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Summit on Color in Medical Imaging

May 8-9 2013

Abstracts and speaker bios

Session IWSI / Digital microscopy / histopathology
Session IIEndoscopy / Laparoscopy
Session IIIDermatology, Opthalmology and Medical Photography
Session IVTelemedicine / Mobile displays
Session VDisplays
Session VIStandards (DICOM, ICC, CIE, AAPM) & Color measurement
Individual presentations can be viewed by clicking on the presentation title below, or by visiting the download page.

Alberto Gutierrez

Conference Welcome Note

Alberto Gutierrez, Ph.D. is the Director of the Office of In Vitro Diagnostic Device Evaluation and Safety at the Food and Drug Administration (FDA). He joined the FDA in 1992 as a researcher and reviewer in FDA's Center for Biologics Evaluation and Research working on vaccine adjuvants and method development for determination of the purity and structure of vaccine components. Dr. Gutierrez has more than 10 years of experience in research in the area of structural organic and organometallic chemistry. In 2000, he joined the FDA Center for Devices and Radiological Health as a scientific reviewer, becoming a Team Leader for Toxicology in 2003, Director of the Division of Chemistry and Toxicology Devices in 2005, Deputy Director of the Office of In Vitro Diagnostic Device Evaluation and Safety in 2007, and Office Director in 2009. Dr. Gutierrez received a bachelor's degree from Haverford College and master and doctorate degrees in chemistry from Princeton University.

Session IWSI / Digital microscopy / histopathology
Yukako Yagi
Color Aspects and Color Standardization in Digital Microscopy

Standardization and validation of the color displayed by digital slides is an important aspect of digital microscopy implementation. While the most common reason for color variation is the variance in the protocols and practices in the histology lab, a variety of staining types, the color displayed can also be affected by variation in capture parameters (for example, illumination and filters), image processing and display factors in the digital systems themselves. Current most common digital microscope system is the whole slide imaging (WSI) system.

We have been developing techniques for color validation and optimization along two paths for WSI: the first is based on two standard slides that are scanned and displayed by the imaging system in question. In one slide, nine filters with colors (color calibration slide) are embedded from the results of our previous study and modified for WSI. The other is an H&E stained mouse embryo. Each WSI scanner's color transformation matrix is estimated from the scanned color calibration slide then applied to standardize the scanned mouse embryo image to confirm the matrix is appropriate or not. The second approach is based on our previous multispectral imaging research in stain standardization.

The results of the calibration slide set and multispectral techniques can be combined and will be widely available.

Bio Yukako Yagi started her career as an electrical engineer in Japan to develop robotic microscopes and their applications such as Telepathology. In 1995 she won a Nikon Fellowship for two research years for the International Consortium for Internet Telepathology at Georgetown University, Washington, D.C. She was Director of Technologies Management at the University of Pittsburgh Medical Center where she developed and implemented telepathology systems for organ transplantation, frozen section and 2nd opinion consultations. She established clinical and technical standards for whole slide imaging systems. Dr. Yagi came to Massachusetts General Hospital, Boston, in 2007 and is now Director of the Pathology Imaging and Communication Technology Center at MGH. She is Assistant Professor of Pathology at Harvard Medical School and the 1st President of the International Academy of Digital Pathology.
Darren Treanor
Colour in Histopathology Imaging

The Leeds digital pathology project has been using and developing digital pathology systems since 2003.

I will briefly describe the work we have done in digital pathology project, and our experience of colour in histopathology imaging. The talk will include descriptions of the role of colour in image analysis, quantification of histochemical staining, 3D reconstruction and the diagnostic workstation. Further information is on our website.

Bio Dr. Darren Treanor is a consultant liver and gastrointestinal pathologist at Leeds Teaching Hospitals NHS Trust, UK, and honorary senior lecturer at the Leeds Institute of Molecular Medicine, University of Leeds. Dr. Treanor also runs the Leeds virtual pathology project and he is the principal investigator on the UK National Institute for Health Research (NIHR)-funded project entitled "A virtual reality microscope for pathology", which aims to study current diagnostic and teaching practice to inform the development of a better pathology workstation.
Stephen Hewitt
Color Within The Context Of Whole-Slide Imaging

The perception of color within the context of diagnostic pathology has undergone a constant evolution, with the development of microscopes and stains over the last century. The introduction of whole slide imaging (WSI), where a digital image of a slide becomes the diagnostic medium, rather than the direct observation of the slide under a microscope, is a substantial shift. WSI introduces of multiple nodes at which color can be altered, beyond what is commonly encountered with the manual microscope and direct observation. Critical to ensuring a "fit-for-purpose" application of digital image capture and display of microscopic images, is understanding the interplay of the detector, the image processing software and the display to render an image that a pathologist can interpret, and obtain an equivalent diagnosis. Integral to this process is the development of calibrators of color to ensure instrumentation performance. There are opportunities for digital capture image to improve on what is observed by direct observation, however they must be robust and based on data, rather than subjective evaluation of stain quality.


