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Differentiation of sCJD and vCJD forms by automated analysis of basal ganglia intensity distribution in multisequence MRI of the brain--definition and evaluation of new MRI-based ratios.

We present a method for the analysis of basal ganglia (including the thalamus) for accurate detection of human spongiform encephalopathy in multisequence magnetic resonance imaging (MRI) of the brain. One common feature of most forms of prion protein diseases is the appearance of hyperintensities in the deep grey matter area of the brain in T2-weighted magnetic resonance (MR) images. We employ T1, T2, and Flair-T2 MR sequences for the detection of intensity deviations in the internal nuclei. First, the MR data are registered to a probabilistic atlas and normalized in intensity. Then smoothing is applied with edge enhancement. The segmentation of hyperintensities is performed using a model of the human visual system. For more accurate results, a priori anatomical data from a segmented atlas are employed to refine the registration and remove false positives. The results are robust over the patient data and in accordance with the clinical ground truth. Our method further allows the quantification of intensity distributions in basal ganglia. The caudate nuclei are highlighted as main areas of diagnosis of sporadic Creutzfeldt-Jakob Disease (sCJD), in agreement with the histological data. The algorithm permitted the classification of the intensities of abnormal signals in sCJD patient FLAIR images with a higher hypersignal in caudate nuclei (10/10) and putamen (6/10) than in thalami. Defining normalized MRI measures of the intensity relations between the internal grey nuclei of patients, we robustly differentiate sCJD and variant CJD (vCJD) patients, in an attempt to create an automatic classification tool of human spongiform encephalopathies.

Algorithms↗

Image registration with auto-mapped control volumes.

Many image registration algorithms rely on the use of homologous control points on the two input image sets to be registered. In reality, the interactive identification of the control points on both images is tedious, difficult, and often a source of error. We propose a two-step algorithm to automatically identify homologous regions that are used as a priori information during the image registration procedure. First, a number of small control volumes having distinct anatomical features are identified on the model image in a somewhat arbitrary fashion. Instead of attempting to find their correspondences in the reference image through user interaction, in the proposed method, each of the control regions is mapped to the corresponding part of the reference image by using an automated image registration algorithm. A normalized cross-correlation (NCC) function or mutual information was used as the auto-mapping metric and a limited memory Broyden-Fletcher-Goldfarb-Shanno algorithm (L-BFGS) was employed to optimize the function to find the optimal mapping. For rigid registration, the transformation parameters of the system are obtained by averaging that derived from the individual control volumes. In our deformable calculation, the mapped control volumes are treated as the nodes or control points with known positions on the two images. If the number of control volumes is not enough to cover the whole image to be registered, additional nodes are placed on the model image and then located on the reference image in a manner similar to the conventional BSpline deformable calculation. For deformable registration, the established correspondence by the auto-mapped control volumes provides valuable guidance for the registration calculation and greatly reduces the dimensionality of the problem. The performance of the two-step registrations was applied to three rigid registration cases (two PET-CT registrations and a brain MRI-CT registration) and one deformable registration of inhale and exhale phases of a lung 4D CT. Algorithm convergence was confirmed by starting the registration calculations from a large number of initial transformation parameters. An accuracy of approximately 2 mm was achieved for both deformable and rigid registration. The proposed image registration method greatly reduces the complexity involved in the determination of homologous control points and allows us to minimize the subjectivity and uncertainty associated with the current manual interactive approach. Patient studies have indicated that the two-step registration technique is fast, reliable, and provides a valuable tool to facilitate both rigid and nonrigid image registrations.

Algorithms↗

Optimizing the automatic segmentation of the left ventricle in magnetic resonance images.

Automatic segmentation of the left ventricular (LV) myocardial borders in cardiovascular MR (CMR) images allows a significant speed-up of the procedure of quantifying LV function, and improves its reproducibility. The automated boundary delineation is usually based on a set of parameters that define the algorithms. Since the automatic segmentation algorithms are usually sensitive to the image quality and frequently depend heavily on the acquisition protocol, optimizing the parameters of the algorithm for such different protocols may be necessary to obtain optimal results. In other words, using a default set of parameters may be far from optimal for different scanners or protocols. For the MASS-software, for example, this means that a total of 14 parameters need to be optimized. This optimization is a difficult and labor-intensive process. To be able to more consistently and rapidly tune the parameters, an automated optimization system would be extremely desirable. In this paper we propose such an approach, which is based on genetic algorithms (GAs). The GA is an unsupervised iterative tool that generates new sets of parameters and converges toward an optimal set. We implemented and compared two different types of the genetic algorithms: a simple GA (SGA) and a steady state GA (2SGA). The difference between these two algorithms lies in the characteristics of the generated populations: "nonoverlapping populations" and "overlapping populations," respectively "nonoverlapping" population means that the two populations are disjoint, and "overlapping" means that the best parameters found in the previous generation are included in the present population. The performance of both algorithms was evaluated on twenty routinely obtained short-axis examinations (eleven examinations acquired with a steady-state free precession pulse sequence, and nine examinations with a gradient echo pulse sequence). The optimal parameters obtained with the GAs were used for the LV myocardial border delineation. Finally, the automatically outlined contours were compared to the gold standard--manually drawn contours by experts. The result of the comparison was expressed as a degree of similarity after a processing time of less than 72 h to a 59.5% of degree of similarity for SGA and a 66.7% of degree of similarity for 2SGA. In conclusion, genetic algorithms are very suitable to automatically tune the parameters of a border detection algorithm. Based on our data, the 2SGA was more suitable than the SGA method. This approach can be generalized to other optimization problems in medical image processing.

