Medical feature based evaluation of structuring elements for morphological enhancement of ultrasonic images

This paper investigates the use of morphology-based nonlinear filters, and performs deterministic and statistical analysis of the linear combinations of the filters for the image quality enhancement of B-mode ultrasound images. The fact that the structuring element shape greatly influences the output of the filter, is one of the most important features of mathematical morphology. The present reported work comparatively evaluates the structuring elements for morphological liver image enhancement and verifies the hypothesis that the speckles visible in US images are short, slightly ‘banana-shaped’ white lines. Initially, five different liver images were morphologically filtered using 10 different structuring elements and then the filtered images were assessed quantitatively. Image quality parameters such as peak signal-to-noise ratio, mean square error and correlation coefficient have been used to evaluate the performance of the morphological filters with different structuring elements. To endorse the observation of the quantitative analysis, the filtered images were then evaluated qualitatively, based on the image features looked into by the medical fraternity. The evaluation parameters have been taken on the basis of the suggestions made by a group of radiologists. The results of the processed images were then evaluated by a different group of radiologists. A multi-point rank order method has been used to identify small differences or trends in observation. The subjective analysis by radiologists indicates that morphological filter using line shaped structuring element with length 2 performs better than the other structuring elements. These observations were found to be in line with the observations of quantitative analysis.     

Improvement of digital mammogram images using histogram equalization, histogram stretching and median filter

Breast cancer is one of the most important diseases in females worldwide. According to the Malaysian Oncological Society, about 4% of women who are 40 years old and above are involved have breast cancer. Masses and microcalcifications are two important signs of breast cancer diagnosis on mammography. Enhancement techniques, i.e. histogram equalization, histogram stretching and median filters, were used to provide better visualization for radiologists in order to help early detection of breast abnormalities. In this research 60 digital mammogram images which includes 20 normal and 40 confirmed diagnosed cancerous cases were selected and manipulated using the mentioned techniques. The original and manipulated images were scored by three expert radiologists. Results showed that the selected methods have a positive significant effect on image quality.     

多层螺旋CT血管造影评价颅内血管狭窄和闭塞性疾病的临床价值

目的通过与DSA的比较评价多层螺旋CT血管造影（CTA）诊断颅内血管狭窄和闭塞的临床价值。方法32例缺血性脑血管病的患者，其中男性23例，女性9例，年龄48～75岁，平均年龄57岁。接受了CTA和DSA检查。2项检查均在人院后15d内完成。分别测量CTA和DSA影像中动脉的狭窄程度和动脉狭窄处的管腔直径．结果以DSA作为参考标准，CTA发现病变的数量为74个．病变数量和病变部位的判断与DSA一致。CTA诊断颅内动脉中度狭窄的敏感度、特异度和准确度分别为94．3％、98．8％和98．6％；重度狭窄分别为73．7％、99．7％和99．7％：闭塞分别为91．7％、99．8％和100％。CTA与DSA测量狭窄程度及狭窄处管腔直径的能力无统计学差异。结论CTA是一种诊断动脉狭窄和闭塞性疾病的可靠方法．在许多情况下CTA检查结果的特异度和精确度与DSA相当。     

Image quality evaluation of flat panel and image intensifier digital magnification in x-ray fluoroscopy

