To evaluate 16-bit PSP cephalogram images for orthodontist-perceived quality of cephalometric landmark clarity at baseline and with three different image enhancements (emboss, inverse, and inverse/emboss). This presentation concerns results limited for detection of Porion and Pronasale. These two landmarks were evaluated in view of being extremes in contrast requirements. A Sectagraph (Denar Corporation, CA) was used with the DenOptix storage phosphor system (Dentsply/Gendex, IL). Images from 48 patients (plus 12 repeats) were presented randomly and simultaneously to 10 observers engaged in orthodontics. Each observer independently rated Porion and Pronasale detection (1 = poor; 2 = satisfactory; 3 = excellent). Equal numbers of images having single and double peak histograms were included. Enhancements used in the study were: (1) emboss; (2) inverse; and (3) inverse/emboss.