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Purpose: Develop a computer-aided detection (CAD) system for masses in digital breast tomosynthesis (DBT) volume using a deep convolutional neural network (DCNN) with transfer learning from mammograms. Methods: A data set containing 2282 digitized film and digital mammograms and 324 DBT volumes were collected with IRB approval. The mass of interest on the images was marked by an experienced breast radiologist as reference standard. The data set was partitioned into a training set (2282 mammograms with 2461 masses and 230 DBT views with 228 masses) and an independent test set (94 DBT views with 89 masses). For DCNN training, the region of interest (ROI) containing the mass (true positive) was extracted from each image. False positive (FP) ROIs were identified at prescreening by their previously developed CAD systems. After data augmentation, a total of 45 072 mammographic ROIs and 37 450 DBT ROIs were obtained. Data normalization and reduction of non-uniformity in the ROIs across heterogeneous data was achieved using a background correction method applied to each ROI. A DCNN with four convolutional layers and three fully connected (FC) layers was first trained on the mammography data. Jittering and dropout techniques were used to reduce overfitting. After training with the mammographic ROIs, all weights in the first three convolutional layers were frozen, and only the last convolution layer and the FC layers were randomly initialized again and trained using the DBT training ROIs. The authors compared the performances of two CAD systems for mass detection in DBT: one used the DCNN-based approach and the other used their previously developed feature-based approach for FP reduction. The prescreening stage was identical in both systems, passing the same set of mass candidates to the FP reduction stage. For the feature-based CAD system, 3D clustering and active contour method was used for segmentation; morphological, gray level, and texture features were extracted and merged with a linear discriminant classifier to score the detected masses. For the DCNN-based CAD system, ROIs from five consecutive slices centered at each candidate were passed through the trained DCNN and a mass likelihood score was generated. The performances of the CAD systems were evaluated using free-response ROC curves and the performance difference was analyzed using a non-parametric method. Results: Before transfer learning, the DCNN trained only on mammograms with an AUC of 0.99 classified DBT masses with an AUC of 0.81 in the DBT training set. After transfer learning with DBT, the AUC improved to 0.90. For breast-based CAD detection in the test set, the sensitivity for the feature-based and the DCNN-based CAD systems was 83% and 91%, respectively, at 1 FP/DBT volume. The difference between the performances for the two systems was statistically significant (p-value < 0.05). Conclusions: The image patterns learned from the mammograms were transferred to the mass detection on DBT slices through the DCNN. This study demonstrated that large data sets collected from mammography are useful for developing new CAD systems for DBT, alleviating the problem and effort of collecting entirely new large data sets for the new modality. [ABSTRACT FROM AUTHOR]

Purpose: To develop a new algorithm to measure the similarity between the query lung mass and reference lung mass data set for content-based medical image retrieval (CBMIR). Methods: A lung mass data set including 746 mass regions of interest (ROIs) was assembled. Among them, 375 ROIs depicted malignant lesions and 371 depicted benign lesions. Each mass ROI is represented by a vector of 26 texture features. A kernel function was employed to map the original data in input space to a feature space. In this space, a semisupervised distance metric was learned, which used differential scatter discriminant criterion to represent the semantic relevance, and the regularization term to represent the visual similarity. The learned distance metric can measure the similarity of the query mass and reference mass data set. The clustering accuracy is used to configure the parameters. The retrieval accuracy and classification accuracy are used as the performance assessment index. Results: After configuring the parameters, a mean clustering accuracy of 0.87 can be achieved. For retrieval accuracy, our algorithm achieves better performance than other state-of-the-art retrieval algorithms when applying a leave-one-out validation method to the testing data set. For classification accuracy, the area under the ROC curve of our algorithm can be achieved as 0.941±0.006. The running times of 346 query images with the proposed algorithm are 5.399 and 6.0 s, respectively. Conclusions: The study results demonstrated the proposed algorithm outperforms the compared algorithms, when taking the semantic relevant and visual similarity into account in kernel space. The algorithm can be used in a CBMIR system for a query mass to retrieve similarity masses, which can help doctors make better decisions. [ABSTRACT FROM AUTHOR]

