Search PubMed⌕ Search

Biomedical subjects

L Costaridou

Publications and source records attributed to L Costaridou.

At least 19 recordsLinked to original sources

A wavelet-based spatially adaptive method for mammographic contrast enhancement.

A method aimed at minimizing image noise while optimizing contrast of image features is presented. The method is generic and it is based on local modification of multiscale gradient magnitude values provided by the redundant dyadic wavelet transform. Denoising is accomplished by a spatially adaptive thresholding strategy, taking into account local signal and noise standard deviation. Noise standard deviation is estimated from the background of the mammogram. Contrast enhancement is accomplished by applying a local linear mapping operator on denoised wavelet magnitude values. The operator normalizes local gradient magnitude maxima to the global maximum of the first scale magnitude subimage. Coefficient mapping is controlled by a local gain limit parameter. The processed image is derived by reconstruction from the modified wavelet coefficients. The method is demonstrated with a simulated image with added Gaussian noise, while an initial quantitative performance evaluation using 22 images from the DDSM database was performed. Enhancement was applied globally to each mammogram, using the same local gain limit value. Quantitative contrast and noise metrics were used to evaluate the quality of processed image regions containing verified lesions. Results suggest that the method offers significantly improved performance over conventional and previously reported global wavelet contrast enhancement methods. The average contrast improvement, noise amplification and contrast-to-noise ratio improvement indices were measured as 9.04, 4.86 and 3.04, respectively. In addition, in a pilot preference study, the proposed method demonstrated the highest ranking, among the methods compared. The method was implemented in C++ and integrated into a medical image visualization tool.

Algorithms↗

Compression assessment based on medical image quality concepts using computer-generated test images.

Compression algorithms are widely used in medical imaging systems for efficient image storage, transmission, and display. In the acceptance of lossy compression algorithms in the clinical environment, important factors are the assessment of 'visually lossless' compression thresholds, as well as the development of assessment methods requiring fewer data and time than observer performance based studies. In this study a set of quantitative measurements related to medical image quality parameters is proposed for compression assessment. Measurements were carried out using region of interest (ROI) operations on computer-generated test images, with characteristics similar to radiographic images. As a paradigm, the assessment of the lossy Joint Photographic Expert Group (JPEG) algorithm, available in a telematics application for healthcare, is presented. A compression ratio of 15 was found as the visually lossless threshold for the JPEG lossy algorithm, in agreement with previous observer performance studies. Up to this ratio low contrast discrimination is not affected, image noise level is decreased, high contrast line-pair amplitude is decreased by less than 3%, and input/output gray level differences are minor (less than 1%). This type of assessment provides information regarding the type of loss, offering cost and time benefits, in parallel with the advantages of test image adaptation to the requirements of a certain imaging modality and clinical study.

Algorithms↗

Simulating the mammographic appearance of circumscribed lesions.

Optimization performance of digital image post-processing techniques in mammography requires controlled conditions of data sets permitting quantitative representation of image characteristics of pathological findings. Digital test objects, although objective and quantitative, do not mimic mammographic appearance and clinical data sets do not provide adequate sets of values of the various pathological finding characteristics. This can be overcome by digital simulation of pathological findings and superimposition on mammographic images. A simple method for simulation of mammographic appearance of radiopaque and/or radiolucent circumscribed lesions is presented. Circumscribed lesions are simulated using grey-level transformation functions which shift and compress the range of the initial pixel grey-level values in a region of interest (ROI) of a digitized mammographic image, according to grey-level analysis in 200 ROIs of real circumscribed lesions from digitized mammographic images. Simulation addresses lesion image characteristics, such as elliptical shape, orientation, halo sign for radiopaque lesions and capsule for radiolucent lesions, and is implemented in a user-driven PC-based interactive application. The appearance of the lesions is evaluated by six radiologists on a sample of 60 real and 60 simulated radiopaque lesions with the use of receiver operating characteristic (ROC) analysis. The area under the ROC curve, pooling the responses of the observers, was 0.55+/-0.03 indicating no statistically significant difference between real and simulated lesions (p>0.05). The method adequately simulates the mammographic appearance of circumscribed lesions and could be used to generate circumscribed lesion data sets for performance evaluation of image processing techniques, as well as education purposes.

Adipose Tissue↗

A protocol-based evaluation of medical image digitizers.

