Markov random field modeling in posteroanterior chest radiograph segmentation

Quantification of Pulmonary Inflammatory Processes Using Chest Radiography: Tuberculosis as the Motivating Application

The purpose of this work was to develop a quantitative method for evaluating the pulmonary inflammatory process (PIP) through the computational analysis of chest radiography exams in posteroanterior (PA) and lateral views. The quantification procedure was applied to patients with tuberculosis (TB) as the motivating application.A study of high-resolution computed tomography (HRCT) examinations of patients with TB was developed to establish a relation between the inflammatory process and the signal difference-to-noise ratio (SDNR) measured in the PA projection. A phantom essay was used to validate this relation, which was implemented using an algorithm that is able to estimate the volume of the inflammatory region based solely on SDNR values in the chest radiographs of patients.The PIP volumes that were quantified for 30 patients with TB were used for comparisons with direct HRCT analysis for the same patient. The Bland-Altman statistical analyses showed no significant differences between the 2 quantification methods. The linear regression line had a correlation coefficient of R = 0.97 and P < 0.001, showing a strong association between the volume that was determined by our evaluation method and the results obtained by direct HRCT scan analysis.Since the diagnosis and follow-up of patients with TB is commonly performed using X-rays exams, the method developed herein can be considered an adequate tool for quantifying the PIP with a lower patient radiation dose and lower institutional cost. Although we used patients with TB for the application of the method, this method may be used for other pulmonary diseases characterized by a PIP.

Clavicle segmentation in chest radiographs

Automated delineation of anatomical structures in chest radiographs is difficult due to superimposition of multiple structures. In this work an automated technique to segment the clavicles in posterior-anterior chest radiographs is presented in which three methods are combined. Pixel classification is applied in two stages and separately for the interior, the border and the head of the clavicle. This is used as input for active shape model segmentation. Finally dynamic programming is employed with an optimized cost function that combines appearance information of the interior of the clavicle, the border, the head and shape information derived from the active shape model. The method is compared with a number of previously described methods and with independent human observers on a large database. This database contains both normal and abnormal images and will be made publicly available. The mean contour distance of the proposed method on 249 test images is 1.1±1.6mm and the intersection over union is 0.86±0.10.

Automated lung segmentation in digital chest tomosynthesis

PURPOSE

The purpose of this study was to develop an automated lung segmentation method for computerized detection of lung nodules in digital chest tomosynthesis.

METHODS

The authors collected 45 digital tomosynthesis scans and manually segmented reference lung regions in each scan to assess the performance of the method. The authors automated the technique by calculating the edge gradient in an original image for enhancing lung outline and transforming the edge gradient image to polar coordinate space. The authors then employed a dynamic programming technique to delineate outlines of the unobscured lungs in the transformed edge gradient image. The lung outlines were converted back to the original image to provide the final segmentation result. The above lung segmentation algorithm was first applied to the central reconstructed tomosynthesis slice because of the absence of ribs overlapping lung structures. The segmented lung in the central slice was then used to guide lung segmentation in noncentral slices. The authors evaluated the segmentation method by using (1) an overlap rate of lung regions, (2) a mean absolute distance (MAD) of lung borders, (3) a Hausdorff distance of lung borders between the automatically segmented lungs and manually segmented reference lungs, and (4) the fraction of nodules included in the automatically segmented lungs.

RESULTS

The segmentation method achieved mean overlap rates of 85.7%, 88.3%, and 87.0% for left lungs, right lungs, and entire lungs, respectively; mean MAD of 4.8, 3.9, and 4.4 mm for left lungs, right lungs, and entire lungs, respectively; and mean Hausdorrf distance of 25.0 mm, 25.5 mm, and 30.1 mm for left lungs, right lungs, and entire lungs, respectively. All of the nodules inside the reference lungs were correctly included in the segmented lungs obtained with the lung segmentation method.

CONCLUSIONS

The method achieved relatively high accuracy for lung segmentation and will be useful for computer-aided detection of lung nodules in digital tomosynthesis.