Purpose: Statistical modeling of an ultrasound backscattered echo envelope is used for tissue characterization. However, in the presence of complex structures within the analyzed area, estimation of parameters is disturbed and unreliable, e.g., in the case of breast tumor classification. In order to improve the differentiation of breast lesions, the authors proposed a method based on the segmentation of homodyned K distribution parameter maps. Regions within lesions of different scattering properties were extracted and analyzed. In order to improve the classification, the best-performing features were selected from various regions and then combined. Methods: A radio-frequency data set consisting of 103 breast lesions was used in the authors' analysis. Maps of homodyned K distribution parameters were created using an algorithm based on signal-to-noise ratio, kurtosis, and skewness of fractional-order envelope moments. A Markov random field model was used to segment parametric maps. Features of different segments were extracted and evaluated based on bootstrapping and the receiver operating characteristic curve. To determine the best-performing feature subset, the authors applied the joint mutual information criterion. Results: It was found that there were individual features which performed better than the ones commonly used for lesion characterization, like the parameter obtained through averaging of values over the whole lesion. The authors selected and discussed the best-performing features. Properties of different extracted regions were important and improved the distinction between benign and malignant tumors. The best performance was obtained by combining four features with the area under the receiver operating curve of 0.84. Conclusions: The study showed that the analysis of internal changes in lesion parametric maps leads to a better classification of breast tumors. The authors recommend combining multiple features for characterization, instead of using only one parameter, especially in the case of heterogeneous lesions. [ABSTRACT FROM AUTHOR]

Purpose: To investigate the effects of dose level and reconstruction method on density and texture based features computed from CT lung nodules. Methods: This study had two major components. In the first component, a uniform water phantom was scanned at three dose levels and images were reconstructed using four conventional filtered backprojection (FBP) and four iterative reconstruction (IR) methods for a total of 24 different combinations of acquisition and reconstruction conditions. In the second component, raw projection (sinogram) data were obtained for 33 lung nodules from patients scanned as a part of their clinical practice, where low dose acquisitions were simulated by adding noise to sinograms acquired at clinical dose levels (a total of four dose levels) and reconstructed using one FBP kernel and two IR kernels for a total of 12 conditions. For the water phantom, spherical regions of interest (ROIs) were created at multiple locations within the water phantom on one reference image obtained at a reference condition. For the lung nodule cases, the ROI of each nodule was contoured semiautomatically (with manual editing) from images obtained at a reference condition. All ROIs were applied to their corresponding images reconstructed at different conditions. For 17 of the nodule cases, repeat contours were performed to assess repeatability. Histogram (eight features) and gray level co-occurrence matrix (GLCM) based texture features (34 features) were computed for all ROIs. For the lung nodule cases, the reference condition was selected to be 100% of clinical dose with FBP reconstruction using the B45f kernel; feature values calculated from other conditions were compared to this reference condition. A measure was introduced, which the authors refer to as Q, to assess the stability of features across different conditions, which is defined as the ratio of reproducibility (across conditions) to repeatability (across repeat contours) of each feature. Results: The water phantom results demonstrated substantial variability among feature values calculated across conditions, with the exception of histogram mean. Features calculated from lung nodules demonstrated similar results with histogram mean as the most robust feature (Q = 1), having a mean and standard deviation Q of 0.37 and 0.22, respectively. Surprisingly, histogram standard deviation and variance features were also quite robust. Some GLCM features were also quite robust across conditions, namely, diff. variance, sum variance, sum average, variance, and mean. Except for histogram mean, all features have a Q of larger than one in at least one of the 3% dose level conditions. Conclusions: As expected, the histogram mean is the most robust feature in their study. The effects of acquisition and reconstruction conditions on GLCM features vary widely, though trending toward features involving summation of product between intensities and probabilities being more robust, barring a few exceptions. Overall, care should be taken into account for variation in density and texture features if a variety of dose and reconstruction conditions are used for the quantification of lung nodules in CT, otherwise changes in quantification results may be more reflective of changes due to acquisition and reconstruction conditions than in the nodule itself. [ABSTRACT FROM AUTHOR]