Algorithms↗

Automated detection of prostatic adenocarcinoma from high-resolution ex vivo MRI.

Prostatic adenocarcinoma is the most commonly occurring cancer among men in the United States, second only to skin cancer. Currently, the only definitive method to ascertain the presence of prostatic cancer is by trans-rectal ultrasound (TRUS) directed biopsy. Owing to the poor image quality of ultrasound, the accuracy of TRUS is only 20%-25%. High-resolution magnetic resonance imaging (MRI) has been shown to have a higher accuracy of prostate cancer detection compared to ultrasound. Consequently, several researchers have been exploring the use of high resolution MRI in performing prostate biopsies. Visual detection of prostate cancer, however, continues to be difficult owing to its apparent lack of shape, and the fact that several malignant and benign structures have overlapping intensity and texture characteristics. In this paper, we present a fully automated computer-aided detection (CAD) system for detecting prostatic adenocarcinoma from 4 Tesla ex vivo magnetic resonance (MR) imagery of the prostate. After the acquired MR images have been corrected for background inhomogeneity and nonstandardness, novel three-dimensional (3-D) texture features are extracted from the 3-D MRI scene. A Bayesian classifier then assigns each image voxel a "likelihood" of malignancy for each feature independently. The "likelihood" images generated in this fashion are then combined using an optimally weighted feature combination scheme. Quantitative evaluation was performed by comparing the CAD results with the manually ascertained ground truth for the tumor on the MRI. The tumor labels on the MR slices were determined manually by an expert by visually registering the MR slices with the corresponding regions on the histology slices. We evaluated our CAD system on a total of 33 two-dimensional (2-D) MR slices from five different 3-D MR prostate studies. Five slices from two different glands were used for training. Our feature combination scheme was found to outperform the individual texture features, and also other popularly used feature combination methods, including AdaBoost, ensemble averaging, and majority voting. Further, in several instances our CAD system performed better than the experts in terms of accuracy, the expert segmentations being determined solely from visual inspection of the MRI data. In addition, the intrasystem variability (changes in CAD accuracy with changes in values of system parameters) was significantly lower than the corresponding intraobserver and interobserver variability. CAD performance was found to be very similar for different training sets. Future work will focus on extending the methodology to guide high-resolution MRI-assisted in vivo prostate biopsies.

Adenocarcinoma↗

AutoNR: an automated system that measures ECAP thresholds with the Nucleus Freedom cochlear implant via machine intelligence.

OBJECTIVE: AutoNRT is an automated system that measures electrically evoked compound action potential (ECAP) thresholds from the auditory nerve with the Nucleus Freedom cochlear implant. ECAP thresholds along the electrode array are useful in objectively fitting cochlear implant systems for individual use. This paper provides the first detailed description of the AutoNRT algorithm and its expert systems, and reports the clinical success of AutoNRT to date. METHODS: AutoNRT determines thresholds by visual detection, using two decision tree expert systems that automatically recognise ECAPs. The expert systems are guided by a dataset of 5393 neural response measurements. The algorithm approaches threshold from lower stimulus levels, ensuring recipient safety during postoperative measurements. Intraoperative measurements use the same algorithm but proceed faster by beginning at stimulus levels much closer to threshold. When searching for ECAPs, AutoNRT uses a highly specific expert system (specificity of 99% during training, 96% during testing; sensitivity of 91% during training, 89% during testing). Once ECAPs are established, AutoNRT uses an unbiased expert system to determine an accurate threshold. Throughout the execution of the algorithm, recording parameters (such as implant amplifier gain) are automatically optimised when needed. RESULTS: In a study that included 29 intraoperative and 29 postoperative subjects (a total of 418 electrodes), AutoNRT determined a threshold in 93% of cases where a human expert also determined a threshold. When compared to the median threshold of multiple human observers on 77 randomly selected electrodes, AutoNRT performed as accurately as the 'average' clinician. CONCLUSIONS: AutoNRT has demonstrated a high success rate and a level of performance that is comparable with human experts. It has been used in many clinics worldwide throughout the clinical trial and commercial launch of Nucleus Custom Sound Suite, significantly streamlining the clinical procedures associated with cochlear implant use.