Stephen M. Hewitt, M.D., Ph.D., is appointed as a Clinical Investigator within the Laboratory of Pathology, Center for Cancer Research, National Cancer Institute at the National Institutes of Health, in Bethesda Maryland. He has served as chief of the Tissue Array Research Program since its inception in 2000, and as chief of the Applied Molecular Pathology Laboratory since its creation in 2008. Dr. Hewitt received his bachelor's degree in philosophy from the Johns Hopkins University in 1988, and his Ph.D. in genetics from the University of Texas, Graduate School of Bomedical Sciences in 1995 and his M.D. in 1996 at the University of Texas Medical School at Houston. He completed his residency in Anatomic Pathology within the Laboratory of Pathology at the National Cancer Institute and is a board certified Anatomic Pathologist. Dr. Hewitt is a member of the Clinical Laboratory Standards Institute Immunology & Ligand Assay Consensus Committee, having served as co-chair of the Subcommittee on Immunohistochemical Assays. He is a councilor of the Histochemical Society, Research Committee Chair for the Association of Pathology Informatics and a consultant to the Hematology and Pathology Devices Panel, Center for Devices and Radiological Health, Food and Drug Administration. Dr. Hewitt has co-authored more than 190 articles and serves on the editorial board of four peer-reviewed journals.
Session IIEndoscopy / Laparoscopy
Hideto Yokoi
The overview of endoscopy and laparoscopy

In this session, I will present the overview of endoscopy and laparoscopy mainly in digestive organ, reviling the demands of clinicians based on the hearing from endoscopists, surgeons, nurses, endoscopy technicians. However special color imaging for diagnosis is used widely (e.g. Narrow Band Imaging (NBI) endoscopic technology, for early cancer detection), endoscopists rarely change the image color secondary with PACS viewer after finishing their endoscopy procedure. There is a fundamental difference between endoscopists mainly using flexible endoscope for gastrointestinal (GI) tract and surgeons mainly using laparoscope for endoscopic surgery. The difference depends on presence or absence of "idea of original scene". Endoscopists do not know "original scene" of lumen of GI tract because they cannot observe the live lumen of GI tract directly with their eyes (when we cut and open the tracts, they may not be "live"). On the other hand, surgeons can observe the organs directly at open surgery. Despite the difference, both doctors concern only capability of diagnosis; do not have great interest in precise color reproducibility.
Bio Hideto Yokoi, M.D. Ph.D. is an expert on medical informatics. Dr. Yokoi, is Professor and Director of Medical Informatics Department at Kagawa University Hospital in Japan. Dr. Yokoi's background in medicine is digestive organ. With his specialty, Dr. Yokoi is joining some international standardization activities of medical information, especially concerning endoscopy of digestive tract.
Tatsuo Heki
"Color Management of Endoscopic Images"

The re-use of endoscopic images following on-site diagnosis will expand as more flat panel displays are available to healthcare providers and PACS systems provide more imaging capability. It is necessary that these displays should provide a color image that does not alter the impression at the time of on-site diagnosis.

The ISO 22028-1 "Image State" model, shows that this could be made possible by referencing a standardized display-referred color encoding. The author will propose some amendments to current DICOM standards based on this model.

Bio Tatsuo Heki is senior operations manager at Fujifilm Medical Systems Business Division. His first work on standards was the Advanced Photographic System, the last photographic film system in its history. He is working on medical standards and regulatory and is a representative from Global Diagnostic Imaging, Healthcare IT, and Radiation Therapy Trade Association (DITTA) to the Unique Device Identification (UDI) Working Group of the International Medical Device Regulators Forum (IMDRF).
Hiroyuki Homma
Color Imaging in Endoscopy and Laparoscopy

The color of endoscopic and laparoscopic images depends on several factors. The first of these factors being the color spectrum of the illumination supplied by the endoscope itself. The type of light source, whether halogen, xenon or LED, and the color transmission characteristics of the fiberoptic light guide bundle, all affect the color of the illumination light. The light reflecting off of the tissue may then be captured by a second fiberoptic bundle for direct viewing through an eyepiece, or transmitted through a series of rod lenses and captured by an external video camera, or captured by an electronic image sensor mounted in the distal tip of the endoscope.