Purpose: To develop an automated system for mediastinal lymph node detection and station mapping for chest CT. Methods: The contextual organs, trachea, lungs, and spine are first automatically identified to locate the region of interest (ROI) (mediastinum). The authors employ shape features derived from Hessian analysis, local object scale, and circular transformation that are computed per voxel in the ROI. Eight more anatomical structures are simultaneously segmented by multiatlas label fusion. Spatial priors are defined as the relative multidimensional distance vectors corresponding to each structure. Intensity, shape, and spatial prior features are integrated and parsed by a random forest classifier for lymph node detection. The detected candidates are then segmented by the following curve evolution process. Texture features are computed on the segmented lymph nodes and a support vector machine committee is used for final classification. For lymph node station labeling, based on the segmentation results of the above anatomical structures, the textual definitions of mediastinal lymph node map according to the International Association for the Study of Lung Cancer are converted into patient-specific color-coded CT image, where the lymph node station can be automatically assigned for each detected node. Results: The chest CT volumes from 70 patients with 316 enlarged mediastinal lymph nodes are used for validation. For lymph node detection, their system achieves 88% sensitivity at eight false positives per patient. For lymph node station labeling, 84.5% of lymph nodes are correctly assigned to their stations. Conclusions: Multiple-channel shape, intensity, and spatial prior features aggregated by a random forest classifier improve mediastinal lymph node detection on chest CT. Using the location information of segmented anatomic structures from the multiatlas formulation enables accurate identification of lymph node stations. [ABSTRACT FROM AUTHOR]

Purpose: Precisely and efficiently locating a tumor with less manual intervention in ultrasound-guided high-intensity focused ultrasound (HIFU) therapy is one of the keys to guaranteeing the therapeutic result and improving the efficiency of the treatment. The segmentation of ultrasound images has always been difficult due to the influences of speckle, acoustic shadows, and signal attenuation as well as the variety of tumor appearance. The quality of HIFU guidance images is even poorer than that of conventional diagnostic ultrasound images because the ultrasonic probe used for HIFU guidance usually obtains images without making contact with the patient’s body. Therefore, the segmentation becomes more difficult. To solve the segmentation problem of ultrasound guidance image in the treatment planning procedure for HIFU therapy, a novel region-based segmentation method for uterine fibroids in HIFU guidance images is proposed. Methods: Tumor partitioning in HIFU guidance image without manual intervention is achieved by a region-based split-and-merge framework. A new iterative multiple region growing algorithm is proposed to first split the image into homogenous regions (superpixels). The features extracted within these homogenous regions will be more stable than those extracted within the conventional neighborhood of a pixel. The split regions are then merged by a superpixel-based adaptive spectral clustering algorithm. To ensure the superpixels that belong to the same tumor can be clustered together in the merging process, a particular construction strategy for the similarity matrix is adopted for the spectral clustering, and the similarity matrix is constructed by taking advantage of a combination of specifically selected first-order and second-order texture features computed from the gray levels and the gray level co-occurrence matrixes, respectively. The tumor region is picked out automatically from the background regions by an algorithm according to a priori information about the tumor position, shape, and size. Additionally, an appropriate cluster number for spectral clustering can be determined by the same algorithm, thus the automatic segmentation of the tumor region is achieved. Results: To evaluate the performance of the proposed method, 50 uterine fibroid ultrasound images from different patients receiving HIFU therapy were segmented, and the obtained tumor contours were compared with those delineated by an experienced radiologist. For area-based evaluation results, the mean values of the true positive ratio, the false positive ratio, and the similarity were 94.42%, 4.71%, and 90.21%, respectively, and the corresponding standard deviations were 2.54%, 3.12%, and 3.50%, respectively. For distance-based evaluation results, the mean values of the normalized Hausdorff distance and the normalized mean absolute distance were 4.93% and 0.90%, respectively, and the corresponding standard deviations were 2.22% and 0.34%, respectively. The running time of the segmentation process was 12.9 s for a 318×333 (pixels) image. Conclusions: Experiments show that the proposed method can segment the tumor region accurately and efficiently with less manual intervention, which provides for the possibility of automatic segmentation and real-time guidance in HIFU therapy. [ABSTRACT FROM AUTHOR]

