluation . 22
7.3.11 Clinical evaluation . 23
7.4 Quantitative evaluation methods . 23
7.4.1 Basic LUMINANCE evaluation . 23
7.4.2 Basic LUMINANCE evaluation without ambient light . 24
7.4.3 LUMINANCE response evaluation . 24
7.4.4 LUMINANCE evaluation of multiple displays . 27
7.4.5 Chromaticity uniformity evaluation . 27
7.4.6 Chromaticity evaluation of across multiple displays . 27
7.4.7 LUMINANCE uniformity evaluation . 27
7.4.8 Viewing angle evaluation . 28
7.4.9 Greyscale chromaticity evaluation . 28
Annex A (informative) Sample test reports . 29
Annex B (informative) LUMINANCE measurement methods . 48
Annex C (informative) Description of TEST PATTERNS . 51

+AMD2:2021 CSV  IEC 2021
Annex D (informative)  Evaluation methods for handheld display devices . 60
Bibliography . 70
Index of defined terms . 72

Figure 1 – Overall image quality evaluation using the TG18-QC TEST PATTERN . 17
Figure 2 – Overall image quality evaluation using the TG18-OIQ TEST PATTERN . 18
Figure 3 – Magnified view of TG18-MP TEST PATTERN showing the 8-bit and 10-bit
markers . 19
Figure 4 – A close-up of the TG18-CT TEST PATTERN . 20
Figure 5 – The TG18-GV TEST PATTERN is displayed (left), a close-up of the centre of
the TEST PATTERN when covered with a mask (right) . 21
Figure 6 – Geometrical evaluation using the GD pattern . 22
Figure 7 – Visual evaluation of viewing angle response . 23
Figure 8 – Example of the measured LUMINANCE in relation to the standard LUMINANCE
response function according to GREYSCALE STANDARD DISPLAY FUNCTION (GSDF) . 26
Figure 9 – An example of the CONTRAST response computed from 18 grey levels as
related to the expected CONTRAST response associated with the DICOM 3.14 [2]
standard LUMINANCE response with a given tolerance limit (e.g. 15 %) [10] . 26
Figure B.1 – Method A, telescopic method . 48
Figure B.2 – Method B, near-range LUMINANCE meter in combination with an
ILLUMINANCE meter . 49
Figure B.3 – Method C, frontal integrated LUMINANCE meter in combination with
ILLUMINANCE meter . 49
Figure B.4 – Method D, back integrated LUMINANCE meter in combination with
ILLUMINANCE meter . 50
Figure C.1 – Example of TG-18 QC pattern for a matrix size of 1536 × 2048 . 59
Figure D.1 – Hh-Ctr TEST PATTERN . 64
Figure D.2 – Grey level emphasized angular target . 64

Table 1 – Overview to the definitions of physical parameters . 11
Table 2 – TEST PATTERNS used for display testing . 14
Table 3 – List of the evaluation methods that can be used for testing medical IMAGE
DISPLAY SYSTEMS . 16
Table A.1 – Acceptance test sample report of a diagnostic display . 30
Table A.2 – Constancy test sample report of a diagnostic display . 35
Table A.3 – Acceptance test sample report of a monochrome reviewing display . 38
Table A.4 – Constancy test sample report of a monochrome reviewing display . 40
Table A.5 – Acceptance test sample report of a colour reviewing display . 42
Table A.6 – Constancy test sample report of a colour reviewing display . 45
Table C.1 – Description of multi-purpose TEST PATTERNS . 52
Table C.2 – TG18-QC pattern: LUMINANCE levels with 8-bit and [12-bit] pixel values
and CX ratings . 55
Table C.3 – The blurring characteristics of the CX reference set utilized in TG18-QC
TEST PATTERNS [16] . 56
Table C.4 – Evaluation criteria for the examples of the CLINICAL REFERENCE IMAGES . 57
Table C.5 – Example description of TG-18 QC pattern for a matrix size of 1536 × 2048 . 58

