Computer-aided Diagnosis Scheme Research Articles

Computer-aided detection of lung nodules by SVM based on 3D matrix patterns

ObjectiveThe objective was to prevent loss of some implicit structural and local contextual information of lung nodules by current one- (1D) or two-dimensional (2D) schemes. Materials and methodsThe testing data set used in this study consisted of computed tomographic scans from 196 different patients in Jilin Tumor Hospital, which consisted of 8428 sections including 108 nodules. By the proposed support vector machine based on three dimensional matrix patterns (SVM3Dmatrix) which improves the classifier of SVM, 3D volume of interest of suspected lung nodules can be used directly as the training samples. The 3D scheme may effectively reduce the large numbers of false positives (FPs) by current 1D and 2D schemes. ResultFive computer-aided diagnosis (CAD) schemes were investigated for the same 196-case database. SVM3Dmatrix achieved a 98.2% overall sensitivity with 9.1 FPs per section, which was in general superior compared to the other four CAD schemes for our application.

A nonparametric-based rib suppression method for chest radiographs

This paper presents an automated and comprehensive system for eliminating rib shadows in chest radiographs, which integrates lung field identification, rib segmentation, rib intensity estimation, and suppression. We designed a region of interest (ROI)-based method to estimate a suitable initial lung boundary for active shape model (ASM) deformation by determining the translation and scaling parameters from the lung ROI. By considering the anatomical structure of the rib cage, we developed a locale sampling scheme to achieve nonparametric rib modeling. This scheme integrates knowledge-based generalized Hough transform (GHT) for accurate rib segmentation. We subsequently estimated rib intensity using the real-coded genetic algorithm (RCGA). Experimental results indicate that the relative conspicuity of the nodules increased after rib suppression, compared to the original image. Additionally, the proposed system uses only one standard chest radiograph, and the dual-energy subtraction technique is not required. Thus, this system is suitable for radiologists and computer-aided diagnosis (CAD) schemes for detecting lung nodules in chest radiographs.

Computer-Aided Diagnosis for Detection of Lacunar Infarcts on MR Images: ROC Analysis of Radiologists’ Performance

The purpose of this study was to retrospectively evaluate radiologist performance in detection of lacunar infarcts on T1- and T2-weighted images, without and with the use of a computer-aided diagnosis (CAD) scheme. Thirty T1-weighted and 30 T2-weighted MR images obtained from 30 patients were used for assessing observer performance. These images were acquired using the fast spin-echo sequence with a 1.5-T MR imaging scanner. The group included 15 patients (age range, 48-83 years; mean age, 67.2 years; 10 men and five women) with a lacunar infarct and 15 patients (age range, 39-76 years; mean age, 64.0 years; eight men and seven women) without lacunar infarcts. Nine radiologists participated in the study. The radiologists initially interpreted the T1- and T2-weighted images without and then with the use of CAD, which indicated their confidence levels regarding the presence (or absence) of lacunar infarcts and the most likely position of a lesion on each MR scan. The observers' performance without and with the computer output was evaluated by performing receiver operating characteristic analysis. For the nine radiologists, the mean area under the best-fit binormal receiver operating characteristic curve plotted for unit square values of radiologists who interpreted the images without and with the scheme were 0.891 and 0.937, respectively. The performance of the radiologists improved significantly when they used the computer output (p=0.032). The CAD scheme has potential to improve the accuracy of radiologists' performance in detection of lacunar infarcts.

Active Contour Based Micro-Calcification Detection and Classification in Digital Mammogram

Micro-calcifications are important signs of breast cancer. Detection of calcifications and dense masses becomes a significant problem for computer-aided diagnosis (CAD). The proposed work deals with a novel approach for the extraction of features like micro-calcifications and mass lesions in mammograms, and provides classification for the detected cells. The proposed technique is a four-step procedure: (i) regions of interest specification; (ii) improvement of image by two-dimensional wavelet transformations; (iii) feature extraction, the identification of micro-calcification and mass lesions through level set method; and (iv) classification of disease using a back propagation neural classifier. The effectiveness of the proposed CAD scheme is validated from experimental results.

