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Biomedical subjects

S K Mun

Publications and source records attributed to S K Mun.

At least 37 records · Page 2Linked to original sources

Differentiation between nodules and end-on vessels using a convolution neural network architecture.

In recent years, many computer-aided diagnosis schemes have been proposed to assist radiologists in detecting lung nodules. The research efforts have been aimed at increasing the sensitivity while decreasing the false-positive detections on digital chest radiographs. Among the problems of reducing the number of false positives, the differentiation between nodules and end-on vessels is one of the most challenging tasks performed by computer. Most investigators have used a conventional two-stage pattern recognition approach, ie, feature extraction followed by feature classification. The performance of this approach depends totally on good feature definition in the feature extraction stage. Unfortunately, suitable feature definition and corresponding extraction implementation algorithms proved to be very difficult to define and specify. A convolution neural network (CNN) architecture, trained by direct connection to the raw image is proposed to tackle the problem. The CNN, which uses locally responsive activation function, is directly and locally connected to the raw image. The performance of the CNN is evaluated in comparison to an expert radiologist. We used the receiver operating characteristics (ROC) method with area under the curve (Az) as the performance index to evaluate all the simulation results. The CNN showed superior performance (Az = 0.99) to the radiologist's (Az = 0.83). The CNN approach can potentially be applied to other applications, such as the differentiation of film defects and microcalcifications in mammography, in which the image features are difficult to define or not known a priori.

Algorithms↗

Quality control of storage phosphor digital radiography systems.

Quality control (QC) of storage phosphor devices is important in assuring that the image information entered into an Image management and communication (IMAC) system is sufficient for diagnosis. QC of storage phosphor digital radiography systems is complex because of the self-corrective nature of the image-processing software used in these machines. Currently, one must produce hard copy to perform adequate QC. Inspection of images with reject analysis and inspection of cassettes and imaging plates has helped us in our QC program. For those QC tests using control limits, the appropriate settings for these limits are unknown. Starting approximations are given. Recommended tests are described.

Equipment Failure↗

Classification of microcalcifications in radiographs of pathologic specimens for the diagnosis of breast cancer.

RATIONALE AND OBJECTIVES: Early detection of breast cancer depends on accurate classification of microcalcifications. We have developed a computer vision system that has the potential to classify microcalcifications objectively and consistently to aid radiologists in diagnosing breast cancer. METHODS: A convolution neural network (CNN) was used to classify benign and malignant microcalcifications in radiographs of pathologic specimens. Digital images were acquired by digitizing radiographs at a high resolution of 21 microns x 21 microns. RESULTS: Eighty regions of interest selected from digitized radiographs of pathologic specimens were used for training and testing of the neural network system. The CNN achieved an Az value (area under the receiver operating characteristic curve) of 0.90 in classifying clusters of microcalcifications associated with benign and malignant processes. CONCLUSION: Classification of microcalcifications in pathologic specimens for diagnosis of breast cancer was achieved at a high level in our computer vision system, which consists of high-resolution digitization of mammograms and a CNN.

Breast Neoplasms↗

US tissue characterization workstation: applications and design.

This article discusses the purpose, design, and uses of an ultrasonographic tissue characterization workstation. The distinguishing characteristic of a tissue characterization workstation is its ability to analyze and classify image textures. Texture is defined as regularly or randomly repeating patterns. Small texture differences in an image are difficult to observe in the presence of noise. Therefore, it is necessary to analyze the image quantitatively. Quantitative measurements include run-length statistics, fractal dimension, and correlation statistics. The workstation is designed so that a radiologist can analyze the patient's images through an easy-to-use graphical user interface. The workstation software is based on standards, so that it can be run on a variety of different hardware platforms. The workstation can be used in a research environment to distinguish between images of malignant and benign breast lesions, which are difficult to diagnose visually. Further work is being done to make the workstation software into a useful clinical tool.

Image Processing, Computer-Assisted↗

Automatic lung nodule detection using profile matching and back-propagation neural network techniques.

The potential advantages of using digital techniques instead of film-based radiography have been discussed extensively for the past 10 years. A major future application of digital techniques is computer-assisted diagnosis: the use of computer techniques to assist the radiologist in the diagnostic process. One aspect of this assistance is computer-assisted detection. The detection of small lung nodule has been recognized as a clinically difficult task for many years. Most of the literature has indicated that the rate for finding lung nodules (size range from 3 mm to 15 mm) is only approximately 65%, in those cases in which the undetected nodules could be found retrospectively. In recent published research, image processing techniques, such as thresholding and morphological analysis, have been used to enhance true-positive detection. However, these methods still produce many false-positive detections. We have been investigating the use of neural networks to distinguish true-positives nodule detections among those areas of interest that are generated from a signal enhanced image. The initial results show that the trained neural networks program can increase true-positive detections and moderately reduce the number of false-positive detections. The program reported here can perform three modes of lung nodule detection: thresholding, profile matching analysis, and neural network. This program is fully automatic and has been implemented in a DEC 5000/200 (Digital Equipment Corp, Maynard, MA) workstation. The total processing time for all three methods is less than 35 seconds. In this report, key image processing techniques and neural network for the lung nodule detection are described and the results of this initial study are reported.