– 4 – IEC 62563-1:2009+AMD1:2016
+AMD2:2021 CSV  IEC 2021
Table D.1 – Major characteristics of typical handheld devices compared to IMAGE
DISPLAY SYSTEMS . 60
Table D.2 – TEST PATTERNS for handheld device . 61
Table D.3 – Recommended TEST ITEMS for handheld devices . 63
Table D.4 – Description of TEST PATTERNS for handheld devices . 65

+AMD2:2021 CSV  IEC 2021
INTERNATIONAL ELECTROTECHNICAL COMMISSION
____________
MEDICAL ELECTRICAL EQUIPMENT –
MEDICAL IMAGE DISPLAY SYSTEMS –

Part 1: Evaluation methods
FOREWORD
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patent rights. IEC shall not be held responsible for identifying any or all such patent rights.
This consolidated version of the official IEC Standard and its amendments has been
prepared for user convenience.
IEC 62563-1 edition 1.2 contains the first edition (2009-12) [documents 62B/743/CDV and
62B/768/RVC], its amendment 1 (2016-03) [documents 62B/983/CDV and 62B/995/RVC]
and its amendment 2 (2021-07) [documents 62B/1168/CDV and 62B/1203/RVC].
In this Redline version, a vertical line in the margin shows where the technical content
is modified by amendments 1 and 2. Additions and deletions are displayed in red, with
deletions being struck through. A separate Final version with all changes accepted is
available in this publication.

– 6 – IEC 62563-1:2009+AMD1:2016
+AMD2:2021 CSV  IEC 2021
International Standard IEC 62563-1 has been prepared by subcommittee 62B: Diagnostic
imaging equipment of technical committee 62: Electrical equipment in medical practice.
This publication has been drafted in accordance with the ISO/IEC Directives, Part 2.
In this standard, the following print types are used:
– requirements and definitions: roman type;
– informative material appearing outside of tables, such as notes, examples and references: in smaller type.
Normative text of tables is also in a smaller type;
– TERMS DEFINED IN CLAUSE 3 OF THIS INTERNATIONAL STANDARD, OR AS NOTED: SMALL
CAPITALS.
A list of all parts of the IEC 62563 series, published under the general title Medical electrical
equipment – Medical image display systems, can be found on the IEC website.
The committee has decided that the contents of the base publication and its amendments will
remain unchanged until the stability date indicated on the IEC web site under webstore.iec.ch
in the data related to the specific publication. At this date, the publication will be
• reconfirmed,
• withdrawn,
• replaced by a revised edition, or
• amended.
IMPORTANT – The 'colour inside' logo on the cover page of this publication indicates
that it contains colours which are considered to be useful for the correct
understanding of its contents. Users should therefore print this document using a
colour printer.
+AMD2:2021 CSV  IEC 2021
INTRODUCTION
This International Standard provides evaluation methods for testing IMAGE DISPLAY SYSTEMS
used in MEDICAL ELECTRICAL EQUIPMENT and medical electrical systems for diagnostic imaging.
On site or after installation, two types of testing can be carried out. An acceptance test is
carried out after a new IMAGE DISPLAY SYSTEM has been installed, or major modifications have
been made to the existing IMAGE DISPLAY SYSTEM. Since an IMAGE DISPLAY SYSTEM may
degrade over time, the constancy test is carried out by the user in a periodic cycle to verify
that the performance is maintained for the intended use.
The standard describes various evaluation methods without dictating what particular tests
shall be used for acceptance and/or constancy tests.
Rather, it is the intention of this standard to be a reference for other standards and guidelines
specific to each modality or to be defined by national authorities who will refer to the
evaluation methods of this standard and mention limiting values and frequencies for
acceptance and constancy tests. Annex A shows sample reports of such a reference.
To maintain the homogeneity in the IEC standards for MEDICAL ELECTRICAL EQUIPMENT,
IEC 61223-2-5, Evaluation and routine testing in medical imaging departments – Part 2-5:
Constancy tests – Image display devices should be reviewed.