Purpose: Glioblastoma multiforme (GBM) is the most common and aggressive primary brain cancer. Four molecular subtypes of GBM have been described but can only be determined by an invasive brain biopsy. The goal of this study is to evaluate the utility of texture features extracted from magnetic resonance imaging (MRI) scans as a potential noninvasive method to characterize molecular subtypes of GBM and to predict 12-month overall survival status for GBM patients. Methods: The authors manually segmented the tumor regions from postcontrast T1 weighted and T2 fluid-attenuated inversion recovery (FLAIR) MRI scans of 82 patients with de novo GBM. For each patient, the authors extracted five sets of computer-extracted texture features, namely, 48 segmentation-based fractal texture analysis (SFTA) features, 576 histogram of oriented gradients (HOGs) features, 44 run-length matrix (RLM) features, 256 local binary patterns features, and 52 Haralick features, from the tumor slice corresponding to the maximum tumor area in axial, sagittal, and coronal planes, respectively. The authors used an ensemble classifier called random forest on each feature family to predict GBM molecular subtypes and 12-month survival status (a dichotomized version of overall survival at the 12-month time point indicating if the patient was alive or not at 12 months). The performance of the prediction was quantified and compared using receiver operating characteristic (ROC) curves. Results: With the appropriate combination of texture feature set, image plane (axial, coronal, or sagittal), and MRI sequence, the area under ROC curve values for predicting different molecular subtypes and 12-month survival status are 0.72 for classical (with Haralick features on T1 postcontrast axial scan), 0.70 for mesenchymal (with HOG features on T2 FLAIR axial scan), 0.75 for neural (with RLM features on T2 FLAIR axial scan), 0.82 for proneural (with SFTA features on T1 postcontrast coronal scan), and 0.69 for 12-month survival status (with SFTA features on T1 postcontrast coronal scan). Conclusions: The authors evaluated the performance of five types of texture features in predicting GBM molecular subtypes and 12-month survival status. The authors' results show that texture features are predictive of molecular subtypes and survival status in GBM. These results indicate the feasibility of using tumor-derived imaging features to guide genomically informed interventions without the need for invasive biopsies. [ABSTRACT FROM AUTHOR]

Purpose: Breast tissue composition is considered to be associated with breast cancer risk. This study aimed to develop a computer-aided classification (CAC) system to automatically classify echotexture patterns as heterogeneous or homogeneous using automated breast ultrasound (ABUS) images. Methods: A CAC system was proposed that can recognize breast echotexture patterns in ABUS images. For each case, the echotexture pattern was assessed by two expert radiologists and classified as heterogeneous or homogeneous. After neutrosophic image transformation and fuzzy c-mean clusterings, the lower and upper boundaries of the fibroglandular tissues were defined. Then, the number of hypoechoic regions and histogram features were extracted from the fibroglandular tissues, and the support vector machine model with the leave-one-out cross-validation method was utilized as the classifier. The authors' database included a total of 208 ABUS images of the breasts of 104 females. Results: The accuracies of the proposed system for the classification of heterogeneous and homogeneous echotexture patterns were 93.48% (43/46) and 92.59% (150/162), respectively, with an overall Az (area under the receiver operating characteristic curve) of 0.9786. The agreement between the radiologists and the proposed system was almost perfect, with a kappa value of 0.814. Conclusions: The use of ABUS and the proposed method can provide quantitative information on the echotexture patterns of the breast and can be used to evaluate whether breast echotexture patterns are associated with breast cancer risk in the future. [ABSTRACT FROM AUTHOR]

