Under typical dark conditions found in reading rooms, a reader's pupils will contract and dilate as the visual focus
intermittently shifts between the high luminance monitor and the darker background wall, resulting in increased visual
fatigue and the degradation of diagnostic performance. A controlled increase of ambient lighting may, however,
minimize these visual adjustments and potentially improve reader comfort and accuracy. This paper details results from
two psychophysical studies designed to determine the effect of a controlled ambient lighting increase on observer
detection of subtle objects and lesions viewed on a DICOM-calibrated medical-grade LCD. The first study examined the
effect of increased ambient lighting on detection of subtle objects embedded within a uniform background, while the
second study examined observer detection performance of subtle cancerous lesions in mammograms and chest
radiographs. In both studies, observers were presented with images under a dark room condition (1 lux) and an increased
room illuminance level (50 lux) for which the luminance level of the diffusely reflected light from the background wall
was approximately equal to that of the displayed image. The display was calibrated to an effective luminance ratio of
409 for both lighting conditions. Observer detection performance under each room illuminance condition was then
compared. Identification of subtle objects embedded within the uniform background improved from 59% to 67%, while
detection time decreased slightly with additional illuminance. An ROC analysis of the anatomical image results revealed
that observer AUC values remained constant while detection time decreased under increased illuminance. The results
provide evidence that an ambient lighting increase may be possible without compromising diagnostic efficacy.
Last year in this conference, we presented a theoretical analysis of how ambient lighting in dark reading rooms
could be moderately increased without compromising the interpretation of images displayed on LCDs. Based on
that analysis, in this paper we present results of two psychophysical experiments which were designed to verify
those theoretical predictions. The first experiment was designed to test how an increase in ambient lighting affects
the detection of subtle objects at different luminance levels, particularly at lower luminance levels. Towards that
end, images of targets consisting of low-contrast objects were shown to seven observers, first under a dark room
illumination condition of 1 lux and then under a higher room illumination condition of 50 lux. The targets had three
base luminance values of 1, 12 and 35 cd/m2 and were embedded in a uniform background. The uniform background
was set to 12 cd/m2 which enabled fixing Ladp, the visual adaptation luminance value when looking at the display,
to 12 cd/m2. This value also matched the luminance value of about 12 cd/m2 reflected off the wall surrounding the
LCD at the higher ambient lighting condition. The task of the observers was to detect and classify the displayed
objects under the two room lighting conditions. The results indicated that the detection rate in dark area (base
luminance of 1 cd/m2) increased by 15% when the ambient illumination is increased from 1 to 50 lux. The increase
was not conclusive for targets embedded in higher luminance regions, but there was no evidence to the contrary
either. The second experiment was designed to investigate the adaptation luminance value of the eye when viewing
typical mammograms. It was found that, for a typical display luminance calibration, this value might lie between 12
and 20 cd/m2. Findings from the two experiments provide justification for a controlled increase of ambient lighting
to improve ergonomic viewing conditions in darkly lit reading rooms while potentially improving diagnostic
performance.
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