title: Automated registration of frontal and lateral radionuclide lung scans with digital chest radiographs.
abstract: OBJECTIVE
  The purpose of this study was to develop and evaluate a fully automated method that spatially registers anterior, posterior, and lateral ventilation/perfusion (V/Q) images with posteroanterior and lateral digital chest radiographs to retrospectively combine the physiologic information contained in the V/Q scans with the anatomic detail in the chest radiographs.
  
  
  METHODS
  Gray-level thresholding techniques were used to segment the aerated lung regions in the radiographic images. A variable-thresholding technique combined with an analysis of image noise was used to segment the adequately perfused or ventilated lung regions in the scintigraphic images. The physical dimensions of the segmented lung regions in images from both modalities were used to properly scale the radiographic images relative to the radionuclide images. Computer-determined locations of anatomic landmarks were then used to rotate and translate the images to achieve registration. Pairs of corresponding radionuclide and radiographic images were enhanced with color and then merged to create superimposed images.
  
  
  RESULTS
  Five observers used a five-point rating scale to subjectively evaluate four image combinations for each of 50 cases. Of these ratings, 95.5% reflected very good, good, or fair registration.
  
  
  CONCLUSIONS
  The automated method for the registration of radionuclide lung scans with digital chest radiographs to produce images that combine functional and structural information should benefit nuclear medicine physicians and radiologists, who must visually correlate images that differ greatly in physical size, resolution properties, and information content.
authors.affiliation: Kurt Rossmann Laboratories for Radiologic Image Research, University of Chicago, IL 60637, USA.
authors.forename: S G
authors.initials: SG
authors.lastname: Armato
authors.forename: M L
authors.initials: ML
authors.lastname: Giger
authors.forename: C T
authors.initials: CT
authors.lastname: Chen
authors.forename: C J
authors.initials: CJ
authors.lastname: Vyborny
authors.forename: J
authors.initials: J
authors.lastname: Ryan
authors.forename: H
authors.initials: H
authors.lastname: MacMahon
mesh_terms: D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008168:Lung / Q000000981:diagnostic imaging*; D008171:Lung Diseases / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D011856:Radiographic Image Enhancement; D011877:Radionuclide Imaging; D014692:Ventilation-Perfusion Ratio; D014980:Xenon Radioisotopes
chemical_list: D014980:Xenon Radioisotopes