Computerized scar detection on renal cortical scintigraphy images

Renal cortical scintigraphy is a well-established functional imaging technique for visual analysis of radiopharmaceutical tracer distribution. However, the visual evaluation is subjective, causing interobserver variability, especially in a quantifiable number of scars. The purpose of this study was to develop new computerized methods in renal cortical scintigraphy image interpretation, particularly addressing activity distribution and cortex continuity (scars). The proposed methods involve preprocessing stages of model-based automatic kidney segmentation using active-shape model and image normalization (transforming each kidney image into a standardized image vector). For our previous computer-aided diagnosis scheme, two new image-based features [localized activity drop and principal component analysis (PCA)] were defined. Their performance was evaluated and compared with our previous scheme by using free-response receiver operating characteristic that is in terms of sensitivity (true-positive fraction) and the mean number of false positives (FPs) per image. Clinical tests were conducted in 297 patients (231 normal and 66 abnormal). The PCA-based image feature presented the best scar detection performance, followed by the localized activity drop feature. Both schemes were found to be superior to our previous computer-aided diagnosis scheme. In the PCA-based scheme, for sensitivity of 0.90 (76/84), the mean number of FPs was measured as 4.52 (1343/297). For another setting with reduced sensitivity of 0.79 (66/84), the mean number of FPs improved to 1.21 (360/297). Finally, a decision fusion scheme using 'majority voting' was also proposed, the sensitivity and mean number of FPs of which were measured as 0.83 (70/84) and 1.90 (563/297), respectively. The proposed methods have potential to provide effective second-reader information to nuclear medicine specialists in finding scar regions. Possible ways to improve the FP rate were also proposed.

Computerized Segmentation Method for Individual Calcifications Within Clustered Microcalcifications While Maintaining Their Shapes on Magnification Mammograms

In a computer-aided diagnosis (CADx) scheme for evaluating the likelihood of malignancy of clustered microcalcifications on mammograms, it is necessary to segment individual calcifications correctly. The purpose of this study was to develop a computerized segmentation method for individual calcifications with various sizes while maintaining their shapes in the CADx schemes. Our database consisted of 96 magnification mammograms with 96 clustered microcalcifications. In our proposed method, a mammogram image was decomposed into horizontal subimages, vertical subimages, and diagonal subimages for a second difference at scales 1 to 4 by using a filter bank. The enhanced subimages for nodular components (NCs) and the enhanced subimages for both nodular and linear components (NLCs) were obtained from analysis of a Hessian matrix composed of the pixel values in those subimages for the second difference at each scale. At each pixel, eight objective features were given by pixel values in the subimages for NCs at scales 1 to 4 and the subimages for NLCs at scales 1 to 4. An artificial neural network with the eight objective features was employed to enhance calcifications on magnification mammograms. Calcifications were finally segmented by applying a gray-level thresholding technique to the enhanced image for calcifications. With the proposed method, a sensitivity of calcifications within clustered microcalcifications and the number of false positives per image were 96.5% (603/625) and 1.69, respectively. The average shape accuracy for segmented calcifications was also 91.4%. The proposed method with high sensitivity of calcifications while maintaining their shapes would be useful in the CADx schemes.

Combined use of T2‐weighted MRI and T1‐weighted dynamic contrast–enhanced MRI in the automated analysis of breast lesions

A multiparametric computer-aided diagnosis scheme that combines information from T1-weighted dynamic contrast-enhanced (DCE)-MRI and T2-weighted MRI was investigated using a database of 110 malignant and 86 benign breast lesions. Automatic lesion segmentation was performed, and three categories of lesion features (geometric, T1-weighted DCE, and T2-weighted) were automatically extracted. Stepwise feature selection was performed considering only geometric features, only T1-weighted DCE features, only T2-weighted features, and all features. Features were merged with Bayesian artificial neural networks, and diagnostic performance was evaluated by ROC analysis. With leave-one-lesion-out cross-validation, an area under the ROC curve value of 0.77±0.03 was achieved with T2-weighted-only features, indicating high diagnostic value of information in T2-weighted images. Area under the ROC curve values of 0.79±0.03 and 0.80 ± 0.03 were obtained for geometric-only features and T1-weighted DCE-only features, respectively. When all features were considered, an area under the ROC curve value of 0.85±0.03 was achieved. We observed P values of 0.006, 0.023, and 0.0014 between the geometric-only, T1-weighted DCE-only, and T2-weighted-only features and all features conditions, respectively. When ranked, the P values satisfied the Holm-Bonferroni multiple-comparison test; thus, the improvement of multiparametric computer-aided diagnosis was statistically significant. A computer-aided diagnosis scheme that combines information from T1-weighted DCE and T2-weighted MRI may be advantageous over conventional T1-weighted DCE-MRI computer-aided diagnosis.

