Stent enhancement in digital x-ray fluoroscopy using an adaptive feature enhancement filter

Abstract

Fluoroscopic images belong to the classes of low contrast and high noise. Simply lowering radiation dose will render the images unreadable. Feature enhancement filters can reduce patient dose by acquiring images at low dose settings and then digitally restoring them to the original quality. In this study, a stent contrast enhancement filter is developed to selectively improve the contrast of stent contour without dramatically boosting the image noise including quantum noise and clinical background noise. Gabor directional filter banks are implemented to detect the edges and orientations of the stent. A high orientation resolution of 9° is used. To optimize the use of the information obtained from Gabor filters, a computerized Monte Carlo simulation followed by ROC study is used to find the best nonlinear operator. The next stage of filtering process is to extract symmetrical parts in the stent. The global and local symmetry measures are used. The information gathered from previous two filter stages are used to generate a stent contour map. The contour map is then scaled and added back to the original image to get a contrast enhanced stent image. We also apply a spatio-temporal channelized Hotelling observer model and other numerical measures to characterize the response of the filters and contour map to optimize the selections of parameters for image quality. The results are compared to those filtered by an adaptive unsharp masking filter previously developed. It is shown that stent enhancement filter can effectively improve the stent detection and differentiation in the interventional fluoroscopy.