Computer-aided diagnosis of proliferative diabetic retinopathy via modeling of the major temporal arcade in retinal fundus images.

Monitoring the openness of the major temporal arcade (MTA) and how it changes over time could facilitate diagnosis and treatment of proliferative diabetic retinopathy (PDR). We present methods for user-guided semiautomated modeling and measurement of the openness of the MTA based on Gabor filters for the detection of retinal vessels, morphological image processing, and a form of the generalized Hough transform for the detection of parabolas. The methods, implemented via a graphical user interface, were tested with retinal fundus images of 11 normal individuals and 11 patients with PDR in the present pilot study on potential clinical application. A method of arcade angle measurement was used for comparative analysis. The results using the openness parameters of single- and dual-parabolic models as well as the arcade angle measurements indicate areas under the receiver operating characteristics of A z = 0.87, 0.82, and 0.80, respectively. The proposed methods are expected to facilitate quantitative analysis of the architecture of the MTA, as well as assist in detection and diagnosis of PDR.

Computer-aided diagnosis of knee-joint disorders via vibroarthrographic signal analysis: a review.

The knee is the lower-extremity joint that supports nearly the entire weight of the human body. It is susceptible to osteoarthritis and other knee-joint disorders caused by degeneration or loss of articular cartilage. The detection of a knee-joint abnormality at an early stage is important, because it helps increase therapeutic options that may slow down the degenerative process. Imaging-based arthrographic modalities can provide anatomical images of the joint cartilage surfaces, but fail to demonstrate the functional integrity of the cartilage. Knee-joint auscultation, by means of recording the vibroarthrographic (VAG) signal during bending motion of a knee, could be used to develop a noninvasive diagnostic tool. Computer-aided analysis of VAG signals could provide quantitative indices for screening of degenerative conditions of the cartilage surface and staging of osteoarthritis. In addition, the diagnosis of knee-joint pathology by means of VAG signal analysis may reduce the number of semi-invasive diagnostic arthroscopic examinations. This article reviews studies related to VAG signal analysis, first summarizing the pilot studies that demonstrated the diagnostic potential of knee-joint auscultation for the detection of degenerative diseases, and then describing the details of recent progress in analysis of VAG signals using temporal analysis, frequency-domain analysis, time-frequency analysis, and statistical modeling. The decision-making methods used in the related studies are summarized, followed by a comparison of the diagnostic performance achieved by different pattern classifiers. The final section is a perspective on the future and further development of VAG signal analysis.

Analysis of the glomerular basement membrane in images of renal biopsies using the split-and-merge method: a pilot study.

Abnormal thinning, thickening, or variation in the thickness of the glomerular basement membrane (GBM) are caused by familial hematuria, diabetes mellitus, and Alport syndrome, respectively. We propose a semi-automated procedure for the segmentation and analysis of the thickness of the GBM in images of renal biopsy samples obtained by using a transmission electron microscope (TEM). The procedure includes the split-and-merge algorithm, morphological image processing, skeletonization, and statistical analysis of the width of the GBM. The procedure was tested with 34 TEM images of six patients. The mean and standard deviation of the GBM width for a patient with normal GBM were estimated to be 368 +/- 177 nm, those for a patient with thin GBM associated with familial hematuria were 216 +/- 95 nm, and those for a patient with thick GBM due to diabetic nephropathy were 1,094 +/- 361 nm. Comparative analysis of the results of image processing with manual measurements by an experienced renal pathologist indicated low error in the range of 12 +/- 9 nm.

Automatic segmentation of the ribs, the vertebral column, and the spinal canal in pediatric computed tomographic images.

