Image reconstruction and imaging configuration optimization with a novel nanotechnology enabled breast tomosynthesis multi-beam X-ray system

Digital breast tomosynthesis is a new technology that provides three-dimensional information of the breast and makes it possible to distinguish the cancer from overlying breast tissues. We are dedicated to optimizing image reconstruction and imaging configuration for a new multi-beam parallel digital breast tomosynthesis prototype system. Several commonly used algorithms from the typical image reconstruction models which were used for iso-centric tomosynthesis systems were investigated for our multi-beam parallel tomosynthesis imaging system. The representative algorithms, including back-projection (BP), filtered back-projection (FBP), matrix inversion tomosynthesis reconstruction (MITS), maximum likelihood expectation maximization (MLEM), ordered-subset maximum likelihood expectation maximization (OS-MLEM), simultaneous algebraic reconstruction technique (SART), were implemented to fit our system design. An accelerated MLEM algorithm was proposed, which significantly reduced the running time but had the same image quality. Furthermore, two statistical variants of BP reconstruction were validated for our tomosynthesis prototype system. Experiments based on phantoms and computer simulations show that the prototype system combined with our algorithms is capable of providing three-dimensional information of the objects with good image quality and has great potentials to improve digital breast tomosynthesis technology. Four methodologies were employed to optimize the reconstruction algorithms and different imaging configurations for the prototype system. A linear tomosynthesis imaging analysis tool was used to investigate blurring-out reconstruction algorithms. Computer simulations of sphere and wire objects aimed at the performance of out-of-plane artifact removal. A frequency-domain-based methodology, relative NEQ(f) analysis, was investigated to evaluate the overall system performance based on the propagation of signal and noise. Conclusions were made to determine the optimal image reconstruction algorithm and imaging configuration of this new multi-beam parallel digital breast tomosynthesis prototype system for better image quality and system performance

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

Development and Validation of Mechatronic Systems for Image-Guided Needle Interventions and Point-of-Care Breast Cancer Screening with Ultrasound (2D and 3D) and Positron Emission Mammography

The successful intervention of breast cancer relies on effective early detection and definitive diagnosis. While conventional screening mammography has substantially reduced breast cancer-related mortalities, substantial challenges persist in women with dense breasts. Additionally, complex interrelated risk factors and healthcare disparities contribute to breast cancer-related inequities, which restrict accessibility, impose cost constraints, and reduce inclusivity to high-quality healthcare. These limitations predominantly stem from the inadequate sensitivity and clinical utility of currently available approaches in increased-risk populations, including those with dense breasts, underserved and vulnerable populations. This PhD dissertation aims to describe the development and validation of alternative, cost-effective, robust, and high-resolution systems for point-of-care (POC) breast cancer screening and image-guided needle interventions. Specifically, 2D and 3D ultrasound (US) and positron emission mammography (PEM) were employed to improve detection, independent of breast density, in conjunction with mechatronic and automated approaches for accurate image acquisition and precise interventional workflow. First, a mechatronic guidance system for US-guided biopsy under high-resolution PEM localization was developed to improve spatial sampling of early-stage breast cancers. Validation and phantom studies showed accurate needle positioning and 3D spatial sampling under simulated PEM localization. Subsequently, a whole-breast spatially-tracked 3DUS system for point-of-care screening was developed, optimized, and validated within a clinically-relevant workspace and healthy volunteer studies. To improve robust image acquisition and adaptability to diverse patient populations, an alternative, cost-effective, portable, and patient-dedicated 3D automated breast (AB) US system for point-of-care screening was developed. Validation showed accurate geometric reconstruction, feasible clinical workflow, and proof-of-concept utility across healthy volunteers and acquisition conditions. Lastly, an orthogonal acquisition and 3D complementary breast (CB) US generation approach were described and experimentally validated to improve spatial resolution uniformity by recovering poor out-of-plane resolution. These systems developed and described throughout this dissertation show promise as alternative, cost-effective, robust, and high-resolution approaches for improving early detection and definitive diagnosis. Consequently, these contributions may advance breast cancer-related equities and improve outcomes in increased-risk populations and limited-resource settings

Automated Analysis of Mammograms using Evolutionary Algorithms

Breast cancer is the leading cause of death in women in the western countries. The diagnosis of breast cancer at the earlier stage may be particularly important since it provides early treatment, this will decreases the chance of cancer spreading and increase the survival rates. The hard work is the early detection of any tissues abnormal and confirmation of their cancerous natures. In additionally, finding abnormal on very early stage can also affected by poor quality of image and other problems that might show on a mammogram. Mammograms are high resolution x-rays of the breast that are widely used to screen for cancer in women. This report describes the stages of development of a novel representation of Cartesian Genetic programming as part of a computer aided diagnosis system. Specifically, this work is concerned with automated recognition of microcalcifications, one of the key structures used to identify cancer. Results are presented for the application of the proposed algorithm to a number of mammogram sections taken from the Lawrence Livermore National Laboratory Database. The performance of any algorithm such as evolutionary algorithm is only good as the data it is trained on. More specifically, the class represented in the training data must consist of the true examples or else reliable classifications. Considering the difficulties in obtaining a previously constructed database, there is a new database has been construct to avoiding pitfalls and lead on the novel evolutional algorithm Multi-chromosome Cartesian genetic programming the success on classification of microcalcifications in mammograms

Evaluation of a diffraction-enhanced imaging (DEI) prototype and exploration of novel applications for clinical implementation of DEI

