基于三维重建人体的胸片前瞻性质量控制。

IF 3.3 3区 医学 Q2 ENGINEERING, BIOMEDICAL
Yuqi Tan, Zheng Ye, Jingyu Ye, Yuzhou Hou, Shaoqing Li, Zejun Liang, Hanyu Li, Jing Tang, Chunchao Xia, Zhenlin Li
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引用次数: 0

摘要

目的:胸部x线摄影需要有效的质量控制,以降低高重拍率。然而,现有的质量控制措施都是回顾性的,并在照射后实施,往往需要在图像质量不符合标准时重新拍摄,从而增加了患者的辐射暴露。为了解决这一问题,我们提出了一种3D人体(3D- hb)重建算法来实现前瞻性QC。我们的目的是探讨在胸片中使用重建的3D-HB进行前瞻性QC的可行性,并评估其对重摄率的影响。方法:这项前瞻性研究包括2024年5月接受后前位(PA)和侧位(LA)胸片检查的患者。提出了一种结合SMPL-X模型和HybrIK-X算法的3D-HB重建算法,将患者的2D图像转换为3D-HB。使用胸片(参考标准)和3d - hb评估患者体位和准直的QC指标,并使用icc、线性回归和受试者工作特征曲线对结果进行比较。为了评估重摄率,我们开发了一个实时3D-HB可视化界面,并分两个为期四周的阶段进行胸部x线摄影:第一个阶段没有前瞻性QC,第二个阶段有前瞻性QC。用卡方检验比较两阶段的重摄率。主要结果:纳入324例受试者(平均年龄42岁±19岁[SD];145人;324 PA及294 LA考试)。锁骨角ICCs为0.80,腋中线角ICCs为0.78。线性回归结果显示锁骨角与腋中线角呈正相关(R2: 0.655)。在PA胸片中,3d - hb评估肩胛骨旋转、侧倾、居中定位和中央x线对准的auc分别为0.89、0.87、0.91和0.92,准直评估准确率为97%。在LA胸片中,3d - hb评估手臂抬起、胸部旋转、居中定位和x线中心对准的auc分别为0.87、0.84、0.87和0.88,准直评估准确率为94%。在重摄率评估中,记录了3995张PA胸片和3295张LA胸片。基于3D-HB的前瞻性QC的实施使重摄率从8.6%降至3.5% (PA),从19.6%降至4.9% (LA) (p < .001)。意义:重建的3D-HB是胸片前瞻性QC的可行工具,可提供暴露前患者体位和准直的实时反馈。基于重建3D-HB的前瞻性QC有可能通过显著降低重摄率和提高临床标准化来重塑放射学QC的未来。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Prospective quality control in chest radiography based on the reconstructed 3D human body.

Objective: Chest radiography requires effective quality control (QC) to reduce high retake rates. However, existing QC measures are all retrospective and implemented after exposure, often necessitating retakes when image quality fails to meet standards and thereby increasing radiation exposure to patients. To address this issue, we proposed a 3D human body (3D-HB) reconstruction algorithm to realize prospective QC. Our objective was to investigate the feasibility of using the reconstructed 3D-HB for prospective QC in chest radiography and evaluate its impact on retake rates. Approach: This prospective study included patients indicated for posteroanterior (PA) and lateral (LA) chest radiography in May 2024. A 3D-HB reconstruction algorithm integrating the SMPL-X model and the HybrIK-X algorithm was proposed to convert patients' 2D images into 3D-HBs. QC metrics regarding patient positioning and collimation were assessed using chest radiographs (reference standard) and 3D-HBs, with results compared using ICCs, linear regression, and receiver operating characteristic curves. For retake rate evaluation, a real-time 3D-HB visualization interface was developed and chest radiography was conducted in two four-week phases: the first without prospective QC and the second with prospective QC. Retake rates between the two phases were compared using chi-square tests.  Main results: 324 participants were included (mean age, 42 years±19 [SD]; 145 men; 324 PA and 294 LA examinations). The ICCs for the clavicle and midaxillary line angles were 0.80 and 0.78, respectively. Linear regression showed good relation for clavicle angles (R2: 0.655) and midaxillary line angles (R2: 0.616). In PA chest radiography, the AUCs of 3D-HBs were 0.89, 0.87, 0.91 and 0.92 for assessing scapula rotation, lateral tilt, centered positioning and central X-ray alignment respectively, with 97% accuracy in collimation assessment. In LA chest radiography, the AUCs of 3D-HBs were 0.87, 0.84, 0.87 and 0.88 for assessing arms raised, chest rotation, centered positioning and central X-ray alignment respectively, with 94% accuracy in collimation assessment. In retake rate evaluation, 3995 PA and 3295 LA chest radiographs were recorded. The implementation of prospective QC based on the 3D-HB reduced retake rates from 8.6% to 3.5% (PA) and 19.6% to 4.9% (LA) (p < .001). Significance: The reconstructed 3D-HB is a feasible tool for prospective QC in chest radiography, providing real-time feedback on patient positioning and collimation before exposure. Prospective QC based on the reconstructed 3D-HB has the potential to reshape the future of radiography QC by significantly reducing retake rates and improving clinical standardization.

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来源期刊
Physics in medicine and biology
Physics in medicine and biology 医学-工程:生物医学
CiteScore
6.50
自引率
14.30%
发文量
409
审稿时长
2 months
期刊介绍: The development and application of theoretical, computational and experimental physics to medicine, physiology and biology. Topics covered are: therapy physics (including ionizing and non-ionizing radiation); biomedical imaging (e.g. x-ray, magnetic resonance, ultrasound, optical and nuclear imaging); image-guided interventions; image reconstruction and analysis (including kinetic modelling); artificial intelligence in biomedical physics and analysis; nanoparticles in imaging and therapy; radiobiology; radiation protection and patient dose monitoring; radiation dosimetry
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