INTRODUCTION to Amendment 1
This amendment is published to introduce colour measurement.
Since publication of IEC 62563-1:2009, IEC 61223-2-5, Evaluation and routine testing in
medical imaging departments Part 2-5: Constancy tests – Image display devices has been
reviewed and withdrawn.
INTRODUCTION to Amendment 2
This amendment is intended to introduce evaluation methods for handheld display devices.

– 8 – IEC 62563-1:2009+AMD1:2016
+AMD2:2021 CSV  IEC 2021
MEDICAL ELECTRICAL EQUIPMENT –
MEDICAL IMAGE DISPLAY SYSTEMS –

Part 1: Evaluation methods
1 Scope
This part of IEC 62563 describes the evaluation methods for testing medical IMAGE DISPLAY
SYSTEMS.
The scope of this International Standard is directed to practical tests that can be visually
evaluated or measured using basic test equipment. More advanced or more quantitative
measurements can be performed on these devices, but these are beyond the scope of this
document.
This standard applies to medical IMAGE DISPLAY SYSTEMS, which can display monochrome
image information in the form of greyscale values on colour and on greyscale and colour
IMAGE DISPLAY SYSTEMS (e.g. CATHODE RAY TUBE (CRT) monitors, FLAT PANEL DISPLAYS,
PROJECTION SYSTEM). This standard applies to medical IMAGE DISPLAY SYSTEMS used for
diagnostic (interpretation of medical images toward rendering clinical diagnosis) or viewing
(viewing medical images for medical purposes other than for providing a medical
interpretation) purposes and therefore having specific requirements in terms of image quality.
Head mounted IMAGE DISPLAY SYSTEMS and IMAGE DISPLAY SYSTEMS used for confirming
positioning and for operation of the system are not covered by this standard. Handheld IMAGE
DISPLAY SYSTEMS might require additional or modified versions of the procedures described in
this standard.
It is not in the scope of this standard to define the requirements of acceptance and constancy
tests nor the frequencies of constancy tests.
2 Normative references
The following referenced documents are indispensable for the application of this document.
For dated references, only the edition cited applies. For undated references, the latest edition
of the referenced document (including any amendments) applies.
IEC 60788:2004, Medical electrical equipment – Glossary of defined terms
ISO 11664-1:2007, Colorimetry – Part 1: CIE standard colorimetric observers
CIE S 010/E:2004 Photometry – The CIE system of physical photometry
3 Terms, definitions, symbols and abbreviations
3.1 Terms and definitions
For the purpose of this document, the terms and definitions given in IEC 60788:2004 and the
following apply.
3.1.1
accuracy
closeness of agreement between a test result and the accepted reference value