Purpose: Triple-negative breast cancer (TNBC), an aggressive subtype, is frequently misclassified as fibroadenoma due to benign morphologic features on breast ultrasound (US). This study aims to develop a computer-aided diagnosis (CAD) system based on texture features for distinguishing between TNBC and benign fibroadenomas in US images. Methods: US images of 169 pathology-proven tumors (mean size, 1.65 cm; range, 0.7-3.0 cm) composed of 84 benign fibroadenomas and 85 TNBC tumors are used in this study. After a tumor is segmented out using the level-set method, morphological, conventional texture, and multiresolution gray-scale invariant texture feature sets are computed using a best-fitting ellipse, gray-level co-occurrence matrices, and the ranklet transform, respectively. The linear support vector machine with leave-one-out cross-validation schema is used as a classifier, and the diagnostic performance is assessed with receiver operating characteristic curve analysis. Results: The Az values of the morphology, conventional texture, and multiresolution gray-scale invariant texture feature sets are 0.8470 [95% confidence intervals (CIs), 0.7826-0.8973], 0.8542 (95% CI, 0.7911-0.9030), and 0.9695 (95% CI, 0.9376-0.9865), respectively. The Az of the CAD system based on the combined feature sets is 0.9702 (95% CI, 0.9334-0.9882). Conclusions: The CAD system based on texture features extracted via the ranklet transform may be useful for improving the ability to discriminate between TNBC and benign fibroadenomas. [ABSTRACT FROM AUTHOR]

Purpose: Radiomics, which is the high-throughput extraction and analysis of quantitative image features, has been shown to have considerable potential to quantify the tumor phenotype. However, at present, a lack of software infrastructure has impeded the development of radiomics and its applications. Therefore, the authors developed the imaging biomarker explorer (IBEX), an open infrastructure software platform that flexibly supports common radiomics workflow tasks such as multimodality image data import and review, development of feature extraction algorithms, model validation, and consistent data sharing among multiple institutions. Methods: The IBEX software package was developed using the MATLAB and c / c + + programming languages. The software architecture deploys the modern model-view-controller, unit testing, and function handle programming concepts to isolate each quantitative imaging analysis task, to validate if their relevant data and algorithms are fit for use, and to plug in new modules. On one hand, IBEX is self-contained and ready to use: it has implemented common data importers, common image filters, and common feature extraction algorithms. On the other hand, IBEX provides an integrated development environment on top of MATLAB and c / c + +, so users are not limited to its built-in functions. In the IBEX developer studio, users can plug in, debug, and test new algorithms, extending IBEX'S functionality. IBEX also supports quality assurance for data and feature algorithms: image data, regions of interest, and feature algorithm-related data can be reviewed, validated, and/or modified. More importantly, two key elements in collaborative workflows, the consistency of data sharing and the reproducibility of calculation result, are embedded in the IBEX workflow: image data, feature algorithms, and model validation including newly developed ones from different users can be easily and consistently shared so that results can be more easily reproduced between institutions. Results: Researchers with a variety of technical skill levels, including radiation oncologists, physicists, and computer scientists, have found the IBEX software to be intuitive, powerful, and easy to use. IBEX can be run at any computer with the windows operating system and 1GB RAM. The authors fully validated the implementation of all importers, preprocessing algorithms, and feature extraction algorithms. Windows version 1.0 beta of stand-alone IBEX and IBEX'S source code can be downloaded. Conclusions: The authors successfully implemented IBEX, an open infrastructure software platform that streamlines common radiomics workflow tasks. Its transparency, flexibility, and portability can greatly accelerate the pace of radiomics research and pave the way toward successful clinical translation. © 2015 American Association of Physicists in Medicine. [ABSTRACT FROM AUTHOR]

