Shape-based computer-aided detection of lung nodules in thoracic CT images

Automatic detection of subsolid pulmonary nodules in thoracic computed tomography images

Subsolid pulmonary nodules occur less often than solid pulmonary nodules, but show a much higher malignancy rate. Therefore, accurate detection of this type of pulmonary nodules is crucial. In this work, a computer-aided detection (CAD) system for subsolid nodules in computed tomography images is presented and evaluated on a large data set from a multi-center lung cancer screening trial. The paper describes the different components of the CAD system and presents experiments to optimize the performance of the proposed CAD system. A rich set of 128 features is defined for subsolid nodule candidates. In addition to previously used intensity, shape and texture features, a novel set of context features is introduced. Experiments show that these features significantly improve the classification performance. Optimization and training of the CAD system is performed on a large training set from one site of a lung cancer screening trial. Performance analysis on an independent test from another site of the trial shows that the proposed system reaches a sensitivity of 80% at an average of only 1.0 false positive detections per scan. A retrospective analysis of the output of the CAD system by an experienced thoracic radiologist shows that the CAD system is able to find subsolid nodules which were not contained in the screening database.

A novel approach for lung nodules segmentation in chest CT using level sets

A new variational level set approach is proposed for lung nodule segmentation in lung CT scans. A general lung nodule shape model is proposed using implicit spaces as a signed distance function. The shape model is fused with the image intensity statistical information in a variational segmentation framework. The nodule shape model is mapped to the image domain by a global transformation that includes inhomogeneous scales, rotation, and translation parameters. A matching criteria between the shape model and the image implicit representations is employed to handle the alignment process. Transformation parameters evolve through gradient descent optimization to handle the shape alignment process and hence mark the boundaries of the nodule “head.” The embedding process takes into consideration the image intensity as well as prior shape information. A nonparametric density estimation approach is employed to handle the statistical intensity representation of the nodule and background regions. The proposed technique does not depend on nodule type or location. Exhaustive experimental and validation results are demonstrated on 742 nodules obtained from four different CT lung databases, illustrating the robustness of the approach.

Automated pulmonary nodule detection based on three-dimensional shape-based feature descriptor

Computer-aided detection (CAD) can help radiologists to detect pulmonary nodules at an early stage. In pulmonary nodule CAD systems, feature extraction is very important for describing the characteristics of nodule candidates. In this paper, we propose a novel three-dimensional shape-based feature descriptor to detect pulmonary nodules in CT scans. After lung volume segmentation, nodule candidates are detected using multi-scale dot enhancement filtering in the segmented lung volume. Next, we extract feature descriptors from the detected nodule candidates, and these are refined using an iterative wall elimination method. Finally, a support vector machine-based classifier is trained to classify nodules and non-nodules. The performance of the proposed system is evaluated on Lung Image Database Consortium data. The proposed method significantly reduces the number of false positives in nodule candidates. This method achieves 97.5% sensitivity, with only 6.76 false positives per scan.

Computer-aided tumor detection based on multi-scale blob detection algorithm in automated breast ultrasound images

Automated whole breast ultrasound (ABUS) is an emerging screening tool for detecting breast abnormalities. In this study, a computer-aided detection (CADe) system based on multi-scale blob detection was developed for analyzing ABUS images. The performance of the proposed CADe system was tested using a database composed of 136 breast lesions (58 benign lesions and 78 malignant lesions) and 37 normal cases. After speckle noise reduction, Hessian analysis with multi-scale blob detection was applied for the detection of tumors. This method detected every tumor, but some nontumors were also detected. The tumor like lihoods for the remaining candidates were estimated using a logistic regression model based on blobness, internal echo, and morphology features. The tumor candidates with tumor likelihoods higher than a specific threshold (0.4) were considered tumors. By using the combination of blobness, internal echo, and morphology features with 10-fold cross-validation, the proposed CAD system showed sensitivities of 100%, 90%, and 70% with false positives per pass of 17.4, 8.8, and 2.7, respectively. Our results suggest that CADe systems based on multi-scale blob detection can be used to detect breast tumors in ABUS images.

