Automatic extraction of brachial artery and measuring associated indices such as flow-mediated dilatation and Intima-media thickness are important for early detection of cardiovascular disease and other vascular endothelial malfunctions. In this paper, we propose the basic but important component of such decision-assisting medical software development – noise tolerant fully automatic segmentation of brachial artery from ultrasound images. Pixel clustering with Fuzzy C-Means algorithm in the quantization process is the key component of that segmentation with various image processing algorithms involved. This algorithm could be an alternative choice of segmentation process that can replace speckle noise-suffering edge detection procedures in this application domain

Choi, Hyun-Min

Kim, Kwang Baek

Kim, Kyung-Ae

Nho, Hosung

Park, Hyun Jun

Park, Joonsung

Song, Doo Heon

English

Joonsung Park

Doo Heon Song

Hosung Nho

Hyun-Min Choi

Kyung-Ae Kim

Hyun Jun Park

Kwang Baek Kim7

ZENODO

Automatic Segmentation of Brachial Artery based on Fuzzy C-Means Pixel Clustering from Ultrasound Images

NEUROSURGERY ENTHUSIASTIC WOMEN SOCIETY

Automatic extraction of brachial artery and measuring associated indices such as flow-mediated dilatation and Intima-media thickness are important for early detection of cardiovascular disease and other vascular endothelial malfunctions. In this paper, we propose the basic but important component of such decision-assisting medical software development – noise tolerant fully automatic segmentation of brachial artery from ultrasound images. Pixel clustering with Fuzzy C-Means algorithm in the quantization process is the key component of that segmentation with various image processing algorithms involved. This algorithm could be an alternative choice of segmentation process that can replace speckle noise-suffering edge detection procedures in this application domain.</jats:p

Kwang Baek Kim

Crossref

International Journal of Electrical and Computer Engineering (IJECE)

