A Decision Support System (DSS) for Breast Cancer Detection Based on Invariant Feature Extraction, Classification, and Retrieval of Masses of Mammographic Images

This paper presents an integrated system for the breast cancer detection from mammograms based on automated mass detection, classification, and retrieval with a goal to support decision-making by retrieving and displaying the relevant past cases as well as predicting the images as benign or malignant. It is hypothesized that the proposed diagnostic aid would refresh the radiologist’s mental memory to guide them to a precise diagnosis with concrete visualizations instead of only suggesting a second diagnosis like many other CAD systems. Towards achieving this goal, a Graph-Based Visual Saliency (GBVS) method is used for automatic mass detection, invariant features are extracted based on using Non-Subsampled Contourlet transform (NSCT) and eigenvalues of the Hessian matrix in a histogram of oriented gradients (HOG), and finally classification and retrieval are performed based on using Support Vector Machines (SVM) and Extreme Learning Machines (ELM), and a linear combination-based similarity fusion approach. The image retrieval and classification performances are evaluated and compared in the benchmark Digital Database for Screening Mammography (DDSM) of 2604 cases by using both the precision-recall and classification accuracies. Experimental results demonstrate the effectiveness of the proposed system and show the viability of a real-time clinical application

Similarity Classification and Retrieval in Cancer Images and Informatics

Techniques in image similarity, classification, and retrieval of breast cancer images and informatics are presented in this thesis. Breast cancer images in the mammogram modality have a lot of non-cancerous structures that are similar to cancer, which makes them especially difficult to work with. Only the cancerous part of the image is relevant, so the techniques must learn to recognize cancer in noisy mammograms and extract features from that cancer to classify or retrieve similar images. There are also many types or classes of cancer with different characteristics over which the system must work. Mammograms come in sets of four, two images of each breast, which enables comparison of the left and right breast images to help determine relevant features and remove irrelevant features. Image feature comparisons are used to create a similarity function that works well in the high-dimensional space of image features. The similarity function is learned on an underlying clustering and then integrated to produce an agglomeration that is relevant to the images. This technique diagnoses breast cancer more accurately than commercial systems and other published results. In order to collect new data and capture the medical diagnosis used to create and improve these methods, as well as develop relevant feedback, an innovative image retrieval, diagnosis capture, and multiple image viewing tool is presented to fulfill the needs of radiologists. Additionally, retrieval and classification of prostate cancer data is improved using new high-dimensional techniques like dimensionally-limited distance functions and dimensional choice

Similarity Measurement of Breast Cancer Mammographic Images Using Combination of Mesh Distance Fourier Transform and Global Features

Similarity measurement in breast cancer is an important aspect of determining the vulnerability of detected masses based on the previous cases. It is used to retrieve the most similar image for a given mammographic query image from a collection of previously archived images. By analyzing these results, doctors and radiologists can more accurately diagnose early-stage breast cancer and determine the best treatment. The direct result is better prognoses for breast cancer patients. Similarity measurement in images has always been a challenging task in the field of pattern recognition. A widely-adopted strategy in Content-Based Image Retrieval (CBIR) is comparison of local shape-based features of images. Contours summarize the orientations and sizes images, allowing for heuristic approach in measuring similarity between images. Similarly, global features of an image have the ability to generalize the entire object with a single vector which is also an important aspect of CBIR. The main objective of this paper is to enhance the similarity measurement between query images and database images so that the best match is chosen from the database for a particular query image, thus decreasing the chance of false positives. In this paper, a method has been proposed which compares both local and global features of images to determine their similarity. Three image filters are applied to make this comparison. First, we filter using the mesh distance Fourier descriptor (MDFD), which is based on the calculation of local features of the mammographic image. After this filter is applied, we retrieve the five most similar images from the database. Two additional filters are applied to the resulting image set to determine the best match. Experiments show that this proposed method overcomes shortcomings of existing methods, increasing accuracy of matches from 68% to 88%

