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Principles of cathode-ray tube and liquid crystal display devices

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 Aldo Badano, PhD

■ DIGITAL RADIOGRAPHIC DISPLAY TECHNOLOGIES

Principles of Cathode-Ray
Tube and Liquid Crystal
Display Devices1

The effectiveness of digital diagnostic imaging modalities that rely on display devices
for interpretation, review, or consultation is determined by the performance of indi-
vidual system components, from the image acquisition device through image pro-
cessing and transmission, until the image is displayed and a diagnosis is determined.
When human observers are in charge of or involved in the diagnostic decision-making
process, the quality of the display system has important effects on overall system
performance and the ability of the observer to make an accurate diagnosis.
Current display offerings for diagnostic radiology systems are based on two com-
peting technologies, the cathode-ray tube (CRT) and the active-matrix liquid crystal
display (AMLCD). The CRT is a half-century-old mature technology that is based on
the excitation of cathodoluminescent phosphors by focused energetic electron beams.
Light is generated in an emissive structure, where it diffuses in a controlled manner
until it emerges toward the viewer, forming the displayed image. The AMLCD, which
is based on active-matrix liquid crystal (LC) modulators, is the result of 25 years of
engineering advances.
Display image quality can be defined as the relationship between the information
contained in the image and the information conveyed to the observer through a lu-
minance field. When all available information is transferred, the display system is
considered to provide full fidelity. For applications with high information content
(eg, diagnostic radiography), this situation is never found in reality. Display systems
always degrade the information content of the image because of limitations in many
areas. On the other hand, when the information conveyed matches the limitations of
the visual system of the observer, the display system can be defined as a high-fidelity
system, even when it fails to convey image information that is beyond human visual
capabilities (1).
This chapter introduces the design principles and components of modern mono-
chrome medical devices used for the display of digital radiographs. The chapter begins
by reviewing basic technologic features of CRT and AMLCD devices, with an emphasis
on aspects that affect the quality of the displayed image. The chapter then describes
key trade-offs in display design and their relationship to image quality. Finally, the

Advances in Digital Radiography: RSNA Categorical Course in Diagnostic Radiology Physics 2003; pp 91–102.
1From the Medical Imaging and Computer Applications Branch, Office of Science and Technology, Center for Devices

and Radiological Health, Food and Drug Administration, 12720 Twinbrook Pkwy, HFZ-142, Rockville, MD 20857 (e-mail:
agb@cdrh.fda.gov).

The mention of commercial products herein is not to be construed as either an actual or implied endorsement of such
products by the U.S. Department of Health and Human Services. This chapter is a contribution of the Food and Drug 91
Administration and is not subject to copyright.
 Figure 1. Components of a
typical medical CRT. The glass
Badano
bulb contains the electron gun,
while the deflection coils fit
snugly outside the neck of the
tube. Drawing at right shows
elements involved in the gen-
eration and transport of light.
Energetic electrons excite the
cathodoluminescent phosphor,
generating light that scatters
multiple times before it emerges
to form the image on the screen.
AR = antireflective. (Adapted,
with permission, from refer-
ence 40.)
chapter reviews some of the long list of display speci-
fications that need to be considered in comparing
devices for specific applications.
BASIC COMPONENTS OF MEDICAL CRTs
CRT technology has matured for more than 100 years—
from the discovery of luminescent “phosphor” mate-
rials in 1630 by Vincenzo Cascariolo, an Italian shoe-
maker and alchemist, until the recent development of
complex electron optics for beam focusing. The first
commercial CRTs were produced in the early 1920s,
but not until the 1940s did massive numbers of units
become available as consumer products (2).
The CRT is a cathodoluminescent display: light is
generated by exciting a luminescent material with en-
ergetic electrons. An electron gun located in the back
of the device emits an energetic beam that strikes a
phosphor screen within a small spot steered in a raster
scan by magnetic deflection coils. Finally, a cathodo-
luminescent phosphor converts electron energy into
light. The beam current is modulated to cause vary-
ing brightness. The electron beam travels in a vacu-
um region contained by a glass bulb made out of
thick glass to reduce the mechanical stress. A 74-cm-
diagonal bulb with a relatively flat faceplate requires
glass thickness of about 13 mm. Figure 1 shows the
main components of a typical CRT.
Electron Beam
Electrons are generated by a resistive heater that
promotes thermal emission from low-surface-poten-
tial materials with temperatures of about 600°C. The
stability of the emission is ensured in modern high-
performance CRTs by using dispenser cathodes that
consist of a porous pellet impregnated with emissive
oxide material. Dispenser cathodes can achieve higher
current density with longer lifetime and better stabil-
ity than conventional oxide cathodes because of the
replenishment of the oxide material. In addition, dis-
penser cathodes have better aging characteristics, with
92 only about 1% loss in emission for every 1,000 hours.
The electron beam generated at the cathode is accel-
erated and focused by a series of electrostatic Einzel-
type lenses that form the electron gun. The beam is
then directed at a particular spot in the emissive screen
by a deflection yoke situated at the exit of the electron
gun. The yoke is an external device designed to fit
closely the shape of the glass bulb. It generates mag-
netic fields responsible for the beam deflection. The
electron beam then traverses the remaining field-free
vacuum space until it hits the front screen. For large-
screen CRTs, the degradation of the focus at large
angle deflections is controlled with dynamic focusing
provided by special yoke designs.
Emissive Structure
A key component of the CRT that markedly affects
its image quality is the emissive structure, which con-
sists of all of the elements responsible for the genera-
tion and delivery of light. Emissive structures vary
greatly according to the type of CRT. In general, they
consist of a conductive coating (normally a thin alu-
minum overcoat), a cathodoluminescent phosphor
(3), a black-matrix layer, a glass faceplate, and some-
times an antireflective coating. A smooth, continuous,
and highly reflective submicrometer layer of alumi-
num is overlaid on top of the phosphor to conduct
the incoming electron current and maximize light
output toward the viewer.
Cathodoluminescent phosphors are deposited onto
a glass faceplate panel as a powder layer by using a
sedimentation technique. The choice of phosphor is
an important element to consider when comparing
different monitors. Typically, two alternatives exist:
single-component phosphors (eg, P45) and blended
phosphors (eg, P104). These two phosphors differ in
many aspects. First, the luminous efficiency of a P104
screen (ie, the percentage of luminance compared
with that of a standard phosphor [P4] under specified
conditions of beam current, high voltage, and face-
plate transmission) is about 54% higher than that of a
P45 screen. This implies that for the same tube con-
figuration, the maximum luminance of a CRT with

