Aging display's effect on interpretation of digital pathology slide

It is our conjecture that the variability of colors in a pathology image effects the interpretation of pathology cases, whether it is diagnostic accuracy, diagnostic confidence, or workflow efficiency. In this paper, digital pathology images are analyzed to quantify the perceived difference in color that occurs due to display aging, in particular a change in the maximum luminance, white point, and color gamut. The digital pathology images studied include diagnostically important features, such as the conspicuity of nuclei. Three different display aging models are applied to images: aging of luminance and chrominance, aging of chrominance only, and a stabilized luminance and chrominance (i.e., no aging). These display models and images are then used to compare conspicuity of nuclei using CIE ΔE2000, a perceptual color difference metric. The effect of display aging using these display models and images is further analyzed through a human reader study designed to quantify the effects from a clinical perspective. Results from our reader study indicate significant impact of aged displays on workflow as well as diagnosis. Comparing original (not aged) images to aged images, aged images were significantly more difficult to read (p-value of 0.0005) and took longer to score (p-value of 0.02). Moreover, luminance and chrominance aging significantly reduced inter-session percent agreement of diagnostic scores (p-value of 0.0418).