Potential of Computer-Aided Diagnosis to Improve CT Lung Cancer Screening

The development of low-dose spiral computed tomography (CT) has rekindled hope that effective lung cancer screening might yet be found. Screening is justified when there is evidence that it will extend lives at reasonable cost and acceptable levels of risk. A screening test should detect all extant cancers while avoiding unnecessary workups. Thus optimal screening modalities have both high sensitivity and specificity. Due to the present state of technology, radiologists must opt to increase sensitivity and rely on follow-up diagnostic procedures to rule out the incurred false positives. There is evidence in published reports that computer-aided diagnosis technology may help radiologists alter the benefit-cost calculus of CT sensitivity and specificity in lung cancer screening protocols. This review will provide insight into the current discussion of the effectiveness of lung cancer screening and assesses the potential of state-of-the-art computer-aided design developments

Computer-aided detection of lung nodules: A review

We present an in-depth review and analysis of salient methods for computer-aided detection of lung nodules. We evaluate the current methods for detecting lung nodules using literature searches with selection criteria based on validation dataset types, nodule sizes, numbers of cases, types of nodules, extracted features in traditional feature-based classifiers, sensitivity, and false positives (FP)/scans. Our review shows that current detection systems are often optimized for particular datasets and can detect only one or two types of nodules. We conclude that, in addition to achieving high sensitivity and reduced FP/scans, strategies for detecting lung nodules must detect a variety of nodules with high precision to improve the performances of the radiologists. To the best of our knowledge, ours is the first review of the effectiveness of feature extraction using traditional feature-based classifiers. Moreover, we discuss deep-learning methods in detail and conclude that features must be appropriately selected to improve the overall accuracy of the system. We present an analysis of current schemes and highlight constraints and future research areas

Analysis of Various Classification Techniques for Computer Aided Detection System of Pulmonary Nodules in CT

Lung cancer is the leading cause of cancer death in the United States. It usually exhibits its presence with the formation of pulmonary nodules. Nodules are round or oval-shaped growth present in the lung. Computed Tomography (CT) scans are used by radiologists to detect such nodules. Computer Aided Detection (CAD) of such nodules would aid in providing a second opinion to the radiologists and would be of valuable help in lung cancer screening. In this research, we study various feature selection methods for the CAD system framework proposed in FlyerScan. Algorithmic steps of FlyerScan include (i) local contrast enhancement (ii) automated anatomical segmentation (iii) detection of potential nodule candidates (iv) feature computation & selection and (v) candidate classification. In this paper, we study the performance of the FlyerScan by implementing various classification methods such as linear, quadratic and Fischer linear discriminant classifier. This algorithm is implemented using a publicly available Lung Image Database Consortium – Image Database Resource Initiative (LIDC-IDRI) dataset. 107 cases from LIDC-IDRI are handpicked in particular for this paper and performance of the CAD system is studied based on 5 example cases of Automatic Nodule Detection (ANODE09) database. This research will aid in improving the nodule detection rate in CT scans, thereby enhancing a patient’s chance of survival

Computational methods for the analysis of functional 4D-CT chest images.

Medical imaging is an important emerging technology that has been intensively used in the last few decades for disease diagnosis and monitoring as well as for the assessment of treatment effectiveness. Medical images provide a very large amount of valuable information that is too huge to be exploited by radiologists and physicians. Therefore, the design of computer-aided diagnostic (CAD) system, which can be used as an assistive tool for the medical community, is of a great importance. This dissertation deals with the development of a complete CAD system for lung cancer patients, which remains the leading cause of cancer-related death in the USA. In 2014, there were approximately 224,210 new cases of lung cancer and 159,260 related deaths. The process begins with the detection of lung cancer which is detected through the diagnosis of lung nodules (a manifestation of lung cancer). These nodules are approximately spherical regions of primarily high density tissue that are visible in computed tomography (CT) images of the lung. The treatment of these lung cancer nodules is complex, nearly 70% of lung cancer patients require radiation therapy as part of their treatment. Radiation-induced lung injury is a limiting toxicity that may decrease cure rates and increase morbidity and mortality treatment. By finding ways to accurately detect, at early stage, and hence prevent lung injury, it will have significant positive consequences for lung cancer patients. The ultimate goal of this dissertation is to develop a clinically usable CAD system that can improve the sensitivity and specificity of early detection of radiation-induced lung injury based on the hypotheses that radiated lung tissues may get affected and suffer decrease of their functionality as a side effect of radiation therapy treatment. These hypotheses have been validated by demonstrating that automatic segmentation of the lung regions and registration of consecutive respiratory phases to estimate their elasticity, ventilation, and texture features to provide discriminatory descriptors that can be used for early detection of radiation-induced lung injury. The proposed methodologies will lead to novel indexes for distinguishing normal/healthy and injured lung tissues in clinical decision-making. To achieve this goal, a CAD system for accurate detection of radiation-induced lung injury that requires three basic components has been developed. These components are the lung fields segmentation, lung registration, and features extraction and tissue classification. This dissertation starts with an exploration of the available medical imaging modalities to present the importance of medical imaging in today’s clinical applications. Secondly, the methodologies, challenges, and limitations of recent CAD systems for lung cancer detection are covered. This is followed by introducing an accurate segmentation methodology of the lung parenchyma with the focus of pathological lungs to extract the volume of interest (VOI) to be analyzed for potential existence of lung injuries stemmed from the radiation therapy. After the segmentation of the VOI, a lung registration framework is introduced to perform a crucial and important step that ensures the co-alignment of the intra-patient scans. This step eliminates the effects of orientation differences, motion, breathing, heart beats, and differences in scanning parameters to be able to accurately extract the functionality features for the lung fields. The developed registration framework also helps in the evaluation and gated control of the radiotherapy through the motion estimation analysis before and after the therapy dose. Finally, the radiation-induced lung injury is introduced, which combines the previous two medical image processing and analysis steps with the features estimation and classification step. This framework estimates and combines both texture and functional features. The texture features are modeled using the novel 7th-order Markov Gibbs random field (MGRF) model that has the ability to accurately models the texture of healthy and injured lung tissues through simultaneously accounting for both vertical and horizontal relative dependencies between voxel-wise signals. While the functionality features calculations are based on the calculated deformation fields, obtained from the 4D-CT lung registration, that maps lung voxels between successive CT scans in the respiratory cycle. These functionality features describe the ventilation, the air flow rate, of the lung tissues using the Jacobian of the deformation field and the tissues’ elasticity using the strain components calculated from the gradient of the deformation field. Finally, these features are combined in the classification model to detect the injured parts of the lung at an early stage and enables an earlier intervention

