R. Magro

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.

Automatic detection of lung nodules in CT datasets based on stable 3D mass-spring models

We propose a computer-aided detection (CAD) system which can detect small-sized (from 3mm) pulmonary nodules in spiral CT scans. A pulmonary nodule is a small lesion in the lungs, round-shaped (parenchymal nodule) or worm-shaped (juxtapleural nodule). Both kinds of lesions have a radio-density greater than lung parenchyma, thus appearing white on the images. Lung nodules might indicate a lung cancer and their early stage detection arguably improves the patient survival rate. CT is considered to be the most accurate imaging modality for nodule detection. However, the large amount of data per examination makes the full analysis difficult, leading to omission of nodules by the radiologist. We developed an advanced computerized method for the automatic detection of internal and juxtapleural nodules on low-dose and thin-slice lung CT scan. This method consists of an initial selection of nodule candidates list, the segmentation of each candidate nodule and the classification of the features computed for each segmented nodule candidate.The presented CAD system is aimed to reduce the number of omissions and to decrease the radiologist scan examination time. Our system locates with the same scheme both internal and juxtapleural nodules. For a correct volume segmentation of the lung parenchyma, the system uses a Region Growing (RG) algorithm and an opening process for including the juxtapleural nodules. The segmentation and the extraction of the suspected nodular lesions from CT images by a lung CAD system constitutes a hard task. In order to solve this key problem, we use a new Stable 3D Mass-Spring Model (MSM) combined with a spline curves reconstruction process. Our model represents concurrently the characteristic gray value range, the directed contour information as well as shape knowledge, which leads to a much more robust and efficient segmentation process. For distinguishing the real nodules among nodule candidates, an additional classification step is applied; furthermore, a neural network is applied to reduce the false positives (FPs) after a double-threshold cut. The system performance was tested on a set of 84 scans made available by the Lung Image Database Consortium (LIDC) annotated by four expert radiologists. The detection rate of the system is 97% with 6.1 FPs/CT. A reduction to 2.5 FPs/CT is achieved at 88% sensitivity. We presented a new 3D segmentation technique for lung nodules in CT datasets, using deformable MSMs. The result is a efficient segmentation process able to converge, identifying the shape of the generic ROI, after a few iterations. Our suitable results show that the use of the 3D AC model and the feature analysis based FPs reduction process constitutes an accurate approach to the segmentation and the classification of lung nodules.

Mammogram Segmentation by Contour Searching and Mass Lesions 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 masses in mammographic images will be presented. The database consists of 3762 digital images acquired in several hospitals belonging to the MAGIC-5 collaboration (Medical Applications on a Grid Infrastructure Connection). A reduction of the whole images area under investigation is achieved through a segmentation process, by means of a ROI Hunter algorithm, without loss of meaningful information. 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=0.862plusmn0.007, and we get a 2.8 FP/Image at a sensitivity of 82%. This software is included in the CAD station actually working in the hospitals belonging to the MAGIC-5 Collaboration

A massive lesion detection algorithm in mammography

A new algorithm for massive lesion detection in mammography is presented. The algorithm consists in three main steps: 1) reduction of the dimension of the image to be processed through the identification of regions of interest (roi) as candidates for massive lesions; 2) characterization of the RoI by means of suitable feature extraction; 3) pattern classification through supervised neural networks. Suspect regions are detected by searching for local maxima of the pixel grey level intensity. A ring of increasing radius, centered on a maximum, is considered until the mean intensity in the ring decreases to a defined fraction of the maximum. The ROIS thus obtained are described by average, variance, skewness and kurtosis of the intensity distributions at different fractions of the radius. A neural network approach is adopted to classify suspect pathological and healthy pattern. The software has been designed in the framework of the INFN (Istituto Nazionale Fisica Nucleare) research project GPCALMA (Grid Platform for Calma) which recruits physicists and radiologists from different Italian Research Institutions and hospitals to develop software for breast cancer detection.

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.

A text based indexing system for mammographic image retrieval and classification

Abstract In modern medical systems huge amount of text, words, images and videos are produced and stored in ad hoc databases. Medical community needs to extract precise information from that large amount of data. Currently ICT approaches do not provide a methodology for content-based medical images retrieval and classification. On the other hand, from the Internet of Things (IoT) perspective, the ICT medical data can be produced by several devices. Produced data complies with all Big Data features and constraints. The IoT guidelines put at the center of the system a new smart software to manage and transform Big Data in a new understanding form. This paper describes a text based indexing system for mammographic images retrieval and classification. The system deals with text (structured reports) and images (mammograms) mining and classification in a typical Department of Radiology. DICOM structured reports, containing free text for medical diagnosis, have been analyzed and labeled in order to classify the corresponding mammographic images. Information Retrieval process is based on some text manipulation techniques, such as light semantic analysis, stop-word removing, and light medical natural language processing. The system includes also a Search Engine module, based on a Bayes Naive Classifier. The experimental results provide interesting performance in terms of Specificity and Sensibility. Two more indexes have been computed in order to assess the system robustness: the A z (Area under ROC Curve) index and the σ A z ( A z standard error) index. The dataset is composed of healthy and pathological DICOM structured reports. Two use case scenarios are presented and described to prove the effectiveness of the proposed approach.

