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 radiologist's 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.     

Characterization of Architectural Distortion in Mammograms Based on Texture Analysis Using Support Vector Machine Classifier with Clinical Evaluation

Architecture distortion (AD) is an important and early sign of breast cancer, but due to its subtlety, it is often missed on the screening mammograms. The objective of this study is to create a quantitative approach for texture classification of AD based on various texture models, using support vector machine (SVM) classifier. The texture analysis has been done on the region of interest (ROI) selected from the original mammogram. A comprehensive analysis has been done on samples from three databases; out of which, two data sets are from the public domain, and the third data set is for clinical evaluation. The public domain databases are IRMA version of digital database for screening mammogram (DDSM) and Mammographic Image Analysis Society (MIAS). For clinical evaluation, the actual patient’s database has been obtained from ACE Healthways, Diagnostic Centre Ludhiana, India. The significant finding of proposed study lies in appropriate selection of the size of ROIs. The experiments have been done on fixed size of ROIs as well as on the ground truth (variable size) ROIs. Best results pertain to an accuracy of 92.94 % obtained in case of DDSM database for fixed-size ROIs. In case of MIAS database, an accuracy of 95.34 % is achieved in AD versus non-AD (normal) cases for ground truth ROIs. Clinically, an accuracy of 88 % was achieved for ACE dataset. The results obtained in the present study are encouraging, as optimal result has been achieved for the proposed study in comparison with other related work in the same area.     

A ranklet-based image representation for mass classification in digital mammograms

Regions of interest (ROIs) found on breast radiographic images are classified as either tumoral mass or normal tissue by means of a support vector machine classifier. Classification features are the coefficients resulting from the specific image representation used to encode each ROI. Pixel and wavelet image representations have already been discussed in one of our previous works. To investigate the possibility of improving classification performances, a novel nonparametric, orientation-selective, and multiresolution image representation is developed and evaluated, namely a ranklet image representation. A dataset consisting of 1000 ROIs representing biopsy-proven tumoral masses (either benign or malignant) and 5000 ROIs representing normal breast tissue is used. ROIs are extracted from the digital database for screening mammography collected by the University of South Florida. Classification performances are evaluated using the area Az under the receiver operating characteristic curve. By achieving Az values of 0.978 +/- 0.003 and 90% sensitivity with a false positive fraction value of 4.5%, experiments demonstrate classification results higher than those reached by the previous image representations. In particular, the improvement on the Az value over that achieved by the wavelet image representation is statistically relevant with the two-tailed p value <0.0001. Besides, owing to the tolerance that the ranklet image representation reveals to variations in the ROIs' gray-level intensity histogram, this approach discloses to be robust also when tested on radiographic images having gray-level intensity histogram remarkably different from that used for training.     

Computerized characterization of breast masses on three-dimensional ultrasound volumes

We are developing computer vision techniques for the characterization of breast masses as malignant or benign on radiologic examinations. In this study, we investigated the computerized characterization of breast masses on three-dimensional (3-D) ultrasound (US) volumetric images. We developed 2-D and 3-D active contour models for automated segmentation of the mass volumes. The effect of the initialization method of the active contour on the robustness of the iterative segmentation method was studied by varying the contour used for its initialization. For a given segmentation, texture and morphological features were automatically extracted from the segmented masses and their margins. Stepwise discriminant analysis with the leave-one-out method was used to select effective features for the classification task and to combine these features into a malignancy score. The classification accuracy was evaluated using the area Az under the receiver operating characteristic (ROC) curve, as well as the partial area index Az(0.9), defined as the relative area under the ROC curve above a sensitivity threshold of 0.9. For the purpose of comparison with the computer classifier, four experienced breast radiologists provided malignancy ratings for the 3-D US masses. Our dataset consisted of 3-D US volumes of 102 biopsied masses (46 benign, 56 malignant). The classifiers based on 2-D and 3-D segmentation methods achieved test Az values of 0.87+/-0.03 and 0.92+/-0.03, respectively. The difference in the Az values of the two computer classifiers did not achieve statistical significance. The Az values of the four radiologists ranged between 0.84 and 0.92. The difference between the computer's Az value and that of any of the four radiologists did not achieve statistical significance either. However, the computer's Az(0.9) value was significantly higher than that of three of the four radiologists. Our results indicate that an automated and effective computer classifier can be designed for differentiating malignant and benign breast masses on 3-D US volumes. The accuracy of the classifier designed in this study was similar to that of experienced breast radiologists.     

