Segmentation and size measurement of polyps in CT colonography

Quantitative radiology: automated measurement of polyp volume in computed tomography colonography using Hessian matrix-based shape extraction and volume growing

BACKGROUND

Current measurement of the single longest dimension of a polyp is subjective and has variations among radiologists. Our purpose was to develop a computerized measurement of polyp volume in computed tomography colonography (CTC).

METHODS

We developed a 3D automated scheme for measuring polyp volume at CTC. Our scheme consisted of segmentation of colon wall to confine polyp segmentation to the colon wall, extraction of a highly polyp-like seed region based on the Hessian matrix, a 3D volume growing technique under the minimum surface expansion criterion for segmentation of polyps, and sub-voxel refinement and surface smoothing for obtaining a smooth polyp surface. Our database consisted of 30 polyp views (15 polyps) in CTC scans from 13 patients. Each patient was scanned in the supine and prone positions. Polyp sizes measured in optical colonoscopy (OC) ranged from 6-18 mm with a mean of 10 mm. A radiologist outlined polyps in each slice and calculated volumes by summation of volumes in each slice. The measurement study was repeated 3 times at least 1 week apart for minimizing a memory effect bias. We used the mean volume of the three studies as "gold standard".

RESULTS

Our measurement scheme yielded a mean polyp volume of 0.38 cc (range, 0.15-1.24 cc), whereas a mean "gold standard" manual volume was 0.40 cc (range, 0.15-1.08 cc). The "gold-standard" manual and computer volumetric reached excellent agreement (intra-class correlation coefficient =0.80), with no statistically significant difference [P (F≤f) =0.42].

CONCLUSIONS

We developed an automated scheme for measuring polyp volume at CTC based on Hessian matrix-based shape extraction and volume growing. Polyp volumes obtained by our automated scheme agreed excellently with "gold standard" manual volumes. Our fully automated scheme can efficiently provide accurate polyp volumes for radiologists; thus, it would help radiologists improve the accuracy and efficiency of polyp volume measurements in CTC.

Estimating the size of polyps during actual endoscopy procedures using a spatio-temporal characterization

Colorectal cancer usually appears in polyps developed from the mucosa. Carcinoma is frequently found in those polyps larger than 10mm and therefore only this kind of polyps is sent for pathology examination. In consequence, accurate estimation of a polyp size determines the surveillance interval after polypectomy. The follow up consists in a periodic colonoscopy whose frequency depends on the estimation of the size polyp. Typically, this polyp measure is achieved by examining the lesion with a calibrated endoscopy tool. However, measurement is very challenging because it must be performed during a procedure subjected to a complex mix of noise sources, namely anatomical variability, drastic illumination changes and abrupt camera movements. This work introduces a semi-automatic method that estimates a polyp size by propagating an initial manual delineation in a single frame to the whole video sequence using a spatio-temporal characterization of the lesion, during a routine endoscopic examination. The proposed approach achieved a Dice Score of 0.7 in real endoscopy video-sequences, when comparing with an expert. In addition, the method obtained a root mean square error (RMSE) of 0.87mm in videos artificially captured in a cylindric structure with spheres of known size that simulated the polyps. Finally, in real endoscopy sequences, the diameter estimation was compared with measures obtained by a group of four experts with similar experience, obtaining a RMSE of 4.7mm for a set of polyps measuring from 5 to 20mm. An ANOVA test performed for the five groups of measurements (four experts and the method) showed no significant differences (p<0.01).

Automated Delineation of Lung Tumors from CT Images Using a Single Click Ensemble Segmentation Approach

A single click ensemble segmentation (SCES) approach based on an existing "Click&Grow" algorithm is presented. The SCES approach requires only one operator selected seed point as compared with multiple operator inputs, which are typically needed. This facilitates processing large numbers of cases. Evaluation on a set of 129 CT lung tumor images using a similarity index (SI) was done. The average SI is above 93% using 20 different start seeds, showing stability. The average SI for 2 different readers was 79.53%. We then compared the SCES algorithm with the two readers, the level set algorithm and the skeleton graph cut algorithm obtaining an average SI of 78.29%, 77.72%, 63.77% and 63.76% respectively. We can conclude that the newly developed automatic lung lesion segmentation algorithm is stable, accurate and automated.

Linear measurement of polyps in CT colonography using level sets on 3D surfaces

CT colonography has emerged as a minimally invasive alternative to optical colonoscopy for the screening of polyps which are the precursors to colon cancer. Accurate polyp measurement is crucial as the size of a polyp is considered an indication of its potential for malignancy. We present a novel method for the automatic measurement of polyps. It is based on a level set algorithm capable of evolving on the surface of a 3D object represented by a triangular mesh. It is guided by curvature features and is capable of segmenting the polyp neck, that is, the ridgeline/crestline formed around the polyp by its merging to the colon wall. Our method was validated on 40 polyp surfaces obtained from real clinical data. A 3D manual measurement was used as the reference standard. A correlation of 0.825 was found between polyp measurements from our new method and the reference standard.