+AMD2:2021 CSV  IEC 2021
[ISO 5725-1:1994, definition 3.6]
3.1.2
brightness
LUMINANCE as perceived by the human visual system
3.1.3
cathode ray tube
CRT
picture tube
component of an IMAGE DISPLAY SYSTEM in which images defined via electrical signals are
visualized by means of an electron beam striking a phosphor
3.1.4
clinical reference image
specific medical image typical for the intended use of the IMAGE DISPLAY SYSTEM
NOTE The anatomical patterns reported in Annex C are examples of CLINICAL REFERENCE IMAGE.
3.1.5
clock artefact
artefact in form of distorted vertical bars or stripes, visible on the screens of fixed-pixel type
IMAGE DISPLAY DEVICES (e.g. LCD), when the frequency of the internal dot clock is different
from that of the incoming analogue signal
3.1.6
contrast
ratio of the difference of the LUMINANCE of two image areas, L - L ,
1 2
divided by the average of the two LUMINANCE values:
.
CONTRAST = 2 (L - L )/(L + L )
1 2 1 2
3.1.7
digital driving level
DDL
digital value given as input to an IMAGE DISPLAY SYSTEM producing a LUMINANCE
3.1.8
display controller
electronic component of an IMAGE DISPLAY SYSTEM that provides the analogue or digital
interface between the computer hardware and the IMAGE DISPLAY DEVICE
3.1.9
flat panel display
IMAGE DISPLAY DEVICE that is flat and thin
NOTE E.g. liquid crystal display (LCD), plasma display (PDP), field emission display (FED), surface-conduction
electron-emitter display (SED), carbon-nano-tube display (CNT), organic light-emitting display (OLED).
3.1.10
flicker
perception of unintentional fluctuations of the LUMINANCE over time
3.1.11
greyscale standard display function
GSDF
mathematically defined mapping of input, DIGITAL DRIVING LEVEL (DDL) to LUMINANCE values
based on the Barten model
– 10 – IEC 62563-1:2009+AMD1:2016
+AMD2:2021 CSV  IEC 2021
1)
[Source: DICOM PS 3.14:2007, see [2] ]
3.1.12
illuminance
measurement of the luminous flux incident on a surface per unit area (unit: Lux (lx),
lx = lm/m )
3.1.13
image display device
monitor
specific hardware/medium used to display images presented through an analogue or digital
interface
3.1.14
image display system
workstation consisting of an IMAGE DISPLAY DEVICE, DISPLAY CONTROLLER and computer
hardware and software, capable of displaying images
3.1.15
luminance
ratio of luminous flux penetrating (impinging on) a surface area in a specified direction to the
product of the irradiated solid angle and the projection of the surface area onto a plane
perpendicular to the viewing direction (unit: candela per square meter (cd/m ))
NOTE This definition has been derived from the term in DIN 5031-3:1982-03 [18] and is equivalent to the
definition in the International Electrotechnical Vocabulary (IEV).
3.1.16
phase artefact
artefact in form of blurred edges of displayed objects (letters, lines, etc.), visible on the
screens of fixed-pixel type IMAGE DISPLAY DEVICES (e.g. LCD), when the phase setting of the
internal dot clock is different from that of the incoming analogue signal
3.1.17
precision
closeness of agreement between independent test results obtained under stipulated
conditions
[ISO 5725-1:1994, definition 3.12]
3.1.18
projection system
large-screen IMAGE DISPLAY DEVICE which enlarges the small image generated on a plane by
central projection to a second plane
3.1.19
resolution addressability ratio
RAR
measured pixel at 50 % point of LUMINANCE at peak or nominal rating expressed as a
percentage of addressable space available
3.1.20
spatial resolution
IMAGE DISPLAY SYSTEM to distinguish spatial features of interest
measure of the ability of an
within an image
—————————
1)
Figures in square brackets refer to the Bibliography.