Classification of Mammographic ROI for Microcalcification Detection Using Multifractal Approach

Microcalcifications (MCs) are the main signs of precancerous cells. The development of aided-system for their detection has become a challenge for researchers in this field. In this paper, we propose a system for MCs detection based on the multifractal approach that classifies mammographic ROIs into normal (healthy) or abnormal ROIs containing MCs. The proposed method is divided into four main steps: a mammogram pre-processing step based on breast selection, breast density reduction using haze removal algorithm and contrast enhancement using multifractal measures. The second step consists of extracting the normal and abnormal ROIs and calculating the multifractal spectrum of each ROI. The next step represents the extraction of the multifractal features from the multifractal spectrum and the GLCM characteristics of each ROI. The last step is the classification of ROIs where three classifiers are tested (KNN, DT, and SVM). The system is evaluated on images from the INbreast database (308 images) with a total of 2688 extracted ROIs (1344 normal, 1344 with MC) from different BI-RADS classes. In this study, the SVM classifier gave the best classification results with a sensitivity, specificity, and precision of 98.66%, 97.77%, and 98.20% respectively. These results are very satisfactory and remarkable compared to the literature.     

Computerized analysis of mammographic parenchymal patterns for assessing breast cancer risk: effect of ROI size and location

The long-term goal of our research is to develop computerized radiographic markers for assessing breast density and parenchymal patterns that may be used together with clinical measures for determining the risk of breast cancer and assessing the response to preventive treatment. In our earlier studies, we found that women at high risk tended to have dense breasts with mammographic patterns that were coarse and low in contrast. With our method, computerized texture analysis is performed on a region of interest (ROI) within the mammographic image. In our current study, we investigate the effect of ROI size and ROI location on the computerized texture features obtained from 90 subjects (30 BRCA1/BRCA2 gene-mutation carriers and 60 age-matched women deemed to be at low risk for breast cancer). Mammograms were digitized at 0.1 mm pixel size and various ROI sizes were extracted from different breast regions in the craniocaudal (CC) view. Seventeen features, which characterize the density and texture of the parenchymal patterns, were extracted from the ROIs on these digitized mammograms. Stepwise feature selection and linear discriminant analysis were applied to identify features that differentiate between the low-risk women and the BRCA1/BRCA2 gene-mutation carriers. ROC analysis was used to assess the performance of the features in the task of distinguishing between these two groups. Our results show that there was a statistically significant decrease in the performance of the computerized texture features, as the ROI location was varied from the central region behind the nipple. However, we failed to show a statistically significant decrease in the performance of the computerized texture features with decreasing ROI size for the range studied.     

A study on the computerized fractal analysis of architectural distortion in screening mammograms

Architectural distortion (AD) is a sign of malignancy often missed during mammographic interpretation. The purpose of this study was to explore the application of fractal analysis to the investigation of AD in screening mammograms. The study was performed using mammograms from the Digital Database for Screening Mammography (DDSM). The fractal dimension (FD) of mammographic regions of interest (ROIs) was calculated using the circular average power spectrum technique. Initially, the variability of the FD estimates depending on ROI location, mammographic view and breast side was studied on normal mammograms. Then, the estimated FD was evaluated using receiver operating characteristics (ROC) analysis to determine if it can discriminate ROIs depicting AD from those depicting normal breast parenchyma. The effect of several factors such as ROI size, image subsampling and breast density was studied in detail. Overall, the average FD of the normal ROIs was statistically significantly higher than that of the ROIs with AD. This result was consistent across all factors studied. For the studied set of implementation parameters, the best ROC performance achieved was 0.89 +/- 0.02. The generalizability of these conclusions across different digitizers was also demonstrated.     

Characterization of mammographic masses based on level set segmentation with new image features and patient information

Computer-aided diagnosis (CAD) for characterization of mammographic masses as malignant or benign has the potential to assist radiologists in reducing the biopsy rate without increasing false negatives. The purpose of this study was to develop an automated method for mammographic mass segmentation and explore new image based features in combination with patient information in order to improve the performance of mass characterization. The authors' previous CAD system, which used the active contour segmentation, and morphological, textural, and spiculation features, has achieved promising results in mass characterization. The new CAD system is based on the level set method and includes two new types of image features related to the presence of microcalcifications with the mass and abruptness of the mass margin, and patient age. A linear discriminant analysis (LDA) classifier with stepwise feature selection was used to merge the extracted features into a classification score. The classification accuracy was evaluated using the area under the receiver operating characteristic curve. The authors' primary data set consisted of 427 biopsy-proven masses (200 malignant and 227 benign) in 909 regions of interest (ROIs) (451 malignant and 458 benign) from multiple mammographic views. Leave-one-case-out resampling was used for training and testing. The new CAD system based on the level set segmentation and the new mammographic feature space achieved a view-based Az value of 0.83 +/- 0.01. The improvement compared to the previous CAD system was statistically significant (p = 0.02). When patient age was included in the new CAD system, view-based and case-based Az values were 0.85 +/- 0.01 and 0.87 +/- 0.02, respectively. The study also demonstrated the consistency of the newly developed CAD system by evaluating the statistics of the weights of the LDA classifiers in leave-one-case-out classification. Finally, an independent test on the publicly available digital database for screening mammography with 132 benign and 197 malignant ROIs containing masses achieved a view-based Az value of 0.84 +/- 0.02.     

