Automatic calculation of total lung capacity from automatically traced lung boundaries in postero-anterior and lateral digital chest radiographs

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Abstract
Total lung capacity (TLC) is a very important parameter in the study of pulmonary function. In the pulmonary function laboratory, it is normally obtained using plethysmography or helium dilution techniques. Several authors have developed methods of calculating the TLC using postero-anterior (PA) and lateral chest radiographs. These methods have not been often used in clinical practice. In the present work, we have developed and automated computer-based method for the calculation of TLC, by determining the pulmonary contours from digital PA and lateral radiographs of the thorax. The automatic tracing of the pulmonary borders is carried out using: (1) a group of reference lines is determined in each radiograph; (2) a family of rectangular regions of interest (ROIs) defined, which include the pulmonary borders, and in each of them the pulmonary border is identified using edge enhancement and thresholding techniques; (3) removing outlaying points from the preliminary boundary set; and (4) the pulmonary border is corrected and completed by means of interpolation, extrapolation, and arc fitting. The TLC is calculated using a computerized form of the radiographic ellipses method of Barnhard. The pulmonary borders were automatically traced in a total of 65 normal radiographs (65 PA and 65 lateral views of the same patients). Three radiologists carried out a subjective evaluation of the automatic tracing of the pulmonary borders, with a finding of no error or only one minor error in 67.7% of the PA evaluations, and in 75.9% of the laterals. Comparing the automatically traced borders with borders traced manually by an expert radiologists, we obtained a precision of 0.990 +/- 0.001 for the PA view, and 0.985 +/- 0.002 for the lateral. The values of TLC obtained by the automatic calculation described here showed a high correlation (r = 0.98) with those obtained by applying the manual Barnhard method.