Detection of pulmonary nodules in CT images based on fuzzy integrated active contour model and hybrid parametric mixture model

The segmentation and detection of various types of nodules in a Computer-aided detection (CAD) system present various challenges, especially when (1) the nodule is connected to a vessel and they have very similar intensities; (2) the nodule with ground-glass opacity (GGO) characteristic possesses typical weak edges and intensity inhomogeneity, and hence it is difficult to define the boundaries. Traditional segmentation methods may cause problems of boundary leakage and “weak” local minima. This paper deals with the above mentioned problems. An improved detection method which combines a fuzzy integrated active contour model (FIACM)-based segmentation method, a segmentation refinement method based on Parametric Mixture Model (PMM) of juxta-vascular nodules, and a knowledge-based C-SVM (Cost-sensitive Support Vector Machines) classifier, is proposed for detecting various types of pulmonary nodules in computerized tomography (CT) images. Our approach has several novel aspects: (1) In the proposed FIACM model, edge and local region information is incorporated. The fuzzy energy is used as the motivation power for the evolution of the active contour. (2) A hybrid PMM Model of juxta-vascular nodules combining appearance and geometric information is constructed for segmentation refinement of juxta-vascular nodules. Experimental results of detection for pulmonary nodules show desirable performances of the proposed method.

Machine Learning in Computer-aided Diagnosis of the Thorax and Colon in CT: A Survey

Computer-aided detection (CADe) and diagnosis (CAD) has been a rapidly growing, active area of research in medical imaging. Machine leaning (ML) plays an essential role in CAD, because objects such as lesions and organs may not be represented accurately by a simple equation; thus, medical pattern recognition essentially require "learning from examples." One of the most popular uses of ML is the classification of objects such as lesion candidates into certain classes (e.g., abnormal or normal, and lesions or non-lesions) based on input features (e.g., contrast and area) obtained from segmented lesion candidates. The task of ML is to determine "optimal" boundaries for separating classes in the multidimensional feature space which is formed by the input features. ML algorithms for classification include linear discriminant analysis (LDA), quadratic discriminant analysis (QDA), multilayer perceptrons, and support vector machines (SVM). Recently, pixel/voxel-based ML (PML) emerged in medical image processing/analysis, which uses pixel/voxel values in images directly, instead of features calculated from segmented lesions, as input information; thus, feature calculation or segmentation is not required. In this paper, ML techniques used in CAD schemes for detection and diagnosis of lung nodules in thoracic CT and for detection of polyps in CT colonography (CTC) are surveyed and reviewed.

Automatic Detection of 2D and 3D Lung Nodules in Chest Spiral CT Scans

Automatic detection of lung nodules is an important problem in computer analysis of chest radiographs. In this paper, we propose a novel algorithm for isolating lung abnormalities (nodules) from spiral chest low-dose CT (LDCT) scans. The proposed algorithm consists of three main steps. The first step isolates the lung nodules, arteries, veins, bronchi, and bronchioles from the surrounding anatomical structures. The second step detects lung nodules using deformable 3D and 2D templates describing typical geometry and gray-level distribution within the nodules of the same type. The detection combines the normalized cross-correlation template matching and a genetic optimization algorithm. The final step eliminates the false positive nodules (FPNs) using three features that robustly define the true lung nodules. Experiments with 200 CT data sets show that the proposed approach provided comparable results with respect to the experts.