Computerâ aided detection of lung nodules: False positive reduction using a 3D gradient field method and 3D ellipsoid fitting

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/134878/1/mp4667.pd

Computer-aided diagnosis tool for the detection of cancerous nodules in X-ray images

This thesis involves development of a computer-aided diagnosis (CAD) tool for the detection of cancerous nodules in X-ray images. Both cancerous and non-cancerous regions appear with little distinction on an X-ray image. For accurate detection of cancerous nodules, we need to differentiate the cancerous nodules from the non-cancerous. We developed an artificial neural network to differentiate them. Artificial neural networks (ANN) find a large application in the area of medical imaging. They work in a manner rather similar to the brain and have good decision making criteria when trained appropriately. We trained the neural network by the backpropagation algorithm and tested it with different images from a database of thoracic radiographs (chest X-rays) of dogs from the LSU Veterinary Medical Center. If we give X-ray images directly as input to the ANN, it incurs substantial complexity and training time for the network to process the images. A pre-processing stage involving some image enhancement techniques helps to solve the problem to a certain extent. The CAD tool developed in this thesis works in two stages. We pre-process the digitized images (by contrast enhancement, thresholding, filtering, and blob analysis) obtained after scanning the X-rays and then separate the suspected nodule areas (SNA) from the image by a segmentation process. We then input enhanced SNAs to the backpropagation-trained ANN. When given these enhanced SNAs, the neural network recognition accuracy, compared to unprocessed images as inputs, improved from 70% to 83.33%

A computerized scheme for lung nodule detection in multiprojection chest radiography: Lung nodule detection in multiprojection chest radiography

Purpose: Our previous study indicated that multiprojection chest radiography could significantly improve radiologists’ performance for lung nodule detection in clinical practice. In this study, the authors further verify that multiprojection chest radiography can greatly improve the performance of a computer-aided diagnostic (CAD) scheme

Computer-assisted detection of lung cancer nudules in medical chest X-rays

Diagnostic medicine was revolutionized in 1895 with Rontgen's discovery of x-rays. X-ray photography has played a very prominent role in diagnostics of all kinds since then and continues to do so. It is true that more sophisticated and successful medical imaging systems are available. These include Magnetic Resonance Imaging (MRI), Computerized Tomography (CT) and Positron Emission Tomography (PET). However, the hardware instalment and operation costs of these systems remain considerably higher than x-ray systems. Conventional x-ray photography also has the advantage of producing an image in significantly less time than MRI, CT and PET. X-ray photography is still used extensively, especially in third world countries. The routine diagnostic tool for chest complaints is the x-ray. Lung cancer may be diagnosed by the identification of a lung cancer nodule in a chest x-ray. The cure of lung cancer depends upon detection and diagnosis at an early stage. Presently the five-year survival rate of lung cancer patients is approximately 10%. If lung cancer can be detected when the tumour is still small and localized, the five-year survival rate increases to about 40%. However, currently only 20% of lung cancer cases are diagnosed at this early stage. Giger et al wrote that "detection and diagnosis of cancerous lung nodules in chest radiographs are among the most important and difficult tasks performed by radiologists"