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Biomedical subjects

D Gur

Publications and source records attributed to D Gur.

At least 55 records · Page 3Linked to original sources
PubMed1996

Mass detection in digitized mammograms using two independent computer-assisted diagnosis schemes.

OBJECTIVE: Using two independent computer-assisted diagnosis (CAD) schemes, we investigated the potential to improve the sensitivity of mass detection by applying a logical "or" operation and to improve the specificity using a logical "and" operation. MATERIALS AND METHODS: Two independent mass detectors, one with Gaussian bandpass filtering and multilayer topographic feature analysis and the other with a five-stage search for a single suspicious region, were applied to a large image database that included 428 digitized mammograms with 220 verified masses. The performance of the two schemes and a combination of them in the form of either logical "or" or logical "and" operations were compared. RESULTS: In this preliminary study, a multilayer topographic feature analysis CAD scheme (CAD-1) achieved a sensitivity of 96% and had a false-positive detection rate of 0.79 per image. A five-stage search method scheme (CAD-2) achieved a sensitivity of 94% and had a false-positive detection rate of 1.69 per image. With an "or" operation, the combined results yielded 100% sensitivity with a false-positive detection rate of 2.07 per image. A logical "and" operation produced a reduction of the false-positive detection rate to 0.4 per image, but sensitivity also decreased to 90%. CONCLUSION: Similar to an independent double-reading approach and depending upon the relevant clinical question, sensitivity or specificity can be improved by combining the results of several independent CAD schemes.

Breast Neoplasms↗
PubMed1995

On the generalization of the receiver operating characteristic analysis to the population of readers and cases with the jackknife method: an assessment.

RATIONALE AND OBJECTIVES: A new methodology that analyzes receiver operating characteristic (ROC) data sets based on jackknifing and that considers both case and reader variability has been proposed. The purpose of this investigation was to compare results using this method to those using commonly reported methodology. METHODS: ROC data sets using discrete and continuous rating scales were analyzed using the proposed jackknifing method, and results were compared to analysis of the same data sets using the paired t test. RESULTS: The two methodologies did not result in the same significance levels, and in some cases, the difference was sufficient to affect conclusions regarding comparisons of diagnostic modalities. The probability value for the jackknifing procedure is based on large sample distribution theory, and its appropriateness is unknown for sample sizes used in practice. Also, the jackknifing technique was found to be sensitive to outliers resulting when data from the computer programs used to estimate area under the ROC curve failed to converge. CONCLUSION: Although the proposed methodology yields reasonable results, several fundamental and practical issues must be addressed before it can be used widely as the analytic method of choice in ROC studies comparing different imaging techniques or reading environments.

Analysis of Variance↗
PubMed1995

Computer-aided detection of clustered microcalcifications in digitized mammograms.

RATIONALE AND OBJECTIVES: We investigated a computer-aided detection (CAD) scheme for clustered microcalcifications in digitized mammograms. METHODS: A multistage CAD scheme was developed and tested. To increase sensitivity, the scheme uses a Gaussian band-pass filter and nonlinear threshold. A multistage local minimum searching routine and a multilayer topographic feature analysis are used to reduce the false-positive detection rate. One hundred ten digitized mammograms were used in this preliminary test, with 55 images containing one or two verified microcalcification clusters. RESULTS: The CAD scheme achieved 100% sensitivity and had an average false-positive detection rate of 0.18 per image. CONCLUSION: The CAD scheme performs as well as many published schemes and has some unique advantages to further improve detection sensitivity and specificity of future CAD schemes.

Breast Diseases↗
PubMed1995

Computerized detection of masses from digitized mammograms: comparison of single-image segmentation and bilateral-image subtraction.

RATIONALE AND OBJECTIVES: Two methods--single-image segmentation and bilateral-image subtraction--have been used commonly as the first stage in computer-aided detection (CAD) schemes to detect masses on digitized mammograms. In the current study, we investigated and compared the advantages and disadvantages of the two methods in achieving a high sensitivity for mass detection. METHODS: Two CAD schemes were tested. One used Gaussian filtering based on single-image segmentation, and the other used bilateral-image subtraction based on left-right image pairs to identify suspicious mass regions. A clinical database that contained 152 verified mass cases was used to compare the two approaches. RESULTS: The single-image segmentation method yielded 100% sensitivity and had a somewhat higher number of initial suspicious regions. The bilateral-image subtraction method missed several true-positive regions at the initial phase. Each approach achieved more than 90% sensitivity at a false-positive rate of approximately 0.8 per image. CONCLUSION: Optimal initial image segmentation schemes may depend on the complete detection and classification method used. Single-image segmentation methods may perform comparably with bilateral-image segmentation schemes, and these techniques appear to be more versatile and easily adaptable to future clinical CAD applications.

Breast Neoplasms↗
PubMed1995

Computerized detection of masses in digitized mammograms using single-image segmentation and a multilayer topographic feature analysis.

