By Karen Appold

ContextVision’s GOPView XR2Plus, a digital x-ray image enhancement product, provides radiologists with great visualization of subtle pathology with optimal image enhancement. X-ray equipment manufacturers incorporate the XR2Plus software into their hardware to perform all image enhancement processes after image capturing occurs.

GOPView XR2Plus includes a set of tunable soft tissue noise filters. The adaptive noise suppression methodology analyzes each pixel in its context. Filtering and enhancement can then be applied confidently, knowing that true structures are accurately identified. Even in low-dose applications with a low signal-to-noise ratio, the capacity to adapt and tune the algorithm results in consistent diagnostic image quality.

How It Works

GOPView XR2Plus is detector and generator independent, easily integrated into software and valuable in both specialized and generalized radiography. Independent of the image capturing technology, it processes digital radiology images to optimize their quality.

GOPView XR2Plus is embedded into the manufacturer’s x-ray system and is applied after the image is generated. ContextVision’s GOP technology detects structures by examining the significance of each pixel in an image in relation to the wider context in which they appear. This way, once the structure is identified and analyzed, noise can be suppressed and the true structure, however weak, can be emphasized and seen more clearly.

Benefits to Clinicians and Patients

GOPView XR2Plus includes several features that reduce the clinician’s hands-on time. Its adaptive density tool helps present the images for immediate clinical viewing, while the automatic collimation detection feature provides optimal windowing of the image by including only the relevant anatomy in the process. Windowing is the manual work where the clinician must adjust the window and center (contrast/brightness) to get the optimal visualization of the actual image. These time-consuming adjustments are automatically done with GOPView XR2Plus, leading to increased patient throughput and reducing the cost of digital x-ray image acquisition and clinical review.

As medical imaging centers grow in size, the typical center performs tens of thousands of x-ray examinations each year. At this volume, it is difficult to maintain a homogenous image quality between uses. Without human intervention, the equipment automatically optimizes the images and eliminates the need for time-consuming manual adjustments.

Patients also reap benefits when their medical imaging providers use hardware with GOPView XR2Plus inside. “Because the cumulative radiation from medical imaging tests may pose a cancer concern, both doctors and patients have begun to push for alternatives,” said Peter Kövamees, product manager digital x-ray, ContextVision, Stockholm, Sweden. GOPView XR2Plus helps reduce patient radiation exposure because it requires fewer retakes.

Other Options

GOPView XR2Plus was launched at RSNA 2009. Since then, the products have been supplemented with tuning tools, making it possible for the original equipment manufacturer to do some fine-tuning and for end users to make final fine-tuning to images with a Doctors Interface. Other additional modules have been added to the product portfolio such as Exposure Index Region Calculation to deliver correct exposure to the patient and for optimal image quality for each anatomy and projection.

“It works well for all x-ray examinations of numerous anatomies,” said  Kövamees.  “In a lung exam, for example, it’s important to see the carina, the bronchi, and the small blood vessels in the lungs and over the heart. All in all, it’s important to see subtle pathologies to make the correct diagnosis.”

Radiologists often face challenges when imaging patients with metal implants. The implants typically produce a “dark” frame around the foreign object that is easily misinterpreted as inflammation, leading to a misdiagnosis. With GOPView XR2Plus, radiologists are given greater diagnostic confidence because the software is designed with a metal safe algorithm to effectively eliminate errors associated with these images.

“For orthopedic images, the radiologist receives no implant artifacts that generally appear when imaging a part of the body with metal implants,” Kövamees said.

Customized Integration Process

ContextVision uses professional clinical experts in fine-tuning for customer specific parameter files. When collaboration with a customer is established, ContextVision performs customer-specific fine-tuning with the customer’s reference doctor or on-site clinical experts. “This close clinical relationship addresses individual customer clinical requirements quickly and effectively,” Kövamees said.

Three new add-on modules for GOPView XR2Plus include Intelligent Exposure Index (EI), which automatically monitors patient exposure; Defect Correct Library (DCL), which corrects for XR panel defects; and Doctors Interface for end user image control.