New York State Diagnostic Monitor Requirements
A practical guide to selecting and maintaining a Primary Diagnostic Monitor for digital X-ray imaging in New York.
What Is a Primary Diagnostic Monitor?
New York State defines a Primary Diagnostic Monitor (PDM) as a monitor used by a practitioner to make a primary diagnosis from medical images.
For a chiropractic, podiatry, orthopedic, or similar digital X-ray practice, a display used by the practitioner to interpret X-rays may therefore be considered a PDM. A monitor used only for administrative work or general clinical review may serve a different purpose.
Key Requirement
The monitor system must support DICOM GSDF calibration and the required verification workflow.
Hardware alone is not enough. The facility must also perform and document recurring QC and obtain annual evaluation by a New York State Licensed Medical Physicist.
Official New York State Guidance
New York State Department of Health
Guide for Radiation Safety/Quality Assurance Programs: Primary Diagnostic Monitors
Requirements and guidance may change. Facilities should review the current New York State Department of Health guidance and consult their licensed medical physicist regarding their specific QA program.
New York State Requirements
| Item | NYS Minimum / Guidance | 20/20 Purchasing Target |
|---|---|---|
| DICOM GSDF calibration Key Requirement | DICOM GSDF calibration required as part of the QA program | DICOM Part 14 / GSDF support with automated calibration |
| Maximum luminance | Minimum 171 cd/m²; NYS recommends at least 200 cd/m² | 500 cd/m² calibrated or greater |
| Luminance ratio | Minimum 170; NYS recommends 250 or greater | 250:1 or greater |
| Resolution | No specific pixel-resolution minimum stated in the NYS PDM guide | 3MP or higher |
What We Recommend When Shopping for a Monitor
A standard business monitor may match basic resolution or brightness figures, but still lack the DICOM GSDF calibration and verification workflow, stability, measurement tools, and documentation needed for a PDM quality-control program. For primary interpretation, 20/20 recommends a purpose-built diagnostic display that meets the purchasing targets above and includes these supporting features:
- Integrated calibration/front sensor preferred
- Manufacturer-provided QA and calibration software
- Luminance stabilization
- Uniformity correction preferred
- Designed and marketed for diagnostic medical imaging
- FDA clearance for diagnostic radiology/general radiography preferred
- Professional diagnostic-display warranty and support
About the Monitor Supplied with Your 20/20 System
20/20 Imaging typically supplies a professional 23- to 24-inch monitor with Full HD resolution or greater, at least 300 cd/m² maximum brightness, and at least a 1000:1 published contrast ratio. The manufacturer and model may change based on product availability.
These typical published brightness and contrast specifications exceed New York State's recommended non-mammography targets of at least 200 cd/m² and 250:1. New York does not state a specific pixel-resolution minimum.
Calibration and verification are still required. If the supplied monitor is used for primary diagnosis, the facility must include it in a DICOM GSDF calibration and verification workflow, confirm its measured performance, maintain the required QC records, and obtain the annual Licensed Medical Physicist evaluation. Published hardware specifications alone do not establish compliance.
Example Diagnostic Displays
These are current professional examples; other diagnostic displays may also be suitable.
EIZO RadiForce RX370
- 21.3-inch color diagnostic display
- 3MP, 1536 × 2048
- 500 cd/m² recommended calibration brightness
- 1800:1 typical contrast ratio
- DICOM calibration support
- Integrated front sensor
- Manufacturer QA and calibration software
- Strong general-purpose diagnostic display option
Barco Nio Color 3MP MDNC-3521
- 21.3-inch color diagnostic display
- 3MP, 2048 × 1536
- 600 cd/m² DICOM-calibrated luminance
- 2000:1 typical contrast ratio
- Integrated I-Guard front sensor
- Ambient light sensor
- Uniformity correction
- QAWeb Enterprise support
- Professional diagnostic-radiology display
Ongoing Quality Control
Monitor hardware is only one part of the program. New York calls for recurring visual checks, calibration work, records, and professional evaluation.
Routine Visual QC
- Display and evaluate an appropriate test pattern such as SMPTE.
- Check grayscale differentiation and high and low contrast resolution.
- Check the 95%/100% and 0%/5% patches.
- Check for distortion and display uniformity with white and black images.
- Clean the monitor appropriately.
- For color displays, evaluate color trueness.
Calibration and Records
- Verify DICOM GSDF calibration when display or workstation verification software is available.
- If verification software is not available, perform full GSDF calibration.
- Verify that luminance and luminance ratio remain within required limits.
- Maintain QC records.
Integrated calibration sensors and professional QA software can simplify this process. When quarterly verification is available, full GSDF calibration is recommended annually.
Licensed Medical Physicist Evaluation
A New York State Licensed Medical Physicist should evaluate each PDM using an external calibrated photometer.
- DICOM GSDF verification
- Luminance and luminance ratio
- Luminance uniformity
- Viewing conditions
- Review of facility QC documentation
- Recommended corrective actions
Need Help Selecting a Diagnostic Monitor?
20/20 Imaging can help identify workstation and display hardware appropriate for our digital radiography and PACS solutions and the purchasing targets on this page.
Regulatory Disclaimer: This page provides general information, not legal, regulatory, or medical physics advice. The facility is responsible for confirming applicable requirements and maintaining its Quality Assurance program.