A fully automated method for lung nodule detection from postero-anterior chest radiographs

In the past decades, a great deal of research work has been devoted to the development of systems that could improve radiologists' accuracy in detecting lung nodules. Despite the great efforts, the problem is still open. In this paper, we present a fully automated system processing digital postero-anterior (PA) chest radiographs, that starts by producing an accurate segmentation of the lung field area. The segmented lung area includes even those parts of the lungs hidden behind the heart, the spine, and the diaphragm, which are usually excluded from the methods presented in the literature. This decision is motivated by the fact that lung nodules may be found also in these areas. The segmented area is processed with a simple multiscale method that enhances the visibility of the nodules, and an extraction scheme is then applied to select potential nodules. To reduce the high number of false positives extracted, cost-sensitive support vector machines (SVMs) are trained to recognize the true nodules. Different learning experiments were performed on two different data sets, created by means of feature selection, and employing Gaussian and polynomial SVMs trained with different parameters; the results are reported and compared. With the best SVM models, we obtain about 1.5 false positives per image (fp/image) when sensitivity is approximately equal to 0.71; this number increases to about 2.5 and 4 fp/image when sensitivity is = 0.78 and = 0.85, respectively. For the highest sensitivity (= 0.92 and 1.0), we get 7 or 8 fp/image.

Automatic detection of abnormalities in chest radiographs using local texture analysis

A fully automatic method is presented to detect abnormalities in frontal chest radiographs which are aggregated into an overall abnormality score. The method is aimed at finding abnormal signs of a diffuse textural nature, such as they are encountered in mass chest screening against tuberculosis (TB). The scheme starts with automatic segmentation of the lung fields, using active shape models. The segmentation is used to subdivide the lung fields into overlapping regions of various sizes. Texture features are extracted from each region, using the moments of responses to a multiscale filter bank. Additional "difference features" are obtained by subtracting feature vectors from corresponding regions in the left and right lung fields. A separate training set is constructed for each region. All regions are classified by voting among the k nearest neighbors, with leave-one-out. Next, the classification results of each region are combined, using a weighted multiplier in which regions with higher classification reliability weigh more heavily. This produces an abnormality score for each image. The method is evaluated on two databases. The first database was collected from a TB mass chest screening program, from which 147 images with textural abnormalities and 241 normal images were selected. Although this database contains many subtle abnormalities, the classification has a sensitivity of 0.86 at a specificity of 0.50 and an area under the receiver operating characteristic (ROC) curve of 0.820. The second database consist of 100 normal images and 100 abnormal images with interstitial disease. For this database, the results were a sensitivity of 0.97 at a specificity of 0.90 and an area under the ROC curve of 0.986.

Computer-aided diagnosis in chest radiography: a survey

The traditional chest radiograph is still ubiquitous in clinical practice, and will likely remain so for quite some time. Yet, its interpretation is notoriously difficult. This explains the continued interest in computer-aided diagnosis for chest radiography. The purpose of this survey is to categorize and briefly review the literature on computer analysis of chest images, which comprises over 150 papers published in the last 30 years. Remaining challenges are indicated and some directions for future research are given.

Automatic segmentation of lung fields in chest radiographs

The delineation of important structures in chest radiographs is an essential preprocessing step in order to automatically analyze these images, e.g., for tuberculosis screening support or in computer assisted diagnosis. We present algorithms for the automatic segmentation of lung fields in chest radiographs. We compare several segmentation techniques: a matching approach; pixel classifiers based on several combinations of features; a new rule-based scheme that detects lung contours using a general framework for the detection of oriented edges and ridges in images; and a hybrid scheme. Each approach is discussed and the performance of nine systems is compared with interobserver variability and results available from the literature. The best performance is obtained by the hybrid scheme that combines the rule-based segmentation algorithm with a pixel classification approach. The combinations of two complementary techniques leads to robust performance; the accuracy is above 94% for all 115 images in the test set. The average accuracy of the scheme is 0.969 +/- 0.0080, which is close to the interobserver variability of 0.984 +/- 0.0048. The methods are fast, and implemented on a standard PC platform.