Three-dimensional computer-aided diagnosis scheme for detection ofcolonic polyps

We have developed a three-dimensional (3-D) computer-aided diagnosis scheme for automated detection of colonic polyps in computed tomography (CT) colonographic data sets, and assessed its performance based on colonoscopy as the gold standard. In this scheme, a thick region encompassing the entire colonic wall is extracted from an isotropic volume reconstructed from the CT images in CT colonography. Polyp candidates are detected by first computing of 3-D geometric features that characterize polyps, folds, and colonic walls at each voxel in the extracted colon, and then segmenting of connected components corresponding to suspicious regions by hysteresis thresholding based on these geometric features. We apply fuzzy clustering to these connected components to obtain the polyp candidates. False-positive (FP) detections are then reduced by computation of several 3-D volumetric features characterizing the internal structures of the polyp candidates, followed by the application of discriminant analysis to the feature space generated by these volumetric features. The locations of the polyps detected by our computerized method were compared to the gold standard of conventional colonoscopy. The performance was evaluated based on 43 clinical cases, including 12 polyps determined by colonoscopy. Our computerized scheme was shown to have the potential to detect polyps in CT colonography with a clinically acceptable high sensitivity and a low FP rate.     

Colonic polyp segmentation in CT colonography-based on fuzzy clustering and deformable models

An automatic method to segment colonic polyps in computed tomography (CT) colonography is presented in this paper. The method is based on a combination of knowledge-guided intensity adjustment, fuzzy c-mean clustering, and deformable models. The computer segmentations were compared with manual segmentations to validate the accuracy of our method. An average 76.3% volume overlap percentage among 105 polyp detections was reported in the validation, which was very good considering the small polyp size. Several experiments were performed to investigate the intraoperator and interoperator repeatability of manual colonic polyp segmentation. The investigation demonstrated that the computer-human repeatability was as good as the interoperator repeatability. The polyp segmentation was also applied in computer-aided detection (CAD) to reduce the number of false positive (FP) detections and provide volumetric features for polyp classification. Our segmentation method was able to eliminate 30% of FP detections. The volumetric features computed from the segmentation can further reduce FP detections by 50% at 80% sensitivity.     

An improved electronic colon cleansing method for detection of colonic polyps by virtual colonoscopy

Electronic colon cleansing (ECC) aims to segment the colon lumen from a patient abdominal image acquired using an oral contrast agent for colonic material tagging, so that a virtual colon model can be constructed. Virtual colonoscopy (VC) provides fly-through navigation within the colon model, looking for polyps on the inner surface in a manner analogous to that of fiber optic colonoscopy. We have built an ECC pipeline for a commercial VC navigation system. In this paper, we present an improved ECC method. It is based on a partial-volume (PV) image-segmentation framework, which is derived using the well-established statistical expectation-maximization algorithm. The presented ECC method was evaluated by both visual inspection and computer-aided detection of polyps (CADpolyp) within the cleansed colon lumens obtained using 20 patient datasets. Compared to our previous ECC pipeline, which does not sufficiently consider the PV effect, the method presented in this paper demonstrates improved polyp detection by both visual judgment and CADpolyp measure.     

Surface normal overlap: a computer-aided detection algorithm with application to colonic polyps and lung nodules in helical CT

We developed a novel computer-aided detection (CAD) algorithm called the surface normal overlap method that we applied to colonic polyp detection and lung nodule detection in helical computed tomography (CT) images. We demonstrate some of the theoretical aspects of this algorithm using a statistical shape model. The algorithm was then optimized on simulated CT data and evaluated using a per-lesion cross-validation on 8 CT colonography datasets and on 8 chest CT datasets. It is able to achieve 100% sensitivity for colonic polyps 10 mm and larger at 7.0 false positives (FPs)/dataset and 90% sensitivity for solid lung nodules 6 mm and larger at 5.6 FP/dataset.     

Fully automated colon segmentation for the computation of complete colon centerline in virtual colonoscopy

Virtual colonoscopy detects polyps by navigating along a colon centerline. Complete colon segmentation based on computed tomography (CT) data is a prerequisite to the computation of complete colon centerline. There are two main problems impeding complete segmentation: overdistention/underdistention of colon and the use of oral contrast agents. Overdistention produces loops in the segmented colon, while underdistention may cause the segmented colon collapse into a series of disconnected segments. Use of oral contrast agents, which have high attenuation on CT, may add redundant structures (bones and small bowels) to the segmented colon. A fully automated colon segmentation method is proposed in this paper to address the two problems. We tested the proposed method in 170 cases, including 37 "moderate" and 133 "challenging" cases. Computer-generated centerlines were compared with human-generated centerlines (plotted by three radiologists). The proposed method achieved a 90.56% correct coverage rate with respect to the human-generated centerlines. We also compared the proposed method with two existing colon segmentation methods: Uitert's method and Nappi's method. The results of these two methods were 75.16% and 72.59% correct coverage rates, respectively. Our experimental results indicate that the proposed method could yield more complete colon centerlines than the existing methods.     

