Tracking the hyoid bone in videofluoroscopic swallowing studies
Tracking the hyoid bone in videofluoroscopic swallowing studies
复制标题
在电视透视吞咽研究中追踪舌骨
DOI：
10.1117/12.771198
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发表时间：
2008
期刊：
影响因子：
--
通讯作者：
D. V. Daele
中科院分区：
文献类型：
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作者：
Patrick M. Kellen;Darci Becker;J. Reinhardt;D. V. Daele
吞咽困难，或吞咽困难，已经成为一个日益严重的问题。吞咽并发症会导致营养不良、脱水、呼吸道感染，甚至死亡。目前分析和诊断吞咽困难的金标准是电视透视吞钡检查。在这些研究中，使用荧光镜对患者摄取不同体积和粘度的钡溶液进行成像。舌骨固定了许多与吞咽有关的关键肌肉，并在这一过程中发挥了关键作用。吞咽过程中舌骨运动异常可提示吞咽功能障碍。目前在临床环境中，舌骨运动是定性评估的，这可能会受到评价者内部和评价者之间的偏差的影响。本文提出了一种半自动跟踪舌骨的方法，使定量分析成为可能。用户在一个帧上定义舌骨的模板，并在后续帧中跟踪该模板。通过基于运动学的模板位置预测来优化匹配阶段。一位语音病理学家在十项研究的每一帧上都标出了舌骨的位置，作为黄金标准。在95%的可信区间内进行Bland-Altman分析的结果显示，手动定义的金标准与建议的方法之间的偏差在x为0.0±0.08像素，y为-0.08±0.09像素。该方法与金标准的平均皮尔逊相关系数x为0.987，y为0.980。本文还提出了一种自动建立以患者为中心的舌骨运动坐标系的方法。该坐标系校正研究期间上半身患者的运动，并确定上下半身和前后方的运动成分。这些工具使定量舌骨运动分析在临床和研究环境中使用是可行的。
Difficulty swallowing, or dysphagia, has become a growing problem. Swallowing complications can lead to malnutrition, dehydration, respiratory infection, and even death. The current gold standard for analyzing and diagnosing dysphagia is the videofluoroscopic barium swallow study. In these studies, a fluoroscope is used to image the patient ingesting barium solutions of different volumes and viscosities. The hyoid bone anchors many key muscles involved in swallowing and plays a key role in the process. Abnormal hyoid bone motion during a swallow can indicate swallowing dysfunction. Currently in clinical settings, hyoid bone motion is assessed qualitatively, which can be subject to intra-rater and inter-rater bias. This paper presents a semi-automatic method for tracking the hyoid bone that makes quantitative analysis feasible. The user defines a template of the hyoid on one frame, and this template is tracked across subsequent frames. The matching phase is optimized by predicting the position of the template based on kinematics. An expert speech pathologist marked the position of the hyoid on each frame of ten studies to serve as the gold standard. Results from performing Bland-Altman analysis at a 95% confidence interval showed a bias of 0.0±0.08 pixels in x and -0.08±0.09 pixels in y between the manually-defined gold standard and the proposed method. The average Pearson's correlation between the gold standard and the proposed method was 0.987 in x and 0.980 in y. This paper also presents a method for automatically establishing a patient-centric coordinate system for the interpretation of hyoid motion. This coordinate system corrects for upper body patient motion during the study and identifies superior-inferior and anterior-posterior motion components. These tools make the use of quantitative hyoid motion analysis feasible in clinical and research settings.