Each of these various types of imaging systems has its own set of advantages and disadvantages. And the color performance of each component in the imaging system can influence the color of the final endoscopic image. And there are some endoscopic applications the color of endoscopic image is intentionally modified by post-processing, or by using non-white light illumination (e.g., narrow-band imaging).

Bio Hiroyuki Homma is senior optical engineer in Olympus Medical Systems Corp. He belongs to optical lens design department since he entered the firm in 1998, and took in charge for optical design of observation and illumination system for flexible endoscope and rigid laparoscope.
Session IIIDermatology, Opthalmology and Medical Photography
Stein Olav Skrøvseth
Requirements for color in computer aided diagnostics tool for dermoscopy

Computer aided diagnostics in medicine is becoming increasingly viable as tools for patients, general practitioners and specialists. An important approach is using machine learning techniques where computers learn based on historical data by optimizing a certain loss function. Consistent data is essential when using machine learning, as inconsistencies between training and test sets will be reflected in a loss of precision. When analyzing dermoscopic images with respect to malignancy of skin lesions this is of major concern as color consistency is hard to obtain.

According to the "C" component of the popular ABCD rule of dermoscopy, the number of distinct colors in a dermoscopic image is an important predictor of malignancy. However, trying to estimate this number by statistical algorithms is difficult in any color space, even those considered to be perceptually uniform. In particular, atlas-based methods can be applied when there is strict control on color management in both aquisition, proccessing and comparison in both the new image and the reference. This is often unrealistic under current specifications. The other approach is relative counting, i.e., estimating the number of distinct colors rather than their precise value. This is statistically challenging, requiring clustering in both the image and color space, but has the potential for very robust estimates. However, information on certain colors that are highly specific for malignant melanoma such as the blue-white veil will be missing. A combination of the two approaches is likely to be necessary to obtain sufficient precision.

Bio Stein Olav Skrøvseth holds a PhD in theoretical physics from the Norwegian University of Science and Technology in Trondheim, Norway and performed a postdoc at the University of Sydney, Australia on related topics. Since 2009 he has been a researcher in applied mathematics and statistics at the Norwegian Centre for Telemedicine in Tromsø, Norway, where he is working on a number of projects relating to telemedicine, computer aided diagnostics, pattern recognition and self-management. Core competence areas include statistics, image analysis, machine learning and data analysis.
Mike Flynn
Patient Photographs in the Electronic Health Record

Patient photographs are commonly used in certain clinical specialties to document medical conditions at presentation and following treatment. Specialties with frequent use include plastic surgery, dermatology, wound management, abuse cases in emergency medicine. These used to be obtained with standard film cameras with results placed in the medical record as a photograph. Now these are obtained using digital cameras with varying performance characteristics.

Current guidelines require that photographs be stored in the patients electronic health record (EHR) with full documentation of the patient name and ID, date and time, body part and view, study type, and requesting physician. To protect privacy, photographs need to be immediately sent to the EHR and deleted from the recording device. To support proper rendering, the ICC profile of the recording device needs to be sent along with illumination conditions.

PACS systems that are commonly used in Radiology, Cardiology, and other specialties are well suited to manage the storage of photographs in the EHR and to provide client services for viewing the set of photographs associate with a study performed during a specific encounter. Several implementations have recently been tested and introduced as software products that facilitate the import of photographic studies into a PACS archive system. These systems manage photographs as DICOM objects for which tags provide for the storage of patient and study information not otherwise found in digital image EXIF tags. These DICOM objects do specifically provide for the inclusion of ICC profiles. However, current DICOM objects do not provide for the encapsulation of EXIF tags or otherwise provide tags for camera device tags that document the exposure conditions.

Display of patient photographs using PACS client viewers can be effectively done using professional graphics monitors that can be calibrated to match target profiles (sRGB, aRGB, ..). However, these workstation may also be used for other DICOM objects for which the monitor tone scale should match the DICOM grayscale display function (GSDF). There presently is not an RGB profile with a DICOM grayscale, dRGB, but such a target space is easily established. A more significant limitation is that no present PACS provides a client viewer that can perform ICC color management operations that utilize the camera profile and the monitor profile to render the presentation of photographs with correct skin tones and consistent contrast. Moreover, PACS client viewer with color management support could present both grayscale images with GSDF grayscale and photographs.

Bio Dr. Flynn is a medical imaging scientist with expertise in radiation imaging methods, imaging informatics (PACS), and medical display performance. With Nuclear Science training, Dr.Flynn has been employed at Henry Ford Health System (HFHS) as a Sr. Staff Scientist for the past 30 years. As an Adjunct Professor, he teaches radiation imaging courses at the University of Michigan.

In the Radiology Research group at HFHS, he has investigated visual perception using electron display using human observer experiments. He has helped develop professional standards and guidelines for the performance of medical imaging devices and currently contributes to the development of new standards on color imaging.

