RESUMEN
INTRODUCTION: Chest Radiography (CXR) is a common radiographic procedure. Radiation exposure to patients should be kept as low as reasonably achievable (ALARA), and monitored continuously as part of quality assurance (QA) programs. One of the most effective dose reduction tools is proper collimation practice. The purpose of this study is to determine whether a U-Net convolutional neural networks (U-CNN) can be trained to automatically segment the lungs and calculate an optimized collimation border on a limited CXR dataset. METHODS: 662 CXRs with manual lung segmentations were obtained from an open-source dataset. These were used to train and validate three different U-CNNs for automatic lung segmentation and optimal collimation. The U-CNN dimensions were 128 × 128, 256 × 256, and 512 × 512 pixels and validated with five-fold cross validation. The U-CNN with the highest area under the curve (AUC) was tested externally, using a dataset of 50 CXRs. Dice scores (DS) were used to compare U-CNN segmentations with manual segmentations by three radiographers and two junior radiologists. RESULTS: DS for the three U-CNN dimensions with segmentation of the lungs ranged from 0.93 to 0.96, respectively. DS of the collimation border for each U-CNN was 0.95 compared to the ground truth labels. DS for lung segmentation and collimation border between the junior radiologists was 0.97 and 0.97. One radiographer differed significantly from the U-CNN (p = 0.016). CONCLUSION: We demonstrated that a U-CNN could reliably segment the lungs and suggest a collimation border with great accuracy compared to junior radiologists. This algorithm has the potential to automate collimation auditing of CXRs. IMPLICATIONS FOR PRACTICE: Creating an automatic segmentation model of the lungs can produce a collimation border, which can be used in CXR QA programs.
