Enhanced computer assisted detection of polyps in CT colonography

This thesis presents a novel technique for automatically detecting colorectal polyps in computed tomography colonography (CTC). The objective of the documented computer assisted diagnosis (CAD) technique is to deal with the issue of false positive detections without adversely affecting polyp detection sensitivity. The thesis begins with an overview of CTC and a review of the associated research areas, with particular attention given to CAD-CTC. This review identifies excessive false positive detections as a common problem associated with current CAD-CTC techniques. Addressing this problem constitutes the major contribution of this thesis. The documented CAD-CTC technique is trained with, and evaluated using, a series of clinical CTC data sets These data sets contain polyps with a range of different sizes and morphologies. The results presented m this thesis indicate the validity of the developed CAD-CTC technique and demonstrate its effectiveness m accurately detecting colorectal polyps while significantly reducing the number of false positive detections

Computer-aided detection of colonic polyps with level set-based adaptive convolution in volumetric mucosa to advance CT colonography toward a screening modality

As a promising second reader of computed tomographic colonography (CTC) screening, the computer-aided detection (CAD) of colonic polyps has earned fast growing research interest. In this paper, we present a CAD scheme to automatically detect colonic polyps in CTC images. First, a thick colon wall representation, ie, a volumetric mucosa (VM) with several voxels wide in general, was segmented from CTC images by a partial-volume image segmentation algorithm. Based on the VM, we employed a level set-based adaptive convolution method for calculating the first- and second-order spatial derivatives more accurately to start the geometric analysis. Furthermore, to emphasize the correspondence among different layers in the VM, we introduced a middle-layer enhanced integration along the image gradient direction inside the VM to improve the operation of extracting the geometric information, like the principal curvatures. Initial polyp candidates (IPCs) were then determined by thresholding the geometric measurements. Based on IPCs, several features were extracted for each IPC, and fed into a support vector machine to reduce false positives (FPs). The final detections were displayed in a commercial system to provide second opinions for radiologists. The CAD scheme was applied to 26 patient CTC studies with 32 confirmed polyps by both optical and virtual colonoscopies. Compared to our previous work, all the polyps can be detected successfully with less FPs. At the 100% by polyp sensitivity, the new method yielded 3.5 FPs/dataset

Validating Pareto Optimal Operation Parameters of Polyp Detection Algorithms for CT Colonography

We evaluated a Pareto front-based multi-objective evolutionary algorithm for optimizing our CT colonography (CTC) computer-aided detection (CAD) system. The system identifies colonic polyps based on curvature and volumetric based features, where a set of thresholds for these features was optimized by the evolutionary algorithm. We utilized a two-fold cross-validation (CV) method to test if the optimized thresholds can be generalized to new data sets. We performed the CV method on 133 patients; each patient had a prone and a supine scan. There were 103 colonoscopically confirmed polyps resulting in 188 positive detections in CTC reading from either the prone or the supine scan or both. In the two-fold CV, we randomly divided the 133 patients into two cohorts. Each cohort was used to obtain the Pareto front by a multi-objective genetic algorithm, where a set of optimized thresholds was applied on the test cohort to get test results. This process was repeated twice so that each cohort was used in the training and testing process once. We averaged the two training Pareto fronts as our final training Pareto front and averaged the test results from the two runs in the CV as our final test results. Our experiments demonstrated that the averaged testing results were close to the mean Pareto front determined from the training process. We conclude that the Pareto front-based algorithm appears to be generalizable to new test data

A Robust and Fast System for CTC Computer-Aided Detection of Colorectal Lesions

We present a complete, end-to-end computer-aided detection (CAD) system for identifying lesions in the colon, imaged with computed tomography (CT). This system includes facilities for colon segmentation, candidate generation, feature analysis, and classification. The algorithms have been designed to offer robust performance to variation in image data and patient preparation. By utilizing efficient 2D and 3D processing, software optimizations, multi-threading, feature selection, and an optimized cascade classifier, the CAD system quickly determines a set of detection marks. The colon CAD system has been validated on the largest set of data to date, and demonstrates excellent performance, in terms of its high sensitivity, low false positive rate, and computational efficiency

Hybrid Committee Classifier for a Computerized Colonic Polyp Detection System

We present a hybrid committee classifier for computer-aided detection (CAD) of colonic polyps in CT colonography (CTC). The classifier involved an ensemble of support vector machines (SVM) and neural networks (NN) for classification, a progressive search algorithm for selecting a set of features used by the SVMs and a floating search algorithm for selecting features used by the NNs. A total of 102 quantitative features were calculated for each polyp candidate found by a prototype CAD system. 3 features were selected for each of 7 SVM classifiers which were then combined to form a committee of SVMs classifier. Similarly, features (numbers varied from 10-20) were selected for 11 NN classifiers which were again combined to form a NN committee classifier. Finally, a hybrid committee classifier was defined by combining the outputs of both the SVM and NN committees. The method was tested on CTC scans (supine and prone views) of 29 patients, in terms of the partial area under a free response receiving operation characteristic (FROC) curve (AUC). Our results showed that the hybrid committee classifier performed the best for the prone scans and was comparable to other classifiers for the supine scans