IAES journal

Institute of Advanced Engineering and Science

International Journal of Electrical and Computer Engineering (IJECE) Vol. 8, No. 2, April 2018, pp. 638~643 ISSN: 2088-8708, DOI: 10.11591/ijece.v8i2.pp638-643      638   Journal homepage: http://iaescore.com/journals/index.php/IJECE Automatic Segmentation of Brachial Artery based on Fuzzy  C-Means Pixel Clustering from Ultrasound Images    Joonsung Park1, Doo Heon Song2, Hosung Nho3, Hyun-Min Choi4, Kyung-Ae Kim5,  Hyun Jun Park6, Kwang Baek Kim7 1Applied Physiology Lab, Kyung-Hee University, Gyeonggi-do, 446-701, Korea 2Department of Computer Games, Yong-In SongDam College, Yong-in 17145, Korea 3Wellness IT Association & Corp, Seongnam 13487, Korea 4,5Physical Education, Kyung Hee University, Yong-in 17145, Korea 6Department of Computer Engineering, Pusan National University, Busan 46241, Korea 7Division of Computer Software Engineering, Silla University, Busan 617-736, Korea   Article Info  ABSTRACT  Article history: Received Dec 9, 2017 Revised Feb 30, 2018 Accepted Mar 14, 2018  Automatic extraction of brachial artery and measuring associated indices such as flow-mediated dilatation and Intima-media thickness are important for early detection of cardiovascular disease and other vascular endothelial malfunctions. In this paper, we propose the basic but important component of such decision-assisting medical software development – noise tolerant fully automatic segmentation of brachial artery from ultrasound images. Pixel clustering with Fuzzy C-Means algorithm in the quantization process is the key component of that segmentation with various image processing algorithms involved. This algorithm could be an alternative choice of segmentation process that can replace speckle noise-suffering edge detection procedures in this application domain. Keyword: 4-directional contour tracking Automatic segmentation Brachial artery Fuzzy c-means Pixel clustering Copyright © 2018 Institute of Advanced Engineering and Science.  All rights reserved. Corresponding Author: Kwang Baek Kim,  Division of Computer Software Engineering,  Silla University, Busan 617-736, Korea. Email: gbkim@silla.ac.kr   1. INTRODUCTION  Brachial artery is the main arterial supply of the upper limb providing the blood supply to nearly all of its structures. It is a medium sized artery and is actually a continuation of the axillary artery from the region of the axilla into the arm [1]. Brachial artery injuries are diagnosed by physical examination, with the help of Doppler sonography. If there is associated bone fracture with brachial artery injury, repair of the artery is always done first, and then attention is focused on the bone reconstruction and repair of the soft tissue and muscles [2].  The existing methods for assessing endothelial dysfunction and atherosclerosis in humans are based on functional tests in the brachial artery. With high-resolution ultrasound, the diameter of the superficial brachial arteries is measured, while at rest, during reactive hyperaemia, and then assessed with Doppler ultrasonography, a well-tolerated, noninvasive and low-risk procedure. It is currently the most widely investigated method and shows the greatest promise for clinical application [3]. Automatic extraction of brachial artery and measuring associated indices such as flow-mediated dilatation (FMD) and Intima-media thickness (IMT) are important for early detection of cardiovascular disease [4] and other vascular endothelial malfunctions [5] without operator subjectivity. However, automated techniques still underperform semi-automated IMT measurement methods. Automated techniques cannot reproduce human expertise in selecting the optimal point where IMT should be measured. Hence, superior intelligence must be embedded into automated techniques in order to overcome the performance Int J Elec & Comp Eng  ISSN: 2088-8708   Automatic Segmentation of Brachial Artery based on Fuzzy C-Means Pixel Clustering …. (Joonsung Park) 639 limitations. A possible solution is to extract more information from the image, which could be obtained by an accurate analysis of the image at pixel level [6].  Thus, accurate segmentation of artery region is quite important basic building block of the goal software that computes clinically important parameters such as IMT and FLD for further analysis. The basic idea of the automatic artery segmentation is the structure of the input image that has the dark region (lumen: space where blood circulates), comprised of two bright stripes (the near and far wall artery layers). Therefore, the artery is recognized when the boundaries of the near and far wall endothelium have been traced [3].  There have been efforts to extract the target vessel automatically with feed-forward active contour (snake) [7] or with a probabilistic approach to the computerized tracking of arterial walls [8] among others. However, those based on edge detection, are particularly vulnerable to speckle noise.  