The software that the authors developed provides the ability to annotate images based on a multispecialty methodology for annotation and visual knowledge representation. The authors investigated and developed software-supported methodologies to help clinicians, medical educators, and basic scientists become more efficient and effective in their digital imaging environments. One problem that clinicians, medical educators, and basic scientists encounter when handling images is the difficulty of using business and graphic arts commercial-off-the-shelf (COTS) software in multicontext authoring and interactive teaching environments. Use of digital medical images has become common over the last several years, coincident with the release of inexpensive, mega-pixel quality digital cameras and the transition to digital radiology operation by hospitals. Radiologists should find that image editing can be carried out very rapidly once the basic steps are learned and automated. Editing and annotating images before they are inserted into presentation software is highly recommended, both for convenience and flexibility. Final file size for incorporation into computerized presentations is about 10-100 Kbytes (8-bit, single-layer, gray-scale, high-quality JPEG ), depending on source and intended use. Final file size for gray-scale cross-sectional neuroradiologic images (8-bit, single-layer TIFF at 300 pixels per inch) intended for publication varies from about 700 Kbytes to 3 Mbytes.
Use of the smallest file size necessary for the purpose at hand is recommended. Converting an image to 8-bit gray scale is the first editing function. The Actions palette is a menu of user-defined macros that save time by automating an action or series of actions. The History palette may be used to undo a step or series of steps. For basic editing of gray-scale cross-sectional images, the Tools palette and the History/Actions palette pair should be displayed. The authors introduce Photoshop 6.0 for radiologists and demonstrate basic techniques of editing gray-scale cross-sectional images intended for publication and for incorporation into computerized presentations.
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