Interventional devices used in radiology often have dimensions on the order of a pixel, and radiologists resort to image magnification to better visualize such small devices. Traditional image intensifier (II) systems use analog magnification with x-ray exposure inversely proportional to the area of field of view (FOV) so as to maintain light output for the camera. Analog magnification is impossible with flat panel (FP) detectors, and images must be magnified using digital interpolation that does not reduce the pixel partial area effect for small devices. We quantitatively investigated image quality of digital and analog magnification using a clinically relevant task of detecting a partially deployed stent in x-ray fluoroscopy image sequences that were created using realistic detector models. Using the standard exposure strategy for II analog magnification, exposure was increased from a nominal 43.65 nGy (5.0 microR) per frame at 23 cm FOV to 79.9 nGy (9.15 microR) per frame and 117.81 nGy (13.49 microR) per frame at 17 cm and 14 cm FOV, respectively. Contrast sensitivity improved significantly (p<0.1) by 43.5+/-6.5% and 64.1+/-7.3% with the 17 cm and 14 cm FOV, respectively. Exposure for digitally magnified images was varied in an adaptive forced choice experiment so as to match performance with II analog magnification. For digital magnification, bilinear interpolation was used to give magnified stents sizes equivalent to those in the analog magnified images. For equivalent image quality, FP required 34.87+/-2.59, 80.16+/-5.37, and 84.08+/-5.59 nGy per frame at normal, and the two magnification modes, respectively. Hence, FP with digital magnification gives significant (p<0.1) dose savings of 20+/-6% and 27+/-5% at the normal and highest magnification modes, respectively. Digitally magnified II images required exposures of 110.85+/-8.07 and 103.34+/-5.90 nGy per frame for the two magnifications levels, respectively, giving no significant (p>0.1) dose savings. A spatiotemporal human observer model based on signal detection theory successfully predicted the human data and was used to predict other conditions associated with image magnification. Model predictions quantitatively showed that magnification is most useful when signal size is relatively small and that FP digital magnification can improve image quality for the stent deployment task without increasing exposure. In conclusion, the results show that FP digital magnification can be useful and dose efficient as compared to analog magnification.     

Relationship Between the Contrast Effects of Raw Data Projection Images from Three-Dimensional Digital Subtraction Angiography and the Optimal Volume Rendering Parameters

Volume rendering (VR) is a technique commonly used for the reconstruction of three-dimensional (3D) digital subtraction angiography (DSA) images, and the rendering parameters greatly affect the characteristics of the 3D image. This study aimed to test whether the optimal VR parameters for 3D DSA could be estimated from the contrast effects in rotational two-dimensional (2D) DSA images acquired using 3D DSA. Simulated blood vessels filled with various concentrations of contrast medium were scanned, and the 3D DSA data sets were reconstructed. The syngo AX vessel analysis software that was able to analyze 3D DSA VR image was used for objective measures. Raw data projection images of the 3D DSA data sets in which the mean diameter was calculated as a true value by the software at nine different thresholds for vessel segmentation were selected. In each image set, five images of all 133 rotational 2D DSA images were selected, and the contrast-enhanced area was extracted using a region-growing algorithm. Mean values and standard deviations of each contrast-enhanced area were calculated, and as the thresholds for vessel segmentation of the software increased by 500 every time, significant differences were observed in the mean values (P < 0.01). This optimal threshold can be applied to the window settings of the VR technique. Therefore, the optimal VR parameters for 3D DSA may be determined by analyzing the contrast effects of the raw data projection images, and user-dependent over- and underestimations of 3D DSA VR images also may be prevented.     

Effects of acute intermittent exposure to cigarette smoke on catecholamine levels and turnover in various types of hypothalamic DA and NA nerve terminal systems as well as on the secretion of adenohypophyseal hormones and corticosterone

Male rats were exposed to cigarette smoke (Walton Horizontal Smoking Machine) from one to four cigarettes (Kentucky reference IR-1 type). Catecholamines in the diencephalon were measured by quantitative histofluorimetry in discrete dopamine (DA) and noradrenaline (NA) nerve terminal systems. Blood TSH, prolactin, LH, FSH, ACTH, vasopressin and corticosterone levels were determined by radioimmunoassay procedures. Exposure to unfiltered, but not to filtered (Cambridge glass fibre filters) cigarette smoke resulted in dose-dependent reductions of NA levels in the various hypothalamic NA nerve terminal systems. Evidence was obtained that exposure to unfiltered but not to filtered cigarette smoke resulted in dose-dependent increases of amine turnover (alpha MT-induced CA disappearance experiments) in the various DA and NA nerve terminal systems in the hypothalamus. The lowering of TSH, LH and prolactin secretion induced by unfiltered smoke were probably induced by nicotine and were independent of tyrosine hydroxylase inhibition. Furthermore, unfiltered cigarette smoke produced a dose-related increase in corticosterone secretion. The inhibitory effects of TSH, LH and prolactin secretion were probably in part related to the ability of unfiltered smoke via its nicotine component to activate the lateral and medial tubero-infundibular DA neurons. The increases in corticosterone secretion may at least in part be related to a smoke induced increase in the facilitatory influence of paraventricular NA nerve terminals on CRF activity.     

