Computer-aided detection of malpositioned endotracheal tubes in portable chest radiographs

Zhimin Huo, Hongda Mao, Jane Zhang, Anne Marie Sykes, Samson Munn, John Wandtke

Research output: Chapter in Book/Report/Conference proceedingConference contribution

1 Scopus citations


Portable chest radiographic images play a critical role in examining and monitoring the condition and progress of critically ill patients in intensive care units (ICUs). For example, portable chest images are acquired to ensure that tubes inserted into the patients are properly positioned for effective treatment. In this paper, we present a system that automatically detects the position of an endotracheal tube (ETT), which is inserted into the trachea to assist patients who have difficulty breathing. The computer detection includes the detections of the lung field, spine line, and aortic arch. These detections lead to the identification of regions of interest (ROIs) used for the subsequent detection of the ETT and carina. The detection of the ETT and carina is performed within the ROIs. Our ETT and carina detection methods were trained and tested on a large number of images. The locations of the ETT and carina were confirmed by an experienced radiologist for the purpose of performance evaluation. Our ETT detection achieved an average sensitivity of 85% at less than 0.1 false-positive detections per image. The carina approach correctly identified the carina location within a 10 mm distance from the truth location for 81% of the 217 testing images. We expect our system will assist ICU clinicians to detect malpositioned ETTs and reposition malpositioned ETTs more effectively and efficiently.

Original languageEnglish (US)
Title of host publicationMedical Imaging 2014
Subtitle of host publicationComputer-Aided Diagnosis
ISBN (Print)9780819498281
StatePublished - 2014
EventMedical Imaging 2014: Computer-Aided Diagnosis - San Diego, CA, United States
Duration: Feb 18 2014Feb 20 2014

Publication series

NameProgress in Biomedical Optics and Imaging - Proceedings of SPIE
ISSN (Print)1605-7422


OtherMedical Imaging 2014: Computer-Aided Diagnosis
Country/TerritoryUnited States
CitySan Diego, CA


  • Carina
  • Computer detection
  • Computer-aided
  • Detection
  • Endotracheal tube
  • ICUs
  • Malpositioned
  • Portable chest radiograph

ASJC Scopus subject areas

  • Electronic, Optical and Magnetic Materials
  • Biomaterials
  • Atomic and Molecular Physics, and Optics
  • Radiology Nuclear Medicine and imaging


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