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04.09.2015 | Original Article | Ausgabe 4/2016

International Journal of Computer Assisted Radiology and Surgery 4/2016

A novel bone suppression method that improves lung nodule detection

Suppressing dedicated bone shadows in radiographs while preserving the remaining signal

Zeitschrift:
International Journal of Computer Assisted Radiology and Surgery > Ausgabe 4/2016
Autoren:
Jens von Berg, Stewart Young, Heike Carolus, Robin Wolz, Axel Saalbach, Alberto Hidalgo, Ana Giménez, Tomás Franquet

Abstract

Purpose

Suppressing thoracic bone shadows in chest radiographs has been previously reported to improve the detection rates for solid lung nodules, however at the cost of increased false detection rates. These bone suppression methods are based on an artificial neural network that was trained using dual-energy subtraction images in order to mimic their appearance.

Method

Here, a novel approach is followed where all bone shadows crossing the lung field are suppressed sequentially leaving the intercostal space unaffected. Given a contour delineating a bone, its image region is spatially transferred to separate normal image gradient components from tangential component. Smoothing the normal partial gradient along the contour results in a reconstruction of the image representing the bone shadow only, because all other overlaid signals tend to cancel out each other in this representation.

Results

The method works even with highly contrasted overlaid objects such as a pacemaker. The approach was validated in a reader study with two experienced chest radiologists, and these images helped improving both the sensitivity and the specificity of the readers for the detection and localization of solid lung nodules. The AUC improved significantly from 0.596 to 0.655 on a basis of 146 images from patients and normals with a total of 123 confirmed lung nodules.

Conclusion

Subtracting all reconstructed bone shadows from the original image results in a soft image where lung nodules are no longer obscured by bone shadows. Both the sensitivity and the specificity of experienced radiologists increased.

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