Abstract
INTRODUCTION: Focal areas of high radiotracer uptake in a bone-scan image can result in dynamic range of the intensity value to exceed the dynamic range of the display, requiring multiple interactive contrast adjustments. This unnecessary burden on time of physician can be avoided using power law equation to brighten up the low-intensity areas in image. However, despite the widespread availability of this technique in commercial systems, for this clinical setting, the gamma-value needs to be standardized. MATERIALS AND METHODS: Sixty dark bone scan images were selected. Ten randomly selected images from this set were evaluated qualitatively and quantitatively (perception-based image quality evaluator, absolute mean brightness error, structural similarity, and peak signal to noise ratio) to select a range of gamma values (from 0.1 to 0.9, increment of 0.1), where the results were acceptable. This range of gamma was then applied to rest of the 50 images to find the best value. Images were evaluated by two experienced nuclear medicine physicians. Although not ideal, but for the purpose of simplicity, we tried reaching a single best value. For this, the physicians were asked to reach consensus on the acceptable images. RESULTS: In the first part of the study, after evaluation of 100 images (1 original and 9 processed images with 0.1-0.9 gammas), range of gamma values from 0.3 to 0.8 was found to be optimum. This range was then applied to rest of the 50 images. Evaluation of resultant 350 images (1 original and 6 processed for each input image) further narrowed this range to 0.4-0.7 (0.3 gamma selected only twice by one physician). The kappa for acceptable images was moderate at 0.482 (P <0.001). The single gamma value of 0.6 resulted in 72% of the images to be acceptable. CONCLUSION: Use of power law equation to brighten up the low intensity areas of dark bone scan images, without loss of clinically significant details, is feasible with single gamma value of 0.6 and range of 0.4-0.7 giving best results.