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Software Increases Visibility, Decreases Time to Confirm Placement of Medical Devices

By MedImaging International staff writers
Posted on 22 Jan 2013

New software improves the visual clarity of traditional chest X-ray images and increases radiologists’ efficiency by reducing the time it takes to confirm the proper placement of feeding, drug-delivery and pain management tubes and lines. The software has received European Union CE marking approval.

Portable chest X-ray machines are routinely used to confirm placement of lines and tubes; however, the image quality makes it challenging for radiologists to differentiate these structures, and the rib and clavicle bones obscure visibility of chest tissue by up to 40%. Furthermore, radiologists incur substantial time adjusting the image to make the edges and tips of the devices stand out.

The software, ClearRead +Confirm, was developed by Riverain Technologies (Dayton, OH, USA). The software immediately processes any portable chest X-ray, creating a second, soft tissue image with the ribs and clavicles suppressed, and increasing the contrast, sharpness, and visibility of tubes, lines, and cardiac wires. Radiologists simply toggle between the two images to confirm proper placement of the devices.

A Georgetown University (Washington DC, USA) reader study assessed the time it took radiologists to locate: (1) PICC (peripherally inserted central catheter) lines, which are long, thin tubes that remain inside the chest to deliver nutrients, fluid, blood, and therapeutic agents over time to treat pain, cancer, or infection. PICC lines also are used to draw blood samples and provide kidney dialysis. (2) Nasogastric (NG) tubes, which deliver food and medicine to the stomach through the nose. (3) Wires that conduct or measure electrical impulses, including electrodes for cardiac pacing and defibrillation.

In the study, 334 chest radiographs were reviewed by 10 radiologists with and without the enhanced ClearRead +Confirm image. The software reduced the reading time by an average of nearly 19%, without comprising accuracy. Evaluating the conventional X-ray and ClearRead image together took an average of five and a half seconds less per image than evaluating the traditional X-ray image on its own, amounting to a savings of 30 minutes across all images.

Participating radiologists strongly agreed that the enhanced image increased their confidence in confirming the placement of lines and tubes and made it easier to see venous catheters. “The software-enhanced chest X-ray image increases radiologists’ confidence while reducing decision-making time and time to treatment, with no additional tests or radiation exposure for patients,” said Steve Worrell, Riverain’s chief technology officer.

ClearRead +Confirm employs proprietary machine learning and pattern recognition technologies in Riverain’s chest X-ray bone-suppression and computer-aided detection (CAD) software.

ClearRead +Confirm software is cleared for sale in Europe and is currently being reviewed for clearance by the US Food and Drug Administration (FDA).

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68 (85.115432739258): SELECT fid FROM jos_deeppockets WHERE id=294744397 AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE id=294744397 AND published='1' LIMIT 1

69 (40.054321289062): SELECT id,name,sponsor_text FROM jos_deeppockets dp left outer join jos_channel_sponsor cs on dp.id=cs.fid WHERE cat=10 AND TYPE='file_folder' AND published=1 AND id=216 ORDER BY `ordering`

70 (355.00526428223): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294744397 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

71 (245.09429931641): SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294744397 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

72 (51.021575927734): SELECT id,name,title FROM jos_deeppockets WHERE cat=10 AND TYPE='file_folder' AND published=1 AND id != 294743300 AND id != 294743301 AND id != 294743302 AND id != 294743303 AND id != 294743304 AND id != 294743305 AND id != 294743306 AND id != 294743307 AND id != 294743308 AND id != 294743309 AND id != 294743310 AND metakey != 'aacc' ORDER BY `ordering`

