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The display of medical images involves transforming recorded intensities such at CT numbers into perceivable intensities such as combinations of color and luminance. For the viewer to extract the most information about patterns of decreasing and increasing recorded intensity, the display designer must pay attention to three issues: 1) choice of display scale, including its discretization; 2) correction for variations in contrast sensitivity across the display scale due to the observer and the display device (producing an honest display); and 3) contrast enhancement based on the information in the recorded image and its importance, determined by viewing objectives. This paper will present concepts and approaches in all three of these areas. In choosing display scales three properties are important: sensitivity, associability, and naturalness of order. The unit of just noticeable difference (jnd) will be carefully defined. An observer experiment to measure the jnd values across a display scale will be specified. The overall sensitivity provided by a scale as measured in jnd's gives a measure of sensitivity called the perceived dynamic range (PDR). Methods for determining the PDR fran the aforementioned PDR values, and PDR's for various grey and pseudocolor scales will be presented. Methods of achieving sensitivity while retaining associability and naturalness of order with pseudocolor scales will be suggested. For any display device and scale it is useful to compensate for the device and observer by preceding the device with an intensity mapping (lookup table) chosen so that perceived intensity is linear with display-driving intensity. This mapping can be determined from the aforementioned jnd values. With a linearized display it is possible to standardize display devices so that the same image displayed on different devices or scales (e.g. video and hard copy) will be in sane sense perceptually equivalent. Furthermore, with a linearized display, it is possible to design contrast enhancement mappings that optimize the transmission of information from the recorded image to the display-driving signal with the assurance that this information will not then be lost by a -further nonlinear relation between display-driving and perceived intensity. It is suggested that optimal contrast enhancement mappings are adaptive to the local distribution of recorded intensities.
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