Computer-aided diagnosis systems for lung cancer: challenges and methodologies

This paper overviews one of the most important, interesting, and challenging problems in oncology, the problem of lung cancer diagnosis. Developing an effective computer-aided diagnosis (CAD) system for lung cancer is of great clinical importance and can increase the patient's chance of survival. For this reason, CAD systems for lung cancer have been investigated in a huge number of research studies. A typical CAD system for lung cancer diagnosis is composed of four main processing steps: segmentation of the lung fields, detection of nodules inside the lung fields, segmentation of the detected nodules, and diagnosis of the nodules as benign or malignant. This paper overviews the current state-of-the-art techniques that have been developed to implement each of these CAD processing steps. For each technique, various aspects of technical issues, implemented methodologies, training and testing databases, and validation methods, as well as achieved performances, are described. In addition, the paper addresses several challenges that researchers face in each implementation step and outlines the strengths and drawbacks of the existing approaches for lung cancer CAD systems.

AUTOMATIC QUANTIFICATION OF TREE-IN-BUD PATTERNS FROM CT SCANS

In this paper, we present a fully automatic method to quantify Tree-in-Bud (TIB) patterns for respiratory tract infections. The proposed quantification method is based on our previous effort to detect and track TIB patterns with a computer assisted detection (CAD) system [9]. In addition to accurately identifying TIB on CT, quantifying TIB is important for measuring the volume of affected lung as a potantial marker of disease severity. This quantification can be challenging due to the complex shape of TIB and high intensity variation contributing mixed features. Our proposed quantification method is based on a local scale concept such that TIB regions detected via the CAD system are quantified adaptively, and volume percentages of the quantified regions are compared to visual scoring of participating radiologists. We conducted the experiments with a data set of 94 chest CTs (laboratory confirmed 39 viral bronchiolitis caused by human parainfluenza (HPIV), 34 nontuberculous mycobacterial (NTM), and 21 normal control). Experimental results show that the proposed quantification system is well suited to the CAD system for detecting TIB patterns. Correlations of observer-CAD agreements are reported as (R2 = 0.824, p < 0.01) and (R2 = 0.801, p < 0.01) for HPIV and NTM cases, respectively.

A review of computer-aided diagnosis in thoracic and colonic imaging

Medical imaging has been indispensable in medicine since the discovery of x-rays. Medical imaging offers useful information on patients' medical conditions and on the causes of their symptoms and diseases. As imaging technologies advance, a large number of medical images are produced which physicians/radiologists must interpret. Thus, computer aids are demanded and become indispensable in physicians' decision making based on medical images. Consequently, computer-aided detection and diagnosis (CAD) has been investigated and has been an active research area in medical imaging. CAD is defined as detection and/or diagnosis made by a radiologist/physician who takes into account the computer output as a "second opinion". In CAD research, detection and diagnosis of lung and colorectal cancer in thoracic and colonic imaging constitute major areas, because lung and colorectal cancers are the leading and second leading causes, respectively, of cancer deaths in the U.S. and also in other countries. In this review, CAD of the thorax and colon, including CAD for detection and diagnosis of lung nodules in thoracic CT, and that for detection of polyps in CT colonography, are reviewed.

High performance lung nodule detection schemes in CT using local and global information

PURPOSE

A key issue in current computer-aided diagnostic (CAD) schemes for nodule detection in CT is the large number of false positives, because current schemes use only global three-dimensional (3D) information to detect nodules and discard useful local two-dimensional (2D) information. Thus, the authors integrated local and global information to markedly improve the performance levels of CAD schemes.

METHODS

Our database was obtained from the standard CT lung nodule database created by the Lung Image Database Consortium (LIDC). It consisted of 85 CT scans with 111 nodules of 3 mm or larger in diameter. The 111 nodules were confirmed by at least two of the four radiologists participated in the LIDC. Twenty-six nodules were missed by two of the four radiologists and were thus very difficult to detect. The authors developed five CAD schemes for nodule detection in CT using global 3D information (3D scheme), local 2D information (2D scheme), and both local and global information (2D + 3D scheme, 2D - 3D scheme, and 3D - 2D scheme). The 3D scheme, which was developed previously, used only global 3D information and discarded local 2D information, as other CAD schemes did. The 2D scheme used a uniform viewpoint reformation technique to decompose a 3D nodule candidate into a set of 2D reformatted images generated from representative viewpoints, and selected and used "effective" 2D reformatted images to remove false positives. The 2D + 3D scheme, 2D - 3D scheme, and 3D - 2D scheme used complementary local and global information in different ways to further improve the performance of lung nodule detection. The authors employed a leave-one-scan-out testing method for evaluation of the performance levels of the five CAD schemes.