Generally, edge is detected according to algorithms such as Sobel, Roberts, Prewitt, Canny, and LOG (Laplacian of Gaussian) operators [9]. However, the drawback of such method is also well studied as they consist of high pass filtering, which are not appropriate for noise ultrasound image edge detection [10]. An ultrasound image includes more noise content, especially speckle noise, than any other imaging modality. Speckle is the artifact caused by interference of energy from randomly distributed scattering objects which reduces image resolution and contrast and blurs essential details. Therefore, speckle noise suppression is an important requirement whenever ultrasound imaging is used [11]. Within the limitations of such edge detection based algorithms, a study tries to find the best combination of detection algorithm, with speckle reducing anisotropic diffusion [12]. In this paper, we focus on extracting brachial artery automatically with more noise-tolerant intelligent algorithm. We propose a pixel clustering strategy in extracting target brachial artery area from ultrasonography with Fuzzy C-means (FCM) algorithm. Fuzzy C-Means (FCM) clustering is an unsupervised technique that classifies the image by grouping similar data points in the feature space into clusters. This clustering is achieved by iteratively minimizing a cost function that is dependent on the distance of the pixels to the cluster centers in the feature domain. FCM has shown its effectiveness especially in segmentation in many engineering areas as well as medical domain. A special type of FCM has been applied to carotid artery segmentation [13] but that algorithm is coupled with other special image processing strategies thus may not be used in other areas of application. Thus, we keep the FCM version of our own application used in other medical imaging analysis [14].   2. PROPOSED METHOD OF BRACHIAL ARTERY SEGMENTATION In order to extract the brachial artery, we need to enhance the intensity contrast to differnciate the target area from other area. The process can be summarized as shown in Figure 1. The region of interest (ROI) where the brachial artery exists is marked as a trapezoid as shown in Figure 2(a). In order to enhance the intensuty contrast, we apply Min-Max binarization and the input omage is changes as shown in Figure 2(b).     Figure 1. Process for extracting brachial artery   In order to extract the object in the image, we apply 4-directional contour tracking algorithm with masks shown in Figure 3. Then the labeling algorithm is applied to form a set of obhects found in the ROI. Only the largest object in that area can be the candidate of brachial artery. Small objects in the area are removed as noise. After applying Min-Max binarization and contour tracking algorithm, we can localize the candidate region of target brachial artery as shown in Figure 4(a). From there, we apply FCM in quantization procedure.                  ISSN: 2088-8708 Int J Elec & Comp Eng, Vol. 8, No. 2, February 2018 :  638 – 642 640        (a) ROI    (b) Max-Min binarization  Figure 2. The effect of binarizarion   A B X Y  (a) 2×2 mask  Direction A B X Y Forward 1 0 A B Right 0 1 B Y Right 1 1 A X Left 0 0 X A  (b) 4-diectional contour proceeding rules  Figure 3. Settings for contour tracing          (a) Candidate Input   (b) After FCM  Figure 4. Object extraction by FCM   FCM is a clustering method which allows one piece of data to belong to two or more clusters depending on the degree of membership to each cluster. For n data vectors, we may have c fuzzy clusters  (c < n) and each vector is classified into the cluster whose membership degree is the highest. Let Ur be the rth version of the membership function and m be the weighting exponent then FCM procedure can be summarized as follows; Step 1: Compute the centroid of a cluster is the mean of all points, weighted by their degree of belonging to the cluster as shown in formula (1).  Int J Elec & Comp Eng  ISSN: 2088-8708   Automatic Segmentation of Brachial Artery based on Fuzzy C-Means Pixel Clustering …. (Joonsung Park) 641        (1)  where i denote the cluster number, j denotes the node number on input x of total n data. Step 2: Then compute the distance between the data point and each centroid point of the cluster as shown in formula (2).         (2)  where l denotes the number of nodes. Step 3: Then update the membership function U of its (r+1)th repetition as follows;        (3)  Repeat above steps until the difference between Ur+1 and Ur becomes less than predetermined threshold value, i.e., there is no meaningful difference between two membership function versions.   3. RESULTS The proposed method is implemented with .Net 2010 under Microsoft Visual Studio 2010 C# on the IBM-compatible PC with Intel(R) Core(TM) i5-6200 CPU @ 2.40GHz and 8GB RAM.  The experiment used 12 brachial artery images of 800 x 600 size and the method was successful in extraction judged by the field expert. We could also measure the thickness of the vessel as shown in Figure 5.      Figure 5. Examples of brachial artery extraction and measuring the thickness   Figure 5 is an example snapshot of the implemented software and Figure 6 also demonstrates various input images and extraction results by the proposed method.                 ISSN: 2088-8708 Int J Elec & Comp Eng, Vol. 8, No. 2, February 2018 :  638 – 642 642                 Figure 6. Various input images and artery extractions   4. CONCLUSION  In this paper, we propose a method to extract brachial artery from ultrasound images based on intelligent pixel clustering in quantization with other image processing algorithms. While edge detection base d mothods tried in this problem suffer from specle noise in segmentation, thus FCM based method is simpler and noise tolerant. Fuzzy clustering used to form information granulation is usually employed to overcome a possible curse of dimensionality. With such clear extraction of the target object, we can develop a useful decision making/automatic measuring performance patameters such as IMT for the next step.   REFERENCES  [1] E. N. Marieb, Wilhelm PB, Mallatt J. Human anatomy. Pearson; 2014. [2] “Brachial Artery Injury Symptoms and Treatment: Pain In Brachial Artery”, Available: http://www.tandurust.com/health-faq-8/brachial-artery-injury-symptoms.html [3] M. A. Sanchez-Santana, et al., “A tool for telediagnosis of cardiovascular diseases in a collaborative and adaptive approach,” Journal of Universal Computer Science, vol. 19, no. 9, pp. 1275-94, 2013. [4] M. Sonka, et al., “Automated analysis of brachial ultrasound image sequences: early detection of cardiovascular disease via surrogates of endothelial function,” IEEE transactions on medical imaging, vol. 21, no. 10,  pp. 1271-1279, 2002.  [5] D. N. Pugliese, et al., “Feed-forward active contour analysis for improved brachial artery reactivity testing,” Vascular Medicine, vol. 21, no. 4, pp. 317-324, 2016.  [6] S. Rosati, et al., “A selection and reduction approach for the optimization of ultrasound carotid artery images segmentation,” InMachine Learning in Healthcare Informatics 2014, Springer Berlin Heidelberg, pp. 309-332, 2014. [7] T. W. Cary, et al., “Brachial artery vasomotion and transducer pressure effect on measurements by active contour segmentation on ultrasound,” Medical physics, vol. 41, no. 2, 2014. [8] B. Kanber and K. V. Ramnarine, “A probabilistic approach to computerized tracking of arterial walls in ultrasound image sequences,” ISRN Signal Processing, vol. 2012, 2012. [9] V. G. Narendra and K. S. Hareesha, “Study and Comparison of various Image edge Detection tehniques used in Quality inspection and Evaluation of Agricultural and Food products by Computer vision,” International Journal of Agricultural & Biological Engineering, vol. 4, no. 2, pp. 83-90, 2011. [10] M. Kumar and R. Saxena, “Algorithm and technique on various edge detection: A survey,” Signal & Image Processing, vol. 4, no. 3, pp. 65, 2013. [11] J. L. Mateo and A. Fernández-Caballero, “Finding out general tendencies in speckle noise reduction in ultrasound images,” Expert systems with applications, vol. 36, no. 4, pp. 7786-7797, 2009.  [12] M. Rafati, et al., “Comparison of different edge detections and noise reduction on ultrasound images of carotid and brachial arteries using a speckle reducing anisotropic diffusion filter,” Iranian Red Crescent Medical Journal, vol. 16, no. 9, 2014.  [13] U. Kutbay, et al., “A Computer-Aided Diagnosis System for Measuring Carotid Artery Intima-Media Thickness (IMT) Using Quaternion Vectors,” Journal of medical systems. vol. 40, no. 6, pp. 149, 2016.  Int J Elec & Comp Eng  ISSN: 2088-8708   Automatic Segmentation of Brachial Artery based on Fuzzy C-Means Pixel Clustering …. (Joonsung Park) 643 [14] K. B. Kim, et al., “Extracting fascia and analysis of muscles from ultrasound images with FCM-based quantization technology,” Neural Network World, vol. 20, no. 3, pp. 405, 2010.   BIOGRAPHIES OF AUTHORS    Joonsung Park. He received M.S. degrees from the Department of Sports Medicine in Kyung-Hee University, Korea in 2011 and Ph.D from Graduated School of Physical Education in Kyung-Hee University, Korea in 2014. He is a researcher at the Applied Physiology Lab, Kyung-Hee University. He research interests include sports sciense medicine, aging, and wearable devices.    Doo Heon Song. He received B.S. from Seoul National University in 1981 and M.S. from the Korea Advanced Institute of Science and Technology in 1983 in Computer Science. He received his Ph.D. Certificate in Computer Science from the University of California in 1994. He has been a professor at Department of Computer Games, Yong-in Songdam College, Korea, since 1997. His research interests include machine learning, artificial intelligence, fuzzy systems, medical image processing, and computer game design. He is currently the vice president of Korea Institute of Information and Communication Engineering.    Hosung Nho. He attended University of Tsukuba from1993~1998 for a Master's and Ph.D.  in "Sciences of Physical Education." He also was a full time professor for two years at the same university, and from 2001 to 2016, he was a professor at Kyunghee University for Sports Medicine. He has done many research on health care, exercise prescription and senior body strength test. Currently he is the vice-president of Wellness IT Association.    Hyun-Min Choi. He obtained a PhD in Sports Medicine Studies from KyungHee University of Graduated School of Physical Education in 2005, and is currently an Assistant Professor of Graduate School of Physical Education at KyungHee University. Choi's works include <What are the Risk Factor of Borderline Hypertension and Older Adults>. Recent research interests include dietary supplements, cardiovascular responses, exercise performance, and acute workload exercise.    Kyung-Ae Kim. She received M.S. and Ph.D. degrees from the Department of Sports Medicine, Kyung-Hee University, Gyeonggi-do, Korea, in 2010 and 2013, respectively. From 2013 to the present, she is a researcher at the College of Physical Education, Kyung-Hee University. Her research interests include sports medicine, cardiovascular physiology, senior cognitive functions and wearable devices.    Hyun Jun Park. He received his M.S. and Ph.D. degrees from the Department of Computer Engineering, Pusan National University, Busan, Korea, in 2009 and 2017, respectively. From 2017 to the present, he is a postdoctoral researcher at BK21PLUS, Creative Human Resource Development Program for IT Convergence, Pusan National University, Korea. His research interests include computer vision, image processing, factory automation, neural network, and deep learning applications.    Kwang Baek Kim. He received his M.S. and Ph.D. degrees from the Department of Computer Science, Pusan National University, Busan, Korea, in 1993 and 1999, respectively. From 1997 to the present, he is a professor at the Department of Computer Engineering, Silla University, Korea. He is currently an associate editor for Journal of Intelligence and Information Systems and The Open Computer Science Journal (USA). His research interests include fuzzy neural network and applications, bioinformatics, and image processing.  

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Automatic Segmentation of Brachial Artery based on Fuzzy C-Means Pixel Clustering from Ultrasound Images

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