Digital Pathology Guide:
The Right Monitor

There are still no regulations on using monitors in pathology. However, some experiences and recommendations help pathologists view slides optimally on the monitor.

This guide gives you an overview of the critical aspects, from image quality to technical performance. All information is based on our extensive dialog with experts and users from the field of pathology, as well as on the “Digital Pathology Guide” published by the Federal Association of German Pathologists.

At the end, you will have a precise orientation guide.

Access your guide to diagnostic precision here:

Q&A Monitors for Digital Pathology

The higher the screen resolution, the less pixelated images appear, providing more precise contours and clearer content. For scrutinizing digitally captured images from WSI scanners, robust resolution is crucial to retain intricate detail and data for accurate pathological diagnoses.

When choosing the right screen size, the physical working area and the user‘s field of vision are the most important factors. For use in the digital pathology workflow, the monitor should be selected to match the user’s natural field of view.

Recommended sizes and resolutions include:

  • 27-inch monitor: resolution min. 4 MP (2560×1600)
  • 30-inch monitor: 6 MP (3280×2048)
  • 32-inch monitor: 8 MP (3840×2160)

The luminance or brightness of a display is conventionally measured in candelas per square meter (cd/m²), where a single candela approximates the radiant intensity of an everyday candle. The National Association of German Pathologists recommends a minimum image brightness of 300 cd/m² for monitors in pathology diagnostics, reflecting the familiarity of a traditional microscope view.

The contrast in a monitor pertains to the relationship between the deepest blacks and the brightest whites, illustrated by a static contrast ratio of 1000:1, indicating a thousandfold difference in brightness between an all-white and an all-black image.

A minimum contrast ratio of 1000:1 (static contrast ratio) is recommended for monitors in pathology diagnostics to ensure optimal differentiation between dark and bright sections within images.

Image homogeneity refers to the consistency of brightness and color across the entire monitor. It is crucial for diagnostically relevant content to ensure the pathologist always sees the same image, regardless of its position on the monitor.

Fluctuations in brightness and color can be compensated using a DUE function (Digital Uniformity Equalizer).

A monitor‘s refresh rate quantifies the frequency of new image rendering per second, measured in hertz (Hz). A high refresh rate enables smooth navigation in the slide as well as zooming in and out.

For example, the manufacturer EIZO uses a frame rate of 60 Hz for medical monitors. No recommendation is currently given in the „Digital Pathology Guidelines“ of the Federal Association of German Pathologists.

In the absence of established color reproduction standards in pathology, consistent quality assessments are crucial. Color standards should be used as a guide when calibrating.

The most essential color spaces are sRGB, Adobe RGB, BT.2020, and DCI P3. Most products, including monitors, printers, digital cameras, and applications, are configured to reproduce the sRGB color gamut as accurately as possible.

When two devices use different color palettes, such as a WSI scanner and a monitor, color reproduction will differ. To ensure accurate color reproduction, consideration should be given to using defined color standards and calibrating monitors accordingly.

The brightness of a monitor gradually decreases over time. Only regular quality checks and calibrations guarantee the consistent precision of the display and uniform image reproduction throughout their service life. In addition, the use of calibratable medical monitors guarantees compliance with future standards.

Software calibration requires adjustments in the monitor‘s graphics board. Consequently, the monitor must remain paired with the same computer to retain settings.

Hardware calibration involves adjustments in the monitor, covering parameters like brightness, white point, and gamma values. Any modifications are directly encoded into the monitor‘s Lookup-table (LUT) for meticulous calibration precision.

The Hardware calibration boasts superior precision compared to software calibration.

We will be happy to assist you personally with selecting monitors and other systems for your digital diagnostics workflow. Give us a call at +49 221 999943-00 or send us a message here.