Robust model-based detection of the lung field boundaries in portable chest radiographs supported by selective thresholding

Portable chest radiography is a valuable tool for screening patients hospitalized in intensive care, providing visual cues for diagnosis and physiological measurements. However, its practicality comes at the cost of quality, which is mainly affected by misaligned body positioning, thus increasing x-ray misinterpretation rates. This paper presents a novel methodology for the detection of the lung field boundaries in portable chest radiographs of patients with bacterial pulmonary infections. Such infections are radiographically manifested as foci of consolidations which can lead to vague or invisible lung field boundaries, difficult to distinguish even by experienced physicians. Conventional and state-of-the-art approaches address mainly stationary radiographs, whereas only a few of them cope with pulmonary infections. The proposed methodology is based on an active shape model incorporating shape prior information about the lung fields. The model is initialized by a novel technique utilizing a set of salient points detected on the peripheral anatomic structures of the lungs. A selective thresholding algorithm based on a spinal cord sampling process supports both the initialization and the evolution of the model for the detection of the lung field boundaries. The experiments show that the proposed methodology outperforms state-of-the-art approaches.