Improved visualization of cardiac pacemaker lead on chest radiographs

Chest radiographs provide significant information about the pacing lead for the management and follow-up of post-cardiac pacing patients. However, the pacing lead is not always clearly visible because of cardiac insertion via the mediastinum and low contrast on the chest radiograph. We developed an image-processing technique that improves visualization of the cardiac pacing lead on chest radiographs to facilitate management after pacemaker implantation. In this study, 117 chest radiographs obtained during pacemaker follow-up were analyzed. These chest images were smoothed using a median filter, sharpened by unsharp masking, then binarized by thresholding using the moving average method. To evaluate the usefulness of these processed images, four cardiologists compared the original and processed images using the two-sample preference test. As a result, visualization of the pacing lead was significantly improved on all processed images compared with that on the original images. We conclude that this image processing technique can facilitate pacemaker management.