Medical film digitizers play an important transitory role as digital-to-analogue bridges in radiology. Their use requires performance evaluation to assure medical image quality. A complete quality control protocol is presented, based on a set of test objects adaptable to the specification of various digitizers. The protocol includes parameters such as uniformity, input-output response, noise, geometric distortion, spatial resolution, low contrast discrimination, film slippage and light leakage, as well as associated measurement methods. The applicability of the protocol is demonstrated with two types of medical film digitizers; a charge-coupled device (CCD) digitizer and a laser digitizer. The potential value of the protocol is also discussed.

Analog-Digital Conversion↗

Quantifying image quality at breast periphery vs mammary gland in mammography using wavelet analysis.

Use of high contrast film-screen systems in mammography, in combination with the fact that exposure parameters are selected to ensure good visualization of the mammary gland, results in overexposure of the film area corresponding to the breast periphery, therefore decreasing image quality. The aim of this work was to provide a quantitative evaluation of image quality at the breast periphery compared with the mammary gland. To deal with the difficulties in quantification of image quality introduced by low contrast encountered at the breast periphery, wavelet analysis has been used for derivation of a contrast indicator (CI) and a noise indicator (NI), taking into account local grey level variations. Gradient magnitude coefficients corresponding to region of interest (ROI) grey level values are the basis of CI definition. Mammary gland and breast periphery were sampled by equally spaced ROIs, the quantity of which was determined by a heuristic method. For NI definition, the power values of gradient magnitude coefficients corresponding to the ROI were utilized. Image quality at the breast periphery compared with the mammary gland was evaluated using 150 craniocaudal images from the Digital Database for Screening Mammography. Measurements were carried out using a tool developed in our department. A 50% contrast decrease at the breast periphery was observed, while noise decreased by approximately 2%.

Breast Diseases↗

A digital density equalization technique to improve visualization of breast periphery in mammography.

In mammographic imaging, the film area corresponding to the breast periphery is overexposed, resulting in high optical density and degraded contrast in this region. A digital, model-driven density equalization technique was designed and developed to overcome this overexposure problem, taking into account the non-linear characteristic curve of the film-digitizer system. The method is based on several image processing and analysis techniques, such as thresholding, which is used to segment the pixels of the mammogram belonging to the breast region from the background, and wavelet-based fusion, which is used to equalize the pixels of breast periphery selectively while leaving the remaining breast region unaffected. Initial application of the method resulted in density-equalized mammographic images, characterized by improved contrast at the breast periphery.

Breast Neoplasms↗

A phantom-based evaluation of an exposure equalization technique in mammography.

An anatomical filter based exposure equalization technique in mammography is evaluated quantitatively using a phantom. The evaluation is carried out by a comparative observer performance study, comparing the equalization technique with a conventional one based on visualization of low contrast, 6 mm circular details and high contrast, 0.5 mm and 0.25 mm small size details. These details are situated at the phantom edge, simulating the breast periphery. Visualization of these details is studied with respect to the parameters of tube voltage, optical density, detail location and phantom thickness. Phantom images are interpreted independently by three observers using a four-point grading scale. Use of the Wilcoxon signed ranks test for paired data shows statistically highly significant improvement (p < 0.0001) in the visualization of details for the equalization technique for all values of the parameters studied. The improvement is independent of tube voltage but dependent on optical density, detail location and phantom thickness. Optimal performance is obtained for detail location closer to the outer border of the simulated breast periphery and/or further away from the film, as well as for a greater phantom thickness simulating both thick and dense breast.

Breast Neoplasms↗

Distance learning in mammographic digital image processing.

The potential of interactive multimedia and Internet technologies is investigated with respect to the implementation of a distance learning system in medical imaging. The system is built according to a client-server architecture, based on the Internet infrastructure, composed of server nodes conceptually modelled as World Wide Web (WWW) sites. Sites are implemented by integration and customization of available components. The system evolves around network-delivered interactive multimedia courses and network-based tutoring, which constitute its main learning features. This potential has been demonstrated by means of an implemented system, validated with digital image processing content, specifically image enhancement. Image enhancement methods are theoretically described and applied on mammograms. Emphasis is given in the interactive presentation of the effects of algorithm parameters on images. The system end-user access depends on available bandwidth, so high speed access can be achieved via LAN or local ISDN connections.