73 (92.029571533203): SELECT show_live FROM jos_com_show_setting LIMIT 1

74 (34.093856811523): SELECT show_live FROM jos_com_show_setting LIMIT 1

75 (27.894973754883): SELECT show_live FROM jos_com_show_setting LIMIT 1

76 (25.98762512207): SELECT show_live FROM jos_com_show_setting LIMIT 1

77 (25.98762512207): SELECT show_live FROM jos_com_show_setting LIMIT 1

78 (25.98762512207): SELECT show_live FROM jos_com_show_setting LIMIT 1

79 (32.901763916016): SELECT show_live FROM jos_com_show_setting LIMIT 1

80 (33.855438232422): SELECT show_live FROM jos_com_show_setting LIMIT 1

81 (34.093856811523): SELECT show_live FROM jos_com_show_setting LIMIT 1

82 (32.186508178711): SELECT show_live FROM jos_com_show_setting LIMIT 1

83 (37.908554077148): SELECT show_live FROM jos_com_show_setting LIMIT 1

84 (34.093856811523): SELECT show_live FROM jos_com_show_setting LIMIT 1

85 (38.14697265625): SELECT show_live FROM jos_com_show_setting LIMIT 1

86 (33.855438232422): SELECT show_live FROM jos_com_show_setting LIMIT 1

87 (90.122222900391): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294744397 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

88 (40.054321289062): SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294744397 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

89 (41.961669921875): SELECT id,name,title FROM jos_deeppockets WHERE cat=10 AND TYPE='file_folder' AND published=1 AND id != 294743300 AND id != 294743301 AND id != 294743302 AND id != 294743303 AND id != 294743304 AND id != 294743305 AND id != 294743306 AND id != 294743307 AND id != 294743308 AND id != 294743309 AND id != 294743310 AND metakey != 'aacc' ORDER BY `ordering`

90 (90.837478637695): SELECT show_live FROM jos_com_show_setting LIMIT 1

91 (46.014785766602): SELECT show_live FROM jos_com_show_setting LIMIT 1

92 (46.968460083008): SELECT show_live FROM jos_com_show_setting LIMIT 1

93 (41.007995605469): SELECT show_live FROM jos_com_show_setting LIMIT 1

94 (41.961669921875): SELECT show_live FROM jos_com_show_setting LIMIT 1

95 (40.054321289062): SELECT show_live FROM jos_com_show_setting LIMIT 1

96 (46.968460083008): SELECT show_live FROM jos_com_show_setting LIMIT 1

97 (40.054321289062): SELECT show_live FROM jos_com_show_setting LIMIT 1

98 (36.001205444336): SELECT show_live FROM jos_com_show_setting LIMIT 1

99 (36.954879760742): SELECT show_live FROM jos_com_show_setting LIMIT 1

100 (54.121017456055): SELECT show_live FROM jos_com_show_setting LIMIT 1

101 (66.995620727539): SELECT show_live FROM jos_com_show_setting LIMIT 1

102 (40.054321289062): SELECT show_live FROM jos_com_show_setting LIMIT 1

103 (35.04753112793): SELECT show_live FROM jos_com_show_setting LIMIT 1

104 (96.08268737793): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294744397 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294744397 AND published='1' LIMIT 1

105 (72.002410888672): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294744397 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294744397 AND published='1' LIMIT 1

106 (80.82389831543): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294744397 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

107 (65.088272094727): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets_archive as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294744397 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

108 (115.15617370605): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294744397 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294744397 AND published='1' LIMIT 1

109 (60.796737670898): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294744397 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294744397 AND published='1' LIMIT 1

110 (77.009201049805): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.id=294744397 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

111 (788.92707824707): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets_archive as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.id=294744397 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

112 (570.05882263184): SELECT dp.name, dp.id, dp2.name as channel, ex.name as author_name, ex.specialization, ex.images FROM jos_deeppockets as dp LEFT JOIN jos_experts as ex ON ex.id = dp.author LEFT JOIN jos_deeppockets as dp2 ON dp2.id = dp.fid WHERE dp.author != 0 AND dp.cat = 10 AND dp.published = 1 AND ( (dp.fid = 294743300) OR (dp.fid = 294743301) OR (dp.fid = 294743302) OR (dp.fid = 294743303) OR (dp.fid = 294743304) OR (dp.fid = 294743305) OR (dp.fid = 294743306) OR (dp.fid = 294743307) OR (dp.fid = 294743308) OR (dp.fid = 294743309) OR (dp.fid = 294743310) ) ORDER BY RAND() LIMIT 1