Masahiro Nishibori
Color Aspects and Color Standardization in Digital Microscopy

The differences in colors captured and reproduced using various imaging modalities may cause erroneous medical diagnoses. The influence of the color on the medical diagnosis has been still unclear, but our experiment has shown that the poor reproduction of color information possibly interferes the proper diagnoses. Furthermore, considerable differences in the precision of color reproduction required for proper medical diagnoses have been experienced among the various imaging subjects.

Color imaging with the RGB system neither capture a whole color space of real objects nor reproduce their colors observed under different illuminant. Difference of color sensitivity among physicians' eyes and modification of the color sensitivity caused by color adaptation may affect the diagnosis made on color imaging. Although most of these concerns would be fixed by applying multispectral imaging to medicine, it is mere one of possibilities. Nevertheless, this novel color technology will lead to new morphological diagnostic methods more powerful than human visual perception alone, for example, very early detection of latent decubital ulcers or latent diabetic gangrenes.

The Morphological Internet Survey Research Project Team, which was conducted by the author, proposed a solution for standardization, in which a set of typical medical images with their diagnoses authorized in advance is used as a practical calibrator for common color imaging equipment.

Bio The author is a graduate of Faculty of Medicine, Tokyo Medical and Dental University on March 1984, who has a license of a medical doctor, a degree of a doctor of medicine, a license of a clinical laboratory physician and a license of an industrial physician. He specialized in laboratory medicine (design of clinical laboratory information system, evidence based laboratory medicine), medical informatics (user oriented system design, user interface design), digital biocolor, medical application of multispectral imaging, tailor-made health maintenance, preventive omics medicine.

Professor, Department of Social Services and Healthcare Management, International University of Health and Welfare
Digital Biocolor Society (Corporate Officer)
The Japan Association for Medical Informatics
The Japan Society of Laboratory Medicine (Councillor)
The institute of electrical and electronics engineers, inc.

John Penczek
Color Error in the Digital Camera Image Capture Process

The color error of images taken by digital cameras is evaluated with respect to its sensitivity to the image capture conditions. A parametric study was conducted to investigate the dependence of image color error on camera technology, illumination spectra, and lighting uniformity. The measurement conditions were selected to simulate the variation that might be expected in typical Telemedicine situations. Substantial color errors were observed, depending on the measurement conditions. Several image post-processing methods were also investigated for their effectiveness in reducing the color errors. The results of this study quantify the level of color error that may occur in the digital camera image capture process, and provide guidance for improving the color accuracy through appropriate changes in that process and post-processing.
Bio John Penczek is a Sr. Research Associate at the University of Colorado, Boulder, and Guest Researcher at the National Institute of Standards and Technology, Boulder, Colorado. He received a BS in Physics from Rensselaer Polytechnic Institute, a MS in Physics from San Jose State University, and a PhD in Electrical Engineering from University of California, Davis. Dr. Penczek has been developing optical and electro-optic devices and systems for over 25 years. He initially worked at the Swiss Federal Institute of Technology, investigating numerical models for optical waveguides and thin films. He then joined Lockheed Palo Alto Research Labs, where he developed Electro-optic systems. Dr. Penczek has spent the latter 15 years on display development and characterization. As a scientist at the Georgia Tech Phosphor Technology Center of Excellence, he helped to introduce new high performance phosphors for Field Emission Displays (FEDs). These phosphors were subsequently leveraged to make efficient white LEDs. His work on FEDs continued at Candescent Technologies, where he designed and implemented phosphor and display characterization methods and systems. He later expanded into OLED displays at DuPont Displays, where he was involved in optical device modeling and display metrology. Dr. Penczek is currently developing display metrology for various display technologies at the NIST and serves as a consulting Engineer.

Dr. Penczek is involved in several display standards groups, including the International Electrotechnical Commission (IEC), International Standards Organization (ISO), and the International Committee on Display Metrology (ICDM). He served as the primary author for multiple display standards, and received the IEC 1906 award for his contributions to display standards development.

Christye P. Sisson
Color Variability Analysis in Fundus Photography

Anecdotal and clinical evidence indicates tremendous color capture variability among different fundus cameras and different manufacturers (and even within the same manufacturer). In this project, we examined the specific image capture characteristics of a fundus camera, and the inherent variability within that system to help determine the best approach for systematic color management. Clinically, these images provide a document of the patient's fundus on that particular day; in theory, these should be identical to what the ophthalmologist would view when examining the patient's retina with a direct ophthalmoscope. In practice, the variability inherent in the current systems are creating either a disconnect between what is examined and what is captured, or, at worst, adding or masking color data that would not be observed.