Vessel Tree Segmentation in Presence of Interstitial Lung Disease in MDCT

The automated segmentation of vessel tree structures is a crucial preprocessing stage in computer aided diagnosis (CAD) schemes of interstitial lung disease (ILD) patterns in multidetector computed tomography (MDCT). The accuracy of such preprocessing stages is expected to influence the accuracy of lung CAD schemes. Although algorithms aimed at improving the accuracy of lung fields segmentation in presence of ILD have been reported, the corresponding vessel tree segmentation stage is under-researched. Furthermore, previously reported vessel tree segmentation methods have only dealt with normal lung parenchyma. In this paper, an automated vessel tree segmentation scheme is proposed, adapted to the presence of pathologies affecting lung parenchyma. The first stage of the method accounts for a recently proposed method utilizing a 3-D multiscale vessel enhancement filter based on eigenvalue analysis of the Hessian matrix and on unsupervised segmentation. The second stage of the method is a texture-based voxel classification refinement to correct possible over-segmentation. The performance of the proposed scheme, and of the previously reported technique, in vessel tree segmentation was evaluated by means of area overlap (previously reported: 0.715± 0.082, proposed: 0.931 ± 0.027), true positive fraction (previously reported: 0.968 ± 0.019, proposed: 0.935 ± 0.036) and false positive fraction (previously reported: 0.400 ± 0.181, proposed: 0.074 ± 0.031) on a dataset of 210 axial slices originating from seven ILD affected patient scans (used for performance evaluation out of 15). The proposed method demonstrated a statistically significantly ( p < 0.05) higher performance as compared to the previously reported vessel tree segmentation technique. The impact of suboptimal vessel tree segmentation in a reticular pattern quantification system is also demonstrated.

The Recent Progress in Quantitative Medical Image Analysis for Computer Aided Diagnosis Systems

Computer-aided diagnosis (CAD) has become one of the major research subjects in medical imaging and diagnostic radiology. Many different CAD schemes are being developed for use in the detection and/or characterization of various lesions found through various types of medical imaging. These imaging technologies employ conventional projection radiography, computed tomography, magnetic resonance imaging, ultrasonography, etc. In order to achieve a high performance level for a computerized diagnosis, it is important to employ effective image analysis techniques in the major steps of a CAD scheme. The main objective of this review is to attempt to introduce the diverse methods used for quantitative image analysis, and to provide a guide for clinicians.

Fully automatic lung segmentation and rib suppression methods to improve nodule detection in chest radiographs

Computer-aided Diagnosis (CAD) systems can assist radiologists in several diagnostic tasks. Lung segmentation is one of the mandatory steps for initial detection of lung cancer in Posterior-Anterior chest radiographs. On the other hand, many CAD schemes in projection chest radiography may benefit from the suppression of the bony structures that overlay the lung fields, e.g. ribs. The original images are enhanced by an adaptive contrast equalization and non-linear filtering. Then an initial estimation of lung area is obtained based on morphological operations and then it is improved by growing this region to find the accurate final contour, then for rib suppression, we use oriented spatial Gabor filter. The proposed method was tested on a publicly available database of 247 chest radiographs. Results show that this method outperformed greatly with accuracy of 96.25% for lung segmentation, also we will show improving the conspicuity of lung nodules by rib suppression with local nodule contrast measures. Because there is no additional radiation exposure or specialized equipment required, it could also be applied to bedside portable chest x-rays. In addition to simplicity of these fully automatic methods, lung segmentation and rib suppression algorithms are performed accurately with low computation time and robustness to noise because of the suitable enhancement procedure.