Algorithms↗

Vector quantization distortion of medical ultrasound features.

Pruned-tree structured vectored quantization (PTSVQ) was applied to the lower five gray scale remapped bits of normal and fatty ultrasound liver images. The upper bits were compressed reversibly. This combination of techniques is termed PTSVQ with splitting. The effect of the compression on the difference in texture between normal and fatty liver images was studied at different compression rates and distortions. The changes in texture were measured by changes in the principal components of the covariance matrix of image vectors. The vectors were the same size as those used in the compression technique. There were clear differences in the components of normal and fatty liver images. These differences were largely removed by the PTSVQ with splitting technique even at average single pixel distortions several times smaller than the image noise. These results suggest that the effect of compression on second order statistics should be measured when evaluating algorithms in addition to the first order average distortion.

Fatty Liver↗

Improving the distinction between benign and malignant breast lesions: the value of sonographic texture analysis.

To improve the ability of ultrasound to distinguish benign from malignant breast lesions, we used quantitative analysis of ultrasound image texture. Eight cancers, 22 cysts, 28 fibroadenomata, and 22 fibrocystic nodules were studied. The true nature of each lesion was determined by aspiration (for some cysts) or by open biopsy. Analysis of image texture was performed on digitized video output from the ultrasound scanner using fractal analysis and statistical texture analysis methods. The most useful features were those derived from co-occurrence matrices of the images. Using two features together (contrast of a co-occurrence matrix taken in an oblique direction, and correlation of a co-occurrence matrix taken in the horizontal direction), it was possible to exclude 78% of fibroadenomata, 73% of cysts, and 91% of fibrocystic nodules while maintaining 100% sensitivity for cancer. These findings suggest that ultrasonic image texture analysis is a simple way to markedly reduce the number of benign lesion biopsies without missing additional cancers.

Adolescent↗

Application of artificial neural networks for reduction of false-positive detections in digital chest radiographs.

A methodology based on the fuzzy set theory and the convolution neural network (CNN) architecture is proposed to tackle the problem of reducing false-positive rate in automatic lung nodule detection. The CNN which simulates human visual mechanism was trained by a supervised back-propagation algorithm based on fuzzy membership functions. The training and testing database consists of image blocks (each 32 x 32 pixels) of suspected lung nodule areas (nodule candidates) which were generated from our pre-scanning program [1]. A linguistic label was assigned to each nodule candidate of the training set, then the label was converted to a membership value through a pre-defined membership function and used as teaching signal (desired outputs) during the network learning. Before the nodule candidate was fed to the network input, it was pre-processed to reduce the complex background noise and the contrast discrepancy resulted from film development. During the network testing phase, a defuzzification process was applied to decipher the trained network's output triggered by the nodule candidate in the testing set. Finally, a Receiver Operating Characteristic (ROC) analysis was used to evaluate the CNN's performance based on the defuzzified output of the testing database. Preliminary results showed an average Az (the performance index) of 0.84 which is equivalent to 0.80 true-positive detection (sensitivity) with an average 2-3 false-positive detections per chest image.

Computer Simulation↗

A comparison of case retrieval times: film versus picture archiving and communications systems.

One of the advantages that a picture archiving and communications system (PACS) is supposed to provide over a film-based operation is improved performance in retrieving images. Although it seems self-evident that this should be so, this experiment was intended to verify this and to provide some time comparisons for the two methods. The experiment consisted of randomly selecting ultrasound and computed tomography cases and determining how long it took to retrieve files at a PACS workstation or in person from the file room. To simulate actual retrieval volumes, a total of 40 cases from current to 6 months old, 20 cases from the past year, and 10 cases more than 1 year old was selected. Results indicate that PACS retrieval can indeed be faster than file room retrieval. However, the difference is less for recent cases than for older cases. For cases 6 or fewer months old, the workstation retrieval was approximately 2.5 minutes faster per case than the film file room. This time difference increased markedly when extended to the 1-year and older-than-1-year groups. This report details the results of this study and provides information about the reliability of the two archives.

Filing↗

PACS clinical experience at Georgetown University.

Georgetown University Hospital has been operating an image management and communications system (IMACS or PACS) for 3.5 years. This work was initially funded under the Army Medical Research and Development Command Digital Imaging Network Systems (DINS) project. The system was taken from a research system supporting only radiology tasks to one extended to clinical use, and has been used in clinical work for 3 years. This paper will summarize our PACS clinical experience and will describe the operational features implemented and those still necessary.

Computer Systems↗

An image management and communications (IMAC) system for radiology.

Managing x-ray films is a difficult problem in a hospital. Advances in digital imaging, high speed networks and high fidelity displays make it possible to develop an image management and communication system for a hospital. As many of the technical problems are solved, many operational problems remain. Experience with a prototype installation became the basis for a much more comprehensive implementation of a fully digital filmless imaging support system in a number of hospitals. The use of IMAC technology will bring about profound changes in the radiology community; physicians, administrators, manufactures of imaging systems and the users of radiology service, the patients.

