Improved visualization of tubes and lines in portable intensive care unit radiographs: a study comparing a new approach to the standard approach

Foos, David H.; Yankelevitz, David F.; Wang, Xiaohui; Berlin, David; Zappetti, Dana; Cham, Matthew D.; Sanders, Abraham; Parker, Katherine Novak; Henschke, Claudia I.

doi:10.1016/j.clinimag.2010.10.003

Cited by 5 publications

(4 citation statements)

References 17 publications

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“…To the best of our knowledge, there are no published studies that evaluate a software algorithm for pneumothorax enhancement. So far, the software has only been used for detection of tubes and lines [6].…”

Section: Discussionmentioning

confidence: 99%

“…The local contrast is adaptively adjusted such that the contrast in non-homogeneous regions is enhanced while the contrast in more homogeneous regions is limited. This emphasizes the textural differences between the characteristic markings for the regions inside and outside of the lung; accentuating the appearance of free air in the chest cavity [6, 9].…”

Section: Methodsmentioning

confidence: 99%

“…As ICU patients are often unstable, it is difficult to transport them away from the ICU environment and therefore it is important to evaluate strategies for improving the detection of a pneumothorax using portable chest radiography. In addition, the initial evaluation of a portable chest radiograph may be performed by a relatively inexperienced reader, and this may cause additional complexity in the accurate and timely detection of a pneumothorax [6, 7].…”

Section: Introductionmentioning

confidence: 99%

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Enhanced pneumothorax visualization in ICU patients using portable chest radiography

et al. 2018

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ObjectivePneumothorax development can cause precipitous deterioration in ICU patients, therefore quick and accurate detection is vital. Portable chest radiography is commonly performed to exclude pneumothoraces but is hampered by supine patient position and overlying internal and external material. Also, the initial evaluation of the chest radiograph may be performed by a relatively inexperienced physician. Therefore, a tool that could significantly improve pneumothorax detection on portable radiography would be helpful in patient care. The aim of this study was to evaluate the clinical utility of novel enhancement software for pneumothorax detection in readers with varied clinical experience of detecting/excluding pneumothoraces on portable chest radiographs in ICU patients.Subjects and methods206 portable ICU chest radiographs, 103 with pneumothoraces, were processed with and without enhancement software and reviewed by 5 readers who varied in reading experience. Images were grouped for different complexity levels.ResultsThe mean AUC for pneumothorax detection increased for 4/5 readers from 0.846–0.957 to 0.88–0.971 with a largest improvement for the reader with least experience. No significant change was noted for the reader with the longest reading experience. The image complexity had no impact on the interpretation result.ConclusionPneumothorax detection improves with novel enhancement software; the largest improvement is seen in less experienced readers.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Enhanced pneumothorax visualization in ICU patients using portable chest radiography

et al. 2018

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“…In adults, automatic processing algorithms which enhance radiographs and emphasize the edges of devices are able to improve visualization of central catheters on digital chest radiographs [13, 14].…”

Section: Introductionmentioning

confidence: 99%

Improved visualization of peripherally inserted central catheters on chest radiographs of neonates using fractional multiscale image processing

et al. 2019

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BackgroundPeripherally inserted central catheters (PICCs) provide secure intravenous access for the delivery of life-sustaining medications and nutrition. They are commonly used in pediatrics. Confirmation of correct central catheter tip position is crucial. Verification is usually done by a radiograph. The aim of this study is to evaluate the ability of Fractional Multiscale image Processing (FMP) to detect PICC tips on the digital chest radiographs of neonates.MethodsA total of 94 radiographs of 47 patients were included in the study. 29 patients were male, 18 were female. The mean age of all examined children was 9.2 days (range 0–99 days). In total, six readers (two radiologists, two residents in radiology, one last year medical student, one neonatologist) evaluated 94 unprocessed and catheter-enhanced radiographs using a 5-point Likert scale (1 = poor catheter tip visualization, 5 = excellent catheter tip visualization). Additionally, the two radiologists evaluated the diagnostic confidence for chest pathologies using a 5-point Likert scale (1 = poor diagnostic confidence, 5 = excellent diagnostic confidence). Radiographs were evaluated on a dedicated workstation.ResultsIn all cases, the catheter-enhanced radiograph rated higher than (n = 471), or equal (n = 93) to, the unprocessed radiograph when visualizing catheter tips. 87% of the catheter-enhanced radiographs obtained a rating of 4 or higher, while only 42% of unprocessed radiographs received 4 or more points. Regarding diagnostic confidence for chest pathologies one radiologist rated two catheter-enhanced radiographs higher than the unprocessed radiographs, while all other 186 evaluations rated the catheter-enhanced radiographs equal to (n = 78) or lower than (n = 108) the unprocessed radiographs. Only 60% of the catheter-enhanced radiographs yielded a diagnostic confidence of 4 or higher, while 90% of the unprocessed images received 4 or more points.ConclusionCatheter-enhanced digital chest radiographs demonstrate improved visualization of low contrast PICC tips in neonates compared to unprocessed radiographs. Furthermore, they enable detection of accompanying chest pathologies. However, definitive diagnosis of chest pathologies should be made on unprocessed radiographs.

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Abnormal Bones, Soft Tissue, and Other Findings

Folio

2011

Chest Imaging

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Improved visualization of tubes and lines in portable intensive care unit radiographs: a study comparing a new approach to the standard approach

Cited by 5 publications

References 17 publications

Enhanced pneumothorax visualization in ICU patients using portable chest radiography

Enhanced pneumothorax visualization in ICU patients using portable chest radiography

Improved visualization of peripherally inserted central catheters on chest radiographs of neonates using fractional multiscale image processing

Abnormal Bones, Soft Tissue, and Other Findings

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