This project aims to quantify the variability in the fundus camera/digital imaging system, and formulate a system of management/correction to act as a sort of baseline calibration for all systems. Benefits would include a more accurate record of patient data, and providing the potential for the image to stand in for the patient's physical presence, as in telemedicine applications.

Bio Christye Sisson joined the Biomedical Photographic Communications department at RIT in 1997 after working as an ophthalmic photographer in Boston, Massachusetts and in Rochester, NY. Christye is an Associate Professor, and teaches various Biomedical Photography courses as well as Basic, Intermediate, and Advanced Ophthalmic Photography courses. In July 2010, she was appointed chair of the Photographic Sciences, including Biomedical Photographic Communications and Imaging and Photographic Technology. Christye holds a Visiting Faculty appointment at the Eye Institute, a Master's Degree in Information Technology, a Bachelor's of Science in Biomedical Photographic Communications, and is a Certified Retinal Angiographer.
Session IVTelemedicine / Mobile displays
Masahiro Yamaguchi
High-fidelity Color Reproduction and Multispectral Medical Imaging

Experimental investigations on medical color imaging, with using spectrum-based color reproduction system, are introduced. Experiments were carried out in the applications of video telemedicine, surgery video, dermatology, and pathology imaging. The system consists of color or multispectral cameras, devices for illumination spectrum measurement, calibrated color displays, and the spectrum-based color conversion.

In the experiment of video telemedicine, a 6-band video camera was installed at a clinic in a small island and multispectral video of a simulated patient was transmitted to a core hospital in real time. In the surgery video experiment, short clips of open surgery were recorded and medical doctors visually evaluated the displayed images. In addition, both video and still-image systems were evaluated by dermatologists. As the results, doctors rated that multispectral systems achieved sufficiently higher color reproducibility, better image fidelity, and superior appearance of material surface, as compared with conventional RGB based systems. In the digital pathology imaging, the color is affected not only by the imaging device characteristics but by the staining processes. Thus applying multispectral imaging to pathology, the dye amounts were estimated for every pixel, allowing the color correction of staining variation.

Multispectral image analysis is obviously valuable as well. For example, indistinct inflammatory skin lesions were successfully enhanced by spectral color enhancement technique. In histopathology imaging, it was shown that a particular tissue element could be visualized by spectral analysis.

It can be concluded that quantitative color information captured by spectrum-based technique plays important roles for both color image display and analysis.

Bio Masahiro Yamaguchi, D. Eng., is a professor in Global Scientific Information and Computing Center, Tokyo Institute of Technology since 2011. He is a chair of CIE TC8-07 "Multispectral imaging."
Thomas Roger Schopf
Importance of Colors in Teledermatology

Telemedicine enables remote diagnosis and management of medical conditions. Teledermatology is the use of telemedicine within dermatology. The main benefit for patients is less travelling and easier access to health services. Two main modalities may be applied in teledermatology: Real-time or store-and-forward telemedicine. While the former was in use in the beginning of the teledermatology era, store-and-forward techniques have gradually taken over. A variety of web-based store-and-forward services have been set up to enable remote consultations. Typically, a primary care physician or a nurse sends case history information and digital images showing the patient`s skin to a dermatologist. The dermatologist responds to the request at a time of convenience. The main use of teledermatology is in the triage of patient referrals from primary care to specialist health care. Research data indicate that up to 70% of referred patients may be treated in primary care, thus avoiding the travel to see the specialist.

Many studies have shown that telemedicine can be used for remote diagnosis of skin disease with a high level of accuracy. Conditions affecting colour quality include lighting, camera settings, image compression and image display. Both colour accuracy and consistency are important in teledermatology. Although most teledermatologists would emphasize the importance of accurate colour in the decision making process, there seems to be little evidence on the clinical significance of colour in teledermatology.

Bio Thomas Schopf is a specialist in dermatology. He received his medical degree at the University of Oslo medical school in 1995. After working in general practice and in the Norwegian armed forces he completed his residency in Tromsø at the Department of Dermatology, University Hospital of North-Norway. In 2007, Thomas Schopf was affiliated with the Norwegian Centre of Integrated Care and Telemedicine in Tromsø. His research interests are in dermatoscopy, telemedicine and e-learning. He has submitted his PhD thesis on atopic eczema and e-learning and is awaiting his viva voce examination.
Elizabeth Krupinski
The Role of Color in Telemedicine Applications

Physicians rely on images as part of the arsenal with which diseases and other abnormalities are detected, diagnosed and treated. Traditionally we think of these images as coming from radiology, but with the advent of digital technologies for readily acquiring specialty specific images (e.g., pathology, endoscopy, ophthalmology), the increased acquisition of visible light images using off-the-shelf devices, and the incorporation of the Electronic Health Record into the healthcare enterprise, color medical images are rapidly proliferating. Optimal display of these color medical images is critical to the interpretation process. This talk will discuss some of the areas in telemedicine where color image acquisition and display are critical, the types of research being done in these areas, and some of the challenges still being faced.


