Medical imaging and telemedicine - from medical data production, to processing, storing, and sharing: a short outlook.
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Database Management Systems↗
Biomedical subjects
Thomas M Lehmann
Publications and source records attributed to Thomas M Lehmann.
Strategies to configure image analysis algorithms for clinical usage.
Medical imaging informatics must exceed the mere development of algorithms. The discipline is also responsible for the establishment of methods in clinical practice to assist physicians and improve health care. From our point of view, it is commonly accepted that model-based analysis of medical images is superior to other concepts, but only a few applications are found in daily clinical use. The gap between development of model-based image analysis and its routine application can be addressed by identifying four necessary transfer steps: formulation, parameterization, instantiation, and validation. Usually, computer scientists formulate the model and define its parameterization, i.e., configure a model to handle a selected subset of clinical data. During instantiation, the algorithm adapts the model to the actual data, which is validated by physicians. Since medical a priori knowledge and particular knowledge on technical details are required for parameterization and validation, these steps are considered to be bottlenecks. In this paper, we propose general schemes that allow an application- or image-specific parameterization to be performed by medical users. Combining noncontextual and contextual approaches, we also suggest a reliable scheme that allows application-specific validation, even if a gold standard is unavailable. To emphasize our point of view, we provide examples based on unsupervised segmentation in medical imagery, which is one of the most difficult tasks. Following the proposed schemes, an exact delineation of cells in micrographs is parameterized, validated, and successfully established in daily clinical use, while automatic determination of body regions in radiographs cannot be configured to support reliable and robust clinical use. The results stress that parameterization and validation must be based on clinical data that show all potential variations and artifact sources.
Algorithms↗
A generic concept for the implementation of medical image retrieval systems.
This work presents mechanisms to support the development and installation of content-based image retrieval in medical applications (IRMA). A strict separation of feature extraction, feature storage, feature comparison, and the user interfaces is suggested. The concept and implementation of a system following these guidelines is described. The system allows to reuse implemented components in different retrieval algorithms, which improves software quality, shortens the development cycle for applications, and allows to establish standardized end-user interfaces.
Algorithms↗
IRMA--content-based image retrieval in medical applications.
The impact of content-based access to medical images is frequently reported but existing systems are designed for only a particular modality or context of diagnosis. Contrarily, our concept of image retrieval in medical applications (IRMA) aims at a general structure for semantic content analysis that is suitable for numerous applications in case-based reasoning or evidence-based medicine. Within IRMA, stepwise processing results in six layers of information modeling (raw data layer, registered data layer, feature layer, scheme layer, object layer, knowledge layer) incorporating medical expert knowledge. At the scheme layer, medical images are represented by a hierarchical structure of ellipses (blobs) describing image regions. Hence, image retrieval transforms to graph matching. The multilayer processing is implemented using a distributed system designed with only three core elements. The central database holds program sources, process-ing schemes, images, features, and blob trees; the scheduler balances distributed computing by addressing daemons running on all connected workstations; and the web server provides graphical user interfaces for data entry and retrieval..
Computer Graphics↗
Determining the view of chest radiographs.
Automatic identification of frontal (posteroanterior/anteroposterior) vs. lateral chest radiographs is an important preprocessing step in computer-assisted diagnosis, content-based image retrieval, as well as picture archiving and communication systems. Here, a new approach is presented. After the radiographs are reduced substantially in size, several distance measures are applied for nearest-neighbor classification. Leaving-one-out experiments were performed based on 1,867 radiographs from clinical routine. For comparison to existing approaches, subsets of 430 and 5 training images are also considered. The overall best correctness of 99.7% is obtained for feature images of 32 x 32 pixels, the tangent distance, and a 5-nearest-neighbor classification scheme. Applying the normalized cross correlation function, correctness yields still 99.6% and 99.3% for feature images of 32 x 32 and 8 x 8 pixel, respectively. Remaining errors are caused by image altering pathologies, metal artifacts, or other interferences with routine conditions. The proposed algorithm outperforms existing but sophisticated approaches and is easily implemented at the same time.
Humans↗
Colour texture analysis for quantitative laryngoscopy.
OBJECTIVE: Whilst considerable progress has been made in enhancing the quality of indirect laryngoscopy and image processing, the evaluation of clinical findings is still based on the clinician's judgement. The aim of this paper was to examine the feasibility of an objective computer-based method for evaluating laryngeal disease. MATERIAL AND METHODS: Digitally recorded images obtained by 90 degree- and 70 degree-angled indirect rod laryngoscopy using standardized white balance values were made of 16 patients and 19 healthy subjects. The digital images were evaluated manually by the clinician based on a standardized questionnaire, and suspect lesions were marked and classified on the image. Following colour separation, normal vocal cord areas as well as suspect lesions were analyzed automatically using co-occurrence matrices, which compare colour differences between neighbouring pixels over a predefined distance. RESULTS: Whilst colour histograms did not provide sufficient information for distinguishing between healthy and diseased tissues, consideration of the blue content of neighbouring pixels enabled a correct classification in 81.4% of cases. If all colour channels (red, green and blue) were regarded simultaneously, the best classification correctness obtained was 77.1%. CONCLUSIONS: Although only a very basic classification differentiating between healthy and diseased tissue was attempted, the results showed progress compared to grey-scale histograms, which have been evaluated before. The results document a first step towards an objective, machine-based classification of laryngeal images, which could provide the basis for further development of an expert system for use in indirect laryngoscopy.
Color↗
Automatic categorization of medical images for content-based retrieval and data mining.
Categorization of medical images means selecting the appropriate class for a given image out of a set of pre-defined categories. This is an important step for data mining and content-based image retrieval (CBIR). So far, published approaches are capable to distinguish up to 10 categories. In this paper, we evaluate automatic categorization into more than 80 categories describing the imaging modality and direction as well as the body part and biological system examined. Based on 6231 reference images from hospital routine, 85.5% correctness is obtained combining global texture features with scaled images. With a frequency of 97.7%, the correct class is within the best ten matches, which is sufficient for medical CBIR applications.
Automation↗
A generic concept for the implementation of medical image retrieval systems.
This paper presents a technical framework to support the development and installation of system for content-based image retrieval in medical applications (IRMA). A strict separation of feature extraction, feature storage, feature comparison, and the user interfaces is suggested. This allows to reuse implemented components in different retrieval algorithms, which improves software quality, shortens the development cycle for applications, and allows to introduce standardized end-user interfaces. Based on the proposed framework, the IRMA engine has been established, which is currently used to evaluate content-based retrieval methods on a collection of 20,000 medical and 135,000 non-medical images.
Algorithms↗