Polyp enhancing level set evolution of colon wall: method and pilot study

Computer aided detection (CAD) in computed tomography colonography (CTC) aims at detecting colonic polyps that are the precursors of colon cancer. In this work, we propose a colon wall evolution algorithm polyp enhancing level sets (PELS) based on the level-set formulation that regularizes and enhances polyps as a preprocessing step to CTC CAD algorithms. The underlying idea is to evolve the polyps towards spherical protrusions on the colon wall while keeping other structures, such as haustral folds, relatively unchanged and, thereby, potentially improve the performance of CTC CAD algorithms, especially for smaller polyps. To evaluate our methods, we conducted a pilot study using an arbitrarily chosen CTC CAD method, the surface normal overlap (SNO) CAD algorithm, on a nine patient CTC data set with 47 polyps of sizes ranging from 2.0 to 17.0 mm in diameter. PELS increased the maximum sensitivity by 8.1% (from 21/37 to 24/37) for small polyps of sizes ranging from 5.0 to 9.0 mm in diameter. This is accompanied by a statistically significant separation between small polyps and false positives. PELS did not change the CTC CAD performance significantly for larger polyps.     

Virtual endoscopic visualization of the colon by shape-scale signatures.

We developed a new visualization method for virtual endoscopic examination of computed tomographic (CT) colonographic data by use of shape-scale analysis. The method provides each colonic structure of interest with a unique color, thereby facilitating rapid diagnosis of the colon. Two shape features, called the local shape index and curvedness, are used for defining the shape-scale spectrum. When we map the shape index and curvedness values within CT colonographic data to the shape-scale spectrum, specific types of colonic structures are represented by unique characteristic signatures in the spectrum. The characteristic signatures of specific types of lesions can be determined by use of computer-simulated lesions or by use of clinical data sets subjected to a computerized detection scheme. The signatures are used for defining a two-dimensional color map by assignment of a unique color to each signature region. The method was evaluated visually by use of computer-simulated lesions and clinical CT colonographic data sets, as well as by an evaluation of the human observer performance in the detection of polyps without and with the use of the color maps. The results indicate that the coloring of the colon yielded by the shape-scale color maps can be used for differentiating among the chosen colonic structures. Moreover, the results indicate that the use of the shape-scale color maps can improve the performance of radiologists in the detection of polyps in CT colonography.     

A fully automatic CAD-CTC system based on curvature analysis for standard and low-dose CT data

Computed tomography colonography (CTC) is a rapidly evolving noninvasive medical investigation that is viewed by radiologists as a potential screening technique for the detection of colorectal polyps. Due to the technical advances in CT system design, the volume of data required to be processed by radiologists has increased significantly, and as a consequence the manual analysis of this information has become an increasingly time consuming process whose results can be affected by inter- and intrauser variability. The aim of this paper is to detail the implementation of a fully integrated CAD-CTC system that is able to robustly identify the clinically significant polyps in the CT data. The CAD-CTC system described in this paper is a multistage implementation whose main system components are: 1) automatic colon segmentation; 2) candidate surface extraction; 3) feature extraction; and 4) classification. Our CAD-CTC system performs at 100% sensitivity for polyps larger than 10 mm, 92% sensitivity for polyps in the range 5 to 10 mm, and 57.14% sensitivity for polyps smaller than 5 mm with an average of 3.38 false positives per dataset. The developed system has been evaluated on synthetic and real patient CT data acquired with standard and low-dose radiation levels.     