Dr. Krupinski is a Professor at the University of Arizona in the Departments of Radiology, Psychology and Public Health. She is Vice-chair of Research & Education in the Department of Radiology. She received her BA from Cornell, MA from Montclair State and PhD from Temple, all in Experimental Psychology. Her interests are in medical image perception, observer performance, medical decision making, and human factors. She is also Associate Director of Evaluation for the Arizona Telemedicine Program. She has published extensively in these areas, and has presented at conferences nationally and internationally. She is Past Chair of the SPIE Medical Imaging Conference, Past President of the American Telemedicine Association, President of the Medical Image Perception Society, and Past Chair of the Society for Imaging Informatics in Medicine. She serves on a number of editorial boards for both radiology and telemedicine journals and is the Co-Editor of the Journal of Telemedicine & Telecare. She serves regularly as a grant reviewer for the NIH, DoD, TATRC and other federal, state and international funding agencies and has served as a member of a number of FDA review panels.
Session VDisplays
Wei-Chung Cheng
Primary Stability: Mechanism, Measurement, Metric, and Remedy

One of the major factors that obstruct the consistency and interoperability of medical color LCDs is the challenge of accurately characterizing and modeling the LCD color response, which originates from the instability of the primaries. The primary instability also manifests itself in other forms such as color gamut shrinkage, color shift, gray imbalance, and contrast reduction. In this talk, we will introduce a quantitative metric for measuring the primary stability and its applications in assessing display quality, guiding display calibration, and optimizing display images.
Bio Wei-Chung Cheng received his Ph.D. in Electrical Engineering from University of Southern California in 2003. He was an Assistant Professor in the Department of Photonics, National Chiao-Tung University, Taiwan before joining the US Food and Drug Administration in 2009. His current research interests include color science, applied vision, eye movement, image acquisition systems, and display systems.
Andy Masia
Display Color Measurement

Visually meaningful and repeatable display color measurement is a prerequisite for their calibration and characterization. This paper reviews general color measurement principles with respect to important display characteristics.

Color measurement principles include tristimulus colorimtery and its physiological basis in color matching, and radiation source geometry. From this basis requirements for color measuring devices are derived including spectral sensitivity and sampling, and front end optical collection systems. Various types of color measurement devices that are useful for display measurement are categorized and described.

Bio Mr. Masia currently is the WW Technical Director, OEM Sales at X-Rite Incorporated. X-Rite is the world leading supplier of instruments, software, and technologies for the measurement and control of color across a wide range of industries and applications. Prior to his current position at X-Rite Mr. Masia was the Director of Product Development for X-Rite?s Center of Excellence for Display Technologies. In this role he was responsible for definition, design, and delivery of all X-Rite products used specifically for measurement of softcopy display and projection systems.

Mr. Masia has spent his career developing and marketing components, systems, and solutions for commercial color image processing and reproduction. He holds Bachelor and Master of Science Degrees from the Rochester Institute of Technology.

Tom Kimpe
Color Behavior of Medical Displays

For many years medical displays have been greyscale displays because of their higher luminance and contrast levels. During the last three years a transition has taken place and most medical displays today are color. At the same time, more and more modalities are producing data where color information has a diagnostic meaning rather than purely being used for visualization of meta-data.

This talk will provide a detailed overview of color behavior of medical display systems. Based on literature and actual measurements on a large number of displays, important characteristics of color displays will be described. This includes eg. color point stability of greyscales and (stability of) color points of primaries. But more importantly, also variation of the entire color gamut will be described including variations in between individual display systems of the same type, as well as variations between different display types.

A second part of the talk will briefly provide an overview of current industry-standard calibration algorithms for medical display systems. Goal is to make clear which types of color instabilities can be handled by existing calibration algorithms and which instabilities remain unsolved. For the remaining instabilities a suggestion will be made for more advanced calibration algorithms that potentially can offer a solution. Finally, the link will be made with relevant medical applications such as clinical photography, digital microscopy and endoscopy. Each of these applications has their own requirements related to color behavior. Comparing these application requirements with characteristics of displays and calibration algorithms will make clear that it is certainly not given that one generic set of display specifications can offer the best solution.