a. b.
Figure 2. Photographs of (a) P104 and (b) P45 CRT screens
showing the difference in noise appearance caused by granu-
larity. (Adapted, with permission, from reference 41.)
Figure 3. Transmission through the faceplate of medical moni-
tors is typically 0.2–0.5 to reduce reflections from ambient lights.
Assuming a transmission of 0.3, diffuse reflections are reduced
to 9%, resulting in improved black levels. The display brightness
is only reduced to 30%. Absorption also reduces veiling glare by
dampening the scattering within the faceplate. (Reprinted, with
permission, from reference 41.)
P104 is higher than that obtained with a P45 phos-
phor. On the other hand, P104 phosphor is a mixture
of grains of different color, which causes a granular
appearance and affects the perceived image noise.
P45 is a single-component phosphor and has re-
duced granularity relative to P104 (Fig 2). The differ-
ence in the luminance noise levels of P45 and P104
phosphors has been documented by Muka et al (4)
with measurements of noise power spectra.
These figures come into play when one considers
the long-term use of the display and the aging caused
by coulomb loading, a term used to represent the
amount of electron energy deposited in the phos-
phor grains. Phosphors degrade over time because of
material changes in regions of high electron bom-
bardment and high current density. The correspond-
ing decrease in brightness that occurs needs to be
corrected for over the useful lifetime of the monitor
by increasing the beam current. The output lumi-
nance of a P104 phosphor screen decreases faster
CRT and LCD Display Devices
than the output of a P45 screen with a given current
density. In other words, the maximum luminance of
a CRT with a P45 phosphor is more stable and needs
less adjustment of the electron beam current during
the lifetime of the monitor.
The glass faceplate of a medical CRT may absorb as
much as 70% of the direct light to improve contrast
and may have a rough surface on the vacuum side to
reduce specular reflections. The absorbing faceplate
strongly reduces veiling glare caused by optical scat-
tering (5) and also reduces reflections of ambient
light. If we assume a transmission of 30%, the diffuse
reflections are reduced to no more than 9%, resulting
in improved black levels. Meanwhile, the display
brightness decreases only to 30% (Fig 3). Good-qual-
ity medical monitors have a thin-film surface coating,
which provides three benefits: (a) conduction (to
eliminate static charge and reduce dust collection),
(b) abrasion resistance, and (c) antireflective proper-
ties. Antireflective coatings have also been shown to
reduce veiling glare in CRTs (6). These coatings gener-
ally have many thin-film layers and are often lami-
nated as added glass thickness to the display surface.
Current multilayer designs are effective in reducing
the specular component of the display reflectance,
without sacrificing brightness or adding unwanted
color shifts.
Color CRTs
Although ubiquitous for desktop applications, color
CRTs typically have a lower display image quality
than monochrome CRTs with similar electron optics
design. Color CRTs differ markedly in their emissive
structure. In any of the current main design alterna-
tives (shadow mask or aperture grille), the emissive
structure contains a black layer known as the “black
matrix,” which separates the red-green-blue phosphor
dots that form an arrangement of color dots or stripes
for luminance and chromatic contrast. In addition to
increasing the degradation in contrast by veiling glare,
the light- and electron-scattering processes that take
place within the emissive structure degrade color satu-
ration. Color purity is obtained by increasing optical
absorption in the emissive structure and by reducing
electronic glare by using low-backscattering materials
as mask coatings (7–9).
Incorrect beam landing is also a major concern in
color CRTs because of the presence of the mask or grille.
If this occurs, that is, if the center of the electron beam
does not fall in line with the center of the phosphor dot,
color purity is degraded. In these designs, alignment of
the electron beam with the openings of mask or aper-
ture grille is paramount, and color electron guns often
compensate for aberrations and space-charge effects that
93
would degrade the convergence of the beam.
 IMAGE QUALITY TOPICS IN MEDICAL CRTs
Badano
The CRT Pixel
Many image quality aspects of CRTs are deter-
mined by the way the pixel luminance is generated
through electron bombardment of a cathodolumi-
nescent screen. The position of the electron beam across
the display screen is controlled by the horizontal and
vertical deflection amplifiers. When an image is dis-
played, the scanning electron beam is required to
modulate its intensity according to the gray-scale val-
