Digital image manipulation: what constitutes acceptable alteration of a radiologic image?

ability toremove existing objects, change theshape ofexist-ingobjects, orintroduce newobjects.Inacademic publishing, digital image manipulation isben-eficial when done forappropriate reasons. Forexample, anincorrectly exposed radiograph canbedigitally corrected sothattheactual findings arebetter depicted inthepublishedmanuscript. Also,defects andartifacts canberemoved fromanimage (Fig. 1).However, itisalsoveryeasy toalteramedical image forlessadmirable purposes. Forexample,images could bemanipulated topromote oneimaging tech-nique overanother. Poorly visualized findings could bedigi-