RATIONALE AND OBJECTIVES: We developed and evaluated a computer-aided detection (CAD) scheme for masses in digitized mammograms. METHODS: A multistep CAD scheme was developed and tested. The method uses a technique of single-image segmentation with Gaussian bandpass filtering to yield a high sensitivity for mass detection. A rule-based multilayer topographic feature analysis method is then used to classify suspected regions. A set of 260 cases, including 162 verified masses, was divided into two subsets; one set was used to set the rule-based classification and one was used to test the performance of the scheme. RESULTS: In a preliminary clinical study, the implemented detection scheme yielded 98% sensitivity with a false-positive detection rate of less than one false-positive region per image. CONCLUSION: Single-image segmentation methods seem to have high sensitivity in selecting true-positive mass regions in the first stage of a CAD scheme. A multilayer topographic image feature analysis method in the second stage of a CAD scheme has the potential to significantly reduce the false-positive detection rate.

Algorithms↗
PubMed1995

Transferable production of PER-1 beta-lactamase in Pseudomonas aeruginosa.

PER-1, an extended-spectrum class A beta-lactamase, has been described only from Pseudomonas aeruginosa RNL-1, which was obtained in France in 1991. During studies on ceftazidime-resistant P. aeruginosa collected from December 1991 to July 1993 in Ankara, Turkey, we found 14 further isolates with PER-1 enzyme, as recognised by isoelectric point (pI 5.4), hydrolytic activity, gene hybridization and DNA sequence. Five of these isolates also had OXA-10 (PSE-2)-related enzymes and one hyper-produced ampC beta-lactamase, whereas eight had PER-1 enzyme alone. The last group, from four wards, appeared to be identical, giving the same DNA restriction patterns and carrying the PER-1 gene on an 8.5 kb HincII fragment. Two more producers were related but the other four were unique. In several representatives of the group of eight replicates, the PER-1 gene was shown to be encoded on a plasmid, larger than 154 kb in size, which transferred to P. aeruginosa PU21. A further isolate had the gene on an even larger conjugative plasmid. By contrast, the PER-1 gene reportedly was chromosomally-inserted in strain RNL-1. The PER-1 producers and their transconjugants were highly resistant to ceftazidime and aztreonam (MIC > or = 128 mg/L) but not to carbapenems or latamoxet. Piperacillin insusceptibility was marginal (MIC 8 mg/L). Clavulanate 4 mg/L, but not tazobactam 4 mg/L, reversed resistance to ceftazidime and carbenicillin. Purification of the enzyme to homogeneity was achieved by three ion exchanges and one gel filtration. We found much lower Vmax rates for aminothiazolyl cephalosporins than reported previously for PER-1 enzyme. This reflected the present assays being in 0.1 M phosphate buffer pH 7.0, whereas the previous were pH-stat-regulated; concentrated phosphate reduced enzyme activity against ceftazidime, but not against cephaloridine.

Base Sequence↗
PubMed1995

OXA-14, another extended-spectrum variant of OXA-10 (PSE-2) beta-lactamase from Pseudomonas aeruginosa.

Pseudomonas aeruginosa 455, isolated in Ankara, Turkey, produced a pI 6.2 beta-lactamase determined by plasmid pMLH53 and resisted all beta-lactams except carbapenems. This beta-lactamase, named OXA-14, corresponded to OXA-10 (PSE-2) except that aspartate replaced glycine at position 157 and thus is intermediate between OXA-10 and OXA-11, which has aspartate at position 157 and a further substitution at position 143.

Anti-Bacterial Agents↗
PubMed1995

Imaging systems evaluation: effect of subtle cases on the design and analysis of receiver operating characteristic studies.

OBJECTIVE: Large-scale receiver operating characteristic (ROC) studies are expensive and time-consuming. If most of the difference in diagnostic accuracy occurs in a subset of subtle cases, considerable effort could be saved by restricting comparisons to this subset. We investigate the effect of subtle cases on diagnostic accuracy, the magnitude of error that can occur because of an imbalance of subtle cases in two groups, and the potential for sample size reductions if only subtle cases are used. METHODS: Data from a previous study of posteroanterior chest radiographs were reanalyzed separately for subsets of typical cases and subsets of subtle cases. Actually positive and actually negative cases were classified as subtle or typical and as difficult or easy for diagnosis of the specific abnormality. The area under the ROC curve (Az) was used as the measure of diagnostic accuracy. Pairwise comparisons were done among three techniques and for the detection of nodules and interstitial disease. RESULTS: The performance index (Az) was significantly (> or = 25%) lower for the subset of subtle cases as compared with the subset of typical cases. The difference in observer performance between two techniques was more often greater in the subset of subtle cases than in the subset of typical cases. CONCLUSION: The difference in diagnostic accuracy between the subset of typical cases and the subset of subtle cases is large enough that a difference in the proportion of subtle cases in two samples could result in clinically significant false differences in observer performance. Furthermore, the generally larger difference observed in the group of subtle cases suggests that sample sizes for some experiments could be reduced by 45-90% if the experiment were restricted to subtle cases.

Humans↗
PubMed1994

Subjective and objective assessment of image quality--a comparison.

