Rationale and Objectives. The authors developed and tested a gray-leve
l thresholding-based approach to automated lung segmentation in digiti
zed posteroanterior chest radiographs. Materials and Methods. Gray-lev
el histogram analysis was initially performed to establish a range of
thresholds for use during an iterative global gray-level thresholding
technique. Local gray-level threshold analysis was then performed on t
he output of global thresholding. The resulting contours ware subjecte
d to several smoothing processes, including a rolling-ball technique.
The final contours closely approximated the boundaries of the aerated
lung regions. The method was applied to a database of 600 posteroanter
ior chest images. Radiologists rated the accuracy and completeness of
the contours with a five-point scale. Results. Results of the subjecti
ve rating evaluation indicated that this method was accurate, with 79%
Of the assigned ratings reflecting moderately or highly accurate segm
entation and only 8% of the ratings indicating moderately or highly in
accurate segmentation. Conclusion. This gray-level thresholding-based
approach provides accurate automated lung segmentation in digital post
eroanterior chest radiographs.