Characterization of clustered microcalcifications in digitized mammograms using neural networks and support vector machines

OBJECTIVE: Detection and characterization of microcalcification clusters in mammograms is vital in daily clinical practice. The scope of this work is to present a novel computer-based automated method for the characterization of microcalcification clusters in digitized mammograms. METHODS AND MATERIAL: The proposed method has been implemented in three stages: (a) the cluster detection stage to identify clusters of microcalcifications, (b) the feature extraction stage to compute the important features of each cluster and (c) the classification stage, which provides with the final characterization. In the classification stage, a rule-based system, an artificial neural network (ANN) and a support vector machine (SVM) have been implemented and evaluated using receiver operating characteristic (ROC) analysis. The proposed method was evaluated using the Nijmegen and Mammographic Image Analysis Society (MIAS) mammographic databases. The original feature set was enhanced by the addition of four rule-based features. RESULTS AND CONCLUSIONS: In the case of Nijmegen dataset, the performance of the SVM was Az=0.79 and 0.77 for the original and enhanced feature set, respectively, while for the MIAS dataset the corresponding characterization scores were Az=0.81 and 0.80. Utilizing neural network classification methodology, the corresponding performance for the Nijmegen dataset was Az=0.70 and 0.76 while for the MIAS dataset it was Az=0.73 and 0.78. Although the obtained high classification performance can be successfully applied to microcalcification clusters characterization, further studies must be carried out for the clinical evaluation of the system using larger datasets. The use of additional features originating either from the image itself (such as cluster location and orientation) or from the patient data may further improve the diagnostic value of the system.     

Classification of breast tissues using Moran's index and Geary's coefficient as texture signatures and SVM

Female breast cancer is the major cause of cancer-related deaths in western countries. Efforts in computer vision have been made in order to help improving the diagnostic accuracy by radiologists. In this paper, we present a methodology that uses Moran's index and Geary's coefficient measures in breast tissues extracted from mammogram images. These measures are used as input features for a support vector machine classifier with the purpose of distinguishing tissues between normal and abnormal cases as well as classifying them into benign and malignant cancerous cases. The use of both proposed techniques showed to be very promising, since we obtained an accuracy of 96.04% and Az ROC of 0.946 with Geary's coefficient and an accuracy of 99.39% and Az ROC of 1 with Moran's index to discriminate tissues in mammograms as normal or abnormal. We also obtained accuracy of 88.31% and Az ROC of 0.804 with Geary's coefficient and accuracy of 87.80% and Az ROC of 0.89 with Moran's index to discriminate tissues in mammograms as benign and malignant.     

Complexity curve and grey level co-occurrence matrix in the texture evaluation of breast tumor on ultrasound images

This work aims at investigating texture parameters in distinguishing malign and benign breast tumors on ultrasound images. A rectangular region of interest (ROI) containing the tumor and its neighboring was defined for each image. Five parameters were extracted from the complexity curve (CC) of the ROI. Another five parameters were calculated from the grey-level co-occurrence matrix (GLCM) also for the ROI. The same was carried out for internal tumor region, hence, totaling 20 parameters. The linear discriminant analysis was applied to sets of up to five parameters and then the performances were assessed. The most relevant individual parameters were the contrast (con) (from the GLCM over the ROI) and the maximum value (mvi) from the CC just for the tumor internal region). When they were taken together, a correct classification slightly over 80% of the breast tumors was achieved. The highest performance (accuracy=84.2%, sensitivity=87.0%, and specificity=78.8%) was obtained with mvi, con, the standard deviation of the pixel pairs and the entropy, both for GLCM, and the internal region contrast also from GLCM. Parameters extracted from the internal region generally performed better and were more significant than those from the ROI. Moreover, parameters calculated only from CC or GLCM resulted in no statistically significant performance difference. These findings suggest that the texture parameters can be useful to help radiologist in distinguishing between benign or malign breast tumors on ultrasound images.     