Caracterización de Patrones Anormales en Mamografías

Abstract. Computer-guided image interpretation is an extensive research area whose main purpose is to provide tools to support decision-making, for which a large number of automatic techniques have been proposed, such as, feature extraction, pattern recognition, image processing, machine learning, among others. In breast cancer, the results obtained at this area, they have led to the development of diagnostic support systems, which have even been approved by the FDA (Federal Drug Administration). However, the use of those systems is not widely extended in clinic scenarios, mainly because their performance is unstable and poorly reproducible. This is due to the high variability of the abnormal patterns associated with this neoplasia. This thesis addresses the main problem associated with the characterization and interpretation of breast masses and architectural distortion, mammographic findings directly related to the presence of breast cancer with higher variability in their form, size and location. This document introduces the design, implementation and evaluation of strategies to characterize abnormal patterns and to improve the mammographic interpretation during the diagnosis process. The herein proposed strategies allow to characterize visual patterns of these lesions and the relationship between them to infer their clinical significance according to BI-RADS (Breast Imaging Reporting and Data System), a radiologic tool used for mammographic evaluation and reporting. The obtained results outperform some obtained by methods reported in the literature both tasks classification and interpretation of masses and architectural distortion, respectively, demonstrating the effectiveness and versatility of the proposed strategies.Resumen. La interpretación de imágenes guiada por computador es una área extensa de investigación cuyo objetivo principal es proporcionar herramientas para el soporte a la toma de decisiones, para lo cual se han usado un gran número de técnicas de extracción de características, reconocimiento de patrones, procesamiento de imágenes, aprendizaje de máquina, entre otras. En el cáncer de mama, los resultados obtenidos en esta área han dado lugar al desarrollo de sistemas de apoyo al diagnóstico que han sido incluso aprobados por la FDA (Federal Drug Administration). Sin embargo, el uso de estos sistemas no es ampliamente extendido, debido principalmente, a que su desempeño resulta inestable y poco reproducible frente a la alta variabilidad de los patrones anormales asociados a esta neoplasia. Esta tesis trata el principal problema asociado a la caracterización y análisis de masas y distorsión de la arquitectura debido a que son hallazgos directamente relacionados con la presencia de cáncer y que usualmente presentan mayor variabilidad en su forma, tamaño y localización, lo que altera los resultados diagnósticos. Este documento introduce el diseño, implementación y evaluación de un conjunto de estrategias para caracterizar patrones anormales relacionados con este tipo de hallazgos para mejorar la interpretación y soportar el diagnóstico mediante la imagen mamaria. Los modelos aquí propuestos permiten caracterizar patrones visuales y la relación entre estos para inferir su significado clínico según el estándar BI-RADS (Breast Imaging Reporting and Data System) usado para la evaluación y reporte mamográfico. Los resultados obtenidos han demostrado mejorar a los resultados obtenidos por los métodos reportados en la literatura en tareas como clasificación e interpretación de masas y distorsión arquitectural, demostrando la efectividad y versatilidad de las estrategia propuestas.Doctorad

Developing and Applying CAD-generated Image Markers to Assist Disease Diagnosis and Prognosis Prediction