We propose methods to perform automatic identification of the rib structure, the vertebral column, and the spinal canal in computed tomographic (CT) images of pediatric patients. The segmentation processes for the rib structure and the vertebral column are initiated using multilevel thresholding and the results are refined using morphological image processing techniques with features based on radiological and anatomical prior knowledge. The Hough transform for the detection of circles is applied to a cropped edge map that includes the thoracic vertebral structure. The centers of the detected circles are used to derive the information required for the opening-by-reconstruction algorithm used to segment the spinal canal. The methods were tested on 39 CT exams of 13 patients; the results of segmentation of the vertebral column and the spinal canal were assessed quantitatively and qualitatively by comparing with segmentation performed independently by a radiologist. Using 13 CT exams of six patients, including a total of 458 slices with the vertebra from different sections of the vertebral column, the average Hausdorff distance was determined to be 3.2 mm with a standard deviation (SD) of 2.4 mm; the average mean distance to the closest point (MDCP) was 0.7 mm with SD = 0.6 mm. Quantitative analysis was also performed for the segmented spinal canal with three CT exams of three patients, including 21 slices with the spinal canal from different sections of the vertebral column; the average Hausdorff distance was 1.6 mm with SD = 0.5 mm, and the average MDCP was 0.6 mm with SD = 0.1 mm.

Segmentation and analysis of the glomerular basement membrane in renal biopsy samples using active contours: a pilot study.

Some renal diseases cause changes in the structure of the glomerular basement membranes (GBM). Measurement of the thickness of the GBM can be performed on transmission electron microscopy (TEM) images of renal biopsy samples. Increased thickness of the GBM is observed in patients with diabetic nephropathy. Abnormally thin GBMs are associated with hematuria. We propose image processing methods for the detection and measurement of the GBM. The methods include edge detection, morphological image processing, active contour modeling, skeletonization, and statistical analysis of the width of the GBM. In the present pilot study, the methods were tested with 34 TEM images of six patients. The estimated mean and standard deviation of the GBM width for a patient with normal GBM were 348 +/- 135 nm; those for a patient with thin GBMs due to hematuria were 227 +/- 94 nm; and those for a patient with diabetic nephropathy were 1,152 +/- 411 nm. Comparison with manual measurements by an experienced renal pathologist indicated low error in the range of 36 +/- 11 nm.

Detection of the optic nerve head in fundus images of the retina using the Hough transform for circles.

Detection of the optic nerve head (ONH) is a key preprocessing component in algorithms for the automatic extraction of the anatomical structures of the retina. We propose a method to automatically locate the ONH in fundus images of the retina. The method includes edge detection using the Sobel operators and detection of circles using the Hough transform. The Hough transform assists in the detection of the center and radius of a circle that approximates the margin of the ONH. Forty images of the retina from the Digital Retinal Images for Vessel Extraction (DRIVE) dataset were used to test the performance of the proposed method. The center and boundary of the ONH were independently marked by an ophthalmologist for evaluation. Free-response receiver operating characteristics (FROC) analysis as well as measures of distance and overlap were used to evaluate the performance of the proposed method. The centers of the ONH were detected with an average distance of 0.36 mm to the corresponding centers marked by the ophthalmologist; the detected circles had an average overlap of 0.73 with the boundaries of the ONH drawn by the ophthalmologist. FROC analysis indicated a sensitivity of detection of 92.5% at 8.9 false-positives per image. With an intensity-based criterion for the selection of the circle and a limit of 40 pixels (0.8 mm) on the distance between the center of the detected circle and the manually identified center of the ONH, a successful detection rate of 90% was obtained with the DRIVE dataset.

Computer-aided detection of architectural distortion in prior mammograms of interval cancer.