ues representing the image. If there are large changes
in image values (which will be translated into large
changes in beam current and luminance output), the
electronics should be capable of modulating the beam
with a time constant smaller than the time needed
for the beam to excite the phosphor at that pixel lo-
cation. Therefore, the bandwidth requirements of
signal amplifiers depend on the pixel array size.
The electron spot size is defined typically as the
width at 50% of the maximum. At low luminance,
CRT spot sizes vary from 0.15 to 0.20 mm. The large
beam current needed to generate higher luminance
causes a larger spot size (0.15–0.30 mm) because of
the divergence of the beam caused by electrostatic re-
pulsion. The width at 5% of the maximum is typically
about twice the width at 50%. The spot size is not
constant across the screen but increases at the edges
relative to the center. To achieve uniform spot sizes, a
dynamic focus adjustment with the use of deflection
information can greatly improve the resolution uni-
formity of the monitor. Table 1 shows typical spot
sizes for different screen configurations.
Factors Affecting CRT Contrast
One important performance issue associated with
image quality in display systems is the ability of the
CRT device to achieve a large value for the small-spot
contrast ratio (10). This capability ensures that dark
areas of the screen with subtle image features are not
affected by brighter areas elsewhere in the screen. The
small-spot contrast of CRTs is dominated by veiling
glare and ambient light reflections (discussed later in
the “Display Reflectance” section).
Veiling glare in display devices is commonly associ-
ated with the multiple light-scattering processes that
take place in the emissive structures of CRTs, causing
a contrast reduction most marked in low-luminance
regions surrounded by bright areas. Although veiling
glare is typically associated with optical scattering or
light diffusion, other sources of veiling glare (light
leakage and electron backscattering) are less known
and also merit a detailed description (Fig 4).
To reduce veiling glare, high-performance mono-
chrome and color CRTs typically have an absorptive
faceplate that reduces the brightness. The contribution
94 to veiling glare caused by light-transport processes
Table 1
Pixel Sizes for Two CRT Screen Sizes
Pixel Size (mm)
No. of Array 300 × 400-mm 270 × 330-mm
Megapixels Size Screen Screen
1 900 ×.1,100 0.35 0.30
2 1,200 ×.1,600 0.25 0.21
5 2,000 ×.2,700 0.15 0.13
Note.—The calculation assumes a 50% overlap between
adjacent Gaussian-like spots.
within the emissive structure depends on the relative
location of dark and bright regions in an image.
Therefore, its effect is determined by the spatial lumi-
nance distribution of each image scene. Conversely,
the other two mechanisms that contribute to glare
(light leakage and electron backscattering) cause a
background signal that is approximately uniform
throughout the entire display surface.
The reflectivity of aluminum backing films used in
CRTs is typically greater than 90%. The transmitted
light will scatter off the walls of the bulb and may
eventually come back and exit through the faceplate,
adding a uniform undesired background to the image.
This light leakage has been recognized and used as
part of an experimental method to determine the alu-
minum layer thickness (11) and also for adjusting the
display curve according to illuminance measurements
made inside the CRT bulb. When the light intensity
transmitted through the aluminum film amounts to
10%, a uniform bright field will be contaminated by
an additional constant luminance of 5 × 10−4 times
the bright field intensity. This figure assumes that 90%
of the light is absorbed after all scattering events in the
walls of the tube. Typically, coatings for the inside sur-
faces of CRT bulbs are carbon-based absorptive mate-
rials, although metallic coatings containing copper or
silver are also used in certain applications. If a small
dark spot is placed in the center of an image at a lumi-
nance level of 1% of the bright field, its physical con-
trast will decrease from 99 to 94. In addition, the thin
aluminum coating that covers the phosphor layer may
have small cracks or holes that will allow more light
generated in the phosphor to escape toward the vac-
uum cell, further decreasing the contrast.
In addition to the optical component, an impor-
tant component of glare is caused by electron back-
scattering. The reduction in contrast caused by back-
scattered electrons has been studied for fluorescent
screens (12) and for scanning electron microscopes
(13). The contrast loss caused by electronic backscat-
tering in color tubes has been reported to be as much
as 98% of the total glare degradation (7,9). The con-
trast ratio of 10 × 10-cm black squares can be in-

