Quality control system for patient positioning and filling in meta-information for chest X-ray examinations

During radiography, irregularities occur, leading to decrease in the diagnostic value of the images obtained. The purpose of this work was to develop a system for automated quality assurance of patient positioning in chest radiographs, with detection of suboptimal contrast, brightness, and metadata errors.

The quality assurance system was trained and tested using more than 69,000 X-rays of the chest and other anatomical areas from the Unified Radiological Information Service (URIS) and several open datasets. Our dataset included studies regardless of a patient's gender and race, while the sole exclusion criterion being age below 18 years. A training dataset of radiographs labeled by expert radiologists was used to train an ensemble of modified deep convolutional neural networks architectures ResNet152V2 and VGG19 to identify various quality deficiencies. Model performance was accessed using area under the receiver operating characteristic curve (ROC-AUC), precision, recall, F1-score, and accuracy metrics.

Seven neural network models were trained to classify radiographs by the following quality deficiencies: failure to capture the target anatomic region, chest rotation, suboptimal brightness, incorrect anatomical area, projection errors, and improper photometric interpretation. All metrics for each model exceed 95%, indicating high predictive value. All models were combined into a unified system for evaluating radiograph quality. The processing time per image is approximately 3 s.

The system supports multiple use cases: integration into an automated radiographic workstations, external quality assurance system for radiology departments, acquisition quality audits for municipal health systems, and routing of studies to diagnostic AI models.