Architectural distortion is an important sign of breast cancer, but because of its subtlety, it is a common cause of false-negative findings on screening mammograms. This paper presents methods for the detection of architectural distortion in mammograms of interval cancer cases taken prior to the detection of breast cancer using Gabor filters, phase portrait analysis, fractal analysis, and texture analysis. The methods were used to detect initial candidates for sites of architectural distortion in prior mammograms of interval cancer and also normal control cases. A total of 4,224 regions of interest (ROIs) were automatically obtained from 106 prior mammograms of 56 interval cancer cases, including 301 ROIs related to architectural distortion, and from 52 prior mammograms of 13 normal cases. For each ROI, the fractal dimension and Haralick's texture features were computed. Feature selection was performed separately using stepwise logistic regression and stepwise regression. The best results achieved, in terms of the area under the receiver operating characteristics curve, with the features selected by stepwise logistic regression are 0.76 with the Bayesian classifier, 0.73 with Fisher linear discriminant analysis, 0.77 with an artificial neural network based on radial basis functions, and 0.77 with a support vector machine. Analysis of the performance of the methods with free-response receiver operating characteristics indicated a sensitivity of 0.80 at 7.6 false positives per image. The methods have good potential in detecting architectural distortion in mammograms of interval cancer cases.

Detection of the optic nerve head in fundus images of the retina with Gabor filters and phase portrait analysis.

We propose a method using Gabor filters and phase portraits to automatically locate the optic nerve head (ONH) in fundus images of the retina. Because the center of the ONH is at or near the focal point of convergence of the retinal vessels, the method includes detection of the vessels using Gabor filters, detection of peaks in the node map obtained via phase portrait analysis, and an intensity-based condition. The method was tested on 40 images from the Digital Retinal Images for Vessel Extraction (DRIVE) database and 81 images from the Structured Analysis of the Retina (STARE) database. An ophthalmologist independently marked the center of the ONH for evaluation of the results. The evaluation of the results includes free-response receiver operating characteristics (FROC) and a measure of distance between the manually marked and detected centers. With the DRIVE database, the centers of the ONH were detected with an average distance of 0.36 mm (18 pixels) to the corresponding centers marked by the ophthalmologist. FROC analysis indicated a sensitivity of 100% at 2.7 false positives per image. With the STARE database, FROC analysis indicated a sensitivity of 88.9% at 4.6 false positives per image.

Effect of pixel resolution on texture features of breast masses in mammograms.

The effect of pixel resolution on texture features computed using the gray-level co-occurrence matrix (GLCM) was analyzed in the task of discriminating mammographic breast lesions as benign masses or malignant tumors. Regions in mammograms related to 111 breast masses, including 65 benign masses and 46 malignant tumors, were analyzed at pixel sizes of 50, 100, 200, 400, 600, 800, and 1,000 µm. Classification experiments using each texture feature individually provided accuracy, in terms of the area under the receiver operating characteristics curve (AUC), of up to 0.72. Using the Bayesian classifier and the leave-one-out method, the AUC obtained was in the range 0.73 to 0.75 for the pixel resolutions of 200 to 800 µm, with 14 GLCM-based texture features using adaptive ribbons of pixels around the boundaries of the masses. Texture features computed using the ribbons resulted in higher classification accuracy than the same features computed using the corresponding regions within the mass boundaries. The t test was applied to AUC values obtained using 100 repetitions of random splitting of the texture features from the ribbons of masses into the training and testing sets. The texture features computed with the pixel size of 200 µm provided the highest average AUC with statistically highly significant differences as compared to all of the other pixel sizes tested, except 100 µm.

Filtering electrocardiographic signals using an unbiased and normalized adaptive noise reduction system.

We present a novel unbiased and normalized adaptive noise reduction (UNANR) system to suppress random noise in electrocardiographic (ECG) signals. The system contains procedures for the removal of baseline wander with a two-stage moving-average filter, comb filtering of power-line interference with an infinite impulse response (IIR) comb filter, an additive white noise generator to test the system's performance in terms of signal-to-noise ratio (SNR), and the UNANR model that is used to estimate the noise which is subtracted from the contaminated ECG signals. The UNANR model does not contain a bias unit, and the coefficients are adaptively updated by using the steepest-descent algorithm. The corresponding adaptation process is designed to minimize the instantaneous error between the estimated signal power and the desired noise-free signal power. The benchmark MIT-BIH arrhythmia database was used to evaluate the performance of the UNANR system with different levels of input noise. The results of adaptive filtering and a study on convergence of the UNANR learning rate demonstrate that the adaptive noise-reduction system that includes the UNANR model can effectively eliminate random noise in ambulatory ECG recordings, leading to a higher SNR improvement than that with the same system using the popular least-mean-square (LMS) filter. The SNR improvement provided by the proposed UNANR system was higher than that provided by the system with the LMS filter, with the input SNR in the range of 5-20 dB over the 48 ambulatory ECG recordings tested.