Effects of digital low pass filtering on the parameters of nystagmus eye movements.

We examined how lowpass filtering has an influence on nystagmus parameters: durations, amplitudes, and mean velocities of its slow and fast phases. We experimented with two types of common linear digital filters by using both nonrecursive and recursive filters, and with two types of nonlinear digital filters by using so-called standard median and hybrid median filters. We concluded that 70 Hz as strict cutoff frequency is high enough not to cause errors in the nystagmus parameters when information content in nystagmus signals is filtered above that cutoff frequency with linear filters. Using nonlinear filters good window lengths of filtering are equal to or less than about nine samples for a sampling frequency of 400 Hz which we applied.     

Rapid detection of group B streptococcal antigen in human amniotic fluid.

Infants exposed in utero to group B streptococcus (GBS)-infected human amniotic fluid (HAF) are at high risk for serious infection. Latex particle agglutination (LPA) tests are not approved for detection of GBS in HAF. Two LPA systems, Patho-Dx Strep B and Wellcogen Strep B, were used to test unfiltered sterile HAF and filtered HAF containing concentrations of GBS carbohydrate from 0.2 to 100 micrograms/ml. Four different processing techniques were used to prevent nonspecific LPA: EDTA, nitrous acid, enzyme, and nitrous acid-heat. GBS (10(2) CFU/ml) was inoculated into filtered HAF, incubated, sampled serially, processed with enzyme, and tested by LPA. Unprocessed, unfiltered HAF showed 33% nonspecific agglutination when tested by LPA. Processing of HAF removed nonspecific agglutination and improved GBS antigen detection. Without processing, LPA could not detect less than 100 micrograms of GBS carbohydrate per ml. With nitrous acid or enzyme processing, as little as 0.2 microgram/ml could be detected. Results were easier to read after enzyme processing than after nitrous acid processing. Although both LPA systems were equally efficient, testing was easier with the Patho-Dx system. After enzyme processing, LPA could detect as few as 10(4) CFU/ml when agglutination was read with a 4 X hand lens. Substances in HAF induce false-positive reactions during LPA testing. Processing removes the interference and improves the detection of GBS. LPA testing of HAF may allow earlier identification and treatment of infants at risk for serious GBS infection.     

Categorization of infant-directed speech: development from 4 to 6 months

To extend a previous finding that 6-month-old infants categorized low-pass filtered infant-directed (ID) utterances, we examined a) 6-month-old infants' categorization of more naturalistic, unfiltered ID utterances and b) the developmental progression of ID-speech categorization. In Experiment 1, 6-month-olds heard seven different unfiltered tokens from one class of ID utterance (approving or comforting), followed by a novel token from either the same or an unfamiliar category. Infants recovered, responding only to the unfamiliar category token, suggesting that they categorized naturalistic ID utterances. Four-month-olds' categorization of filtered and unfiltered versions of the ID utterances was assessed in Experiments 2 and 4. Four-month-olds did not recover, responding to a test token from an unfamiliar class, suggesting that they did not categorize either filtered or unfiltered ID utterances. Experiment 3 demonstrated that 4-month-old infants' failure to categorize did not result from their inability to complete the procedure. These results suggest that infants' processing of ID speech changes from 4 to 6 months of age.     

Competition for attentional resources between low spatial frequency content of emotional images and a foreground task in early visual cortex

Low spatial frequency (LSF) image content has been proposed to play a superior functional role in emotional content extraction via the magnocellular pathway biasing attentional resources toward emotional content in visual cortex. We investigated whether emotionally unpleasant complex images that were presented either unfiltered or with LSF content only in the background while subjects performed a foreground task will withdraw more attentional resources from the task compared to unemotional, neutral images (distraction paradigm). We measured steady‐state visual evoked potentials (SSVEPs) driven by flickering stimuli of a foreground task. Unfiltered unpleasant images resulted in a significant reduction of SSVEP amplitude compared to neutral images. No statistically significant differences were found with LSF background images. In a behavioral control experiment, we found no significant differences for complexity ratings between unfiltered and LSF pictures. Content identification was possible for unfiltered and LSF picture (correct responses > 74%). An additional EEG study examined typical emotion‐related components for complex images presented either as unfiltered, LSF, or high spatial frequency (HSF, as an additional control) filtered, unpleasant, and neutral images. We found a significant main effect of emotional valence in the early posterior negativity. Late positive potential differences were only found for unfiltered and HSF images. Results suggest that, while LSF content is sufficient to allow for content and emotional cue extraction when images were presented alone, LSF content is not salient enough to serve as emotional distractor that withdraws attentional resources from a foreground task in early visual cortex.     

