Computer-aided detection and diagnosis of breast cancer in 2D and 3D medical imaging through multifractal analysis

This Thesis describes the research work performed in the scope of a doctoral research program and presents its conclusions and contributions. The research activities were carried on in the industry with Siemens S.A. Healthcare Sector, in integration with a research team. Siemens S.A. Healthcare Sector is one of the world biggest suppliers of products, services and complete solutions in the medical sector. The company offers a wide selection of diagnostic and therapeutic equipment and information systems. Siemens products for medical imaging and in vivo diagnostics include: ultrasound, computer tomography, mammography, digital breast tomosynthesis, magnetic resonance, equipment to angiography and coronary angiography, nuclear imaging, and many others. Siemens has a vast experience in Healthcare and at the beginning of this project it was strategically interested in solutions to improve the detection of Breast Cancer, to increase its competitiveness in the sector. The company owns several patents related with self-similarity analysis, which formed the background of this Thesis. Furthermore, Siemens intended to explore commercially the computer- aided automatic detection and diagnosis eld for portfolio integration. Therefore, with the high knowledge acquired by University of Beira Interior in this area together with this Thesis, will allow Siemens to apply the most recent scienti c progress in the detection of the breast cancer, and it is foreseeable that together we can develop a new technology with high potential. The project resulted in the submission of two invention disclosures for evaluation in Siemens A.G., two articles published in peer-reviewed journals indexed in ISI Science Citation Index, two other articles submitted in peer-reviewed journals, and several international conference papers. This work on computer-aided-diagnosis in breast led to innovative software and novel processes of research and development, for which the project received the Siemens Innovation Award in 2012. It was very rewarding to carry on such technological and innovative project in a socially sensitive area as Breast Cancer.No cancro da mama a deteção precoce e o diagnóstico correto são de extrema importância na prescrição terapêutica e caz e e ciente, que potencie o aumento da taxa de sobrevivência à doença. A teoria multifractal foi inicialmente introduzida no contexto da análise de sinal e a sua utilidade foi demonstrada na descrição de comportamentos siológicos de bio-sinais e até na deteção e predição de patologias. Nesta Tese, três métodos multifractais foram estendidos para imagens bi-dimensionais (2D) e comparados na deteção de microcalci cações em mamogramas. Um destes métodos foi também adaptado para a classi cação de massas da mama, em cortes transversais 2D obtidos por ressonância magnética (RM) de mama, em grupos de massas provavelmente benignas e com suspeição de malignidade. Um novo método de análise multifractal usando a lacunaridade tri-dimensional (3D) foi proposto para classi cação de massas da mama em imagens volumétricas 3D de RM de mama. A análise multifractal revelou diferenças na complexidade subjacente às localizações das microcalci cações em relação aos tecidos normais, permitindo uma boa exatidão da sua deteção em mamogramas. Adicionalmente, foram extraídas por análise multifractal características dos tecidos que permitiram identi car os casos tipicamente recomendados para biópsia em imagens 2D de RM de mama. A análise multifractal 3D foi e caz na classi cação de lesões mamárias benignas e malignas em imagens 3D de RM de mama. Este método foi mais exato para esta classi cação do que o método 2D ou o método padrão de análise de contraste cinético tumoral. Em conclusão, a análise multifractal fornece informação útil para deteção auxiliada por computador em mamogra a e diagnóstico auxiliado por computador em imagens 2D e 3D de RM de mama, tendo o potencial de complementar a interpretação dos radiologistas

Application of Texture Analysis to Study Small Vessel Disease and Blood–Brain Barrier Integrity

artículo 327Evaluamos el uso alternativo del análisis de textura para evaluar el papel de la barrera hematoencefálica (BBB) en la enfermedad de pequeños vasos (SVD). Utilizamos imágenes de resonancia magnética cerebral de 204 pacientes con accidente cerebrovascular, adquiridas antes y 20 minutos después de la administración intravenosa de gadolinio. Segmentamos tejidos, hiperintensidades de la materia blanca (WMH) y aplicamos puntuaciones visuales validadas. Medimos las características de la textura en todos los tejidos antes y después del contraste y utilizamos ANCOVA para evalúe el efecto de los indicadores de SVD en el cambio anterior / posterior al contraste, Kruskal-Wallis para determinar la importancia entre los grupos de pacientes y los modelos lineales mixtos para las variaciones anteriores / posteriores al contraste en el líquido cefalorraquídeo (LCR) con puntuaciones Fazekas. El aumento de la "homogeneidad" textural en los tejidos normales con mayor presencia de indicadores de la EVP fue consecuentemente más evidente que en los tejidos anormales. La “homogeneidad” textural aumentó con la edad, las puntuaciones de los espacios perivasculares de los ganglios basales (p <0,01) y las puntuaciones de la EVP (p <0,05) y fue significativamente mayor en los pacientes hipertensos (p <0,002) y el ictus lacunar (p = 0,04). La hipertensión (74% de los pacientes), la carga de WMH (mediana = 1.5 ± 1.6% del volumen intracraneal) y la edad (media = 65.6 años, SD = 11.3) predijeron el cambio pre / post-contraste en la sustancia blanca normal, WMH e índice Lesión de trazo. Señal CSF Incremento con el aumento de SVD post-contraste. Un patrón general consistente de aumento de la homogeneidad de la textura "con el aumento de la SVD y el cambio posterior al contraste en el LCR con el aumento de WMH sugiere que el análisis de textura puede ser útil para el estudio de la integridad de BBB.S