POSTGRESQL-IE: an image-handling extension for PostgreSQL.

The last decade witnessed a growing interest in research on content-based image retrieval (CBIR) and related areas. Several systems for managing and retrieving images have been proposed, each one tailored to a specific application. Functionalities commonly available in CBIR systems include: storage and management of complex data, development of feature extractors to support similarity queries, development of index structures to speed up image retrieval, and design and implementation of an intuitive graphical user interface tailored to each application. To facilitate the development of new CBIR systems, we propose an image-handling extension to the relational database management system (RDBMS) PostgreSQL. This extension, called PostgreSQL-IE, is independent of the application and provides the advantage of being open source and portable. The proposed system extends the functionalities of the structured query language SQL with new functions that are able to create new feature extraction procedures, new feature vectors as combinations of previously defined features, and new access methods, as well as to compose similarity queries. PostgreSQL-IE makes available a new image data type, which permits the association of various images with a given unique image attribute. This resource makes it possible to combine visual features of different images in the same feature vector. To validate the concepts and resources available in the proposed extended RDBMS, we propose a CBIR system applied to the analysis of mammograms using PostgreSQL-IE.

INDIAM--an e-learning system for the interpretation of mammograms.

We propose the design of a teaching system named Interpretation and Diagnosis of Mammograms (INDIAM) for training students in the interpretation of mammograms and diagnosis of breast cancer. The proposed system integrates an illustrated tutorial on radiology of the breast, that is, mammography, which uses education techniques to guide the user (doctors, students, or researchers) through various concepts related to the diagnosis of breast cancer. The user can obtain informative text about specific subjects, access a library of bibliographic references, and retrieve cases from a mammographic database that are similar to a query case on hand. The information of each case stored in the mammographic database includes the radiological findings, the clinical history, the lifestyle of the patient, and complementary exams. The breast cancer tutorial is linked to a module that simulates the analysis and diagnosis of a mammogram. The tutorial incorporates tools for helping the user to evaluate his or her knowledge about a specific subject by using the education system or by simulating a diagnosis with appropriate feedback in case of error. The system also makes available digital image processing tools that allow the user to draw the contour of a lesion, the contour of the breast, or identify a cluster of calcifications in a given mammogram. The contours provided by the user are submitted to the system for evaluation. The teaching system is integrated with AMDI-An Indexed Atlas of Digital Mammograms-that includes case studies, e-learning, and research systems. All the resources are accessible via the Web.

Polygonal modeling of contours of breast tumors with the preservation of spicules.

Malignant breast tumors typically appear in mammograms with rough, spiculated, or microlobulated contours, whereas most benign masses have smooth, round, oval, or macrolobulated contours. Several studies have shown that shape factors that incorporate differences as above can provide high accuracies in distinguishing between malignant tumors and benign masses based upon their contours only. However, global measures of roughness, such as compactness, are less effective than specially designed features based upon spicularity and concavity. We propose a method to derive polygonal models of contours that preserve spicules and details of diagnostic importance. We show that an index of spiculation derived from the turning functions of the polygonal models obtained by the proposed method yields better classification accuracy than a similar measure derived using a previously published method. The methods were tested with a set of 111 contours of 65 benign masses and 46 malignant tumors. A high classification accuracy of 0.94 in terms of the area under the receiver operating characteristics curve was obtained.

Screening of knee-joint vibroarthrographic signals using statistical parameters and radial basis functions.

