A. Lauria

Mammogram segmentation by contour searching and massive lesion classification with neural network

The mammography is the most effective procedure for an early diagnosis of the breast cancer. In this paper, an algorithm for detecting massive lesions in mammographic images will be presented. The database consists of 3762 digital images acquired in several hospitals belonging to the MAGIC-5 collaboration. A reduction of the surface under investigation is achieved, without loss of meaningful information, through segmentation of the whole image, by means of a ROI Hunter algorithm. In the following classification step, feature extraction plays a fundamental role: some features give geometrical information, other ones provide shape parameters. Once the features are computed for each ROI, they are used as inputs to a supervised neural network with momentum. The output neuron provides the probability that the ROI is pathological or not. Results are provided in terms of ROC and FROC curves; the area under the ROC curve was found to be Az=(85.6plusmn0.8)%. This software is included in the CAD station actually working in the hospitals belonging to the MAGIC-5 Collaboration

A completely automated CAD system for mass detection in a large mammographic database

Mass localization plays a crucial role in computer-aided detection (CAD) systems for the classification of suspicious regions in mammograms. In this article we present a completely automated classification system for the detection of masses in digitized mammographic images. The tool system we discuss consists in three processing levels: (a) Image segmentation for the localization of regions of interest (ROIs). This step relies on an iterative dynamical threshold algorithm able to select iso-intensity closed contours around gray level maxima of the mammogram. (b) ROI characterization by means of textural features computed from the gray tone spatial dependence matrix (GTSDM), containing second-order spatial statistics information on the pixel gray level intensity. As the images under study were recorded in different centers and with different machine settings, eight GTSDM features were selected so as to be invariant under monotonic transformation. In this way, the images do not need to be normalized, as the adopted features depend on the texture only, rather than on the gray tone levels, too. (c) ROI classification by means of a neural network, with supervision provided by the radiologists diagnosis. The CAD system was evaluated on a large database of 3369 mammographic images [2307 negative, 1062 pathological (or positive), containing at least one confirmed mass, as diagnosed by an expert radiologist]. To assess the performance of the system, receiver operating characteristic (ROC) and free-response ROC analysis were employed. The area under the ROC curve was found to be Az = 0.783 +/- 0.008 for the ROI-based classification. When evaluating the accuracy of the CAD against the radiologist-drawn boundaries, 4.23 false positives per image are found at 80% of mass sensitivity.

Comparison of standard reading and computer aided detection (CAD) on a national proficiency test of screening mammography

OBJECTIVE To evaluate the role of computer aided detection (CAD) in improving the interpretation of screening mammograms MATERIAL AND METHODS Ten radiologists underwent a proficiency test of screening mammography first by conventional reading and then with the help of CAD. Radiologists were blinded to test results for the whole study duration. Results of conventional and CAD reading were compared in terms of sensitivity and recall rate. Double reading was simulated combining conventional readings of four expert radiologists and compared with CAD reading. RESULTS Considering all ten readings, cancer was identified in 146 or 153 of 170 cases (85.8 vs. 90.0%; chi(2)=0.99, df=1, P=0.31) and recalls were 106 or 152 of 1330 cases (7.9 vs. 11.4%; chi(2)=8.69, df=1, P=0.003) at conventional or CAD reading, respectively. CAD reading was essentially the same (sensitivity 97.0 vs. 96.0%; chi(2)=7.1, df=1, P=0.93; recall rate 10.7 vs. 10.6%; chi(2)=1.5, df=1, P=0.96) as compared with simulated conventional double reading. CONCLUSION CAD reading seems to improve the sensitivity of conventional reading while reducing specificity, both effects being of limited size. CAD reading had almost the same performance of simulated conventional double reading, suggesting a possible use of CAD which needs to be confirmed by further studies inclusive of cost-effective analysis.

The MAGIC-5 Project: medical applications on a GRID infrastructure connection

The MAGIC-5 Project aims at developing computer aided detection (CAD) software for medical applications on distributed databases by means of a GRID infrastructure connection. The use of automatic systems for analyzing medical images is of paramount importance in the screening programs, due to the huge amount of data to check. Examples are: mammographies for breast cancer detection, computed-tomography (CT) images for lung cancer analysis, and the positron emission tomography (PET) imaging for the early diagnosis of the Alzheimer disease. The need for acquiring and analyzing data stored in different locations requires a GRID approach of distributed computing system and associated data management. The GRID technologies allow remote image analysis and interactive online diagnosis, with a relevant reduction of the delays actually associated to the screening programs. From this point of view, the MAGIC-5 Collaboration can be seen as a group of distributed users sharing their resources for implementing different virtual organizations (VO), each one aiming at developing screening programs, tele-training, tele-diagnosis and epidemiologic studies for a particular pathology.

MAGIC-5: an Italian mammographic database of digitised images for research

The implementation of a database of digitised mammograms is discussed. The digitised images were collected beginning in 1999 by a community of physicists in collaboration with radiologists in several Italian hospitals as a first step in developing and implementing a computer-aided detection (CAD) system. All 3,369 mammograms were collected from 967 patients and classified according to lesion type and morphology, breast tissue and pathology type. A dedicated graphical user interface was developed to visualise and process mammograms to support the medical diagnosis directly on a high-resolution screen. The database has been the starting point for developing other medical imaging applications, such as a breast CAD, currently being upgraded and optimised for use in a distributed environment with grid services, in the framework of the Instituto Nazionale di Fisicia Nucleare (INFN)-funded Medical Applications on a Grid Infrastructure Connection (MAGIC)-5 project.RiassuntoIn qesto lavoro viene discussa l’implementazione di un database immagini mammografiche digitalizzate. Le immagini sono state raccolte dal 1999 da un gruppo di fisici in collaborazione con radiology di alcuni ospedali italiani, come primo passo dello sviluppo e implementazione di un sistema di Computer Aided Detection (CAD). I 3369 mammogrammi appartengono a 967 pazienti e sono classificati secondo I tipi e la morfologia delle lesioni, il tessuto mammario e i tipi di patologie. Una interfaccia grafica opportunamente progettata è stata sviluppata per la visualizzazione e l’elaborazione delle mammografie digitalizzate al fine di runpoter supportare direttamente una diagnosi medica su monitor ad alta risoluzione. Il database ha rappresentato il punto di partenza per lo sviluppo di altre applicazioni di imaging medicale come il CAD mammografico costantemente ottimizzato e aggiornato con l’uso di un ambiente distribuito che dispone di servizi GRID, nel framework del progetto MAGIC-5, finanziato dell’INFN.

GPCALMA, a mammographic CAD in a GRID connection

Abstract The purpose of this work is the development of an automatic system which could be useful for radiologists in the investigation of breast cancer. A breast neoplasia is often marked by the presence of microcalcifications and massive lesions in the mammogram: hence the need for tools able to recognize such lesions at an early stage. Grid Platform Computer-Assisted Library for MAmmography (GPCALMA), a collaboration among Italian physicists and radiologists, has built a large distributed database of digitized mammographic images (at this moment about 5500 images corresponding to 1650 patients). This collaboration has developed a Computer Aided Detection (CAD) system which, installed in an integrated station, can also be used for digitization, as archive, and to perform statistical analysis. With a GRID configuration, it would be possible for clinicians tele- and co-working in new and innovative groupings (‘virtual organizations’), and using the whole database, by the GPCALMA tools, several analysis can be performed. Furthermore, GPCALMA allows to be abreast of the CAD technical progressing into several hospital locations always with remote working by GRID connection. We report in the results obtained by the GPCALMA CAD software implemented with a GRID connection.