Automatic correction of level set based subvoxel precise centerlines for virtual colonoscopy using the colon outer wall

Virtual colonoscopy (VC) is becoming a more prevalent method to detect and diagnose colorectal cancer. An essential component of using VC to detect cancerous polyps, especially in conjunction with computer-aided diagnosis, is the accurate calculation of the centerline of the colon. While the colon is often modeled as a simple cylinder, the amount of colonic distention may vary between patients and within the same patient often causing loops and multiple disconnected segments to be present in the colon segmentation. These variations have caused previous centerline algorithms to fail to capture a complete and accurate centerline for all colons. We have developed an automatic method to determine from a computed tomography (CT) VC a subvoxel precise centerline that is accurate even in cases of over-distended or under-distended colons. In this algorithm, the loops in the colon caused by over-distention are detected and removed when the centerline calculation is performed. Also, a newly developed method for the detection and segmentation of the outer wall of the colon is used to connect collapsed portions of the colon where the lumen segmentation fails to produce a continuous centerline. These two methods allow for a complete and accurate centerline to be calculated in uniformly distended colons as well as in colons containing segments which are over-distended and/or under-distended. We have demonstrated successfully the effectiveness of our algorithm on 50 cases, 25 of which resulted in erroneous solutions by previous centerline algorithms due to variability in the colon distention.     

Edge displacement field-based classification for improved detection of polyps in CT colonography

Colorectal cancer can easily be prevented provided that the precursors to tumors, small colonic polyps, are detected and removed. Currently, the only definitive examination of the colon is fiber-optic colonoscopy, which is invasive and expensive. Computed tomographic colonography (CTC) is potentially a less costly and less invasive alternative to FOC. It would be desirable to have computer-aided detection (CAD) algorithms to examine the large amount of data CTC provides. Most current CAD algorithms have high false positive rates at the required sensitivity levels. We developed and evaluated a postprocessing algorithm to decrease the false positive rate of such a CAD method without sacrificing sensitivity. Our method attempts to model the way a radiologist recognizes a polyp while scrolling a cross-sectional plane through three-dimensional computed tomography data by classification of the changes in the location of the edges in the two-dimensional plane. We performed a tenfold cross-validation study to assess its performance using sensitivity/specificity analysis on data from 48 patients. The mean specificity over all experiments increased from 0.19 (0.35) to 0.47 (0.56) for a sensitivity of 1.00 (0.95).     

A novel approach to extract colon lumen from CT images for virtual colonoscopy

An automatic method has been developed for segmentation of abdominal computed tomography (CT) images for virtual colonoscopy obtained after a bowel preparation of a low-residue diet with ingested contrast solutions to enhance the image intensities of residual colonic materials. Removal of the enhanced materials was performed electronically by a computer algorithm. The method is a multistage approach that employs a modified self-adaptive on-line vector quantization technique for a low-level image classification and utilizes a region-growing strategy for a high-level feature extraction. The low-level classification labels each voxel based on statistical analysis of its three-dimensional intensity vectors consisting of nearby voxels. The high-level processing extracts the labeled stool, fluid and air voxels within the colon, and eliminates bone and lung voxels which have similar image intensities as the enhanced materials and air, but are physically separated from the colon. This method was evaluated by volunteer studies based on both objective and subjective criteria. The validation demonstrated that the method has a high reproducibility and repeatability and a small error due to partial volume effect. As a result of this electronic colon cleansing, routine physical bowel cleansing prior to virtual colonoscopy may not be necessary.     

A statistical 3-D pattern processing method for computer-aideddetection of polyps in CT colonography

Adenomatous polyps in the colon are believed to be the precursor to colorectal carcinoma, the second leading cause of cancer deaths in United States. In this paper, we propose a new method for computer-aided detection of polyps in computed tomography (CT) colonography (virtual colonoscopy), a technique in which polyps are imaged along the wall of the air-inflated, cleansed colon with X-ray CT. Initial work with computer aided detection has shown high sensitivity, but at a cost of too many false positives. We present a statistical approach that uses support vector machines to distinguish the differentiating characteristics of polyps and healthy tissue, and uses this information for the classification of the new cases. One of the main contributions of the paper is the new three-dimensional pattern processing approach, called random orthogonal shape sections method, which combines the information from many random images to generate reliable signatures of shape. The input to the proposed system is a collection of volume data from candidate polyps obtained by a high-sensitivity, low-specificity system that we developed previously. The results of our ten-fold cross-validation experiments show that, on the average, the system increases the specificity from 0.19 (0.35) to 0.69 (0.74) at a sensitivity level of 1.0 (0.95).     