Facilitating Colorectal Cancer Diagnosis with Computed Tomographic Colonography

Computed tomographic colonography (CTC) is a diagnostic technique involving helical volume acquisition of the cleansed, distended colorectum to detect colorectal cancer or potentially premalignant polyps. This Thesis summarises the evidence base, identifies areas in need of further research, quantifies sources of bias and presents novel techniques to facilitate colorectal cancer diagnosis using CTC. CTC literature is reviewed to justify the rationale for current implementation and to identify fruitful areas for research. This confirms excellent diagnostic performance can be attained providing CTC is interpreted by trained, experienced observers employing state-of-the-art implementation. The technique is superior to barium enema and consequently, it has been embraced by radiologists, clinicians and health policy-makers. Factors influencing generalisability of CTC research are investigated, firstly with a survey of European educational workshop participants which revealed limited CTC experience and training, followed by a systematic review exploring bias in research studies of diagnostic test accuracy which established that studies focussing on these aspects were lacking. Experiments to address these sources of bias are presented, using novel methodology: Conjoint analysis is used to ascertain patients‘ and clinicians’ attitudes to false-positive screening diagnoses, showing that both groups overwhelmingly value sensitivity over specificity. The results inform a weighted statistical analysis for CAD which is applied to the results of two previous studies showing the incremental benefit is significantly higher for novices than experienced readers. We have employed eye-tracking technology to establish the visual search patterns of observers reading CTC, demonstrated feasibility and developed metrics for analysis. We also describe development and validation of computer software to register prone and supine endoluminal surface locations demonstrating accurate matching of corresponding points when applied to a phantom and a generalisable, publically available, CTC database. Finally, areas in need of future development are suggested

Multi-scale and multi-spectral shape analysis: from 2d to 3d

Shape analysis is a fundamental aspect of many problems in computer graphics and computer vision, including shape matching, shape registration, object recognition and classification. Since the SIFT achieves excellent matching results in 2D image domain, it inspires us to convert the 3D shape analysis to 2D image analysis using geometric maps. However, the major disadvantage of geometric maps is that it introduces inevitable, large distortions when mapping large, complex and topologically complicated surfaces to a canonical domain. It is demanded for the researchers to construct the scale space directly on the 3D shape. To address these research issues, in this dissertation, in order to find the multiscale processing for the 3D shape, we start with shape vector image diffusion framework using the geometric mapping. Subsequently, we investigate the shape spectrum field by introducing the implementation and application of Laplacian shape spectrum. In order to construct the scale space on 3D shape directly, we present a novel idea to solve the diffusion equation using the manifold harmonics in the spectral point of view. Not only confined on the mesh, by using the point-based manifold harmonics, we rigorously derive our solution from the diffusion equation which is the essential of the scale space processing on the manifold. Built upon the point-based manifold harmonics transform, we generalize the diffusion function directly on the point clouds to create the scale space. In virtue of the multiscale structure from the scale space, we can detect the feature points and construct the descriptor based on the local neighborhood. As a result, multiscale shape analysis directly on the 3D shape can be achieved

Registration of prone and supine CT colonography images and its clinical application

Computed tomographic (CT) colonography is a technique for detecting bowel cancer and potentially precancerous polyps. CT imaging is performed on the cleansed and insufflated bowel in order to produce a virtual endoluminal representation similar to optical colonoscopy. Because fluids and stool can mimic pathology, images are acquired with the patient in both prone and supine positions. Radiologists then match endoluminal locations visually between the two acquisitions in order to determine whether pathology is real or not. This process is hindered by the fact that the colon can undergo considerable deformation between acquisitions. Robust and accurate automated registration between prone and supine data acquisitions is therefore pivotal for medical interpretation, but a challenging problem. The method proposed in this thesis reduces the complexity of the registration task of aligning the prone and supine CT colonography acquisitions. This is done by utilising cylindrical representations of the colonic surface which reflect the colon's specific anatomy. Automated alignment in the cylindrical domain is achieved by non-rigid image registration using surface curvatures, applicable even when cases exhibit local luminal collapses. It is furthermore shown that landmark matches for initialisation improve the registration's accuracy and robustness. Additional performance improvements are achieved by symmetric and inverse-consistent registration and iteratively deforming the surface in order to compensate for differences in distension and bowel preparation. Manually identified reference points in human data and fiducial markers in a porcine phantom are used to validate the registration accuracy. The potential clinical impact of the method has been evaluated using data that reflects clinical practise. Furthermore, correspondence between follow-up CT colonography acquisitions is established in order to facilitate the clinical need to investigate polyp growth over time. Accurate registration has the potential to both improve the diagnostic process and decrease the radiologist's interpretation time. Furthermore, its result could be integrated into algorithms for improved computer-aided detection of colonic polyps