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Image integrity: editing, cropping and the legal record
Processing to show anatomy is fine; changing an exposure indicator, hiding poor collimation or deleting a bad image is not.
The rule
Every image sent to PACS is part of the patient's legal medical record. Changing the brightness, contrast, window or processing so the anatomy shows well is a normal part of the job, within department protocol. Changing data to hide an error is not. Typing over or editing an exposure indicator so an over- or underexposed image looks acceptable is falsifying the record and a violation of the ARRT Rules of Ethics. So is changing the date, time or patient information to hide a mistake. Processing also has limits: it cannot restore detail lost to saturation (clipping), add anatomy that was cut off, or remove noise from too few photons.