An Adaptive K-means Clustering Algorithm for Breast Image Segmentation

Breast cancer is one of the major causes of death among women. Small clusters of micro calcifications appearing as collection of white spots on mammograms show an early warning of breast cancer. Early detection performed on X-ray mammography is the key to improve breast cancer diagnosis. In order to increase radiologist’s diagnostic performance, several computer-aided diagnosis (CAD) schemes have been developed to improve the detection of primary identification of this disease. In this paper, an attempt is made to develop an adaptive k-means clustering algorithm for breast image segmentation for the detection of micro calcifications and also a computer based decision system for early detection of breast cancer. The method was tested over several images of image databases taken from BSR APPOLO for cancer research and diagnosis, India. The algorithm works faster so that any radiologist can take a clear decision about the appearance of micro calcifications by visual inspection of digital mammograms and detection accuracy has also improved as compared to some

Computer-aided Detection: The Impact of Machine Learning Classifier and Image Feature Selection on Scheme Performance

Computer-aided detection and diagnosis (CAD) schemes have been developed and applied to detect suspicious lesions depicted on biomedical images. After identifying initial candidates for the targeted suspicious lesions, most CAD schemes use a pre-trained multi-image-feature based machine learning classifier to classify these candidates into two groups of positive and negative detections. Although a large number of image features and machine learning classifiers have been developed and tested using different image databases, selecting the optimal image features and a machine learning classifier remains a challenged issue in CAD development. In this study, we assembled two independent image datasets for training and testing. We optimized four machine learning classifiers (namely, artificial neural network, support vector machine, Bayesian belief network, and k-nearest neighbor algorithm), which were trained and tested using the same dataset with two sets of image features. The results showed that using the first feature set, the case-based classification performance of four classifiers measured with the normalized areas under FROC-type performance curves (AUCs) ranged from 0.925 to 0.943 without statistically significant difference (p > 0.05). When using the second image feature set, AUC values of four classifies significantly reduced to the range from 0.886 to 0.903 (p < 0.01). This study suggested that although these four classifiers were built based on different machine learning concepts, their actual performance levels were likely to converge to the similar level when using the same image features and an independent testing dataset. Thus, selecting image features rather than a machine learning classifier plays a more important role in determining CAD performance.

Detection of Cancer Using Vector Quantization for Segmentation

Breast cancer is one of the major causes of death among women. An improvement of early diagnostic techniques is critical for women’s quality of life. Mammography is the main test used for screening and early diagnosis. Contrast-enhanced magnetic resonance of the breast is the most attractive alternative to standard mammography. This paper presents a vector quantization segmentation method to detect cancerous mass from mammogram images. In order to increase radiologist’s diagnostic performance, several computer-aided diagnosis (CAD) schemes have been developed to improve the detection of primary signatures of this disease: masses and microcalcifications.

Multimodality Computer-Aided Breast Cancer Diagnosis with FFDM and DCE-MRI

To investigate a multimodality computer-aided diagnosis (CAD) scheme that combines image information from full-field digital mammography (FFDM) and dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) for computerized breast cancer classification. From a retrospective FFDM database with 432 lesions (255 malignant, 177 benign) and a retrospective DCE-MRI database including 476 lesions (347 malignant, 129 benign), we constructed a multimodality dataset of 213 lesions (168 malignant, 45 benign). Each lesion was present on both FFDM and DCE-MRI images and deemed to be a difficult case given the necessity of having both clinical imaging exams. Using a manually indicated lesion location (ie, a seed point on FFDM images or a region of interest on DCE-MRI images, the computer automatically segmented the mass lesions and extracted lesion features). A subset of features was selected using linear stepwise feature selection and merged by a Bayesian artificial neural network to yield an estimate of the probability of malignancy. Receiver operating characteristic (ROC) analysis was used to evaluate the performance of the selected features in distinguishing between malignant and benign lesions. With leave-one-lesion-out cross-validation on the multimodality dataset, the mammography-only features yielded an area under the ROC curve (AUC) of 0.74 +/- 0.04, and the DCE-MRI-only features yielded an AUC of 0.78 +/- 0.04. The combination of these two modalities, which included a spiculation feature from mammography and two kinetic features from DCE-MRI, yielded an AUC of 0.87 +/- 0.03. The improvement of combining multimodality information was statistically significant as compared to the use of single modality information alone. A CAD scheme that combines features extracted from FFDM and DCE-MRI images may be advantageous to single-modality CAD in the task of differentiating between malignant and benign lesions.

