Nancy O. Mahfouz¹, Aliza Virji¹, Parker Flanagan¹, Jana Radwan¹, Stephen Waite¹, Robert G. Alexander¹; ¹Department of Psychology & Counseling, New York Institute of Technology, USA

Radiologic diagnosis relies heavily on a clinician’s ability to notice faint visual cues, yet image interpretation is ultimately limited by both the biology of the human visual system and the quality of the display used to view images. Medical-grade monitors (MGMs) are designed to optimize this final stage of the imaging pipeline, but the vision science principles behind their specifications are not always made explicit. This project highlights the perceptual foundations of ACR–AAPM–SIIM standards for electronic medical imaging displays and explains how these standards support accurate clinical interpretation and decision making. We outline how luminance, contrast sensitivity, spatial resolution, color perception, and visual adaptation shape what radiologists can—and cannot—see on a display. Because human contrast sensitivity is nonlinear, monitors must be calibrated using the DICOM Grayscale Standard Display Function to ensure that small differences in grayscale values remain perceptible. High luminance ratios and stable minimum luminance levels protect low-contrast lesion detection, while pixel pitch and display size must align with the limits of foveal acuity and the useful visual field. Consistent luminance across the full screen is also essential, as peripheral vision plays a key role in guiding radiologists’ search patterns. Overall, this project demonstrates that display standards in radiology are grounded in the core fundamental properties of human vision. Understanding these perceptual constraints can help inform the selection of clinical displays and support ongoing efforts to improve diagnostic reliability through vision-science-aligned technology design.

Acknowledgements: This work was supported by a New York Institute of Technology Teaching and Learning with Technology grant and by the National Institute of Health (Award R16GM159810 to RGA), which provided support for student training and research activities that contributed to this project.