Externally detected vibroarthrographic (VAG) signals bear diagnostic information related to the roughness, softening, breakdown, or the state of lubrication of the articular cartilage surfaces of the knee joint. Analysis of VAG signals could provide quantitative indices for noninvasive diagnosis of articular cartilage breakdown and staging of osteoarthritis. We propose the use of statistical parameters of VAG signals, including the form factor involving the variance of the signal and its derivatives, skewness, kurtosis, and entropy, to classify VAG signals as normal or abnormal. With a database of 89 VAG signals, screening efficiency of up to 0.82 was achieved, in terms of the area under the receiver operating characteristics curve, using a neural network classifier based on radial basis functions.

Screening of knee-joint vibroarthrographic signals using the strict 2-surface proximal classifier and genetic algorithm.

We propose the strict 2-surface proximal (S2SP) classifier, by seeking two cross proximal planes to fit the distribution of the given samples in a corresponding feature space. The method is applied to screen knee-joint vibration or vibroarthrographic (VAG) signals based on statistical parameters derived from signals and selected by the genetic algorithm. A database of 89 VAG signals was studied. With the leave-one-out procedure, the linear S2SP classifier provided an efficiency of 0.82 in terms of the area under the receiver operating characteristics curve (A(z)); the nonlinear S2SP classifier provided 0.95 in A(z) value using the Gaussian kernel, and possessed good robustness around the selected kernel parameter.

Automatic delineation of the diaphragm in computed tomographic images.

Segmentation of the internal organs in medical images is a difficult task. By incorporating a priori information regarding specific organs of interest, results of segmentation may be improved. Landmarking (i.e., identifying stable structures to aid in gaining more knowledge concerning contiguous structures) is a promising segmentation method. Specifically, segmentation of the diaphragm may help in limiting the scope of segmentation methods to the abdominal cavity; the diaphragm may also serve as a stable landmark for identifying internal organs, such as the liver, the spleen, and the heart. A method to delineate the diaphragm is proposed in the present work. The method is based upon segmentation of the lungs, identification of the lower surface of the lungs as an initial representation of the diaphragm, and the application of least-squares modeling and deformable contour models to obtain the final segmentation of the diaphragm. The proposed procedure was applied to nine X-ray computed tomographic (CT) exams of four pediatric patients with neuroblastoma. The results were evaluated against the boundaries of the diaphragm as identified independently by a radiologist. Good agreement was observed between the results of segmentation and the reference contours drawn by the radiologist, with an average mean distance to the closest point of 5.85 mm over a total of 73 CT slices including the diaphragm.

Analysis of Machine Learning Algorithms for Diagnosis of Diffuse Lung Diseases.

Computational Intelligence Re-meets Medical Image Processing A Comparison of Some Nature-Inspired Optimization Metaheuristics Applied in Biomedical Image Registration BACKGROUND: Diffuse lung diseases (DLDs) are a diverse group of pulmonary disorders, characterized by inflammation of lung tissue, which may lead to permanent loss of the ability to breathe and death. Distinguishing among these diseases is challenging to physicians due their wide variety and unknown causes. Computer-aided diagnosis (CAD) is a useful approach to improve diagnostic accuracy, by combining information provided by experts with Machine Learning (ML) methods. OBJECTIVES: Exploring the potential of dimensionality reduction combined with ML methods for diagnosis of DLDs; improving the classification accuracy over state-of-the-art methods. METHODS: A data set composed of 3252 regions of interest (ROIs) was used, from which 28 features were extracted per ROI. We used Principal Component Analysis, Linear Discriminant Analysis, and Stepwise Selection - Forward, Backward, and Forward-Backward to reduce feature dimensionality. The feature subsets obtained were used as input to the following ML methods: Support Vector Machine, Gaussian Mixture Model, k-Nearest Neighbor, and Deep Feedforward Neural Network. We also applied a Deep Convolutional Neural Network directly to the ROIs. RESULTS: We achieved the maximum reduction from 28 to 5 dimensions using LDA. The best classification results were obtained by DFNN, with 99.60% of overall accuracy. CONCLUSIONS: This work contributes to the analysis and selection of features that can efficiently characterize the DLDs studied.