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NOTE Systems designed with adequate SPATIAL RESOLUTION characteristics are necessary to assure that spatial
details of interest are preserved when a medical image is displayed. Portraying image data on a IMAGE DISPLAY
DEVICE with insufficient resolution will compromise the ACCURACY of the radiological interpretation.
3.1.21
test image
test pattern
image for testing or verifying the IMAGE DISPLAY SYSTEMS
3.1.22
veiling glare
enhancement of the LUMINANCE measurable on the IMAGE DISPLAY DEVICE caused by internal
scatter processes
NOTE The value of the LUMINANCE enhancement is dependent on the illuminated portion of the image displayed.
3.1.23
window setting
display of a subset of the pixel values existing in the digital image
NOTE The WINDOW SETTING is determined by the window width and level (centre) and serves for CONTRAST
enhancement.
3.2 Symbols
The symbols of physical parameters used in this standard are listed in Table 1. All
measurements referred to in Table 1 are in the centre of the IMAGE DISPLAY DEVICE. Note that
LUMINANCE may also be measured at other locations according to the methodologies
described in this document.
Table 1 – Overview to the definitions of physical parameters
Abbreviation Mathematically derived Definition and explanation
L LUMINANCE generated by the ambient light on the surface of an
amb
IMAGE DISPLAY DEVICE when the IMAGE DISPLAY DEVICE is off.
L Minimum LUMINANCE generated by a IMAGE DISPLAY DEVICE at
min
DIGITAL DRIVING LEVEL (DDL) = 0 measured at the centre of the
screen. It includes VEILING GLARE specific to TEST PATTERN used for
measurement. It is measured with ambient light totally switched off
(in the dark).
L Maximum LUMINANCE generated by a IMAGE DISPLAY DEVICE at
max
DIGITAL DRIVING LEVEL (DDL) = max measured at the centre of the
screen. It includes VEILING GLARE specific to TEST PATTERN used for
measurement. It is measured with ambient light totally switched off
(in the dark).
L′ L + L LUMINANCE that will be perceived by the human eye at the centre of
min min amb
the screen at DIGITAL DRIVING LEVEL (DDL) = 0. It contains VEILING
GLARE and L
amb
L′ L + L LUMINANCE produced by the IMAGE DISPLAY DEVICE at the maximum
max max amb
DIGITAL DRIVING LEVEL (DDL) measured at the centre of the screen.
It contains VEILING GLARE and L
amb.
R Diffuse reflection coefficient (provided by manufacturer with a
d
specific measurement method, ideally following the methods
described in Reference [10] using a CIE standard illuminant A and
an aperture size 20 to 30 % larger than the diameter of the
LUMINANCE meter).
r' LUMINANCE ratio of an IMAGE DISPLAY DEVICE containing VEILING
L′ /L′
max min
GLARE and ambient LUMINANCE.
E ILLUMINANCE.
a Safety factor.
L /L′
amb min
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Abbreviation Mathematically derived Definition and explanation
a L /L Alternative safety factor. This factor is defined to provide
R amb min
consistency with other relevant documents (e.g. ACR–AAPM–SIIM
Technical Standard For Electronic Practice Of Medical Imaging,
Amended 2014, Resolution 39).
2 2 1/2
Δu'v' ((u ’-u ’) + (v ’-v ’) ) Maximum Distance in u'-v' space.
1 2 1 2
3.3 Abbreviations
The following abbreviations are used in this standard.
CRT cathode ray tube
CT computed tomography
DDL digital driving level
DICOM digital imaging and communication in medicine
LCD liquid crystal display
MR magnetic resonance
4 General
In IMAGE DISPLAY SYSTEMS, every individual component can limit or reduce the image quality of
the system. Therefore it is necessary to adopt suitable measures for quality monitoring. If
IMAGE DISPLAY SYSTEMS are correctly adjusted and maintained, these devices can consistently
generate similar images.
Simple test equipment is used (LUMINANCE meter, TEST IMAGES) with PRECISION appropriate for
the purpose of a test. Before a test, all test equipment shall be checked for its functioning
according to the manufacturer’s specifications.
The manufacturer's data (e.g. requirements on operating voltage, humidity etc.) are required
for the correct setting of the IMAGE DISPLAY SYSTEM and for correct installation. The
manufacturer's data shall be enclosed with the technical documentation of the IMAGE DISPLAY
SYSTEM.
