Lossy JPEG compression: easy to compress, hard to compare

Objectives: To review the literature on lossy compression in dental radiography and to discuss the importance and suitability of the methodology used for evaluation of image compression. Methods: A search of Medline (from 1966 to October 2004) was undertaken with the search expression "(Radiography, dental) and compression". Inclusion criterion was that the reference should be evaluating the effect of lossy image compression on diagnostic accuracy. For all included studies, information ill relation to mode of image acquisition, image content.. image compression, image display, and method of image evaluation was extracted. Results: 12 out of 32 papers were included in the review. The design of these 12 studies was found to vary considerably. Parameters used to express the degree of information loss (DIL) were either or both compression ratio (CR) and compression level (CL). The highest acceptable CR reported in the studies ranged from 3.6% to 15.4%. Furthermore, different CR values were proposed even for the same diagnostic task, for example, for caries diagnosis CR ranged from 6.2% to 11.1%. Conclusion: Lossy image compression can be used in clinical radiology if it does not conflict with national law. However, the acceptable DIL is difficult to express and standardize. CR is probably not suitable to express DIL, because it is image content dependent. CL is also probably not suitable to express DIL because of the lack of compression software standardization.