BP神经网络在肝癌数字减影血管造影诊断中的应用

目的 探讨利用BP神经网络对肝癌数字减影血管造影(DSA)图像进行计算机辅助诊断的应用价值.方法 分析32例肝癌病例DSA影像资料,应用BP神经网络建立计算机临床辅助诊断模型,然后把100个随机抽样测试样本(非病灶样本55个,病灶样本45个)输入模型验证诊断准确率.结果 肝癌计算机辅助诊断模型成功建立,100个随机抽样样本经模型分析,真阳性率为91%,真阴性率95%.结论 BP神经网络可应用于临床辅助肝癌DSA诊断.     

Displaying radiologic images on pesonal computers: Image processing and analysis

This is the fourth article of our series for radiologists and imaging scientists on displaying, manipulating, and analyzing radiologic images on personal computers. Classic image processing is divided into point, area, frame, and geometric processes. Point processes change image pixel values based on the value of the pixel of interest. Histogram equalization adjusts the pixel values in the image based on the distribution of pixel values. Area processes change the pixel of interest based on the values of the surrounding pixels, known as the neighborhood. Area processes using a convolution kernel are often used as image filters. Common convolution kernels include low-frequency, high-frequency, and edge-enhancement filters. Edge enhancement can be performed with convolution kernels such as shift and difference, gradient-directional and Laplacian filters, or with nonlinear methods such as Sobel's algorithm. Frame processes mathematically combine two or more images, often for noise reduction and background subtraction. Geometric processes alter the location of pixels within the image, but usually not the pixel values. Common radiologic applications of image processing include window width and window level adjustments (point process), adaptive histogram equalization (area process), unsharp masking (area process), computed radiography image processing (combined area and point processes), digital subtraction angiography (frame and geometric processes), region of interest analysis (area process), and image rotation (geometric process). As digital imaging becomes more widespread, radiologists need to understand the image processing that is fundamental to these modalities.     

Comparison of digital subtraction angiography and contrast-enhanced ultrasound in assessment of carotid stenosis

IntroductionThe performances of contrast-enhanced ultrasound (CEUS) and digital subtraction angiography (DSA) were used to establish an efficient as well as non-invasive clinical technique for the diagnosis of extra-cranial internal carotid artery (ICA) stenosis.Materials and methodsThirty-six successive patients (11 women and 25 men, mean age: 65.0 ± 9.2, range: 43–78 years) with internal carotid artery (ICA) stenosis were tested by CEUS and DSA. These tests were carried out by means of Hitachi Preirus ultrasound machine for CEUS and Allura Xper FD20 system (Philips Medical Systems, Nederland B.V.) for DSA. 1.2 ml SonoVue (Bracco, Switzerland) was used a s contrast agent.ResultsThe results clearly indicated that there were no noteworthy variations among the distributions recorded by CEUS as well as DSA for the four tested groups. The percentage of diameter stenosis calculated by CEUS was clearly in accordance with the DSA images. CEUS showed accurate results with good specificity and sensitivity at 50%, 70%, and 100%. Also, CEUS performance was relatively better than DSA in the diagnosis of ICA and suitability of CEA.ConclusionCEUS proved to be a precise non-invasive testing method for the diagnosis of carotid artery stenosis which is more feasible and well-tolerated in patients with various stages of carotid stenosis.     