Registration under topological change for CT colonography

Computed tomography (CT) colonography is a minimally invasive screening technique for colorectal polyps, in which X-ray CT images of the distended colon are acquired, usually in the prone and supine positions of a single patient. Registration of segmented colon images from both positions will be useful for computer-assisted polyp detection. We have previously presented algorithms for registration of the prone and supine colons when both are well distended and there is a single connected lumen. However, due to inadequate bowel preparation or peristalsis, there may be collapsed segments in one or both of the colon images resulting in a topological change in the images. Such changes make deformable registration of the colon images difficult, and at present, there are no registration algorithms that can accommodate them. In this paper, we present an algorithm that can perform volume registration of prone/supine colon images in the presence of a topological change. For this purpose, 3-D volume images are embedded as a manifold in a 4-D space, and the manifold is evolved for nonrigid registration. Experiments using data from 24 patients show that the proposed method achieves good registration results in both the shape alignment of topologically different colon images from a single patient and the polyp location estimation between supine and prone colon images.     

Segmentation of Lung Lobes in High-Resolution Isotropic CT Images

Modern multislice computed tomography (CT) scanners produce isotropic CT images with a thickness of 0.6 mm. These CT images offer detailed information of lung cavities, which could be used for better surgical planning of treating lung cancer. The major challenge for developing a surgical planning system is the automatic segmentation of lung lobes by identifying the lobar fissures. This paper presents a lobe segmentation algorithm that uses a two-stage approach: 1) adaptive fissure sweeping to find fissure regions and 2) wavelet transform to identify the fissure locations and curvatures within these regions. Tested on isotropic CT image stacks from nine anonymous patients with pathological lungs, the algorithm yielded an accuracy of 76.7%–94.8% with strict evaluation criteria. In comparison, surgeons obtain an accuracy of 80% for localizing the fissure regions in clinical CT images with a thickness of 2.5–7.0 mm. As well, this paper describes a procedure for visualizing lung lobes in three dimensions using software—amira—and the segmentation algorithm. The procedure, including the segmentation, needed about 5 min for each patient. These results provide promising potential for developing an automatic algorithm to segment lung lobes for surgical planning of treating lung cancer.      

一种改进级联U-Net网络的结肠息肉分割算法

结肠镜图像中息肉的精确分割是诊断结肠癌的关键环节,针对目前结肠息肉分割算法存在孔洞、分割粗糙以及分割不完全的问题,提出了一种改进级联U-Net结构的结肠息肉分割算法。运用特征融合思想,设计了多尺度语义嵌入模块和残差模块,充分利用深、浅层特征的语义信息。引入注意力机制,在模型的级联处构建了改进空洞卷积模块,扩大卷积感受野并增强特征捕获能力。改进了卷积层模块和分割损失函数,提升模型的泛化性和鲁棒性。在Kvasir-SEG数据集上进行实验分析,相似系数、平均交并比、召回率和准确率分别达到了90.39%、88.34%、83.62%和95.12%。实验结果表明,该文所提算法改善了分割图像内部孔洞、边缘粗糙及分割不完全的问题,优于其他息肉分割算法。     

Hierarchical morphological segmentation for image sequence coding

This paper deals with a hierarchical morphological segmentation algorithm for image sequence coding. Mathematical morphology is very attractive for this purpose because it efficiently deals with geometrical features such as size, shape, contrast, or connectivity that can be considered as segmentation-oriented features. The algorithm follows a top-down procedure. It first takes into account the global information and produces a coarse segmentation, that is, with a small number of regions. Then, the segmentation quality is improved by introducing regions corresponding to more local information. The algorithm, considering sequences as being functions on a 3-D space, directly segments 3-D regions. A 3-D approach is used to get a segmentation that is stable in time and to directly solve the region correspondence problem. Each segmentation stage relies on four basic steps: simplification, marker extraction, decision, and quality estimation. The simplification removes information from the sequence to make it easier to segment. Morphological filters based on partial reconstruction are proven to be very efficient for this purpose, especially in the case of sequences. The marker extraction identifies the presence of homogeneous 3-D regions. It is based on constrained flat region labeling and morphological contrast extraction. The goal of the decision is to precisely locate the contours of regions detected by the marker extraction. This decision is performed by a modified watershed algorithm. Finally, the quality estimation concentrates on the coding residue, all the information about the 3-D regions that have not been properly segmented and therefore coded. The procedure allows the introduction of the texture and contour coding schemes within the segmentation algorithm. The coding residue is transmitted to the next segmentation stage to improve the segmentation and coding quality. Finally, segmentation and coding examples are presented to show the validity and interest of the coding approach.     

基于运动窗生成的时空视频分割

本文提出了一种基于运动窗生成的时空视频分割方法.首先通过检测运动变化区域而生成运动窗,然后只对视频图像在运动窗内的部分进行时空视频分割,从而大大减少了运算量,提高了运算速度.此外,在空间分割中,本文提出了一种符合人眼视觉特性的逐级划分的空间分割方法;最后根据运动相似性将区域合并,完成视频分割.实验结果表明,本文的方法运算速度快并能有效地进行空间分割,最后能取得较好的视频分割结果.     