RESULTS

At the sensitivities of 85%, 80%, and 75%, the existing 3D scheme reported 17.3, 7.4, and 2.8 false positives per scan, respectively; the 2D scheme improved the detection performance and reduced the numbers of false positives to 7.6, 2.5, and 1.3 per scan; the 2D + 3D scheme further reduced those to 2.7, 1.9, and 0.6 per scan; the 2D - 3D scheme reduced those to 7.6, 2.1, and 0.8 per scan; and the 3D - 2D scheme reduced those to 17.3, 1.6, and 1.0 per scan.

CONCLUSIONS

The local 2D information appears to be more useful than the global 3D information for nodule detection, particularly, when it is integrated with 3D information.

Enhancing image analytic tools by fusing quantitative physiological values with image features

Computer-aided diagnosis systems (CADs) can quantify the severity of diseases by analyzing a set of images and employing prior statistical models. In general, CADs have proven to be effective at providing quantitative measurements of the extent of a particular disease, thus helping physicians to better monitor the progression of cancer, infectious diseases, and other health conditions. Electronic Health Records frequently include a large amount of clinical data and medical history that can provide critical information about the underlying condition of a patient. We hypothesize that the fusion of image and clinical-physiological features can be used to enhance the accuracy of automatic image classification models. In particular, this paper shows how image analytic tools can move beyond classical image interpretation models to broader systems where image and physiological measurements are fused and used to create more generic detection models. To test our hypothesis, a CAD system capable of quantifying the severity of patients with pulmonary fibrosis has been developed. Results show that CAD systems augmented with multimodal physiological values are more robust and accurate at determining the severity of the disease.

Pixel-based machine learning in medical imaging

Machine learning (ML) plays an important role in the medical imaging field, including medical image analysis and computer-aided diagnosis, because objects such as lesions and organs may not be represented accurately by a simple equation; thus, medical pattern recognition essentially require “learning from examples.” One of the most popular uses of ML is classification of objects such as lesions into certain classes (e.g., abnormal or normal, or lesions or nonlesions) based on input features (e.g., contrast and circularity) obtained from segmented object candidates. Recently, pixel/voxel-based ML (PML) emerged in medical image processing/analysis, which use pixel/voxel values in images directly instead of features calculated from segmented objects as input information; thus, feature calculation or segmentation is not required. Because the PML can avoid errors caused by inaccurate feature calculation and segmentation which often occur for subtle or complex objects, the performance of the PML can potentially be higher for such objects than that of common classifiers (i.e., feature-based MLs). In this paper, PMLs are surveyed to make clear (a) classes of PMLs, (b) similarities and differences within (among) different PMLs and those between PMLs and feature-based MLs, (c) advantages and limitations of PMLs, and (d) their applications in medical imaging.

NMF-SVM based CAD tool applied to functional brain images for the diagnosis of Alzheimer's disease

This paper presents a novel computer-aided diagnosis (CAD) technique for the early diagnosis of the Alzheimer's disease (AD) based on nonnegative matrix factorization (NMF) and support vector machines (SVM) with bounds of confidence. The CAD tool is designed for the study and classification of functional brain images. For this purpose, two different brain image databases are selected: a single photon emission computed tomography (SPECT) database and positron emission tomography (PET) images, both of them containing data for both Alzheimer's disease (AD) patients and healthy controls as a reference. These databases are analyzed by applying the Fisher discriminant ratio (FDR) and nonnegative matrix factorization (NMF) for feature selection and extraction of the most relevant features. The resulting NMF-transformed sets of data, which contain a reduced number of features, are classified by means of a SVM-based classifier with bounds of confidence for decision. The proposed NMF-SVM method yields up to 91% classification accuracy with high sensitivity and specificity rates (upper than 90%). This NMF-SVM CAD tool becomes an accurate method for SPECT and PET AD image classification.