Gabor filters and phase portraits for the detection of architectural distortion in mammograms

Architectural distortion is a subtle abnormality in mammograms, and a source of overlooking errors by radiologists. Computer-aided diagnosis (CAD) techniques can improve the performance of radiologists in detecting masses and calcifications; however, most CAD systems have not been designed to detect architectural distortion. We present a new method to detect and localise architectural distortion by analysing the oriented texture in mammograms. A bank of Gabor filters is used to obtain the orientation field of the given mammogram. The curvilinear structures (CLS) of interest (spicules and fibrous tissue) are separated from confounding structures (pectoral muscle edge, parenchymal tissue edges, breast boundary, and noise). The selected core CLS pixels and the orientation field are filtered and downsampled, to reduce noise and also to reduce the computational effort required by the subsequent methods. The downsampled orientation field is analysed to produce three phase portrait maps: node, saddle, and spiral. The node map is further analysed in order to detect the sites of architectural distortion. The method was tested with 19 mammograms containing architectural distortion. In a preliminary experiment, a sensitivity of 84% was obtained at 7.8 false positives per image.An erratum to this article can be found at     

Receiver operating characteristic study of image preprocessing for teleradiology and digital workstations

The purpose of this study was to evaluate whether digitized analog images displayed on a digital workstation can be improved by using a preprocessing algorithm, and if so, whether the quality of the resulting images can reach that of the original films. The material contained 120 difficult cases (about 50% with selected pathology). Four radiologists each evaluated half of the randomly ordered cases with the digital workstation and half of the cases with the original radiographs. The data were compared with a previous similar study, where the workstation had no option for preprocessed images. Preprocessed digital images were clearly superior to digital images without preprocessing, although for those of the highest diagnostic difficulty they were inferior to the original films. The preprocessing algorithm has improved the diagnostic quality of the digital workstation. There is room yet for improvement compared to plain films, although the current setup may be sufficient in some settings.     

Image filtering for improved dose resolution in CT polymer gel dosimetry

X-ray computed tomography (CT) has been established as a feasible method of performing dosimetry using polyacrylamide gels (PAGs). A small density change occurs in PAG upon irradiation that provides contrast in PAG CT images. However, low dose resolution limits the clinical usefulness of the technique. This work investigates the potential of using image filtering techniques on PAG CT images in order to reduce image noise and improve dose resolution. CT image noise for the scanner and protocol used for the gel images is analyzed and found to be Gaussian distributed and independent of the contrast level in the images. As a result, several filters for reducing spatially invariant noise are investigated: mean, median, midpoint, adaptive mean, alpha-trimmed mean, sigma mean, and a relatively new filter called SUSAN (smallest univalue segment assimilating nucleus). All filters are applied, using 3x3, 5x5, and 7x7 pixel masks, to a CT image of a PAG irradiated with a stereotactic radiosurgery dose distribution. The dose resolution within 95% confidence (D(delta)95%) is calculated and compared for each filtered image, as well the unfiltered image. In addition, the ability of the filters to maintain the spatial integrity of the dose distribution is evaluated and compared. Results clearly indicate that the filters are not equal in their ability to improve D(delta)95% or in their effect on the spatial integrity of the dose distribution. In general, increasing mask size improves D(delta)95% but simultaneously degrades spatial dose information. The mean filter provides the greatest improvement in D(delta)95%, but also the greatest loss of spatial dose information. The SUSAN, mean adaptive, and alpha-trimmed mean filters all provide comparable, but slightly poorer dose resolution. In addition, the SUSAN and adaptive filters both excel at maintaining the spatial distribution of dose and overall are the best performing filters for this application. The midpoint filter, normally useful for Gaussian noise, is poor all-round, dramatically distorting the dose distribution for masks greater than 3x3. The median filter, a common edge preserving noise reduction filter, performs moderately well, but artificially increases high dose gradients. The sigma filter preserves the spatial distribution of dose very well but is least effective at improving dose resolution. In summary, dose resolution can be significantly improved in CT PAG dosimetry through postprocessing of CT images using spatial noise reduction filters. However, such filters are not equal in their ability to improve dose resolution or to maintain the spatial integrity of the dose distribution and an appropriate filter must be chosen depending on clinical demands of the application.     

