Diagnostic medical imaging systems consist of multiple subsystems. Between the image acquisition and diagnostic image display there can be more than six subsystems. These systems can utilize both analog and digital processing, and can be from several different manufacturers. Procedures have been developed to monitor total imaging systems with multiple input devices and multiple vendors. These procedures utilize 'standard' test images and apply objective measurement methods with the aid of a desktop computer. The devices being monitored include film digitizers, video frame grabbers, clinical display stations, film laser printers, vinyl paper printers, CT scanners, MR scanners, and ultrasound scanners. Vendor calibration test patterns provided internally on different devices were evaluated and found to be necessary for image quality monitoring. Vendor provided image analysis software tools, transmission and reflective densitometers, and photometers are utilized to evaluate the image quality. A commercially available image program is used to measure the bit values of the resultant image files. A comprehensive yet simple test procedure has been developed. A 'standard' phantom scanned by a CT scanner and a vendor-provided SMPTE pattern is used to evaluate the total system. The accuracy of data acquisition, image display and printing are all verified with the test images. The SMPTE pattern is used to evaluate the frame grabber A/D conversion and laser printer/processor performance. A SMPTE film printed on a properly calibrated laser printer is used to monitor the performance of film digitizers and display stations. These evaluations are performed visually in the clinical setting and offline with a desktop computer.