Multilevel analysis of spatiotemporal association features for differentiation of tumor enhancement patterns in breast DCE‐MRI

Analyzing spatiotemporal enhancement patterns is an important task for the differential diagnosis of breast tumors in dynamic contrast-enhanced MRI (DCE-MRI), and yet remains challenging because of complexities in analyzing the time-series of three-dimensional image data. The authors propose a novel approach to breast MRI computer-aided diagnosis (CAD) using a multilevel analysis of spatiotemporal association features for tumor enhancement patterns in DCE-MRI. A database of 171 cases consisting of 111 malignant and 60 benign tumors was used. Time-series contrast-enhanced MR images were obtained from two different types of MR scanners and protocols. The images were first registered for motion compensation, and then tumor regions were segmented using a fuzzy c-means clustering-based method. Spatiotemporal associations of tumor enhancement patterns were analyzed at three levels: Mapping of pixelwise kinetic features within a tumor, extraction of spatial association features from kinetic feature maps, and extraction of kinetic association features at the spatial feature level. A total of 84 initial features were extracted. Predictable values of these features were evaluated with an area under the ROC curve, and were compared between the spatiotemporal association features and a subset of simple form features which do not reflect spatiotemporal association. Several optimized feature sets were identified among the spatiotemporal association feature group or among the simple feature group based on a feature ranking criterion using a support vector machine based recursive feature elimination algorithm. A least-squares support vector machine (LS-SVM) classifier was used for tumor differentiation and the performances were evaluated using a leave-one-out testing. Predictable values of the extracted single features ranged in 0.52-0.75. By applying multilevel analysis strategy, the spatiotemporal association features became more informative in predicting tumor malignancy, which was shown by a statistical testing in ten spatiotemporal association features. By using a LS-SVM classifier with the optimized second and third level feature set, the CAD scheme showed Az of 0.88 in classification of malignant and benign tumors. When this performance was compared to the same LS-SVM classifier with simple form features which do not reflect spatiotemporal association, there was a statistically significant difference (0.88 vs 0.79, p <0.05), suggesting that the multilevel analysis strategy yields a significant performance improvement. The results suggest that the multilevel analysis strategy characterizes the complex tumor enhancement patterns effectively with the spatiotemporal association features, which in turn leads to an improved tumor differentiation. The proposed CAD scheme has a potential for improving diagnostic performance in breast DCE-MRI.

Online Mammographic Images Database for Development and Comparison of CAD Schemes

Considering the difficulties in finding good-quality images for the development and test of computer-aided diagnosis (CAD), this paper presents a public online mammographic images database free for all interested viewers and aimed to help develop and evaluate CAD schemes. The digitalization of the mammographic images is made with suitable contrast and spatial resolution for processing purposes. The broad recuperation system allows the user to search for different images, exams, or patient characteristics. Comparison with other databases currently available has shown that the presented database has a sufficient number of images, is of high quality, and is the only one to include a functional search system.

Neural Network Ensemble-Based Computer-Aided Diagnosis for Differentiation of Lung Nodules on CT Images: Clinical Evaluation