Bio Tom Kimpe received his masters in computer engineering from University of Ghent, Belgium in 2001. He also obtained a PhD from the same university on the topic of image quality of medical displays. In 2010 he finalized a Masters in Business Administration at the Vlerick Management School.

Since 2001 Tom has been working in Barco's Healthcare Division. He has taken the positions of development engineer, project manager, innovation manager, VP of Technology and Innovation and Chief Technology Officer of Barco's Healthcare Division. Already for several years, Tom is coordinating all research and innovation activities of Barco's Healthcare Division and is steering an international team of researchers in USA, Belgium and Italy. His main topics of expertise are (medical) display technology, image quality modeling and human perception.

Takashi Matsui
Advancement of LCD Technologies and Consistent Presentation of Image

Great advancement of liquid crystal display technologies we've recently seen sometimes damage the most important mission of medical displays, to provide consistent presentation of clinical images (CPI) especially when the images are colored and unless the technologies are properly used.

This talk describes concretely how the CPI can be damaged and introduces/proposes solutions from the perspective of a display manufacturer.

Bio Takashi Matsui started his engineering career at Eizo in 1993 and then participated in several standardization activities at VESA, USB Device Working Group and UPnP Implementers Forum etc. Under the VESA, he had served as the vice chair of Digital Packet Video Link, in short, DPVL committee for two years.

Since 2005, he has been participating in the standardization of Quality Control for medical image display systems under IEC as a representative of Japan Industrial Association of Radiological Systems.

Paul Boynton
Color Error in Mobile Displays and Desktop Monitors

A variety of mobile and desktop displays are evaluated for their ability to render color images correctly. The color error from a smartphone, tablet, typical desktop monitor, and a medical monitor are determined relative to a reference image. Several color correction methods are also applied to these displays in an effort to reduce the rendered color errors. The results of this study provide a sampling of the current state of display color rendering accuracy, and quantify the relative impact of color correction methods.
Bio Paul Boynton has been at NIST for the past 31 years. Initially, he worked in the area of DC-low frequency standards. For fourteen years, he had been with the Display Metrology Project at NIST, of which he was the project leader. Currently, he is also involved with the NIST Smart Grid standards acceleration effort. His interest is in the development and evaluation of electronic display measurement procedures, diagnostics, and standards. Mr. Boynton has served as a technical expert for the ISO TC159/SC4/WG 2 (Visual display requirements), and the Society for Information Display (SID) International Committee for Display Metrology. He served as the chair of the SID Standards and Definitions Committee and chair of the Council for Optical Radiation Measurements (CORM) Electronic Displays Technical Committee. He has been a member of the SID, CORM, and the International Society for Optical Engineering (SPIE).
Session VIStandards (DICOM, ICC, CIE, AAPM) & Color measurement
Balázs Vince Nagy
Chromatic Stimuli and Instrumentation in Vision Science and Testing

Color vision is one hot topic in vision research. Special devices and applications are made to present color stimuli and acquire the response of the test subjects. Both in human and animal research chromatic stimulations are applied in basic and clinical research studying the visual system and the effects of diseases on visual impairment. In the fields of psychology and neuroscience psychophysical and electrophysiological devices use color stimuli to generate responses of the visual system. The current presentation will show examples of the instrumental applications in vision research using chromatic stimulation. These instruments include calibrated computer displays, Ganzfelds, light sources and custom made devices along with their calibration issues including spectral characteristics and their effects on perception. Specific experiments with color stimuli in basic and applied research of human and animal vision will be introduced. Spatial and temporal characteristics of color vision will be detailed as related to color representation along with international standards and recommendations (ISCEV, CIE).
Bio Graduated as MSc in mechanical engineering at the Budapest University of Technology and Economics (Hungary, 2000), MSc in economics at the Corvinus University of Budapest (Hungary, 2005), specialization in illumination engineering at the Budapest Polytechnic (Hungary, 2006) and PhD in mechanical engineering Budapest University of Technology and Economics (Hungary, 2009) with the title of 'Measurement technology of human color identification and discrimination'.

Working position is senior lecturer at the Department of Mechatronics, Optics Budapest University of Technology and Economics and currently is a research fellow at Institute of Psychology of the University of Sao Paulo.

Active member of the International Commission on Illumination (CIE) from both Hungarian and Brazilian side and the International Electrotechnical Commission (IEC) representing Brazil in the maintenance team on Medical image display systems.

Phil Green
The ICC Approach to Color Management

The ICC colour management architecture was first established almost 20 years ago as an open consortium of the major vendors of colour instrumentation, software and imaging devices, and has proved to be a robust framework for exchanging colour information across devices, platforms and colour encodings. ICC focuses primarily on the profile specification, ISO 15076, and also publishes a range of technical White Papers and other informative documents on its web site ICC has a number of active working groups that work on development of the specification and on aiding implementation in different market sectors.