creased by a factor of about 10 through careful selec-
tion of coating material and thickness. The absence
of a shadow mask in monochrome tubes results in a
lower backscattered fraction because all of the elec-
trons hit the aluminum conductive coating and
phosphor layer.
AMLCDs
The worldwide market for displays has evolved rap-
idly during the past several years. Panel sizes and reso-
lution have increased considerably, while prices have
decreased.
As opposed to the CRT emissive technology, AMLCDs
are light-modulating devices that form the image on
the screen by controlling the transparency of indi-
Figure 4. Schematic repre-
sentation of the three sources
CRT and LCD Display Devices
of veiling glare in CRTs: light
diffusion, light leakage, and
electron backscattering. AR =
antireflective. (Reprinted, with
permission, from reference
41.)
Figure 5. Cross section of an
AMLCD with in-plane switch-
ing pixel design. LC molecules
rotate under the influence of
the electric field but always re-
main in the display plane. This
arrangement improves the
viewing angle performance
but sacrifices brightness,
which can be compensated for
with a more powerful back-
light. The TFT is the switching
element for the addressing of
each pixel. a-Si:H = hydroge-
nated amorphous silicon, ITO =
indium tin oxide, E = electric
field. (Adapted, with permis-
sion, from reference 40.)
vidual display pixels. This technology, in its basic ar-
rangement, suffers from marked variations in lumi-
nance and contrast depending on the viewing angle.
However, during the past 10 years, LCD designs
with a more uniform luminance and contrast profile
within a larger viewing angle cone have been intro-
duced for radiology. AMLCDs consist of a stack of lay-
ers, each serving a particular purpose. Figure 5 shows
a cross section of a typical medical AMLCD consisting
of a backlight, polarizer and color filters, back and
front plates, and LC cells (14,15).
The LC Cell
Liquid crystal is an intermediate state of matter
(16) that exhibits properties typical of solids (ie, a
crystalline structure with a highly ordered molecular 95
 arrangement) as well as properties associated with
liquids (ie, viscosity). LC materials are typically long
Badano
organic molecules with multiple unsaturated bonds.
Because of the corresponding charge delocalization,
molecules are electrically polarized, forming strong
dipoles that tend to orient themselves along a main
axis (called the director), forming a unique spatial
configuration determined by elasticity, viscosity, and
deformation constants. This three-dimensional ar-
rangement of the LC molecules leads to anisotropy, a
characteristic defined as the dependence of the mate-
rial properties on the direction along which the
property is measured.
To modulate light transmission through the LC, the
orientation of the LC molecules must be controlled.
When LC molecules encounter a textured surface, they
align parallel to the grooves. The fundamental discov-
ery that led to display applications of LCs (14,15) is
that the orientation of the director can be altered by
an external electric field. When the director is twisted,
light polarization also twists as it passes through the
cell because of the birefringence of the LC layer. The
wavelength dependence of this effect leads to slightly
colored panels when a broad-spectrum backlight is
used.
With the help of polarizer films that allow trans-
mission of light when the polarization vector and
the axis of the film are aligned, LC cells can be de-
signed to transmit or block light, depending on the
orientation of the director, which is controlled by the
applied pixel voltage. When the twist in the LC direc-
tor and the configuration of top and bottom polarizer
films are such that light is fully transmitted with no
applied voltage, the arrangement is called “normally
white.” When light is blocked in these conditions, a
“normally black” design results. In addition to the
top and bottom substrates, LCD pixel structures re-
quire alignment layers, polarizer films, and electrodes.
The gap between the substrates (on the order of a few
micrometers) is maintained by spherical glass beads
that act as spacers.
Because of the multitude of elements that light
needs to go through before generating an image in
the front screen, LCDs are intrinsically inefficient de-
vices. Typically, only 3%–5% of the total light gener-
ated by the backlight is seen at the front face of color
LCDs. This fraction is higher for monochrome devices
(on the order of 8%–15%) because of the lack of ab-
sorption in the color filters. Given the transmission
of typical LC stacks, a highly efficient backlight is re-
quired. A backlight consists of one or many multiple-
phosphor lamps, a reflector, and a diffuser. The criti-
cal design parameters are compactness, uniformity,
efficiency, and lifetime. In LCD applications, both
behind-the-panel (brighter) designs and on-edge
(more uniform and thinner) designs have been de-
96
veloped. Another way to increase efficiency of the LC
transmission is by employing high-quality polarizer
films. These are typically iodine-doped polymer
films stretched in one direction. Finally, a major
cause of luminance loss in color LCDs is the red-
green-blue filters used to obtain full color. Typically,
each pixel is divided into three subpixels with a red,
green, or blue filter on top. The color filters can be
formed by patterning and dying resin deposits, by
pigment impregnation, or by printing.
The Active Matrix
The control of the pixel luminance is achieved by
controlling the voltage at each individual pixel. The
high-resolution displays used in diagnostic radiol-
ogy, with large numbers of rows and columns (high
pixel density), require active addressing methods
with a matrix or array of nearly ideal switches (fast
transition from the “black” state to full pixel trans-
mission) to allow faster and more accurate control of
the pixel luminance. The term “active” refers to the
ability to control each pixel in the array, as opposed
to passive addressing, in which pixels are controlled
a row or column at a time. In AMLCDs, the active el-
ement is usually a thin-film transistor (TFT). The
most commonly used TFT technology for AMLCDs is
hydrogenated amorphous silicon (a-Si:H) because of
its high mobility (0.6–1.5 cm2/V⋅s) and the reliabil-
ity of the manufacturing process with large area sub-
strates (17). A fundamental characteristic of the TFT
design is the on-off current ratio; low-leakage cur-
rents, which affect the “off” state, are needed for
high-definition display systems (18).
The TFTs are usually located on one of the corners of
the display pixel. Because an opaque coating shields
the TFT circuitry from the high illumination pro-
duced by the backlight, light is not transmitted over
the area where the TFT is deposited. In addition, cer-
tain pixel areas can have low light transmission (eg,
metal electrodes). The fraction of the total pixel area
that allows transmission of light is called the “aperture
ratio.” In consumer product displays, the aperture ratio
can be as small as 50%, while in high-performance dis-
plays, it can be as high as 80%. The aperture ratio af-
fects the display power requirements and the control
of the luminance levels. For instance, in a 10.4-inch
SVGA display, the power can be reduced by a factor
of 0.57 because of an enhanced aperture ratio. A
higher aperture ratio also increases the achievable
display contrast performance by reducing the nonac-
tive regions or gaps of the display pixel.
IMAGE QUALITY TOPICS IN MEDICAL AMLCDs
The image quality of medical AMLCDs is affected by
certain factors not addressed in the evaluation of
CRTs. These factors include the gray-scale resolution
and the angular variation in luminance and contrast.