Classification-based summation of cerebral digital subtraction angiography series for image post-processing algorithms

X-ray-based 2D digital subtraction angiography (DSA) plays a major role in the diagnosis, treatment planning and assessment of cerebrovascular disease, i.e. aneurysms, arteriovenous malformations and intracranial stenosis. DSA information is increasingly used for secondary image post-processing such as vessel segmentation, registration and comparison to hemodynamic calculation using computational fluid dynamics. Depending on the amount of injected contrast agent and the duration of injection, these DSA series may not exhibit one single DSA image showing the entire vessel tree. The interesting information for these algorithms, however, is usually depicted within a few images. If these images would be combined into one image the complexity of segmentation or registration methods using DSA series would drastically decrease. In this paper, we propose a novel method automatically splitting a DSA series into three parts, i.e. mask, arterial and parenchymal phase, to provide one final image showing all important vessels with less noise and moving artifacts. This final image covers all arterial phase images, either by image summation or by taking the minimum intensities. The phase classification is done by a two-step approach. The mask/arterial phase border is determined by a Perceptron-based method trained from a set of DSA series. The arterial/parenchymal phase border is specified by a threshold-based method. The evaluation of the proposed method is two-sided: (1) comparison between automatic and medical expert-based phase selection and (2) the quality of the final image is measured by gradient magnitudes inside the vessels and signal-to-noise (SNR) outside. Experimental results show a match between expert and automatic phase separation of 93%/50% and an average SNR increase of up to 182% compared to summing up the entire series.     

人内耳显微结构的计算机三维重建

目的：建立一套人类耳蜗组织放大40倍的显微结构图像资料,探讨基于PC平台的显微结构三维重建技术。方法：应用火棉胶切片技术获得人类颞骨组织连续切片,在显微镜下放大40倍后对耳蜗组织摄像;在个人计算机上使用Photoshop6．0图像处理软件和AMIRA3．0三维重建软件对内耳结构进行图像拼接、图像对位和图像三维重建。结果：建立了一套人类耳蜗组织放大40倍的完整显微结构图像资料。结论：建立了基于PC平台上实现显微结构三维重建的一套办法。三维重建效果表明我们在显微结构的数据输入、图像拼接、内定位技术、三维重建的方法是可行的。     

The effect of digital lowpass filters on the maximum velocity of saccadic eye movements

The present paper is a study of how the inaccuracy of coefficients of digital lowpass filters may distort the maximum angular velocities of saccadic eye movements. Maximum velocity is one of the most important parameters of saccades. There are several diseases which decrease the maximum velocities of saccades. It was investigated how a fourth order Butterworth lowpass filter can affect maximum velocities. The lowpass filter has been tested by simulation as well as real eye movement data recorded electro-oculographically and photoelectrically. The coefficients of digital lowpass filters should be computed and applied with sufficient accuracy to prevent filters from altering the maximum velocities a phenomenon which might lead to erroneous diagnosis.     

血管DSA中路图图像质量控制的研究

目的解决在腹部出现的血管DSA路图图像中影响诊断和治疗的图像质量问题,主要包括血管失真、边缘模糊、背景减影程度不够、成像区域中过饱和、注入药物路图不清晰等情况。方法组1肝癌患者30例,其中男性23例,女性7例;年龄32～65岁,平均年龄51岁。组2肝癌患者30例,其中男性18例,女性12例;年龄27～54岁,平均年龄48岁。组1采用调整前造影方案。针对肝癌的患者DSA过程中的路图图像,分析影响其质量下降的因素,并对这些因素进行调整,用于组2造影。具体包括路图中透视图像血管图像叠加的数量由3调整为1、实时背景衰减因素由1.4调整为1.0、透视减影增益步长由14调整为11、整体图像的亮度由0.63调整为0.76、对比度由1.00调整为0.94等,同时请3位介入临床医生评价调整后的图像质量,达到满意为止。结果组1患者30例中,路图图像质量优0例（0%）,良6例（20%）,差24例（80%）;组2病例中,优27例（90%）,良3例（10%）,差0例（0%）。调整的这些参数确实使路图图像得到了改善,调整后的路图图像血管清晰、边缘清楚及背景、亮度、对比度、成像区域过饱和情况得到改善,图像能够满足医生的诊断和治疗要求。结论由于在腹部特别是横膈附近运动幅度比较大,原先预置的与路图相关参数不能满足临床图像要求,这些参数的调整解决了路图图像质量的问题,达到了临床诊断的要求。