113 (416.99409484863): SELECT dp.name, dp.id, dp2.name as channel, ex.name as author_name, ex.specialization, ex.images FROM jos_deeppockets as dp LEFT JOIN jos_experts as ex ON ex.id = dp.author LEFT JOIN jos_deeppockets as dp2 ON dp2.id = dp.fid WHERE dp.author != 0 AND dp.cat = 10 AND dp.published = 1 AND ( (dp.fid = 294743300) OR (dp.fid = 294743301) OR (dp.fid = 294743302) OR (dp.fid = 294743303) OR (dp.fid = 294743304) OR (dp.fid = 294743305) OR (dp.fid = 294743306) OR (dp.fid = 294743307) OR (dp.fid = 294743308) OR (dp.fid = 294743309) OR (dp.fid = 294743310) ) ORDER BY RAND() LIMIT 1

114 (100.85105895996): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294744397 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294744397 AND published='1' LIMIT 1

115 (74.863433837891): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294744397 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294744397 AND published='1' LIMIT 1

116 (114.20249938965): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294744397 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294744397 AND published='1' LIMIT 1

117 (41.007995605469): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294744397 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294744397 AND published='1' LIMIT 1

118 (85.115432739258): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294744397 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294744397 AND published='1' LIMIT 1

119 (55.074691772461): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294744397 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294744397 AND published='1' LIMIT 1

120 (405.78842163086): SELECT * FROM trending_articles WHERE `journal_id` = 10 AND `timestamp` <= NOW() + INTERVAL 7 DAY ORDER BY `order`

121 (!!!!! 24401.903152466): SELECT * FROM jos_deeppockets WHERE jos_deeppockets.cat = 10 AND jos_deeppockets.type = 'deeppockets_item' AND jos_deeppockets.published = 1 AND jos_deeppockets.created + INTERVAL 14 DAY >= NOW() ORDER BY jos_deeppockets.hits DESC LIMIT 7

122 (120.16296386719): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294744397 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294744397 AND published='1' LIMIT 1

123 (55.074691772461): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294744397 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294744397 AND published='1' LIMIT 1

124 (579.833984375): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294744397 AND type='deeppockets_item' AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294744397 AND type='deeppockets_item' AND published='1' LIMIT 1

125 (!!!!! 541194.20051575): ( SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.video != '' AND dp.video_source != '' AND dp.cat = 10 AND dp.published = 1 AND dp.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) UNION ( SELECT dpa.id, dpa.name, dpa.title, dpa.video, dpa.video_source, dpa.created FROM jos_deeppockets_archive AS dpa WHERE dpa.video != '' AND dpa.video_source != '' AND dpa.cat = 10 AND dpa.published = 1 AND dpa.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) ORDER BY created DESC LIMIT 3

126 (91.075897216797): ( SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.video != '' AND dp.video_source != '' AND dp.cat = 10 AND dp.published = 1 AND dp.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) UNION ( SELECT dpa.id, dpa.name, dpa.title, dpa.video, dpa.video_source, dpa.created FROM jos_deeppockets_archive AS dpa WHERE dpa.video != '' AND dpa.video_source != '' AND dpa.cat = 10 AND dpa.published = 1 AND dpa.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) ORDER BY created DESC LIMIT 3

127 (418.90144348145): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294800513 LIMIT 1

128 (52.213668823242): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294800513 LIMIT 1

129 (315.18936157227): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294800359 LIMIT 1

130 (44.107437133789): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294800359 LIMIT 1

131 (233.17337036133): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294800361 LIMIT 1

132 (40.054321289062): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294800361 LIMIT 1

133 (619.17304992676): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294744397 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

134 (453.94897460938): SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294744397 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