Figure 6. Measurements of contrast ratio (CR) for CRTs and
AMLCDs as a function of the dark spot size. The smallest spot
size that can be measured with this method is between 4 and 6
mm, depending on the distance to the emission surface.
Gray-Scale Resolution
Display systems for radiology comprise a display de-
vice and a display controller. The specifications given
for a system are valid only for that particular combina-
tion. The accuracy of the gray-scale presentation is af-
fected in part by the quality of the display controller.
The digital-to-analog converter in the display controller
determines the ability to finely modify the shape of the
luminance response. Conventional controllers with 8-bit
digital-to-analog converters have limited control over
the display gray-scale function. In medical AMLCDs, the
gray-scale resolution is affected also by the intrinsic
properties of LC pixels, which are often limited to an
8-bit scale in the luminance output. In this case, a
deeper monitor gray scale can be achieved by subpixel
modulation or by temporal modulation. Subpixel
modulation uses the subpixel regions of AMLCDs, origi-
nally designed for color applications, to generate a
lookup table that provides additional gray-scale resolu-
tion (19). In temporally modulated AMLCDs, the actual
pixel luminance is the combined luminance of two dis-
tinct luminance levels in two or more consecutive
frames. Because the frame rate is high, human observers
cannot discriminate between these two levels and there-
fore experience an average pixel luminance.
Factors Affecting AMLCD Contrast
Because of the thin faceplate that AMLCDs com-
monly have, these devices do not suffer from veiling
Table 2
CRT and LCD Display Devices
Small-Spot Contrast Ratio Measured for a 10-mm Dark
Spot
Small-Spot
Display Device Contrast Ratio
Medical AMLCD (Planar C3) (22,42) 750
Medical CRT (Clinton DS2000) (10) 152
Color AMLCD (Silicon Graphics SW1600) (10) 145
Medical CRT (Siemens Simomed) (10) 141
Medical CRT (Image Systems M24L) (43) 89
Color CRT (Sony Trinitron Ultrascan) (10) 48
Color CRT (Hitachi Megascan) (44) 25
Note.—Ratios were measured with a collimated luminance
probe, according to methods described in references 5 and
10. Measurements were performed with a circular spot for
CRTs and with a square spot for AMLCDs.
glare (20). However, in addition to ambient light re-
flections, the small-spot contrast of medical AMLCDs
is affected by cross talk and by the angular variations
of luminance with off-axis viewing angles.
Cross talk.—The effect of cross talk is seen as a
change in the pixel luminance of the displayed image
in a region in which there is a considerable variation
in gray level across the vertical or horizontal direc-
tion. Cross talk is a general term used to describe two
phenomena that degrade display contrast. On one
hand, optical cross talk is generally a short-range ef-
fect with a characteristic distance of less than 10 dis-
play pixels and is negligible at longer pixel-to-pixel
distances. On the other hand, electronic cross talk
has complex spatial characteristics (21,22) that de-
pend strongly on orientation (vertical vs horizontal
according to the panel wiring scheme).
In AMLCDs, the voltage applied across the LC cell
through the pixel electrodes defines the pixel lumi-
nance. Electronic cross talk is associated with unwanted
modification of the pixel voltage effectively applied to
the LC cell caused by incomplete pixel charging, by
leakage currents in the TFT, and by parasitic capacitive
coupling. Accordingly, display cross talk is more im-
portant in large panels with high spatial and gray-
scale resolution (23,24). Methods used for reducing
electronic cross talk employ modified driving tech-
niques to bracket the desired voltage at each indi-
vidual pixel in the active-matrix array.
Figure 6 shows small-spot contrast ratio measure-
ments for a variety of medical CRTs and AMLCDs.
For a spot size of 10 mm, the measured contrast ratio
for CRTs is lower than 150, while medical AMLCDs
can achieve ratios of 800 because of the lack of veil-
ing glare and controlled cross talk (Table 2).
Non-Lambertian emission.—Like most emissive dis-
plays (25), CRTs emit light in such a way that the angu-
lar luminous intensity approximately follows a cosine
distribution according to Lambert’s law. Consequently, 97
 the display luminance remains constant across all view-
ing directions, which is typical of Lambertian emitter
Badano
surfaces. That is not the case for AMLCDs. The lumi-
nance and contrast of AMLCDs are a strong function of
the viewing direction. In some AMLCDs, at large off-
axis angles, the variations can be severe enough to
cause an inversion of the gray scale, a condition that is