Improvement of mammographic mass characterization using spiculation meausures and morphological features

We are developing new computer vision techniques for characterization of breast masses on mammograms. We had previously developed a characterization method based on texture features. The goal of the present work was to improve our characterization method by making use of morphological features. Toward this goal, we have developed a fully automated, three-stage segmentation method that includes clustering, active contour, and spiculation detection stages. After segmentation, morphological features describing the shape of the mass were extracted. Texture features were also extracted from a band of pixels surrounding the mass. Stepwise feature selection and linear discriminant analysis were employed in the morphological, texture, and combined feature spaces for classifier design. The classification accuracy was evaluated using the area Az under the receiver operating characteristic curve. A data set containing 249 films from 102 patients was used. When the leave-one-case-out method was applied to partition the data set into trainers and testers, the average test Az for the task of classifying the mass on a single mammographic view was 0.83 +/- 0.02, 0.84 +/- 0.02, and 0.87 +/- 0.02 in the morphological, texture, and combined feature spaces, respectively. The improvement obtained by supplementing texture features with morphological features in classification was statistically significant (p = 0.04). For classifying a mass as malignant or benign, we combined the leave-one-case-out discriminant scores from different views of a mass to obtain a summary score. In this task, the test Az value using the combined feature space was 0.91 +/- 0.02. Our results indicate that combining texture features with morphological features extracted from automatically segmented mass boundaries will be an effective approach for computer-aided characterization of mammographic masses.     

Computer-aided diagnosis in mammography: classification of mass and normal tissue by texture analysis

Computer-aided diagnosis schemes are being developed to assist radiologists in mammographic interpretation. In this study, we investigated whether texture features could be used to distinguish between mass and non-mass regions in clinical mammograms. Forty-five regions of interest (ROIs) containing true masses with various degrees of visibility and 135 ROIs containing normal breast parenchyma were extracted manually from digitized mammograms as case samples. Spatial-grey-level-dependence (SGLD) matrices of each ROI were calculated and eight texture features were calculated from the SGLD matrices. The correlation and class-distance properties of extracted texture features were analysed. Selected texture features were input into a modified decision-tree classification scheme. The performance of the classifier was evaluated for different feature combinations and orders of features on the tree. A classification accuracy of about 89% sensitivity and 76% specificity was obtained for ordered features, sum average, correlation, and energy, during the training procedure. With a leave-one-out method, the test result was about 76% sensitivity and 64% specificity. The results of this preliminary study demonstrate the feasibility of using texture information for classification of mass and normal breast tissue, which will be likely to be useful for classifying true and false detections in computer-aided diagnosis programmes.     

Fully automated gradient based breast boundary detection for digitized X-ray mammograms

Accurate segmentation of the breast from digital mammograms is an important pre-processing step for computerized breast cancer detection. In this study, we propose a fully automated segmentation method. Noise on the acquired mammogram is reduced by median filtering; multidirectional scanning is then applied to the resultant image using a moving window 15×1 in size. The border pixels are detected using the intensity value and maximum gradient value of the window. The breast boundary is identified from the detected pixels filtered using an averaging filter. The segmentation accuracy on a dataset of 84 mammograms from the MIAS database is 99%.     

Optimization of reference library used in content-based medical image retrieval scheme

Building an optimal image reference library is a critical step in developing the interactive computer-aided detection and diagnosis (I-CAD) systems of medical images using content-based image retrieval (CBIR) schemes. In this study, the authors conducted two experiments to investigate (1) the relationship between I-CAD performance and size of reference library and (2) a new reference selection strategy to optimize the library and improve I-CAD performance. The authors assembled a reference library that includes 3153 regions of interest (ROI) depicting either malignant masses (1592) or CAD-cued false-positive regions (1561) and an independent testing data set including 200 masses and 200 false-positive regions. A CBIR scheme using a distance-weighted K-nearest neighbor algorithm is applied to retrieve references that are considered similar to the testing sample from the library. The area under receiver operating characteristic curve (Az) is used as an index to evaluate the I-CAD performance. In the first experiment, the authors systematically increased reference library size and tested I-CAD performance. The result indicates that scheme performance improves initially from Az= 0.715 to 0.874 and then plateaus when the library size reaches approximately half of its maximum capacity. In the second experiment, based on the hypothesis that a ROI should be removed if it performs poorly compared to a group of similar ROIs in a large and diverse reference library, the authors applied a new strategy to identify "poorly effective" references. By removing 174 identified ROIs from the reference library, I-CAD performance significantly increases to Az = 0.914 (p < 0.01). The study demonstrates that increasing reference library size and removing poorly effective references can significantly improve I-CAD performance.     