Conventional mammographic image contrast is derived from x-ray absorption, resulting in breast structure visualization due to density gradients that attenuate radiation without distinction between transmitted, scattered, or refracted x-rays. Diffraction-enhanced imaging (DEI) allows for increased contrast with decreased radiation dose compared to conventional mammographic imaging due to monochromatic x-rays, its unique refraction-based contrast mechanism, and excellent scatter rejection. Although laboratory breast imaging studies have demonstrated excellent breast imaging, important clinical translation and application studies are needed before the DEI system can be established as a useful breast imaging modality. This dissertation focuses on several important studies toward the development of a clinical DEI system. First, contrast-enhanced DEI was explored using commercially available contrast agents. Phantoms were imaged at a range of x-ray energies and relevant contrast agent concentrations. Second, we performed a reader study to determine if superior DEI contrast mechanisms preserve image quality as tissue thickness increases. Breast specimens were imaged at several thicknesses, and radiologist perception of lesion visibility was recorded. Lastly, a prototype DEI system utilizing an x-ray tube source was evaluated through a reader study. Breast tissue specimens were imaged on the traditional and prototype DEI systems, and expert radiologists evaluated image quality and pathology correlation. This dissertation will demonstrate proof-of-principle for contrast-enhanced DEI, establishing the feasibility of contrast-enhanced DEI using commercially available contrast agents. Further, it will show that DEI might be able to reduce breast compression, and thus the perception of pain during mammography, without significantly decreasing breast lesion visibility. Finally, this research shows the successful implementation of a DEI prototype, displaying breast features with approximately statistically equivalent visibility to the traditional DEI system. Together, this research is an important step toward the clinical translation of DEI, a technology with the potential to facilitate early breast cancer detection and diagnosis

Ultrasound Imaging

Ultrasound Imaging - Current Topics presents complex and current topics in ultrasound imaging in a simplified format. It is easy to read and exemplifies the range of experiences of each contributing author. Chapters address such topics as anatomy and dimensional variations, pediatric gastrointestinal emergencies, musculoskeletal and nerve imaging as well as molecular sonography. The book is a useful resource for researchers, students, clinicians, and sonographers looking for additional information on ultrasound imaging beyond the basics

Automated Characterisation and Classification of Liver Lesions From CT Scans

Cancer is a general term for a wide range of diseases that can affect any part of the body due to the rapid creation of abnormal cells that grow outside their normal boundaries. Liver cancer is one of the common diseases that cause the death of more than 600,000 each year. Early detection is important to diagnose and reduce the incidence of death. Examination of liver lesions is performed with various medical imaging modalities such as Ultrasound (US), Computer tomography (CT), and Magnetic resonance imaging (MRI). The improvements in medical imaging and image processing techniques have significantly enhanced the interpretation of medical images. Computer-Aided Diagnosis (CAD) systems based on these techniques play a vital role in the early detection of liver disease and hence reduce liver cancer death rate. Moreover, CAD systems can help physician, as a second opinion, in characterising lesions and making the diagnostic decision. Thus, CAD systems have become an important research area. Particularly, these systems can provide diagnostic assistance to doctors to improve overall diagnostic accuracy. The traditional methods to characterise liver lesions and differentiate normal liver tissues from abnormal ones are largely dependent on the radiologists experience. Thus, CAD systems based on the image processing and artificial intelligence techniques gained a lot of attention, since they could provide constructive diagnosis suggestions to clinicians for decision making. The liver lesions are characterised through two ways: (1) Using a content-based image retrieval (CBIR) approach to assist the radiologist in liver lesions characterisation. (2) Calculating the high-level features that describe/ characterise the liver lesion in a way that is interpreted by humans, particularly Radiologists/Clinicians, based on the hand-crafted/engineered computational features (low-level features) and learning process. However, the research gap is related to the high-level understanding and interpretation of the medical image contents from the low-level pixel analysis, based on mathematical processing and artificial intelligence methods. In our work, the research gap is bridged if a relation of image contents to medical meaning in analogy to radiologist understanding is established. This thesis explores an automated system for the classification and characterisation of liver lesions in CT scans. Firstly, the liver is segmented automatically by using anatomic medical knowledge, histogram-based adaptive threshold and morphological operations. The lesions and vessels are then extracted from the segmented liver by applying AFCM and Gaussian mixture model through a region growing process respectively. Secondly, the proposed framework categorises the high-level features into two groups; the first group is the high-level features that are extracted from the image contents such as (Lesion location, Lesion focality, Calcified, Scar, ...); the second group is the high-level features that are inferred from the low-level features through machine learning process to characterise the lesion such as (Lesion density, Lesion rim, Lesion composition, Lesion shape,...). The novel Multiple ROIs selection approach is proposed, in which regions are derived from generating abnormality level map based on intensity difference and the proximity distance for each voxel with respect to the normal liver tissue. Then, the association between low-level, high-level features and the appropriate ROI are derived by assigning the ability of each ROI to represents a set of lesion characteristics. Finally, a novel feature vector is built, based on high-level features, and fed into SVM for lesion classification. In contrast with most existing research, which uses low-level features only, the use of high-level features and characterisation helps in interpreting and explaining the diagnostic decision. The methods are evaluated on a dataset containing 174 CT scans. The experimental results demonstrated that the efficacy of the proposed framework in the successful characterisation and classification of the liver lesions in CT scans. The achieved average accuracy was 95:56% for liver lesion characterisation. While the lesion’s classification accuracy was 97:1% for the entire dataset. The proposed framework is developed to provide a more robust and efficient lesion characterisation framework through comprehensions of the low-level features to generate semantic features. The use of high-level features (characterisation) helps in better interpretation of CT liver images. In addition, the difference-of-features using multiple ROIs were developed for robust capturing of lesion characteristics in a reliable way. This is in contrast to the current research trend of extracting the features from the lesion only and not paying much attention to the relation between lesion and surrounding area. The design of the liver lesion characterisation framework is based on the prior knowledge of the medical background to get a better and clear understanding of the liver lesion characteristics in medical CT images