generally unacceptable in diagnostic display devices.
Figure 7 shows measured contrast variations for a med-
ical AMLCD. In this example, the contrast reduction ex-
perienced along the diagonal viewing directions is the
most severe (a factor of 0.1 at 45°) (26).
The viewing angle problem in medical imaging can
be appreciated when one views different areas of a
large display screen (which can reach more than 30 cm
on a side). In this scenario, the more severe changes in
the luminance presentation curve and available con-
trast associated with different viewing directions are
likely to happen between the center and the corners of
the screen (Figs 8, 9). The second aspect of this prob-
lem arises when more than one individual is looking
at the same image displayed on the same screen. In
this case, the variations can be much larger because
the angles that are involved and the departure from
the on-axis calibration are also larger.
Several solutions have been developed to compen-
sate for angular variations in AMLCD display lumi-
nance. The approaches come from a recognition that
the anisotropy of the light modulation is the dominat-
ing factor in defining the viewing angle characteristics
of the device. When light is emitted at different angles
with respect to the display surface normal, it has differ-
ent effective path lengths through the LC. This condi-
tion is most severe for intermediate gray levels, where
LC molecules in conventional modes are oriented ob-
liquely with respect to the display surface. The solu-
tions reviewed here belong to three different classes:
compensation films, multiple domains, and modified
LC alignments. In current AMLCD designs, many if
not all of these classes are combined and employed
in the same device. The benefits of using one of these
solutions are compounded with the addition of
other solutions, but each solution has drawbacks.
Special birefringent films have been designed to
compensate for the anisotropy introduced by the LC
alignment with respect to the different directions of
light transmitted by the LC cell (27,28). Because the
films are static, in the sense of not dynamically adjust-
able with the pixel gray level, the compensation is op-
timal only for a single luminance level.
The viewing angle of AMLCDs can be markedly
improved by dividing the pixel area into multiple
subpixel domains having different LC director orien-
tations. Because each domain has an asymmetric re-
sponse with respect to the viewing direction, the net
effect is an average emission that tends to reduce the
98
luminance variations with angle (29,30). The main
Figure 7. Contrast ratio measurements for a medical AMLCD
at different off-axis angles from the display surface normal. The
contrast ratio in this case is the ratio of maximum to minimum lu-
minance with a 20% region in a midgray background. (Adapted,
with permission, from reference 41.)
challenge associated with this technology is the domain
stability associated with a highly changing director
orientation across the small subpixel dimensions. In
addition, the fabrication cost increases considerably
with the number of domains because of the increase
in processing steps.
If the LC director remains in the display plane for
all gray-scale states, the asymmetry for the different
angles is minimized. This is the basis of the in-plane
switching structure used in many medical imaging
AMLCDs. With in-plane switching, the pixel elec-
trodes are located on the same bottom glass plate. The
switching of the LC cell between on and off states
comes from the application of an electric field parallel
to the glass plates (31,32). Although this improves the
angular constancy of the luminance, it also reduces
the transmission through the LC stack caused by the
presence of interdigitated electrodes, resulting in a
lower luminance. Another design that improves the
viewing angle performance is the vertically aligned LC
mode. In a normally black mode, vertically aligned
cells provide an almost perfect blockage of light when
crossed polarizers are used. This arrangement can be
achieved by oblique electric fields with displaced
electrodes or, more commonly, with pyramid-shaped
protrusions on both substrate plates (33). Figure 10
shows the arrangement of LC molecules in an in-
plane-switching mode and a vertically aligned mode,
along with the more conventional twisted-nematic
mode used in low-grade AMLCDs.
DISPLAY REFLECTANCE
The reflections of ambient light from CRT devices
can be represented by the addition of a specular and
a diffuse component (Fig 11) with different effects
on the quality of the image displayed. More gener-
ally, reflections have to include a third component

