Automating chest radiograph imaging quality control.

Abstract

To automate diagnostic chest radiograph imaging quality control (lung inclusion at all four edges, patient rotation, and correct inspiration) using convolutional neural network models. The data comprised of 2589 postero-anterior chest radiographs imaged in a standing position, which were divided into train, validation, and test sets. We increased the number of images for the inclusion by cropping appropriate images, and for the inclusion and the rotation by flipping the images horizontally. The image histograms were equalized, and the images were resized to a 512×512 resolution. We trained six convolutional neural networks models to detect the image quality features using manual image annotations as training targets. Additionally, we studied the inter-observer variability of the image annotation. The convolutional neural networks' areas under the receiver operating characteristic curve were >0.88 for the inclusions, and >0.70 and >0.79 for the rotation and the inspiration, respectively. The inter-observer agreement between two human annotators for the assessed image-quality features were: 92%, 90%, 82%, and 88% for the inclusion at patient's left, patient's right, cranial, and caudal edges, and 78% and 89% for the rotation and inspiration, respectively. Higher inter-observer agreement was related to a smaller variance in the network confidence. The developed models provide automated tools for the quality control in a radiological department. Additionally, the convolutional neural networks could be used to obtain immediate feedback of the chest radiograph image quality, which could serve as an educational instrument.