Computerized-aid diagnosis of breast mass using ultrasound image

This paper presents a comparative study of the diagnostic results of the ultrasologists with/without using a novel enhancement algorithm for breast ultrasonic images based on fuzzy entropy principle and textural information. Totally, 350 ultrasound images of 115 cases were analyzed including 59 benign and 56 malignant lesions. The original breast images were fuzzified, the edge and textural information were extracted, and the images were enhanced. The original and enhanced images were assessed and evaluated by ultrasologists using double blind method before and after enhancement. The diagnostic sensitivity and specificity were calculated by the areas (Az) under the receiver operating characteristic (ROC) curves. And the two diagnostic results before and after enhancement were compared by Chi-square test in a 2 x 2 table. The results demonstrated that the discrimination rate of breast masses had been highly improved after employing the novel enhancement algorithm. The result indicates the sensitivity could be raised from 74.3% to 89.3% with the false-positive rate 14.3%, and the area (Az) under the ROC curve of diagnosis also increased from 0.84 to 0.93. The novel enhancement algorithm can increase the classification accuracy and decrease the rate of missing and misdiagnosis, and it is useful for breast cancer control.     

A novel approach for detection and classification of mammographic microcalcifications using wavelet analysis and extreme learning machine

The objective of this paper is to reveal the effectiveness of wavelet based tissue texture analysis for microcalcification detection in digitized mammograms using Extreme Learning Machine (ELM). Microcalcifications are tiny deposits of calcium in the breast tissue which are potential indicators for early detection of breast cancer. The dense nature of the breast tissue and the poor contrast of the mammogram image prohibit the effectiveness in identifying microcalcifications. Hence, a new approach to discriminate the microcalcifications from the normal tissue is done using wavelet features and is compared with different feature vectors extracted using Gray Level Spatial Dependence Matrix (GLSDM) and Gabor filter based techniques. A total of 120 Region of Interests (ROIs) extracted from 55 mammogram images of mini-Mias database, including normal and microcalcification images are used in the current research. The network is trained with the above mentioned features and the results denote that ELM produces relatively better classification accuracy (94%) with a significant reduction in training time than the other artificial neural networks like Bayesnet classifier, Naivebayes classifier, and Support Vector Machine. ELM also avoids problems like local minima, improper learning rate, and over fitting.     

Computer aided detection of masses in mammography using subregion Hotelling observers

We propose to investigate the use of the subregion Hotelling observer for the basis of a computer aided detection scheme for masses in mammography. A database of 1320 regions of interest (ROIs) was selected from the DDSM database collected by the University of South Florida using the Lumisys scanner cases. The breakdown of the cases was as follows: 656 normal ROIs, 307 benign ROIs, and 357 cancer ROIs. Each ROI was extracted at a size of 1024 x 1024 pixels and sub-sampled to 128 x 128 pixels. For the detection task, cancer and benign cases were considered positive and normal was considered negative. All positive cases had the lesion centered in the ROI. We chose to investigate the subregion Hotelling observer as a classifier to detect masses. The Hotelling observer incorporates information about the signal, the background, and the noise correlation for prediction of positive and negative and is the optimal detector when these are known. For our study, 225 subregion Hotelling observers were set up in a 15 x 15 grid across the center of the ROIs. Each separate observer was designed to "observe," or discriminate, an 8 x 8 pixel area of the image. A leave one out training and testing methodology was used to generate 225 "features," where each feature is the output of the individual observers. The 225 features derived from separate Hotelling observers were then narrowed down by using forward searching linear discriminants (LDs). The reduced set of features was then analyzed using an additional LD with receiver operating characteristic (ROC) analysis. The 225 Hotelling observer features were searched by the forward searching LD, which selected a subset of 37 features. This subset of 37 features was then analyzed using an additional LD, which gave a ROC area under the curve of 0.9412 +/- 0.006 and a partial area of 0.6728. Additionally, at 98% sensitivity the overall classifier had a specificity of 55.9% and a positive predictive value of 69.3%. Preliminary results suggest that using subregion Hotelling observers in combination with LDs can provide a strong backbone for a CAD scheme to help radiologists with detection. Such a system could be used in conjunction with CAD systems for false positive reduction.