Figure 9. Angular changes of the luminance in medical
AMLCDs for on-axis luminance output and for 45° along the
horizontal (45°H) and diagonal (45°D) viewing directions.
called “haze,” which becomes important in flat-
panel LC displays.
Because of the nature of CRT emissive structures, a
large fraction of the light that illuminates the device
is reflected either at the first surface or after multiple
internal scattering. Light that enters the faceplate and
strikes the phosphor layer encounters a structure that
by design is highly reflective. The phosphor structure
consists of small grains in a binder with a reflective
backing. Similar to radiographic screens, this struc-
ture is designed for good light emission with little
self-absorption.
To dampen specular reflections, antireflective struc-
tures are used that consist of several thin-film layers de-
signed to reduce the reflectance of the front surface by
increasing the light transmission into the faceplate (34).
Figure 8. Effect of viewing
angle on luminance calibration
CRT and LCD Display Devices
functions of AMLCDs for a
fixed centered observer. The
luminance output seen at right
for on-axis viewing is distorted
at the corners and at the edge
of the display screen. If a le-
sion is present in these screen
locations, its detectability will
be different than if it were in
the center. (Adapted, with per-
mission, from reference 41.)
Figure 10. Relative orientation of the LC molecules with re-
spect to the display plane in the twisted-nematic (TN), in-plane
switching (IPS), and vertically aligned (VA) LC modes. The
alignment of the LC director with the display surface improves
the viewing-angle characteristics of the in-plane switching and
vertically aligned modes. E = electric field.
Normally, antireflective coatings will also include a
conductive layer that dissipates the static charge gen-
erated at the front surface and helps maintain a dust-
free surface (35). The reflections from antireflective
coatings can have a color shift when illuminated with a
broad-spectrum light source because of the wavelength
dependence of the thin-film response (36). However,
by decreasing the reflection of incident light, antire-
flective coatings may increase diffuse reflections be-
cause more light enters the faceplate. The effectiveness
of antireflective coatings is then associated with a com-
promise between the specular and diffuse components
of ambient light reflection.
The diffuse reflection of light adds an unstruc-
tured constant luminance to the image, which re-
duces the contrast in dark regions. To reduce diffuse
reflectance, medical CRTs have an absorptive face-
plate that attenuates light, which scatters several
times in the glass. For a faceplate with a transmit-
99
tance of 50%, the diffuse reflections will be reduced
 Figure 11. Specular and dif-
fuse reflections for a CRT. The
Badano