The tests listed in this International Standard are a compilation of all the evaluation methods
that may be used for testing an IMAGE DISPLAY SYSTEM. A subset of these test items or test
methods may be selected and applied in any order depending on the intended purpose of the
IMAGE DISPLAY SYSTEM.
For mobile systems, a fixed location for these tests shall be determined and used so that it is
representative for the locations where such mobile systems may be used. Care should be
taken to ensure that the ambient lighting in these areas can be adequately controlled.
5 Prerequisites
Prior to testing an IMAGE DISPLAY SYSTEM, the following shall be considered:
a) The testing of an IMAGE DISPLAY SYSTEM shall include the complete system including
software, hardware and settings involved in image handling.
b) For all IMAGE DISPLAY SYSTEMS to be tested, all components including computer, IMAGE
DISPLAY DEVICE, display card, display software, and software version shall be traceable.
TEST IMAGES and the clinical images shall be presented in the same way on the IMAGE
c) The
DISPLAY SYSTEM.
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d) Before starting the tests, the front surface of the IMAGE DISPLAY DEVICE shall be cleaned
according to the instructions for use.
e) It shall be ensured that no prior nominal settings have been changed.
f) Room lights, windows, viewing devices etc. shall not cause any disturbing reflections on
the IMAGE DISPLAY DEVICE. Methods to prevent reflections are described in the standards
ISO 9241-302, ISO 9241-303, ISO 9241-305 and ISO 9241-307.
g) The ambient lighting in the room shall be maintained at normally used conditions.
h) Before initiating a test, the IMAGE DISPLAY SYSTEM shall be installed and started up
according to the manufacturer’s recommendations; to ensure stable performance, the
IMAGE DISPLAY DEVICE shall be switched on before the test for a period as specified by the
manufacturer (e.g. 30 min). The IMAGE DISPLAY SYSTEM should be set to the desired display
function. The GREYSCALE STANDARD DISPLAY FUNCTION (GSDF) is recommended and is a
necessary prerequisite for some tests.
6 Equipment and tools
6.1 LUMINANCE meter
A LUMINANCE meter shall have the following specifications. The range of the LUMINANCE meter
shall cover at least the range of LUMINANCE of the IMAGE DISPLAY SYSTEM with a PRECISION of at
most 5 % (repeatability), and an ACCURACY of at most 10 %, with a calibration traceable to a
primary standards laboratory. The manufacturer of the meter shall provide a clear calibration
program. The aperture angle shall not exceed 5°. The relative spectral sensitivity shall
correspond to the BRIGHTNESS CIE standard photopic spectral response (CIE S 010/E:2004).
The influence of the photopic response shall be within the overall ±10 % ACCURACY described
in this paragraph.
For near range LUMINANCE meters, a predefined angle and distance of measurement result in
a defined measurement field size. During a measurement, the area to be measured shall be
displayed by a field (or patch) that is significantly bigger than the defined measurement field
size.
A LUMINANCE meter can be integrated into the IMAGE DISPLAY SYSTEM or be a stand-alone
device.
6.2 ILLUMINANCE meter
An ILLUMINANCE meter may be required for testing IMAGE DISPLAY SYSTEMS with a range of 1 to
1 000 lux with an ACCURACY of at most 10 % and a PRECISION of at most 5 % (repeatability).
The device calibration shall be traceable to a primary standards laboratory and shall have a
clear calibration program. It shall have a uniform response to a Lambertian light source.
In measurement method B, C and D (described in Annex B), the ILLUMINANCE meter is ideally
located at the centre of the screen facing outward. Side locations will also be acceptable as
long as they provide similar measured values.
6.3 Colour meter
A colour meter may be required for testing IMAGE DISPLAY SYSTEMS. The meter shall be able to
evaluate the CIE-specified (ISO11664-1:2007) colour coordinate with better than ±0,004
ACCURACY in the u’,v’ space (0,007 in the x,y space) for a standard illuminant, within the
LUMINANCE range of the IMAGE DISPLAY SYSTEM. The device calibration shall be traceable to a
primary measurement standard and shall have a clear calibration program.

