Enhanced visualization of mobile chest X-ray images in the intensive care setting using software scatter correction

Abstract

Background Mobile chest X-ray (CXR) scans are performed within intensive treatment units (ITU) without anti-scatter grids for confirming tube and line hardware placement. Assessment is therefore challenging due to degraded subject contrast resulting from scatter. Purpose To evaluate the efficacy of a software scatter correction method (commercially named Trueview) for enhanced hardware visualization and diagnostic quality in the ITU setting. Material and Methods A total of 30 CXR scans were processed using Trueview and compared with standard original equipment manufacturer (OEM) images via observer scoring study involving two radiology and four ITU doctors to compare visualization of tubes and lines. Results were analyzed to determine observer preference and likelihood of diagnostic quality. Results Reviewers were more likely to score Trueview higher than OEM for mediastinal structures, bones, retrocardiac region, tube visibility, and tube safety ( P < 0 .01). Visual grading characteristic analysis suggested a clinical preference for Trueview compared with OEM for mediastinal structures (area under the visual grading characteristic curve [AUCVGC] = 0.60, 95% confidence interval [CI] = 0.55–0.65), bones (AUCVGC = 0.61, 95% CI = 0.55–0.66), retrocardiac region (AUCVGC = 0.64, 95% CI = 0.59–0.69), tube visibility (AUCVGC = 0.65, 95% CI = 0.60–0.70), and tube safety (AUCVGC = 0.68, 95% CI = 0.64–0.73). Reviewers were indifferent to visualization of the lung fields (AUCVGC = 0.49, 95% CI = 0.44–0.55). Registrars (3/6 reviewers) were indifferent to the mediastinal structure regions (AUCVGC = 0.54, 95% CI = 0.47–0.62). Conclusion Reviewers were more confident in identifying the placement and safety of tubes and lines when reviewing Trueview images than they were when reviewing OEM.

Comparison of image quality assessments between interventional radiographers and interventional radiologists using digital subtraction angiography

“…5,15 There is a paucity of literature on the use of VGC analysis for evaluating the image quality of angiographic images. Studies have previously used VGC analysis for extremity computed tomography (CT), [16][17][18] chest, appendicular, and spine radiography, [19][20][21][22][23][24] abdominal CT, [25][26][27] head CT, 28,29 pelvic CT, 30 propagation-based phase-contrast CT, 31 pediatric radiograph, 32 and magnetic resonance imaging (MRI) olfactory bulb volumetry sequences. 33 Fridh et al 10 used angiographic images from lower limb DSA runs to detect infrapopliteal lesions, where the observers were interventional radiologists or vascular surgeons.…”

Effects of applying high‐pass filtering in pelvimetry with Martius images

“…14,15 In recent years, image processing techniques have been developed and clinically applied to improve image contrast by correcting for scattered X-rays. 16,17 To identify the APD and TD endpoints on Martius images, it has been considered useful to apply a high-pass filtering process to reduce the low-frequency components caused by the scattered X-rays. However, to the best of our knowledge, there are no reports of pelvimetry using high-pass filtered images demonstrating improved contrast of Martius images.…”

“…For example, multi‐objective frequency processing is used in chest and breast images, and has been reported to improve the detection of nodules and microcalcifications, respectively 14,15 . In recent years, image processing techniques have been developed and clinically applied to improve image contrast by correcting for scattered X‐rays 16,17 . To identify the APD and TD endpoints on Martius images, it has been considered useful to apply a high‐pass filtering process to reduce the low‐frequency components caused by the scattered X‐rays.…”