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Skyrocketing health care costs and pressures from managed care have combined to promote cost-cutting strategies in radiology and radiation oncology departments. A study was conducted to evaluate the use of a high-resolution laser printer for printing plain-paper images as substitutes for both original and duplicate radiologic film images. A variety of radiologic images were used to evaluate the image reproduction capabilities of the printer in terms of linearity, detail, and contrast. In many cases, printed images had a quality comparable to that of the original images. Six computed tomographic (CT) scans and six radiation therapy simulator radiographs were compared with printed reproductions by each of seven board-certified radiation oncologists, who rated the reproductions as acceptable for documentation, acceptable for diagnostic purposes (CT scans only), or unacceptable. Ninety-five percent of printed CT images and 90% of printed simulation images were rated acceptable for documentation. The quality of printed images of radiation therapy port films was not quantitatively measured but was improved by adjusting image contrast and brightness and using various image enhancement techniques. The use of printed images is less expensive than that of processed film and eliminates the environmental, time, storage, and delivery problems associated with film. Technologic advances in imaging, networking, and printing have made possible the inexpensive duplication of medical images.

A decision between film and paper for CT hard copy must be based on the different latitudes of the two media. The author conducted a receiver operating characteristic (ROC) analysis in which image information was matched to the characteristics of the recording media by adjusting both the window width of the display and the monitor contrast. Under these conditions, film images were found to be superior to print images for detection of noise-limited features. It is proposed that if the same optimization procedure were applied to clinical CT scans, the information content of the images could be increased.

A method of recording continuous gray-tone images on dry-process silver paper from raster-scan video signals is described. The Tektronix 4634 image-forming module uses a fiber-optic faceplate cathode-ray tube to couple the light output onto the recording paper. The latent image is heat developed and presented in sheet form. An initial comparison between dry silver paper and conventional film for video-generated computed tomography and nuclear medicine examinations, shows little apparent difference in image quality. Considerable cost savings are possible when using dry silver paper. Additional cost savings are possible if multiple images can be recorded on each dry silver sheet.

A method to display CT scans on paper has been developed using an electrostatic printer. The scans are displayed in threshold and gray level form, allowing the radiologist to utilize the CT values in the analysis of the scan. This system also has logistic, storage, and economic advantages.