A fundamental element of the ICC architecture is the use of a well-defined colorimetric exchange space. Known as the Profile Connection Space, this is based on the 1931 CIE standard observer and the CIE D50 illuminant. In practice, source and destination data encodings are often based on other illuminants, and such data is transformed to the ICC PCS by chromatic adaptation. Other connection spaces are possible, and current work in ICC is aimed at supporting spectral data as well as other colorimetric observers and illuminants.

The ICC profile is a binary file format, with well-defined data typing and a flexible tag structure. It is supported by almost all professional colour hardware and software, and is widely used in consumer and business markets. ICC colour management requires profile generators, colour management-aware applications, and colour matching modules (CMMs) that interpret the profile and apply it to the data. A wide range of utilities are available to those implementing colour management, including professional software applications, open source utilities, and support within programming environments such as Java and Matlab.

Bio Phil Green is currently Associate Professor of colour imaging at Gjøvik University College, Norway, and is the Technical Secretary of the International Color Consortium. Before joining GUC, he ran a postgraduate teaching and research program in colour imaging at London College of Communication. His PhD in colour science was obtained from the Colour & Imaging Institute, University of Derby, UK.

Phil has also written or edited several books on colour imaging, including 'Understanding Digital Color', 'Colour Engineering' and 'Colour Management'.

David Clunie
DICOM & IHE Standards for Medical Color Imaging

The Digital Imaging and Communications in Medicine (DICOM) standard is universally used for encoding, storing and distributing images in radiology, nuclear medicine and cardiology, not only for grayscale but also for true color and pseudo-color images. It is increasingly used in other specialties both for visible light and specialized forms of acquisition. DICOM information objects are defined for photography and video that are generally applicable to endoscopy and microscopy as well as for specific techniques such as ophthalmology and whole slide imaging. DICOM is used rather than consumer image formats like JPEG, TIFF, PNG and BMP since it provides a consistent mechanism for communicating patient and study identification metadata as well as acquisition technique information, and allows reuse of the existing medical imaging infrastructure and workflow. Color consistency in DICOM is addressed through the inclusion of ICC profiles either in the images or in separate presentation states, objects that define how to display a particular image, unlike for grayscale images for which DICOM defines a standard display function; the intent is to leverage the availability of ICC color calibration and management technology from other industries. Additional information in the DICOM images describes the color characteristics of the illuminant and optical path. The Integrating the Health Care Enterprise (IHE) standards include profiles for Consistent Presentation of Images (CPI) that leverage the DICOM standard and provide a forum for interoperability testing of different DICOM implementations (the IHE Connectathon).
Bio David Clunie is a neuro-radiologist, medical imaging software developer and consultant on DICOM and PACS. He owns PixelMed Publishing and is the CTO of CoreLab Partners, Inc, a Princeton, NJ company that performs independent review and provides core laboratory and contract research services for image-based clinical trials, particularly for new oncology drugs and biologics.

He is the editor of the DICOM standard, was previously industry co-chair of the DICOM Standards Committee, serves on various DICOM working groups, is the co-chair of the Integrating the Healthcare Enterprise (IHE) Radiology Technical Committee, and is also a member of the American College of Radiology's (ACR) DICOM Standards and IT Informatics Committees, and was a participant in the National Cancer Institute (NCI) Cancer Biomedical Informatics Grid (caBIG) in vivo Imaging Workspace.

Aldo Badano
Standards and recommendations for color medical displays, a review of current activities at AAPM and IEC

In this talk, I will review current efforts aimed at providing standard methodologies to characterize the color performance of medical displays including an intercomparison of display color meters and proposed approaches to quantify agreement with a target color response.
Bio Aldo Badano is the Laboratory Leader for Imaging Physics in the Division of Imaging and Applied Mathematics, Office of Science and Engineering Laboratories, Center for Devices and Radiological Health, US Food and Drug Administration. Dr. Badano leads a program on the characterization, modeling and assessment of medical image acquisition and display devices using advanced experimental and computational methods. Dr. Badano is also an affiliate faculty of Bioengineering at the University of Maryland, College Park and an adjunct professor at the Computer Science and Electrical Engineering Department of University of Maryland, Baltimore County.

He received a PhD degree in Nuclear Engineering and a MEng in Radiological Health Engineering from the University of Michigan in 1999 and 1995, and a ChemEng degree from the Universidad de la República, Montevideo, Uruguay in 1992. He serves as Associate Editor for several scientific journals and as a reviewer of technical grants for DOD and NIH. Dr. Badano has authored more than 200 publications and a tutorial textbook on medical displays.