Evaluation of the post-processing algorithms SimGrid and S-Enhance for paediatric intensive care patients and neonates

• Published in: Pediatric radiology Vol. 52; no. 6; pp. 1029 - 1037
• Main Authors: Krueger, Paul-Christian, Ebeling, Katharina, Waginger, Matthias, Glutig, Katja, Scheithauer, Marcel, Schlattmann, Peter, Proquitté, Hans, Mentzel, Hans-Joachim
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01.05.2022; Springer Nature B.V
• Subjects: Algorithms; Bones; Child; Children; Critical Care; Deep learning; Digital imaging; Evaluation; Humans; Image enhancement; Image quality; Imaging; Infant, Newborn; Intensive care; Intensive care units; Medical imaging; Medicine; Medicine & Public Health; Neonates; Neural networks; Neuroradiology; Newborn babies; Nuclear Medicine; Oncology; Original; Original Article; Patients; Pediatrics; Radiation; Radiation Dosage; Radiographic Image Enhancement - methods; Radiographs; Radiography; Radiography, Thoracic; Radiology; Scattering, Radiation; Software; Ultrasound; Weight; Deep learning; Radiography; Pediatric intensive care unit; Neonatal intensive care unit; Digital radiography; Image enhancement; Radiation dosage
• ISSN: 0301-0449; 1432-1998
• DOI: 10.1007/s00247-021-05279-2

Background Post-processing software can be used in digital radiography to achieve higher image quality, especially in cases of scattered radiation. SimGrid is a grid-like software based on a Convolutional Neuronal Network that estimates the distribution and degree of scattered radiation in radiographs and thus improves image quality by simulating an anti-scatter grid. S-Enhance is an algorithm programmed to improve contrast visibility of foreign material. Objective The objective of this study was to evaluate the SimGrid and S-Enhance digital radiography post-processing methods for neonatology and paediatric intensive care. Materials and Methods Two hundred and ten radiographs from the neonatal ( n  = 101, 0 to 6 months of age) and paediatric ( n  = 109, 6 months to 18 years of age) intensive care units performed in daily clinical routine using a mobile digital radiography system were post-processed with one of the algorithms, anonymized and then evaluated comparatively by two experienced paediatric radiologists. For every radiograph, patient data and exposure data were collected and analysed. Results Analysis of different radiographs showed that SimGrid significantly improves image quality for patients with a weight above 10 kg (range: 10–30 kg: odds ratio [OR] = 6.683, P  < 0.0001), especially regarding the tracheobronchial system, intestinal gas, and bones. Utilizing S-Enhance significantly advances the assessment of foreign material (OR = 136.111, P  < 0.0001) and bones (OR = 34.917, P  < 0.0001) for children of all ages and weight, whereas overall image quality decreases. Conclusion SimGrid offers a differentiated spectrum in image improvement for children beyond the neonatal period whereas S-Enhance especially improves visibility of foreign material and bones for all patients.