Forced-choice just noticeable difference (JND) studies are extremely sensitive to image quality variations that are below the threshold at which the differences are apparent to or definable by the observer. Paired comparisons of 4K and 2K laser-printed posteroanterior chest images consistently demonstrated that although images are viewed as comparable by radiologists, when forced to choose the better ("sharper") image, they actually select the higher-resolution images in 83% of the paired observations. We conclude that small differences in image quality may be detectable even in image sets which are considered to be comparable by subjective assessments.

Differential Threshold↗
PubMed1994

Joint photographic experts group (JPEG) compatible data compression of mammograms.

We have developed a Joint Photographic Experts Group (JPEG) compatible image compression scheme tailored to the compression of digitized mammographic images. This includes a preprocessing step that segments the tissue area from the background, replaces the background pixels with a constant value, and applies a noise-removal filter to the tissue area. The process was tested by performing a just-noticeable difference (JND) study to determine the relationship between compression ratio and a reader's ability to discriminate between compressed and noncompressed versions of digitized mammograms. We found that at compression ratios of 15:1 and below, image-processing experts are unable to detect a difference, whereas at ratios of 60:1 and above they can identify the compressed image nearly 100% of the time. The performance of less specialized viewers was significantly lower because these viewers seemed to have difficulty in differentiating between artifact and real information at the lower and middle compression ratios. This preliminary study suggests that digitized mammograms are very amenable to compression by techniques compatible with the JPEG standard. However, this study was not designed to address the efficacy of image compression process for mammography, but is a necessary first step in optimizing the compression in anticipation of more elaborate reader performance (ROC) studies.

Algorithms↗
PubMed1994

Fractal analysis of trabecular patterns in projection radiographs. An assessment.

RATIONALE AND OBJECTIVES: Fractal analysis of digitized images has been investigated in recent years as a potential measure of structural bone strength. Several technical issues associated with such measurements are assessed. METHODS: In a series of experiments using a hand phantom, the effects of system noise and modulation transfer function on fractal dimension were explored. The authors evaluated a method for correcting the estimated power spectrum using a step-wedge image exposed and digitized under identical conditions as a reference. RESULTS: System noise and modulation transfer function significantly affect estimated fractal dimension in bony regions computed from conventional radiographs. CONCLUSIONS: Before conventional radiographs are used for fractal analysis in the clinical environment, many of the technical problems associated with this methodology must be addressed.

Bone and Bones↗
PubMed1994

Effectiveness of antiscatter grids in digital radiography. A phantom study.

INTRODUCTION: With ever-increasing interest in bedside radiography using digital imaging techniques, one question often asked is whether and which antiscatter grid should be used to reduce the effects of scattered radiation. In this article, the authors quantitatively analyze and compare images obtained with a flexible circular hole (FCH) grid, a conventional 6:1 focused grid, or without a grid. METHODS: Scatter-to-primary ratios (SPRs), contrast signals, and contrast-to-noise ratios (CNRs) were measured for fixed patient exposure and were compared at various locations in the images of an anthropomorphic chest phantom. RESULTS: Although both grids resulted in greater contrast signals, a significant improvement of the CNR was achieved only in the upper and middle mediastinum regions when the conventional grid was used. With the FCH grid, the CNR is degraded at most locations in the chest image. DISCUSSION: Our results indicate that at fixed exposure level, the use of either grid yields only marginal improvement, at best, in bedside digital chest radiography.

Humans↗
PubMed1994

Diagnostic reading session: temporal patterns and case-order effects.

The authors analyzed receiver-operating-characteristic studies to determine temporal patterns and performance as a function of the elapsed time in a reading session. Nineteen radiologists each read as many as 300 chest images with use of seven different display modalities, including conventional and laser-printed film and high-resolution soft display. With a computerized reporting system, the ratio of observers' interpretation rates (time to diagnosis) were recorded for the last five and 10 compared with the first five and 10 of 30-40 cases seen in sessions lasting 45-110 minutes. Observers tended to accelerate their interpretation as the sessions progressed by an average of 15% (P < .001). The acceleration was consistent for all readers (both fast and slow) with a variety of display modes under the nonrestricted time environment.

Humans↗
PubMed1994

Sequential viewing of abdominal CT images at varying rates.

PURPOSE: To evaluate radiologists' ability to detect abdominal masses during sequential viewing of series of computed tomographic (CT) scans at varying rates. MATERIALS AND METHODS: Receiver operating characteristic (ROC) analysis was used to assess the ability of five experienced radiologists to determine the presence or absence of subtle abdominal masses in 29 cases (15 positive, 14 negative) while viewing CT scans sequentially at different rates (0.5, 1, 2, 4, 7, and 21 images per second) and also at reader-selectable rates. RESULTS: Even at extremely fast viewing rates (21 images per second), radiologists performed significantly better (P < .05) than would be expected by chance alone (average area Az under the ROC curve = 0.73 vs 0.5). As the viewing rate decreased, their performance increased. The reader-selectable mode was better than any fixed-rate cine mode (average Az = 0.93). CONCLUSION: Fixed-rate sequential viewing of CT images for the primary diagnosis of subtle abdominal masses should be restricted to no more than one or two images per second, but the reader-selectable viewing mode is preferable to any fixed-rate cine mode.

Humans↗