Biomedical Engineering↗

Evaluation of an anatomical filter-based exposure equalization technique in mammography.

An anatomical filter-based exposure equalization technique in mammography is clinically evaluated. An observer performance comparative study, between this technique and the conventional one, is carried out on the basis of the visualization of six anatomical features situated at the breast periphery. The effect of parenchymal breast patterns and compressed breast thickness in the visualization of these features is studied. 533 craniocaudal mammograms were interpreted by two radiologists independently, using a five-point rating scale. Use of the Wilcoxon ranking test for unpaired data shows statistically highly significant improvement (p < 0.0001) in the visualization of the nipple, areola, skin and subcutaneous fat in all cases, for the equalization technique. The improvement is dependent on parenchymal breast patterns and compressed breast thickness for peripheral Cooper's ligaments and peripheral surface veins. In the case of total fatty replacement and/or thin breasts neither technique seems to be superior (p > 0.05) with respect to these two features. Clinical results indicate the value of this technique in clinical routine.

Adult↗

PRONET services for distance learning in mammographic image processing.

The potential of telematics services is investigated with respect to learning needs of medical physicists and biomedical engineers. Telematics services are integrated into a system, the PRONET, which evolves around multimedia computer based courses and distance tutoring support. In addition, information database access and special interest group support are offered. System architecture is based on a component integration approach. The services are delivered in three modes: LAN, ISDN and Internet. Mammographic image processing is selected as an example content area.

Biomedical Engineering↗

Use of wavelet analysis for contrast enhancement in mammography.

A wavelet analysis approach to contrast enhancement in mammography is presented. The approach consists of application of non-linear enhancement of multiscale gradient magnitudes utilising edge location information. The performance of wavelet analysis is evaluated by means of a breast phantom. Preliminary results indicate the value of the approach in contrast enhancement and edge preservation for both simulated tumours and microcalcifications.

Breast Neoplasms↗

Radiographic skills learning: procedure simulation using adaptive hypermedia.

The design and development of a simulation tool supporting learning of radiographic skills is reported. This tool has by textual, graphical and iconic resources, organized according to a building-block, adaptive hypermedia approach, which is described and supported by an image base of radiographs. It offers interactive user-controlled simulation of radiographic imaging procedures. The development is based on a commercially available environment (Toolbook 3.0, Asymetrix Corporation). The core of the system is an attributed precedence (priority) graph, which represents a task outline (concept and resources structure), which is dynamically adjusted to selected procedures. The user interface imitates a conventional radiography system, i.e. operating console, tube, table, patient and cassette. System parameters, such as patient positioning, focus-to-patient distance, magnification, field dimensions, tube voltage and mAs are under user control. Their effects on image quality are presented, by means of an image base acquired under controlled exposure conditions. Innovative use of hypermedia, computer based learning and simulation principles and technology in the development of this tool resulted in an enhanced interactive environment providing radiographic parameter control and visualization of parameter effects on image quality.

Computer Simulation↗

Using component technologies for web based wavelet enhanced mammographic image visualization.

The poor contrast detectability of mammography can be dealt with by domain specific software visualization tools. Remote desktop client access and time performance limitations of a previously reported visualization tool are addressed, aiming at more efficient visualization of mammographic image resources existing in web or PACS image servers. This effort is also motivated by the fact that at present, web browsers do not support domain-specific medical image visualization. To deal with desktop client access the tool was redesigned by exploring component technologies, enabling the integration of stand alone domain specific mammographic image functionality in a web browsing environment (web adaptation). The integration method is based on ActiveX Document Server technology. ActiveX Document is a part of Object Linking and Embedding (OLE) extensible systems object technology, offering new services in existing applications. The standard DICOM 3.0 part 10 compatible image-format specification Papyrus 3.0 is supported, in addition to standard digitization formats such as TIFF. The visualization functionality of the tool has been enhanced by including a fast wavelet transform implementation, which allows for real time wavelet based contrast enhancement and denoising operations. Initial use of the tool with mammograms of various breast structures demonstrated its potential in improving visualization of diagnostic mammographic features. Web adaptation and real time wavelet processing enhance the potential of the previously reported tool in remote diagnosis and education in mammography.

Female↗

A tool for designing digital test objects for module performance evaluation in medical digital imaging.