Multifractal techniques for analysis and classification of emphysema images

This thesis proposes, develops and evaluates different multifractal methods for detection, segmentation and classification of medical images. This is achieved by studying the structures of the image and extracting the statistical self-similarity measures characterized by the Holder exponent, and using them to develop texture features for segmentation and classification. The theoretical framework for fulfilling these goals is based on the efficient computation of fractal dimension, which has been explored and extended in this work. This thesis investigates different ways of computing the fractal dimension of digital images and validates the accuracy of each method with fractal images with predefined fractal dimension. The box counting and the Higuchi methods are used for the estimation of fractal dimensions. A prototype system of the Higuchi fractal dimension of the computed tomography (CT) image is used to identify and detect some of the regions of the image with the presence of emphysema. The box counting method is also used for the development of the multifractal spectrum and applied to detect and identify the emphysema patterns. We propose a multifractal based approach for the classification of emphysema patterns by calculating the local singularity coefficients of an image using four multifractal intensity measures. One of the primary statistical measures of self-similarity used in the processing of tissue images is the Holder exponent (α-value) that represents the power law, which the intensity distribution satisfies in the local pixel neighbourhoods. The fractal dimension corresponding to each α-value gives a multifractal spectrum f(α) that was used as a feature descriptor for classification. A feature selection technique is introduced and implemented to extract some of the important features that could increase the discriminating capability of the descriptors and generate the maximum classification accuracy of the emphysema patterns. We propose to further improve the classification accuracy of emphysema CT patterns by combining the features extracted from the alpha-histograms and the multifractal descriptors to generate a new descriptor. The performances of the classifiers are measured by using the error matrix and the area under the receiver operating characteristic curve (AUC). The results at this stage demonstrated the proposed cascaded approach significantly improves the classification accuracy. Another multifractal based approach using a direct determination approach is investigated to demonstrate how multifractal characteristic parameters could be used for the identification of emphysema patterns in HRCT images. This further analysis reveals the multi-scale structures and characteristic properties of the emphysema images through the generalized dimensions. The results obtained confirm that this approach can also be effectively used for detecting and identifying emphysema patterns in CT images. Two new descriptors are proposed for accurate classification of emphysema patterns by hybrid concatenation of the local features extracted from the local binary patterns (LBP) and the global features obtained from the multifractal images. The proposed combined feature descriptors of the LBP and f(α) produced a very good performance with an overall classification accuracy of 98%. These performances outperform other state-of-the-art methods for emphysema pattern classification and demonstrate the discriminating power and robustness of the combined features for accurate classification of emphysema CT images. Overall, experimental results have shown that the multifractal could be effectively used for the classifications and detections of emphysema patterns in HRCT images

Implementing decision tree-based algorithms in medical diagnostic decision support systems

As a branch of healthcare, medical diagnosis can be defined as finding the disease based on the signs and symptoms of the patient. To this end, the required information is gathered from different sources like physical examination, medical history and general information of the patient. Development of smart classification models for medical diagnosis is of great interest amongst the researchers. This is mainly owing to the fact that the machine learning and data mining algorithms are capable of detecting the hidden trends between features of a database. Hence, classifying the medical datasets using smart techniques paves the way to design more efficient medical diagnostic decision support systems. Several databases have been provided in the literature to investigate different aspects of diseases. As an alternative to the available diagnosis tools/methods, this research involves machine learning algorithms called Classification and Regression Tree (CART), Random Forest (RF) and Extremely Randomized Trees or Extra Trees (ET) for the development of classification models that can be implemented in computer-aided diagnosis systems. As a decision tree (DT), CART is fast to create, and it applies to both the quantitative and qualitative data. For classification problems, RF and ET employ a number of weak learners like CART to develop models for classification tasks. We employed Wisconsin Breast Cancer Database (WBCD), Z-Alizadeh Sani dataset for coronary artery disease (CAD) and the databanks gathered in Ghaem Hospital’s dermatology clinic for the response of patients having common and/or plantar warts to the cryotherapy and/or immunotherapy methods. To classify the breast cancer type based on the WBCD, the RF and ET methods were employed. It was found that the developed RF and ET models forecast the WBCD type with 100% accuracy in all cases. To choose the proper treatment approach for warts as well as the CAD diagnosis, the CART methodology was employed. The findings of the error analysis revealed that the proposed CART models for the applications of interest attain the highest precision and no literature model can rival it. The outcome of this study supports the idea that methods like CART, RF and ET not only improve the diagnosis precision, but also reduce the time and expense needed to reach a diagnosis. However, since these strategies are highly sensitive to the quality and quantity of the introduced data, more extensive databases with a greater number of independent parameters might be required for further practical implications of the developed models