Abstract
This study explores an automated framework to assist the recognition of hemorrhage traces and bleeding lesions in video streams of small bowel capsule endoscopy (SBCE). The proposed methodology aims to achieve fast image control (<10 minutes), save valuable time of the physicians, and enable high performance diagnosis. A specialized elimination algorithm excludes all identical consecutive frames by utilizing the difference of gray levels in pixel luminance. An image filtering algorithm is proposed based on an experimentally calculated bleeding index and blood-color chart, which inspects all remaining frames of the footage and identifies pixels that reflect active or potential hemorrhage in color. The bleeding index and blood-color chart are estimated of the chromatic thresholds in RGB and HSV color spaces, and have been extracted after experimenting with more than 3200 training images, derived from 99 videos of a pool of 138 patients. The dataset has been provided by a team of expert gastroenterologist surgeons, who have also evaluated the results. The proposed algorithms are tested on a set of more than 1000 selected frame samples from the entire 39 testing videos, to a prevalence of 50% pathologic frames (balanced dataset). The frame elimination of identical and consecutive frames achieved a reduction of 36% of total frames. The best statistical performance for diagnosis of positive pathological frames from a video stream is achieved by utilizing masks in the HSV color model, with sensitivity up to 99%, precision 94.41% to a prevalence of 50%, accuracy up to 96.1%, FNR 1%, FPR 6.8%. The estimated blood-color chart will be clinically validated and used in feature extraction schemes supporting machine learning ML algorithms to improve the localization potential.
Highlights
Most endoscopic capsule designers offer some form of basic software upon purchase of the device, which are able to manage, detect present and suggest the most suspicious images to the examiner, in order to facilitate more complete and successful diagnosis
This study explores an automated framework to assist the recognition of hemorrhage traces and bleeding lesions in video streams of small bowel capsule endoscopy (SBCE)
The best statistical performance for diagnosis of positive pathological frames from a video stream is achieved by utilizing masks in the HSV color model, with sensitivity up to 99%, precision 94.41% to a prevalence of 50%, accuracy up to 96.1%, False Negative Ratio (FNR) 1%, False Positive Ratio (FPR) 6.8%
Summary
Most endoscopic capsule designers offer some form of basic software upon purchase of the device, which are able to manage, detect present and suggest the most suspicious images to the examiner, in order to facilitate more complete and successful diagnosis. It can be argued that the development of software algorithms to recognize suspected images is not as sophisticated and innovative as the actual hardware technology of the capsule itself. They mainly proceed with: 1) the serial reading of each one of the captured images and 2) the application of a selected mix of image analysis tools (image recognition filters and operators that each company implements by their own engineers).
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