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.

Computer-assisted diagnosis (CAD) in mammography: comparison of diagnostic accuracy of a new algorithm (Cyclopus®, Medicad) with two commercial systems

PurposeThe study compares the diagnostic accuracy (correct identification of cancer) of a new computer-assisted diagnosis (CAD) system (Cyclopus) with two other commercial systems (R2 and CADx).Materials and methodsCyclopus was tested on a set of 120 mammograms on which the two compared commercial systems had been previously tested. The set consisted of mammograms reported as negative, preceding 31 interval cancers reviewed as screening error or minimal sign, and of 89 verified negative controls randomly selected from the same screening database.ResultsCyclopus sensitivity was 74.1% (R2=54.8%; CADx=41.9%) and was higher for interval cancers reviewed as screening error (90.9%; R2=54.5%; CADx=81.8%) compared with those reviewed as minimal sign (65.0%; R2=55.0%; CADx=20.0%). Specificity was 15.7% (R2=29.2%; CADx=17.9%). Overall accuracy was 30.8% (R2=35.8%; CADx=24.1%). The positive predictive value of a case with CAD marks [regions of interest (ROI)] was 23.4% (23/98; R2=16.0%; CADx=15.1%). Average ROI number per view among negative controls was 1.13 (R2=0.93; CADx=0.99). Cyclopus was more sensitive for masses compared with isolated microcalcifications (208 vs 62 ROI; R2=90 vs 213; CADx=192 vs 130).ConclusionsCompared with two other commercial systems, Cyclopus was more sensitive (R2 p=0.14; CADx p=0.02) and less specific (R2 p=0.02; CADx p=0.64).RiassuntoObiettiviLo studio confronta l’accuratezza diagnostica (corretta identificazione di neoplasie) di un nuovo sistema CAD (Cyclopus) rispetto a due sistemi CAD commerciali di uso comune, CADx e R2Materiali e metodiCyclopus è stato testato su un set di 120 mammografie sul quale erano precedentemente stati testati i due sistemi commerciali a confronto. Il set contiene 31 mammografie di screening refertate come negative, precedenti la comparsa di carcinomi di intervallo classificati alla revisione come errori di screening o minimal sign, e 89 controlli negativi verificati, scelti a random dalla stessa casistica di screening.RisultatiLa sensibilità di Cyclopus è stata del 74,3% (R2=54,8%; CADx=41,9%), ed è risultata più elevata per i carcinomi di intervallo classificati come errore di screening (90,9%; R2=54,5%; CADx=81,8%) che per quelli classificati come minimal sign (65,0%; R2=55,0%; CADx=20,0%). La specificità è risultata del 15,7% (R2=29,2%; CADx=17,9%). L’accuratezza complessiva è stata del 30,8% (R2=35,8%; CADx=24,1%). Il valore predittivo positivo di un caso con marcatura (ROI) è stato del 23,4% (23/98; R2=16,0%; CADx=15,1%). Il numero medio di ROI per proiezione tra i controlli negativi è risultato essere di 1,13 (R2=0,93; CADx=0,99). Cyclopus è risultato assai più sensibile per la presenza di opacità di massa che per microcalcificazioni (208 vs 62 ROI; R2=90 vs 213; CADx=192 vs130).ConclusioniRispetto ai due sistemi CAD a confronto Cyclopus risulta più sensibile (R2 p=0,14; CADxp=0,02), e meno specifico (R2 p=0,02; CADxp=0,64).

GPCALMA: an italian mammographic database of digitized images for research

In this work the implementation of a database of digitized mammograms is described. The digitized images were collected since 1999 by a community of physicists in collaboration with radiologists in several Italian hospitals, as a first step in order to develop and implement a Computer Aided Detection (CAD) system. 3369 mammograms were collected from 967 patients; they were classified according to the type and the morphology of the lesions, the type of the breast tissue and the type of pathologies. A dedicated Graphical User Interface was developed for mammography visualization and processing, in order to support the medical diagnosis directly on a high-resolution screen. The database has been the starting point for the development of other medical imaging applications such as a breast CAD, currently being upgraded and optimized for the use in conjunction of the GRID technology in the framework of the INFN-funded MAGIC-5 project.