135 (412.94097900391): SELECT name FROM jos_deeppockets WHERE id=216

136 (49.829483032227): SELECT name FROM jos_deeppockets WHERE id=216

137 (724.07722473145): SELECT *, DATE_FORMAT(publish_up,'%d %b %Y') AS date_publish_up, DATE_FORMAT(publish_down,'%d %b %Y') AS date_publish_down FROM jos_events WHERE state=1 AND publish_up > NOW() and extra_info REGEXP '((;)|(^))216((;)|($))' AND catid IN (0,110) ORDER BY publish_up ASC LIMIT 3

138 (697.85118103027): SELECT *, DATE_FORMAT(publish_up,'%d %b %Y') AS date_publish_up, DATE_FORMAT(publish_down,'%d %b %Y') AS date_publish_down FROM jos_events WHERE state=1 AND publish_up > NOW() and extra_info REGEXP '((;)|(^))216((;)|($))' AND catid IN (0,110) ORDER BY publish_up ASC LIMIT 3

139 (!!!!! 1607.8948974609): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294744397 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294744397 AND published='1' LIMIT 1

140 (108.00361633301): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294744397 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294744397 AND published='1' LIMIT 1

141 (!!!!! 13220.071792603): TRUNCATE TABLE jos_trademed_module

142 (159.02519226074): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294744397 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

143 (97.990036010742): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets_archive as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294744397 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

144 (715.01731872559): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294744397 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

145 (93.936920166016): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294744397 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

146 (107.0499420166): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294744397 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294744397 AND published='1' LIMIT 1

147 (70.810317993164): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294744397 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294744397 AND published='1' LIMIT 1

148 (!!!!! 1788.854598999): SELECT jos_item.* FROM jos_item INNER JOIN jos_number ON jos_item.numberID=jos_number.id WHERE 1=1 AND (jos_item.imgMini<>'') AND jos_item.type='L' AND jos_item.numberID= ( SELECT jos_number.id FROM jos_number WHERE jos_number.journalID IN (10) and jos_number.id in (select distinct jos_number.id from jos_number join jos_item on jos_item.numberid=jos_number.id where jos_item.type='P') ORDER BY (CONVERT(SUBSTRING(issue,1,2),SIGNED) + (CONVERT(SUBSTRING(issue,3,2),SIGNED)*100)) DESC LIMIT 0,1 ) ORDER BY RAND() DESC LIMIT 6

149 (125.88500976562): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294744397 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294744397 AND published='1' LIMIT 1

150 (87.02278137207): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294744397 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294744397 AND published='1' LIMIT 1

151 (84.877014160156): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294744397 AND type='deeppockets_item' AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294744397 AND type='deeppockets_item' AND published='1' LIMIT 1

152 (57.93571472168): select distinct links.* from jos_textlinks links join jos_textlinks_placement placement on links.id=placement.link_id where journal_id=(10) and (channel_id=216 or channel_id is null)

153 (48.87580871582): select distinct links.* from jos_textlinks links join jos_textlinks_placement placement on links.id=placement.link_id where journal_id=(10) and (channel_id=216 or channel_id is null)

154 (72.002410888672): SELECT livesite FROM jos_dp_categories WHERE id=10 AND published='1' LIMIT 1

155 (103.95050048828): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294744397 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294744397 AND published='1' LIMIT 1

156 (79.870223999023): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294744397 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294744397 AND published='1' LIMIT 1

157 (112.05673217773): select jos_twitters.link from jos_twitters where cat=10

158 (54.121017456055): select jos_facebook.link from jos_facebook where cat=10

159 (52.928924560547): select jos_google_plus.link from jos_google_plus where cat=10

160 (58.174133300781): select jos_linkedin.link from jos_linkedin where cat=10

161 (456.09474182129): update jos_bannersmanager_banner set impmade=impmade+1 where id in(14615,14202,14203)

162 (!!!!! 2328.8726806641): insert into jos_banners_delta values (14615,'2025-06-18 17:30:27','216.73.216.120','view'),(14202,'2025-06-18 17:30:27','216.73.216.120','view'),(14203,'2025-06-18 17:30:27','216.73.216.120','view')

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