thick lines indicate the position

of the electron beam and the
luminance that it generates
upon impinging on the phos-
phor layer. The specular reflec-
tions occur mostly at the front
surface of the faceplate. The
reflective coating, designed pri-
marily to increase the light out-
put of the phosphor, also in-
creases the diffuse component
of the display reflections.

to no more than 25% because the reflected light

will travel through the glass twice. More reduction
is typically found because of the oblique directions
in which the reflected light may travel and because
of multiple internal scattering. However, this re-
duction comes at the expense of a 50% decrease in
display brightness. In color monitors, the black-
matrix material that is between the phosphor dots
is of considerable benefit in absorbing incident
light without reducing brightness. In this sense, the
design of color monitors is advantageous from the
standpoint of both veiling glare and ambient re-
flection. However, black-matrix phosphor technol-
ogies have not been used to date with high-bright- Figure 12. One-dimensional reflection signature of the AMLCD.
ness monochrome phosphors. The value at 0.1° corresponds to the measurement at 0°, which
is within the specular window. Depending on the specific defini-
Ideally, display devices are designed to absorb am-
tions used for the specular reflection, we can identify the “haze”
bient light. New flat-panel display devices offer op- window as expanding from 1° to 10°. The measurements for
portunities for the absorption of ambient light that angles larger than 10° reflect the diffuse component. a.u. = arbi-
are not possible with CRTs. AMLCDs are being built trary units.
with designs that optimize the absorption of ambi-
ent light for use in sunlit environments, such as for
dent of position across the screen, therefore ne-
avionic applications (37). Typical values for the
glecting all edge-related phenomena. The complete
specular reflection coefficient of display devices vary
expression is then given by a six-dimensional func-
from 0.0019 to 0.042. The coefficients measured for
tion:
the monitors without an antireflective coating are
consistent with the value computed according to
Fresnel equations for a glass-air optical boundary
(0.04). Devices with an antireflective coating have a
smaller specular reflection coefficient. Measured val-
ues of the diffuse reflection coefficients all fall where λ is the photon wavelength, and p is the po-
within a smaller range (0.018–0.064 cd/m2/lux), larization of the incoming light beam. The BRDF has
with the exception of advanced AMLCD designs for units of inverse steradians (sr −1). The angle of inci-
avionic applications. dence of ambient light is defined by (θi, φi), while
For flat-panel systems, the surface reflections in- (θo, φo) represents the angles that define the direction
clude a local component. In this case, the complete of reflected light.
reflection characteristics of the device are best de- The precise evaluation of this function is time
scribed by the bidirectional reflection distribution consuming and costly. The BRDF can be measured
function (BRDF). The BRDF, a formalism often (a) with a goniometric setup with fixed light source
used in optics (38), is defined for any reflecting ob- and variable detector, (b) with a variable source
ject as the ratio of differential reflected luminance and fixed detector, or (c) with a conoscopic ap-
(dLo) to the differential illuminance (dEi) incident proach in which the directional intensity is
on the surface. Here, we consider the reflectance mapped into a two-dimensional distribution re-
100 from the display to be shift invariant, or indepen- corded by a position-sensitive planar detector. The
 Table 3

CRT and LCD Display Devices

Fundamental Differences and Sources of Noise in CRT and AMLCD Technologies

Comparison CRT AMLCD

Mechanism Light emitting Light modulating

Front panel Curved or flat Flat
Array formation Scanning beam Active-matrix addressing
Emission Near-Lambertian Far from Lambertian
Long-range interactions Veiling glare Cross talk
Pixel structure Gaussian spot Rectangular (subpixel domains)
Sources of noise
Fixed pattern (spatially random) Phosphor noise, scan nonuniformity LC nonuniformity, cell thickness
variations, spacers
Structured noise Raster Nonactive pixel regions
Artifacts Deflection Cell voltage variation
Landing Backlight nonuniformity
Electronics Electronics
Temporal Flicker Flicker and LC ghosting

Figure 13. Pixel structure for

a dual-domain AMLCD. Indi-
vidual display pixels consist of
six subpixel regions in a chev-
ron arrangement determined by
the dual domain and three
color stripes. A simplified
equivalent circuit is presented
at right, showing one TFT ac-
tive switch per color subpixel.
The domains are separated by
a region in which the LC mol-
ecule orientation changes dra-
matically (disclination) with low
light transmission.

first two methods suffer from severe dependence of
source and detector positioning precision that has
to be better than 1°. The third method requires ex-
pensive instrumentation. However, the intermedi-
ate component of the reflection signature, which is
called “haze,” can be characterized by taking incre-
mental measurements of the reflected luminance
obtained with a small diffuse light source (5-mm
diameter). As the angle between the direction of the
measurement with the light-measuring device and
the specular direction increases, we can record one
slice of the full BRDF, as shown in Figure 12. Note
that in this experiment, the uncertainties in the po-
sitioning of the source and meter were sufficient to
mask the specular peak (between 0° and 1°).
DISPLAY NOISE
phor granularity) from sources of temporal noise
(image lag or ghosting in AMLCDs). Spatial noise
in a display device can obscure small low-contrast
image features. This is analogous to the effect of
x-ray quantum noise in planar radiography and in
computed tomography. The characteristics of the
spatial noise in displays can be appreciated by us-
ing a magnifier lens to view the light emission pat-
tern from a region with uniform midgray bright-
ness (Fig 2). In AMLCDs, the most notable feature
of the noise characteristic is the subpixel structure
of complex design used in medical displays, shown
in Figure 13. This periodic structure introduces
high-frequency components of the noise that have
been shown to complicate the measurement of
noise power spectra with conventional methods
(39).

Noise sources in a display device can be cataloged in Acknowledgment: The author thanks the many col-
different ways (Table 3). For instance, we can dis- laborators who have contributed to the material re-
criminate sources of spatial noise (eg, CRT phos- viewed in this chapter. 101
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