To evaluate the diagnostic performance of a neural network ensemble-based computer-aided diagnosis (CAD) scheme for classifying lung nodules on thin-section computed tomography (CT). Thirty-two CT images that depicted 19 malignant nodules and 13 benign nodules were used. One of three possible classifications (probably benign, uncertain, and probably malignant) for each nodule was determined by using a neural network ensemble-based CAD scheme. The images were presented to three senior radiologists (each with more than 10 years of thoracic radiology experience) who were asked to determine the classification for each nodule blindly. The radiologists made their diagnostic decisions solely based on images and excluded any external data. The performance of the CAD scheme and of the radiologists was evaluated with receiver operating characteristic (ROC) analysis and agreement analysis. Areas under the ROC curve (Az values) for the CAD scheme and the radiologist group were 0.79 and 0.82, respectively, and the partial areas under the ROC curves at a range of sensitivity values greater than or equal to 90% were 0.051 and 0.020 (P = .203), respectively. The weighted Kappa coefficients between the CAD scheme and each radiologist were 0.657, 0.431, and 0.606, respectively. For the diagnosis of the 11 small nodules (with diameters not greater than 10 mm), areas under the ROC curves of the CAD scheme and the radiologist group were 0.915 and 0.683 (P = .227), respectively. The diagnostic performance of the neural network ensemble-based CAD scheme is similar to that of senior radiologists for classifying lung nodules on thin-section CT. Furthermore, the CAD scheme has certain advantages in diagnosing small lung nodules.

Size-adapted microcalcification segmentation in mammography utilizing scale-space signatures

The purpose of this study is size-adapted segmentation of individual microcalcifications in mammography, based on microcalcification scale-space signature estimation, enabling robust scale selection for initialization of multiscale active contours. Segmentation accuracy was evaluated by the area overlap measure, by comparing the proposed method and two recently proposed ones to expert manual delineations. The method achieved area overlap of 0.61 ± 0.15 outperforming statistically ( p < 0.001) the other two methods (0.53 ± 0.18, 0.42 ± 0.16). Only the proposed method performed equally for both small (<460 μm) and large (≥460 μm) microcalcifications. Results indicate an accurate method, which could be utilized in computer-aided diagnosis schemes of microcalcification clusters.

A Clinical Decision Support Framework for Incremental Polyps Classification in Virtual Colonoscopy

We present in this paper a novel dynamic learning method for classifying polyp candidate detections in Computed Tomographic Colonography (CTC) using an adaptation of the Least Square Support Vector Machine (LS-SVM). The proposed technique, called Weighted Proximal Support Vector Machines (WP-SVM), extends the offline capabilities of the SVM scheme to address practical CTC applications. Incremental data are incorporated in the WP-SVM as a weighted vector space, and the only storage requirements are the hyperplane parameters. WP-SVM performance evaluation based on 169 clinical CTC cases using a 3D computer-aided diagnosis (CAD) scheme for feature reduction comparable favorably with previously published CTC CAD studies that have however involved only binary and offline classification schemes. The experimental results obtained from iteratively applying WP-SVM to improve detection sensitivity demonstrate its viability for incremental learning, thereby motivating further follow on research to address a wider range of true positive subclasses such as pedunculated, sessile, and flat polyps, and over a wider range of false positive subclasses such as folds, stool, and tagged materials.

Computer-aided diagnosis for contrast-enhanced ultrasound in the liver

Computer-aided diagnosis (CAD) has become one of the major research subjects in medical imaging and diagnostic radiology. The basic concept of CAD is to provide computer output as a second opinion to assist radiologists' image interpretations by improving the accuracy and consistency of radiologic diagnosis and also by reducing the image-reading time. To date, research on CAD in ultrasound (US)-based diagnosis has been carried out mostly for breast lesions and has been limited in the fields of gastroenterology and hepatology, with most studies being conducted using B-mode US images. Two CAD schemes with contrast-enhanced US (CEUS) that are used in classifying focal liver lesions (FLLs) as liver metastasis, hemangioma, or three histologically differentiated types of hepatocellular carcinoma (HCC) are introduced in this article: one is based on physicians' subjective pattern classifications (subjective analysis) and the other is a computerized scheme for classification of FLLs (quantitative analysis). Classification accuracies for FLLs for each CAD scheme were 84.8% and 88.5% for metastasis, 93.3% and 93.8% for hemangioma, and 98.6% and 86.9% for all HCCs, respectively. In addition, the classification accuracies for histologic differentiation of HCCs were 65.2% and 79.2% for well-differentiated HCCs, 41.7% and 50.0% for moderately differentiated HCCs, and 80.0% and 77.8% for poorly differentiated HCCs, respectively. There are a number of issues concerning the clinical application of CAD for CEUS, however, it is likely that CAD for CEUS of the liver will make great progress in the future.