Intrathoracic airway trees: segmentation and airway morphology analysis from low-dose CT scans

The segmentation of the human airway tree from volumetric computed tomography (CT) images builds an important step for many clinical applications and for physiological studies. Previously proposed algorithms suffer from one or several problems: leaking into the surrounding lung parenchyma, the need for the user to manually adjust parameters, excessive runtime. Low-dose CT scans are increasingly utilized in lung screening studies, but segmenting them with traditional airway segmentation algorithms often yields less than satisfying results. In this paper, a new airway segmentation method based on fuzzy connectivity is presented. Small adaptive regions of interest are used that follow the airway branches as they are segmented. This has several advantages. It makes it possible to detect leaks early and avoid them, the segmentation algorithm can automatically adapt to changing image parameters, and the computing time is kept within moderate values. The new method is robust in the sense that it works on various types of scans (low-dose and regular dose, normal subjects and diseased subjects) without the need for the user to manually adjust any parameters. Comparison with a commonly used region-grow segmentation algorithm shows that the newly proposed method retrieves a significantly higher count of airway branches. A method that conducts accurate cross-sectional airway measurements on airways is presented as an additional processing step. Measurements are conducted in the original gray-level volume. Validation on a phantom shows that subvoxel accuracy is achieved for all airway sizes and airway orientations.     

Mosaic decomposition: an electronic cleansing method for inhomogeneously tagged regions in noncathartic CT colonography

Electronic cleansing (EC) is a method that segments fecal material tagged by an X-ray-opaque oral contrast agent in computed tomographic colonography (CTC) images, and effectively removes the material for digitally cleansing the colon. In this study, we developed a novel EC method, called mosaic decomposition (MD), for reduction of the artifacts due to incomplete cleansing of inhomogeneously tagged fecal material in CTC images, especially in noncathartic CTC images. In our approach, the entire colonic region, including the residual fecal regions, was first decomposed into a set of local homogeneous regions, called tiles, after application of a 3-D watershed transform to the CTC images. Each tile was then subjected to a single-class support vector machine (SVM) classifier for soft-tissue discrimination. The feature set of the soft-tissue SVM classifier was selected by a genetic algorithm (GA). A scalar index, called a soft-tissue likelihood, is formulated for differentiation of the soft-tissue tiles from those of other materials. Then, EC based on MD, called MD-cleansing, is performed by first initializing of the level-set front with the classified tagged regions; the front is then evolved by use of a speed function that was designed, based on the soft-tissue index, to reserve the submerged soft-tissue structures while suppressing the residual fecal regions. The performance of the MD-cleansing method was evaluated by use of a phantom and of clinical cases. In the phantom evaluation, our MD-cleansing was trained with the supine (prone) scan and tested on the prone (supine) scan, respectively. In both cases, the sensitivity and specificity of classification were 100%. The average cleansing ratio was 90.6%, and the soft-tissue preservation ratio was 97.6%. In the clinical evaluation, 10 noncathartic CTC cases (20 scans) were collected, and the ground truth of a total of 2095 tiles was established by manual assignment of a material class to each tile. Five cases were randomly selected for training GA/SVM, and the remaining five cases were used for testing. The overall sensitivity and specificity of the proposed classification scheme were 97.1% and 85.3%, respectively, and the accuracy was 94.6%. The area under the ROC curve (Az) was 0.96. Our results indicated that the use of MD-cleansing substantially improved the effectiveness of our EC method in the reduction of incomplete cleansing artifacts.     

Spatiotemporal segmentation for compact video representation

In this paper, a novel hierarchical object-oriented video segmentation and representation algorithm is proposed. The local variance contrast and the frame difference contrast are jointly exploited for structural spatiotemporal video segmentation because these two visual features can indicate the spatial homogeneity of the grey levels and the temporal coherence of the motion fields efficiently, where the two-dimensional (2D) spatiotemporal entropic technique is further selected for generating the 2D thresholding vectors adaptively according to the variations of the video components. After the region growing and edge simplification procedures, the accurate boundaries among the different video components are further exploited by an intra-block edge extraction procedure. Moreover, the relationships of the video components among frames are exploited by a temporal tracking procedure. This proposed object-oriented spatiotemporal video segmentation algorithm may be useful for MPEG-4 system generating the video object plane (VOP) automatically.