Purpose: Ultrasound-based solutions for diagnosis and prognosis of prostate cancer are highly desirable. The authors have devised a method for detecting prostate cancer using a vibroelastography (VE) system developed in our group and a tissue classification approach based on texture analysis of VE images. Methods: The VE method applies wide-band mechanical vibrations to the tissue. Here, the authors report on the use of this system for cancer detection and show that the texture of VE images characterized by the first and the second order statistics of the pixel intensities form a promising set of features for tissue typing to detect prostate cancer. The system was used to image patients prior to radical surgery. The removed specimens were sectioned and studied by an experienced histopathologist. The authors registered the whole-mount histology sections to the ultrasound images using an automatic registration algorithm. This enabled the quantitative evaluation of the performance of the authors' imaging method in cancer detection in an unbiased manner. The authors used support vector machine (SVM) classification to measure the cancer detection performance of the VE method. Regions of tissue of size 5 × 5 mm, labeled as cancer and noncancer based on automatic registration to histology slides, were classified using SVM. Results: The authors report an area under ROC of 0.81 ± 0.10 in cancer detection on 1066 tissue regions from 203 images. All cancer tumors in all zones were included in this analysis and were classified versus the noncancer tissue in the peripheral zone. This outcome was obtained in leaveone- patient-out validation. Conclusions: The developed 3D prostate vibroelastography system and the proposed multiparametric approach based on statistical texture parameters from the VE images result in a promising cancer detection method. [ABSTRACT FROM AUTHOR]

Purpose: Tumor grading is an important part of breast cancer diagnosis and currently requires biopsy as its standard. Here, the authors investigate quantitative ultrasound parameters in locally advanced breast cancers that can potentially separate tumors from normal breast tissue and differentiate tumor grades. Methods: Ultrasound images and radiofrequency data from 42 locally advanced breast cancer patients were acquired and analyzed. Parameters related to the linear regression of the power spectrum-midband fit, slope, and 0-MHz-intercept-were determined from breast tumors and normal breast tissues. Mean scatterer spacing was estimated from the spectral autocorrelation, and the effective scatterer diameter and effective acoustic concentration were estimated from the Gaussian form factor. Parametric maps of each quantitative ultrasound parameter were constructed from the gated radiofrequency segments in tumor and normal tissue regions of interest. In addition to the mean values of the parametric maps, higher order statistical features, computed from gray-level co-occurrence matrices were also determined and used for characterization. Finally, linear and quadratic discriminant analyses were performed using combinations of quantitative ultrasound parameters to classify breast tissues. Results: Quantitative ultrasound parameters were found to be statistically different between tumor and normal tissue (p < 0.05). The combination of effective acoustic concentration and mean scatterer spacing could separate tumor from normal tissue with 82% accuracy, while the addition of effective scatterer diameter to the combination did not provide significant improvement (83% accuracy). Furthermore, the two advanced parameters, including effective scatterer diameter and mean scatterer spacing, were found to be statistically differentiating among grade I, II, and III tumors (p = 0.014 for scatterer spacing, p = 0.035 for effective scatterer diameter). The separation of the tumor grades further improved when the textural features of the effective scatterer diameter parametric map were combined with the mean value of the map (p = 0.004). Conclusions: Overall, the binary classification results (tumor versus normal tissue) were more promising than tumor grade assessment. Combinations of advanced parameters can further improve the separation of tumors from normal tissue compared to the use of linear regression parameters. While the linear regression parameters were sufficient for characterizing breast tumors and normal breast tissues, advanced parameters and their textural features were required to better characterize tumor subtypes. [ABSTRACT FROM AUTHOR]