Classification of breast masses via nonlinear transformation of features based on a kernel matrix.

We propose methods to perform a certain nonlinear transformation of features based on a kernel matrix, before the classification step, aiming to improve the discriminating power of the comparatively weak edge-sharpness and texture features of breast masses in mammograms, and seek better incorporation of features representing different radiological characteristics than shape features only. Kernel principal component analysis (KPCA) is applied to improve the discriminating power of each single feature in an expanded feature space and the discriminating capability of different feature combinations in other transformed, more informative, lower-dimensional feature spaces. A kernel partial least squares (KPLS) method is developed to derive score vectors for a shape feature set, and an edge-sharpness and texture feature set, respectively, with minimal covariance between each other, to help in achieving improved diagnosis using multiple radiological characteristics of breast masses. Fisher's linear discriminant analysis (FLDA) is employed to evaluate the classification capability of the transformed features. The methods were tested with a set of 57 regions in mammograms, of which 20 are related to malignant tumors and 37 to benign masses, represented using five shape features, three edge-sharpness features, and 14 texture features. The classification performance of the edge-sharpness and texture features, via KPCA transformation, was significantly improved from 0.75 to 0.85 in terms of the area under the receiver operating characteristics curve (Az). The classification performance of all of the shape, edge-sharpness, and texture features, via KPLS transformation, was improved from 0.95 to 1.0 in Az value.

Gabor filters and phase portraits for the detection of architectural distortion in mammograms.

Architectural distortion is a subtle abnormality in mammograms, and a source of overlooking errors by radiologists. Computer-aided diagnosis (CAD) techniques can improve the performance of radiologists in detecting masses and calcifications; however, most CAD systems have not been designed to detect architectural distortion. We present a new method to detect and localise architectural distortion by analysing the oriented texture in mammograms. A bank of Gabor filters is used to obtain the orientation field of the given mammogram. The curvilinear structures (CLS) of interest (spicules and fibrous tissue) are separated from confounding structures (pectoral muscle edge, parenchymal tissue edges, breast boundary, and noise). The selected core CLS pixels and the orientation field are filtered and downsampled, to reduce noise and also to reduce the computational effort required by the subsequent methods. The downsampled orientation field is analysed to produce three phase portrait maps: node, saddle, and spiral. The node map is further analysed in order to detect the sites of architectural distortion. The method was tested with 19 mammograms containing architectural distortion. In a preliminary experiment, a sensitivity of 84% was obtained at 7.8 false positives per image.

Computer-aided diagnosis of retinopathy in retinal fundus images of preterm infants via quantification of vascular tortuosity.

Retinopathy of prematurity (ROP), a disorder of the retina occurring in preterm infants, is the leading cause of preventable childhood blindness. An active phase of ROP that requires treatment is associated with the presence of plus disease, which is diagnosed clinically in a qualitative manner by visual assessment of the existence of a certain level of increase in the thickness and tortuosity of retinal vessels. The present study performs computer-aided diagnosis (CAD) of plus disease via quantitative measurement of tortuosity in retinal fundus images of preterm infants. Digital image processing techniques were developed for the detection of retinal vessels and measurement of their tortuosity. The total lengths of abnormally tortuous vessels in each quadrant and the entire image were then computed. A minimum-length diagnostic-decision-making criterion was developed to assess the diagnostic sensitivity and specificity of the values obtained. The area ([Formula: see text]) under the receiver operating characteristic curve was used to assess the overall diagnostic accuracy of the methods. Using a set of 19 retinal fundus images of preterm infants with plus disease and 91 without plus disease, the proposed methods provided an overall diagnostic accuracy of [Formula: see text]. Using the total length of all abnormally tortuous vessel segments in an image, our techniques are capable of CAD of plus disease with high accuracy without the need for manual selection of vessels to analyze. The proposed methods may be used in a clinical or teleophthalmological setting.