EMPLOYING TOPOGRAPHICAL HEIGHT MAP IN COLONIC POLYP MEASUREMENT AND FALSE POSITIVE REDUCTION

CT Colonography (CTC) is an emerging minimally invasive technique for screening and diagnosing colon cancers. Computer Aided Detection (CAD) techniques can increase sensitivity and reduce false positives. Inspired by the way radiologists detect polyps via 3D virtual fly-through in CTC, we borrowed the idea from geographic information systems to employ topographical height map in colonic polyp measurement and false positive reduction. After a curvature based filtering and a 3D CT feature classifier, a height map is computed for each detection using a ray-casting algorithm. We design a concentric index to characterize the concentric pattern in polyp height map based on the fact that polyps are protrusions from the colon wall and round in shape. The height map is optimized through a multi-scale spiral spherical search to maximize the concentric index. We derive several topographic features from the map and compute texture features based on wavelet decomposition. We then send the features to a committee of support vector machines for classification. We have trained our method on 394 patients (71 polyps) and tested it on 792 patients (226 polyps). Results showed that we can achieve 95% sensitivity at 2.4 false positives per patient and the height map features can reduce false positives by more than 50%. We compute the polyp height and width measurements and correlate them with manual measurements. The Pearson correlations are 0.74 (p=0.11) and 0.75 (p=0.17) for height and width, respectively.

Protrusion method for automated estimation of polyp size on CT colonography

OBJECTIVE

The purpose of this study was to assess the accuracy and measurement variability of automated lesion measurement on CT colonography in comparison with manual 2D and 3D techniques under varying scanning conditions.

MATERIALS AND METHODS

The study included phantoms (23 phantom objects) and patients (16 polyps). Measurement with sliding calipers served as the reference for the phantom data. The mean of two independent colonoscopic measurements was the reference for the polyps. The automated measurement was developed for a computer-aided detection scheme, and the size of any detected object was obtained from measurement of its largest diameter. The automated measurement was compared with manual 2D and 3D measurements by two experienced observers.

RESULTS

For phantom data, the measurement variability of the automated method was significantly less than that of the two observers (p < 0.05), except for the 3D measurement by observer 1, as follows: automated, 0.86 mm; observer 1, 1.76 mm (2D), 0.96 (3D); observer 2, 1.34 mm (2D), 1.45 mm (3D). The variability of the automated method did not differ significantly from that of manual methods in measurement with patient data. The automated method had a systematic error for phantom data (1.9 mm).

CONCLUSION

For phantoms, the automated method has less measurement variability than manual 2D and 3D techniques. For true polyps, the measurement variability of the automated method is comparable with that of manual methods. The automated method does not suffer from intraobserver variability. Because systematic error can be calibrated, automated size measurement may contribute to a practical evaluation strategy.

Improved classifier for computer-aided polyp detection in CT colonography by nonlinear dimensionality reduction

Computer-aided detection (CAD) has been shown to be feasible for polyp detection on computed tomography (CT) scans. After initial detection, the dataset of colonic polyp candidates has large-scale and high dimensional characteristics. In this article, we propose a nonlinear dimensionality reduction method based on diffusion map and locally linear embedding (DMLLE) for large-scale datasets. By selecting partial data as landmarks, we first map these points into a low dimensional embedding space using the diffusion map. The embedded landmarks can be viewed as a skeleton of whole data in the low dimensional space. Then by using the locally linear embedding algorithm, nonlandmark samples are mapped into the same low dimensional space according to their nearest landmark samples. The local geometry is preserved in both the original high dimensional space and the embedding space. In addition, DMLLE provides a faithful representation of the original high dimensional data at coarse and fine scales. Thus, it can capture the intrinsic distance relationship between samples and reduce the influence of noisy features, two aspects that are crucial to achieving high classifier performance. We applied the proposed DMLLE method to a colonic polyp dataset of 175 269 polyp candidates with 155 features. Visual inspection shows that true polyps with similar shapes are mapped to close vicinity in the low dimensional space. We compared the performance of a support vector machine (SVM) classifier in the low dimensional embedding space with that in the original high dimensional space, SVM with principal component analysis dimensionality reduction and SVM committee using feature selection technology. Free-response receiver operating characteristic analysis shows that by using our DMLLE dimensionality reduction method, SVM achieves higher sensitivity with a lower false positive rate compared with other methods. For 6-9 mm polyps (193 true polyps contained in test set), when the number of false positives per patient is 9, SVM with DMLLE improves the average sensitivity from 70% to 83% compared with that of an SVM committee classifier which is a state-of-the-art method for colonic polyp detection (p<0.001).

Adaptive deformable model for colonic polyp segmentation and measurement on CT colonography

Polyp size is one important biomarker for the malignancy risk of a polyp. This paper presents an improved approach for colonic polyp segmentation and measurement on CT colonography images. The method is based on a combination of knowledge-guided intensity adjustment, fuzzy clustering, and adaptive deformable model. Since polyps on haustral folds are the most difficult to be segmented, we propose a dual-distance algorithm to first identify voxels on the folds, and then introduce a counter-force to control the model evolution. We derive linear and volumetric measurements from the segmentation. The experiment was conducted on 395 patients with 83 polyps, of which 43 polyps were on haustral folds. The results were validated against manual measurement from the optical colonoscopy and the CT colonography. The paired t-test showed no significant difference, and the R(2) correlation was 0.61 for the linear measurement and 0.98 for the volumetric measurement. The mean Dice coefficient for volume overlap between automatic and manual segmentation was 0.752 (standard deviation 0.154).

Detection of protrusions in curved folded surfaces applied to automated polyp detection in CT colonography

Over the past years many computer aided diagnosis (CAD) schemes have been presented for the detection of colonic polyps in CT Colonography. The vast majority of these methods (implicitly) model polyps as approximately spherical protrusions. Polyp shape and size varies greatly, however and is often far from spherical. We propose a shape and size invariant method to detect suspicious regions. The method works by locally deforming the colon surface until the second principal curvature is smaller than or equal to zero. The amount of deformation is a quantitative measure of the 'protrudeness'. The deformation field allows for the computation of various additional features to be used in supervised pattern recognition. It is shown how only a few features are needed to achieve 95% sensitivity at 10 false positives (FP) per dataset for polyps larger than 6 mm.