Academic Medical Centers↗

Picture archiving and communication in radiology: an American perspective.

A comprehensive image management and communication (IMAC) network has been installed at Georgetown University Hospital (GUH) for an extensive clinical evaluation. The network is based on the AT&T CommView system and includes interfaces to 12 imaging devices, 15 workstations (inside and outside the radiology department), a teleradiology link to an imaging center, an optical jukebox, and a number of advanced image display and processing systems. Two years of clinical experience with the network enable us to develop a plan for future activities from an American perspective. The IMAC project is not just a technical challenge, but also a professional, organizational, and administrative one. Several obstacles remain, but they are gradually being overcome as more cost-effective and streamlined technologies become available and as users and developers gain more operational experience in managing diagnostic images in an electronic environment.

Computer Communication Networks↗

Contrast information of digital imaging in laser film digitizer and display monitor.

A 10-bit or 12-bit gray scale is provided in commercial laser film digitizers. The true contrast resolution on the digitized image within a laser spot area of 200 microns in diameter is limited by both the quantum mottle and instrumentation noise. In this report, we investigated the mean value, standard deviation, and adjacent pixel correlation coefficient on a calibrated step wedge film with two laser digitizers. The results were disappointing, because we found that the evaluated contrast information is inferior to the manufacturers' specifications. On the output side, the brightnesses of different gray levels from a clinical monitor were measured with a narrow angle luminance probe and evaluated by a brief human perception study. In addition, the implications for teleradiology applications are discussed.

Data Display↗

Image management and communication in patient care: perspectives on implementation and impact.

Image management and communication (IMAC) systems are automated and integrated systems that capture digital medical images and related patient information and transmit them electronically, display them for interpretation, and store them for future retrieval. The IMAC system concept includes images and relevant information from all clinical sources. The First International Conference on Image Management and Communication in Patient Care (IMAC 89) provides a forum for expert presentations, poster sessions, and discussion and debate among all attendees interested in the implementation and impact of IMAC systems. Plenary sessions provide an international perspective and explore the role of image-based information in patient care, approaches to improved IMAC systems, current technical barriers, quality of care issues, evaluation approaches, and scenarios for the future. Invited participants are from North America, Europe, Japan, Australia, and the WHO. Conference organizers are working with numerous professional organizations and representatives of meetings which focus on IMAC-related technology to complement, and not duplicate, the contribution of other groups.

Delivery of Health Care↗

Environmental designs for reading from imaging work stations: ergonomic and architectural features.

Despite the rapid progress made in the electronic design of imaging work stations for medicine, much less effort has gone into the design of environments in which such systems will be used. Based on studies of radiologist film reading sessions, considerable time will be spent working at such viewing systems. If the rooms in which the work stations are placed are not conducive to comfortable work, it will certainly not favor electronic viewing over film reading. In examining existing reading environments, it is also apparent that they are not optimal, even for film. Since some of the problems for film and electronic viewing overlap, such as heat generation (by the alternators, viewboxes, or work station electronics) and glare from light sources, it should be possible to develop solutions that are applicable to both environments, or to rooms that will feature both viewing systems. This paper will discuss some of the approaches to designing environments in which viewing of images is supported by the room architecture and engineering, rather than being degraded by it. To illustrate these points a design, based on the constraint of a real room size and available architectural materials, will be developed.

Architecture↗

Renal calculi after shock wave lithotripsy: US evaluation with an in vitro phantom.

Fragments of renal calculi from patients who had undergone extracorporeal shock wave lithotripsy (ESWL) were embedded in an in vitro tissue-equivalent ultrasound (US) phantom to assess (a) the accuracy with which such fragments could be measured; (b) the influence of stone composition, stone depth, and transducer frequency; and (c) the effect of fragment "clumping" on size determinations and acoustic shadowing. Fragments as small as 0.8 mm in diameter could be detected at 7.5 MHz, although a practical limitation of 1-2 mm for lower transducer frequencies (3.5 and 5.0 MHz) was observed. Fragment diameter tended to be overestimated with US by a mean of 1 mm. Transducers of 5 and 7.5 MHz were more accurate in determination of size than 3.5-MHz transducers. Struvite fragments were less echogenic and were therefore measured more accurately, but smaller struvite fragments were less detectable than other fragment types. Fragment "clumping" led to significant overestimation of residual stone size even when small fragments were separated by as much as the distance equal to the diameter of one fragment. This study demonstrates that even under the best circumstances the disadvantages of US in assessing residual stone disease are significant.

Humans↗

Cerebral blood flow in humans following resuscitation from cardiac arrest.

Cerebral blood flow was measured by xenon-133 washout in 13 patients 6-46 hours after being resuscitated from cardiac arrest. Patients regaining consciousness had relatively normal cerebral blood flow before regaining consciousness, but all patients who died without regaining consciousness had increased cerebral blood flow that appeared within 24 hours after resuscitation (except in one patient in whom the first measurement was delayed until 28 hours after resuscitation, by which time cerebral blood flow was increased). The cause of the delayed-onset increase in cerebral blood flow is not known, but the increase may have adverse effects on brain function and may indicate the onset of irreversible brain damage.

Adult↗