# US 12,217,419 B2 · Inhalation metric for chest x-ray images

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- Number: US 12,217,419 B2
- Document ID: US12217419B2
- Status: Granted
- Kind: B2
- Application number: 17/641,122
- Filed: 2020-09-01
- Published: 2024-02-08
- Granted: 2025-02-04
- Earliest claimed: 2019-09-09
- Assignees: Koninklijke Philips N.V.
- Applicants: Koninklijke Philips N.V.
- Inventors: Jens Von Berg; Daniel Bystrov; Sven Kroenke; Stewart Young
- Web page: https://patentgrep.com/patent/US12217419B2

## CPC

- G06T 7/0012: {Biomedical image inspection}
- A61B 6/50: specially adapted for specific body parts; specially adapted for specific clinical applications
- A61B 6/5217: {extracting a diagnostic or physiological parameter from medical diagnostic data}
- A61B 5/113: occurring during breathing
- G06T 2207/10116: X-ray image
- G06T 2207/20081: Training; Learning
- G06T 2207/20128: Atlas-based segmentation
- G06T 2207/30008: Bone
- G06T 2207/30061: Lung
- G06T 2207/30168: Image quality inspection
- G06T: IMAGE DATA PROCESSING OR GENERATION, IN GENERAL
- A61B: DIAGNOSIS; SURGERY; IDENTIFICATION (usefulness limited to only animals A61D)

## Abstract

In order to enhance enhanced X-ray image inhalation quality monitoring, a metric is proposed hat reproducibly provides an index of ribs visible to be used in the assessment of the inhalation state. In an example, a detected diaphragm in a chest X-ray image may be projected into an atlas that contains labels for all intercostal spaces, namely spaces between rib centerlines. A spatial representation of both the clavicle and the ribs is provided in the atlas, a cumulative histogram is built for all points, i.e. pixels, of the diaphragm, for every point a rib label counter of the rib in the rib label map at that point is incremented as well as all ribs above it, the rib label counter is normalized by a division by the number of points, the median (or a different quantile) may be taken of this distribution serving as an inhalation index. An objective metric of inhalation state is thus achieved.

## Claims

### Claim 1

A computer implemented method for X-ray image inhalation quality monitoring, comprising:
receiving a chest X-ray image of a patient;
detecting rib bones in the chest X-ray image;
identifying a plurality of intercostal spaces each representing a space between adjacent detected rib bones;
detecting a diaphragm in the chest X-ray image and generating a diaphragm line comprising a plurality of points representing a path of a diaphragm in the chest X-ray image;
assigning a point score to each point of the diaphragm line using a score assigning rule, wherein the score assigning rule defines a correspondence in the image between a point of the diaphragm line and an intercoastal space; and
determining an inhalation index based on the point scores of the points of the diaphragm line.

### Claim 2 (depends on 1)

The method according to claim 1, further comprising:
comparing the determined inhalation index with a pre-determined X-ray image inhalation quality monitoring rule specifying an image inhalation state in terms of the inhalation index, and providing an X-ray image inhalation quality measure based on the comparison.

### Claim 3 (depends on 1)

The method according to claim 1, further comprising
building a statistical atlas by co-registration of training images that comprise a plurality of chest X-ray images of one or more patients; and
registering the statistical atlas with the chest X-ray image of the patient to build a patient specific rib-bone model of the patient.

### Claim 4 (depends on 3)

The method according to claim 3, wherein the plurality of intercostal spaces is identified in the patient specific rib-bone model.

### Claim 5 (depends on 3)

The method according to claim 3, further comprising mapping the detected diaphragm into the patient specific rib-bone model to generate the diaphragm line based on the registration.

### Claim 6 (depends on 1)

The method according to claim 1, wherein the inhalation index is determined based on the point scores of the points of a right lung diaphragm line representing a path of the diaphragm in a right lung field portion and/or a left lung diaphragm line representing a path of the diaphragm in a left lung field portion.

### Claim 7 (depends on 1)

The method according to claim 1, further comprising:
labelling the plurality of intercostal spaces with intercostal labels; and/or
labelling the detected rib bones with rib labels; wherein the score assigning rule defines:
a correspondence between point scores and intercostal labels; and/or
a correspondence between point scores and rib labels.

### Claim 8 (depends on 1)

The method according to claim 1, wherein the score assigning rule further defines a correspondence between point scores and a spatial relation of a point in an intercostal space with respect to two detected rib bones that define the intercostal space; or wherein the score assigning rule provides interpolated rib labels and/or interpolated intercostal labels at each position in the statistical atlas such that a point score can be obtained for a given image pixel of the chest X-ray image by registering the statistical atlas with the chest X-ray image.

### Claim 9 (depends on 1)

The method according to claim 1, wherein the inhalation index comprises at least one of measures of central tendency of the point scores of the diaphragm line.

### Claim 10

An apparatus for X-ray image inhalation quality monitoring, comprising:
an input configured to receive a chest X-ray image of a patient; and
a processor configured to:
detect rib bones in the chest X-ray image;
identify a plurality of intercostal spaces each representing a space between adjacent detected rib bones;
detect diaphragm in the chest X-ray image and generate a diaphragm line comprising a plurality of points representing a path of a diaphragm in the chest X-ray image;
assign a point score to each point of the diaphragm line using a score assigning rule, wherein the score assigning rule defines a correspondence in the image between a point of the diaphragm line and an intercoastal space; and
determine an inhalation index based on the point scores of the points of the diaphragm line.

### Claim 11 (depends on 10)

The apparatus according to claim 10, wherein the processor is further configured to compare the determined inhalation index with a pre-determined X-ray image inhalation quality monitoring rule specifying an image inhalation state in terms of the inhalation index, and provide an X-ray image inhalation quality measure based on the comparison.

### Claim 12 (depends on 10)

The apparatus according to claim 10, further comprising:
an output configured to output the determined inhalation index and/or an X-ray image inhalation quality measure.

### Claim 13

A non-transitory computer-readable medium having executable instructions stored thereon which, when executed by at least one processor, cause the at least one processor to perform a method for X-ray image inhalation quality monitoring, the method comprising:
receiving a chest X-ray image of a patient;
detecting rib bones in the chest X-ray image;
identifying a plurality of intercostal spaces each representing a space between adjacent detected rib bones;
detecting a diaphragm in the chest X-ray image and generating a diaphragm line comprising a plurality of points representing a path of a diaphragm in the chest X-ray image;
assigning a point score to each point of the diaphragm line using a score assigning rule, wherein the score assigning rule defines a correspondence in the image between a point of the diaphragm line and an intercoastal space; and
determining an inhalation index based on the point scores of the points of the diaphragm line.