Developing computer-aided detection and/or diagnosis (CAD) schemes has been an active research topic in medical imaging informatics (MII) with promising results in assisting clinicians in making better diagnostic and/or clinical decisions in the last two decades. To build robust CAD schemes, we need to develop state-of-the-art image processing and machine learning (ML) algorithms to optimize each step in the CAD pipeline, including detection and segmentation of the region of interest, optimal feature generation, followed by integration to ML classifiers. In my dissertation, I conducted multiple studies investigating the feasibility of developing several novel CAD schemes in the field of medicine concerning different purposes. The first study aims to investigate how to optimally develop a CAD scheme of contrast-enhanced digital mammography (CEDM) images to classify breast masses. CEDM includes both low energy (LE) and dual-energy subtracted (DES) images. A CAD scheme was applied to segment mass regions depicting LE and DES images separately. Optimal segmentation results generated from DES images were also mapped to LE images or vice versa. After computing image features, multilayer perceptron-based ML classifiers integrated with a correlation-based feature subset evaluator and leave-one-case-out cross-validation method were built to classify mass regions. The study demonstrated that DES images eliminated the overlapping effect of dense breast tissue, which helps improve mass segmentation accuracy. By mapping mass regions segmented from DES images to LE images, CAD yields significantly improved performance. The second study aims to develop a new quantitative image marker computed from the pre-intervention computed tomography perfusion (CTP) images and evaluate its feasibility to predict clinical outcome among acute ischemic stroke (AIS) patients undergoing endovascular mechanical thrombectomy after diagnosis of large vessel occlusion. A CAD scheme is first developed to pre-process CTP images of different scanning series for each study case, perform image segmentation, quantify contrast-enhanced blood volumes in bilateral cerebral hemispheres, and compute image features related to asymmetrical cerebral blood flow patterns based on the cumulative cerebral blood flow curves of two hemispheres. Next, image markers based on a single optimal feature and ML models fused with multi-features are developed and tested to classify AIS cases into two classes of good and poor prognosis based on the Modified Rankin Scale. The study results show that ML model trained using multiple features yields significantly higher classification performance than the image marker using the best single feature (p<0.01). This study demonstrates the feasibility of developing a new CAD scheme to predict the prognosis of AIS patients in the hyperacute stage, which has the potential to assist clinicians in optimally treating and managing AIS patients. The third study aims to develop and test a new CAD scheme to predict prognosis in aneurysmal subarachnoid hemorrhage (aSAH) patients using brain CT images. Each patient had two sets of CT images acquired at admission and prior to discharge. CAD scheme was applied to segment intracranial brain regions into four subregions, namely, cerebrospinal fluid (CSF), white matter (WM), gray matter (GM), and extraparenchymal blood (EPB), respectively. CAD then computed nine image features related to 5 volumes of the segmented sulci, EPB, CSF, WM, GM, and four volumetrical ratios to sulci. Subsequently, 16 ML models were built using multiple features computed either from CT images acquired at admission or prior to discharge to predict eight prognosis related parameters. The results show that ML models trained using CT images acquired at admission yielded higher accuracy to predict short-term clinical outcomes, while ML models trained using CT images acquired prior to discharge had higher accuracy in predicting long-term clinical outcomes. Thus, this study demonstrated the feasibility of predicting the prognosis of aSAH patients using new ML model-generated quantitative image markers. The fourth study aims to develop and test a new interactive computer-aided detection (ICAD) tool to quantitatively assess hemorrhage volumes. After loading each case, the ICAD tool first segments intracranial brain volume, performs CT labeling of each voxel. Next, contour-guided image-thresholding techniques based on CT Hounsfield Unit are used to estimate and segment hemorrhage-associated voxels (ICH). Next, two experienced neurology residents examine and correct the markings of ICH categorized into either intraparenchymal hemorrhage (IPH) or intraventricular hemorrhage (IVH) to obtain the true markings. Additionally, volumes and maximum two-dimensional diameter of each sub-type of hemorrhage are also computed for understanding ICH prognosis. The performance to segment hemorrhage regions between semi-automated ICAD and the verified neurology residents’ true markings is evaluated using dice similarity coefficient (DSC). The data analysis results in the study demonstrate that the new ICAD tool enables to segment and quantify ICH and other hemorrhage volumes with higher DSC. Finally, the fifth study aims to bridge the gap between traditional radiomics and deep learning systems by comparing and assessing these two technologies in classifying breast lesions. First, one CAD scheme is applied to segment lesions and compute radiomics features. In contrast, another scheme applies a pre-trained residual net architecture (ResNet50) as a transfer learning model to extract automated features. Next, the principal component algorithm processes both initially computed radiomics and automated features to create optimal feature vectors. Then, several support vector machine (SVM) classifiers are built using the optimized radiomics or automated features. This study indicates that (1) CAD built using only deep transfer learning yields higher classification performance than the traditional radiomic-based model, (2) SVM trained using the fused radiomics and automated features does not yield significantly higher AUC, and (3) radiomics and automated features contain highly correlated information in lesion classification. In summary, in all these studies, I developed and investigated several key concepts of CAD pipeline, including (i) pre-processing algorithms, (ii) automatic detection and segmentation schemes, (iii) feature extraction and optimization methods, and (iv) ML and data analysis models. All developed CAD models are embedded with interactive and visually aided graphical user interfaces (GUIs) to provide user functionality. These techniques present innovative approaches for building quantitative image markers to build optimal ML models. The study results indicate the underlying CAD scheme's potential application to assist radiologists in clinical settings for their assessments in diagnosing disease and improving their overall performance

Combining Feature Methods for Content-Based Classification of Mammogram Images

Breast cancer is among the leading cause of death among females. Studies show that early detection allows for a better prognosis. Mammography is one of the successful ways for early detection of breast cancer. It mostly involves manual reading of mammograms, a process that is difficult and error-prone. This paper discusses a classification model for mammograms based on microcalcification characteristics, as a way of helping radiologists make quick and accurate diagnostic decisions by availing to them similar past cases. The images are pre-processed by Gaussian smoothing and median filtering with 5 x 5 and 3 x 3 kernels respectively. Gabor and Haralick features are then extracted to form the image signatures over which similarity measurements are made. Experimental results show an average precision value between 0.5 and 0.61 using Haralick features, 0.49 and 0.57 using Gabor features, and 0.51 and 0.78 using combination of Gabor and Haralick features