A novel computer-aided lung nodule detection system for CT images

PURPOSE

The paper presents a complete computer-aided detection (CAD) system for the detection of lung nodules in computed tomography images. A new mixed feature selection and classification methodology is applied for the first time on a difficult medical image analysis problem.

METHODS

The CAD system was trained and tested on images from the publicly available Lung Image Database Consortium (LIDC) on the National Cancer Institute website. The detection stage of the system consists of a nodule segmentation method based on nodule and vessel enhancement filters and a computed divergence feature to locate the centers of the nodule clusters. In the subsequent classification stage, invariant features, defined on a gauge coordinates system, are used to differentiate between real nodules and some forms of blood vessels that are easily generating false positive detections. The performance of the novel feature-selective classifier based on genetic algorithms and artificial neural networks (ANNs) is compared with that of two other established classifiers, namely, support vector machines (SVMs) and fixed-topology neural networks. A set of 235 randomly selected cases from the LIDC database was used to train the CAD system. The system has been tested on 125 independent cases from the LIDC database.

RESULTS

The overall performance of the fixed-topology ANN classifier slightly exceeds that of the other classifiers, provided the number of internal ANN nodes is chosen well. Making educated guesses about the number of internal ANN nodes is not needed in the new feature-selective classifier, and therefore this classifier remains interesting due to its flexibility and adaptability to the complexity of the classification problem to be solved. Our fixed-topology ANN classifier with 11 hidden nodes reaches a detection sensitivity of 87.5% with an average of four false positives per scan, for nodules with diameter greater than or equal to 3 mm. Analysis of the false positive items reveals that a considerable proportion (18%) of them are smaller nodules, less than 3 mm in diameter.

CONCLUSIONS

A complete CAD system incorporating novel features is presented, and its performance with three separate classifiers is compared and analyzed. The overall performance of our CAD system equipped with any of the three classifiers is well with respect to other methods described in literature.

Computer-assisted detection of infectious lung diseases: a review

Respiratory tract infections are a leading cause of death and disability worldwide. Although radiology serves as a primary diagnostic method for assessing respiratory tract infections, visual analysis of chest radiographs and computed tomography (CT) scans is restricted by low specificity for causal infectious organisms and a limited capacity to assess severity and predict patient outcomes. These limitations suggest that computer-assisted detection (CAD) could make a valuable contribution to the management of respiratory tract infections by assisting in the early recognition of pulmonary parenchymal lesions, providing quantitative measures of disease severity and assessing the response to therapy. In this paper, we review the most common radiographic and CT features of respiratory tract infections, discuss the challenges of defining and measuring these disorders with CAD, and propose some strategies to address these challenges.

Automatic Graph Cut Segmentation of Lesions in CT Using Mean Shift Superpixels

This paper presents a new, automatic method of accurately extracting lesions from CT data. It first determines, at each voxel, a five-dimensional (5D) feature vector that contains intensity, shape index, and 3D spatial location. Then, nonparametric mean shift clustering forms superpixels from these 5D features, resulting in an oversegmentation of the image. Finally, a graph cut algorithm groups the superpixels using a novel energy formulation that incorporates shape, intensity, and spatial features. The mean shift superpixels increase the robustness of the result while reducing the computation time. We assume that the lesion is part spherical, resulting in high shape index values in a part of the lesion. From these spherical subregions, foreground and background seeds for the graph cut segmentation can be automatically obtained. The proposed method has been evaluated on a clinical CT dataset. Visual inspection on different types of lesions (lung nodules and colonic polyps), as well as a quantitative evaluation on 101 solid and 80 GGO nodules, both demonstrate the potential of the proposed method. The joint spatial-intensity-shape features provide a powerful cue for successful segmentation of lesions adjacent to structures of similar intensity but different shape, as well as lesions exhibiting partial volume effect.