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Value of bone suppression software in chest radiographs for improving image quality and reducing radiation dose

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Abstract

Objectives

To compare image quality and radiation dose between dual-energy subtraction (DES)–based bone suppression images (D-BSIs) and software-based bone suppression images (S-BSIs).

Methods

Chest radiographs (CXRs) of forty adult patients were obtained with the two X-ray devices, one with DES and one with bone suppression software. Three image quality metrics (relative mean absolute error (RMAE), peak signal-to-noise ratio (PSNR), and structural similarity index (SSIM)) between original CXR and BSI for each of D-BSI and S-SBI groups were calculated for each bone and soft tissue areas. Two readers rated the visual image quality for original CXR and BSI for each of D-BSI and S-SBI groups. The dose area product (DAP) values were recorded. Paired t test was used to compare the image quality and DAP values between D-BSI and S-BSI groups.

Results

In bone areas, S-BSIs had better SSIM values than D-BSI (94.57 vs. 87.77) but worse RMAE and PSNR values (0.50 vs. 0.20; 20.93 vs. 34.37) (all p < 0.001). In soft tissue areas, S-BSIs had better SSIM values than D-BSI (97.56 vs. 91.42) but similar RMAE and PSNR values (0.29 vs. 0.27; 31.35 vs. 29.87) (all p < 0.001). Both readers gave S-BSIs significantly higher image quality scores than D-BSI (p < 0.001). The mean DAP in software-related images (0.98 dGy·cm2) was significantly lower than that in the DES-related images (1.48 dGy·cm2) (p < 0.001).

Conclusion

Bone suppression software significantly improved the image quality of bone suppression images with a relatively lower radiation dose, compared with dual-energy subtraction technique.

Key Points

• Bone suppression software preserves structure similarity of soft tissues better than dual-energy subtraction technique in bone suppression images.

• Bone suppression software achieves superior image quality for lung lesions than dual-energy subtraction technique in bone suppression images.

• Bone suppression software can decrease the radiation dose over the hardware-based image processing technique.

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Change history

  • 21 January 2020

    The Supplementary Information file has been exchanged.

Abbreviations

aPSNR:

Adjusted value of peak signal-to-noise ratio

aRMAE:

Adjusted value of relative mean absolute error

aSSIM:

Adjusted value of structural similarity index

BSI:

Bone suppression image

CXR:

Chest radiograph

DAP:

Dose area product

D-BSI:

Dual-energy subtraction-based bone suppression images

DES:

Dual-energy subtraction

PSNR:

Peak signal-to-noise ratio

RMAE:

Relative mean absolute error

S-BSI:

Software-based bone suppression images

SSIM:

Structural similarity index

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Acknowledgments

The authors are grateful to Jooae Choe, MD, Hye Jeon Hwang, MD, and Eun Young Kim, MD, for participating as readers.

Funding

This study has received funding by Samsung Electronics Co., Ltd.

Author information

Authors and Affiliations

  1. Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, South Korea

    Gil-Sun Hong, Kyung-Hyun Do, A-Yeon Son, Jihye Yun & Choong Wook Lee

  2. Division of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea

    Kyung-Wook Jo

  3. Department of Nuclear Engineering, Kyung Hee University, Seoul, South Korea

    Kwang Pyo Kim

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  1. Gil-Sun Hong
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  2. Kyung-Hyun Do
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Corresponding author

Correspondence to Kyung-Hyun Do.

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Guarantor

The scientific guarantor of this publication is Kyung-Hyun Do, MD, PhD.

Conflict of interest

The authors of this manuscript declare no relationships with any companies, whose products or services may be related to the subject matter of the article.

Statistics and biometry

No complex statistical methods were necessary for this paper.

Informed consent

Written informed consent was obtained from all subjects (patients) in this study.

Ethical approval

This prospective study was conducted according to the principles of the Declaration of Helsinki. The study protocol was approved by the Institutional Review Board Committee of the Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea (No. 2018-1348).

Methodology

• prospective

• case-control study

• performed at one institution

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Hong, GS., Do, KH., Son, AY. et al. Value of bone suppression software in chest radiographs for improving image quality and reducing radiation dose. Eur Radiol 31, 5160–5171 (2021). https://doi.org/10.1007/s00330-020-07596-w

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  • DOI: https://doi.org/10.1007/s00330-020-07596-w

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