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6.4 TEST PATTERNS
Table 2 – TEST PATTERNS used for display testing

TG18-QC for overall
testing CATHODE RAY TUBE
OIQ for overall testing
(CRT and LCD)
TG18-MP for LUMINANCE
(LCD) TG18-LN8-01 for
resolution
LUMINANCE
TG18-LN8-18 for
TG18-UN10 for LUMINANCE TG18-UN80 for LUMINANCE TG18-CT for LUMINANCE
LUMINANCE
uniformity uniformity response

ANG for angular response GD for geometrical TG18-UNL80 for TG18-GVN for VEILING
properties LUMINANCE uniformity GLARE

TG18-GV for VEILING GLARE TG18-MM1 as example
TG18-CH as example TG18-KN as example
mammogram
chest radiograph extremity radiograph

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TG18-MM2 as example BN01 for LUMINANCE (LCD) BN18 for LUMINANCE (LCD)
mammogram
A subset of these examples or elements from these examples may be used to form composite
TEST PATTERNS depending on the intended use of each modality being tested (see Annex C for
more information).
7 Evaluation methods
7.1 General
This clause describes a number of evaluation methods (tests) that can be used for testing
medical IMAGE DISPLAY SYSTEMS. The number and order of these evaluation methods are not
mandatory; a modality standard can refer to a subset of these tests in any order with a
preference for limiting values and evaluation criteria.
7.2 Evaluation method table overview
Table 3 shows an overview of all evaluation methods described in this standard. Not all of
these tests may be required or be appropriate for a specific IMAGE DISPLAY SYSTEM. A subset
of test items or test methods to be performed can be chosen from these lists that are relevant
to a particular IMAGE DISPLAY SYSTEM. These tests can be performed in any appropriate order.

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Table 3 – List of the evaluation methods that can be used
for testing medical IMAGE DISPLAY SYSTEMS
Evaluation method Equipment, tools
Visual evaluation methods
Overall image quality evaluation TG18-QC TEST PATTERN
– Verify overall performance.
Greyscale resolution evaluation TG18-MP TEST PATTERN
– Verify sufficient greyscale resolution based on 8-
and 10-bit markers
LUMINANCE response evaluation (more complete TG18-CT TEST PATTERN
solution than overall image quality evaluation)

LUMINANCE uniformity evaluation TG18-UN80 TEST PATTERN
– Look for non-uniformities
Chromaticity evaluation TG18-UN80 TEST PATTERN
– Verify colour uniformity
Pixel faults evaluation TG18-UN10 and TG18-UN80 TEST PATTERN
– Look for dark (TG18-UN80) and bright (TG18-UN10)
pixel defects
VEILING GLARE evaluation TG18-GVN and TG18-GV TEST PATTERN, mask
– Look for low CONTRAST objects on 2 TEST PATTERNS
Geometrical image evaluation GD TEST PATTERN, ruler (CATHODE RAY TUBE (CRT) only)
– Verify geometry, phase/clock correction, clipping
Angular viewing evaluation ANG TEST PATTERN
– Verify viewing angle
Clinical evaluation Clinical TEST PATTERNS (examples see TG18-CH, TG18-
KN, TG18-MM1 and TG18-MM2)
Quantitative evaluation methods
Basic LUMINANCE evaluation LUMINANCE meter, ILLUMINANCE meter
Basic LUMINANCE evaluation without ambient light LUMINANCE meter
LUMINANCE response evaluation LUMINANCE meter, ILLUMINANCE meter
The GREYSCALE STANDARD DISPLAY FUNCTION (GSDF) is
prerequisite for this test
LUMINANCE evaluation of multiple displays LUMINANCE meter
Chromaticity uniformity evaluation Colour meter
Chromaticity evaluation of across multiple displays Colour meter
LUMINANCE uniformity evaluation LUMINANCE meter
Viewing angle evaluation (Provided by manufacturer)
Greyscale chromaticity evaluation Colour meter

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7.3 Visual evaluation methods
7.3.1 General
All visual tests shall be performed from the customary viewing distance unless specified
differently.
7.3.2 Overall image quality evaluation
The elements in the TG18-QC TEST IMAGE may be used to assess the overall performance of
IMAGE DISPLAY SYSTEMS as described in Figure 1.
Evaluate black-to-
white and white-to-
black transitions
Evaluate the appearance of
Evaluate the
the high CONTRAST line-pair
continuous
patterns at the centre and
appearance of
the four corners of the
ramp bars
pattern (the use of the low
CONTRAST patterns is
optional)
Evaluate the
appearance of all
16 LUMINANCE
patches
Evaluate the
appearance of the
5 % and 95 %
patches
Evaluate the
Evaluate the appearance of the
appearance of the low bord
...