Currently, medical digital imaging systems are characterized by the introduction of additional modules such as digital display, image compression and image processing, as well as film printing and digitization. These additional modules require performance evaluation to ensure high image quality. A tool for designing computer-generated test objects applicable to performance evaluation of these modules is presented. The test objects can be directly used as digital images in the case of film printing, display, compression and image processing, or indirectly as images on film in the case of digitization. The performance evaluation approach is quality control protocol based. Digital test object design is user-driven according to specifications related to the requirements of the modules being tested. The available quality control parameters include input/output response curve, high contrast resolution, low contrast discrimination, noise, geometric distortion and field uniformity. The tool has been designed and implemented according to an object oriented approach in Visual C++ 5.0, and its user interface is based on the Microsoft Foundation Class Library version 4.2, which provides interface items such as windows, dialog boxes, lists, buttons, etc. The compatibility with DICOM 3.0 part 10 image formats specifications allows the integration of the tool in the existing software framework for medical digital imaging systems. The capability of the tool is demonstrated by direct use of the test objects in case of image processing, and indirect use of the test objects in case of film digitization.

Algorithms↗

An image visualization tool in mammography.

The poor detectability of diagnostic mammographic features, due to their low contrast, is dealt with by a software visualization tool. The tool is domain specific to medical imaging and consequently mammographic imaging, and it is envisaged as part of medical image visualization and manipulation stations. Domain specificity is served by the tool conformance to DICOM 3.0 part 10 image format specifications, specifically PAPYRUS 3.0, window width/level display adjustments of image dynamic range of up to 16 bits, and application of visualization operations to user-defined regions of interest in addition to global operations. The software has been designed and implemented according to an object oriented approach in Visual C++. The tool user interface is friendly, based on a widely used windowing paradigm, the Microsoft Foundation Class library version 4.2, which provides interface items, such as windows, dialogue boxes, lists, slide bars, buttons, etc. The visualization functionality offered by the tool relies on the following three categories of image processing algorithms: dynamic range adjustments by pixel intensity transformations, contrast enhancement and noise suppression by spatial domain direct manipulation of image pixels or by manipulation of wavelet coefficients. The first two categories of algorithms are implemented in real time. Initial use of the tool has demonstrated its potential in improving the detectability of diagnostic mammographic image features.

Algorithms↗

An educational hypertext system supporting radiographic image quality.

Understanding the physical and technical factors affecting image characteristics is an essential learning task in the process of optimizing radiographic image quality. The goal of the present effort is the design of a stand-alone software application acting as an educational aid to radiology residents and radiographers. The application is organized in three modules, each one offering a different approach to the learning task. The core of the system is a hypertext database management system composed of text, digitized radiographs, graphics and animations. User orientation, linking, indexing, and annotation are some of the facilities offered in pursuing topics of interest.

Computer Graphics↗

A learning tool in medical imaging: using procedure graphs in radiographic process simulation.

Teaching the procedural elements of imaging protocols and understanding the interrelationships and interdependencies of diagnostic X-ray system parameters and their effects on image quality, are among the main objectives of medical imaging training programs. A teaching tool is designed and implemented to support these goals. Tool design is influenced by hybrid learning system architectures and it is based on a graph approach, which is described. Implementation is carried out using a hypermedia development environment (Toolbook) coupled with a database (Paradox). The core of the system is an attributed priority graph, capable of supporting the organization of the domain knowledge, monitoring of user-machine interaction and managing the user-system dialogue. Use of this approach resulted in an interactive simulation tool, which provides computer aided learning support, to radiology related personnel, such as radiologists and radiographers. The potential value of the tool is not restricted only to didactic tasks, but may include trouble-shooting and documentation.

Computer Simulation↗

A layered architecture for computer-based simulation supporting skills learning: an X-ray imaging paradigm.

Simulation is characterized by strong learning potential, providing the basis for a new category of systems, the simulation-based learning systems. To strengthen the learning potential of these systems, models are needed not only of the actual system being imitated, but also of the operational expertise required to carry out manipulations of the simulated system, inherently linked to learning. In this paper, an architecture is reported aimed at supporting the organization of multimodal simulation resources to induce skills learning. This architecture is based on distinct layers, allowing independent representation of learning and simulation components. Its applicability has been demonstrated by means of a paradigm, including simulation of X-ray imaging procedure, as well as authoring of learning scenarios pertaining to such procedures.

Algorithms↗