Algorithms↗

Computerized interpretation of breast MRI: investigation of enhancement-variance dynamics.

The advantages of breast MRI using contrast agent Gd-DTPA in the diagnosis of breast cancer have been well established. The variation of interpretation criteria and absence of interpretation guidelines, however, is a major obstacle for applications of MRI in the routine clinical practice of breast imaging. Our study aims to increase the objectivity and reproducibility of breast MRI interpretation by developing an automated interpretation approach for ultimate use in computer-aided diagnosis. The database in this study contains 121 cases: 77 malignant and 44 benign masses as revealed by biopsy. Images were obtained using a T1-weighted 3D spoiled gradient echo sequence. After the acquisition of the precontrast series, Gd-DTPA contrast agent was injected intravenously by power injection with a dose of 0.2 mmol/kg. Five postcontrast series were then taken with a time interval of 60 s. Each series contained 64 coronal slices with a matrix of 128 x 256 pixels and an in-plane resolution of 1.25 x 1.25 mm2. Slice thickness ranged from 2 to 3 mm depending on breast size. The lesions were delineated by an experienced radiologist as well as independently by computer using an automatic volume-growing algorithm. Fourteen features that were extracted automatically from the lesions could be grouped into three categories based on (I) morphology, (II) enhancement kinetics, and (III) time course of enhancement-variation over the lesion. A stepwise feature selection procedure was employed to select an effective subset of features, which were then combined by linear discriminant analysis (LDA) into a discriminant score, related to the likelihood of malignancy. The classification performances of individual features and the combined discriminant score were evaluated with receiver operating characteristic (ROC) analysis. With the radiologist-delineated lesion contours, stepwise feature selection yielded four features and an Az value of 0.80 for the LDA in leave-one-out cross-validation testing. With the computer-segmented lesion volumes, it yielded six features and an Az value of 0.86 for the LDA in the leave-one-out testing.

Algorithms↗

Morphometric analysis in three-dimensional intracoronary ultrasound: an in vitro and in vivo study performed with a novel system for the contour detection of lumen and plaque.

Currently, automated systems for quantitative analysis by intracoronary ultrasound (ICUS) are restricted to the detection of the lumen. The aim of this study was to determine the accuracy and reproducibility of a new semiautomated contour detection method, providing off-line identification of the intimal leading edge and external contour of the vessel in three-dimensional ICUS. The system allows cross-sectional and volumetric quantification of lumen and of plaque. It applies a minimum-cost algorithm and the concept that edge points derived from previously detected longitudinal contours guide and facilitate the contour detection in the cross-sectional images. A tubular phantom with segments of various luminal dimensions was examined in vitro during five catheter pull-backs (1 mm/sec), and subsequently 20 diseased human coronary arteries were studied in vivo with 2.9F 30 MHz mechanical ultrasound catheters (200 images per 20 mm segment). The ICUS measurements of phantom lumen area and volume revealed a high correlation with the true phantom areas and volumes (r = 0.99); relative mean differences were -0.65% to 3.86% for the areas and 0.25% to 1.72% for the volumes of the various segments. Intraob-server and interobserver comparisons showed high correlations (r = 0.95 to 0.98 for area and r = 0.99 for volume) and small mean relative differences (-0.87% to 1.08%), with SD of lumen, plaque, and total vessel measurements not exceeding 7.28%, 10.81%, and 4.44% (area) and 2.66%, 2.81%, and 0.67% (volume), respectively. Thus the proposed analysis system provided accurate measurements of phantom dimensions and can be used to perform highly reproducible area and volume measurements in three-dimensional ICUS in vivo.

Algorithms↗

Automated segmentation of acetabulum and femoral head from 3-D CT images.

This paper describes several new methods and software for automatic segmentation of the pelvis and the femur, based on clinically obtained multislice computed tomography (CT) data. The hip joint is composed of the acetabulum, cavity of the pelvic bone, and the femoral head. In vivo CT data sets of 60 actual patients were used in the study. The 120 (60 x 2) hip joints in the data sets were divided into four groups according to several key features for segmentation. Conventional techniques for classification of bony tissues were first employed to distinguish the pelvis and the femur from other CT tissue images in the hip joint. Automatic techniques were developed to extract the boundary between the acetabulum and the femoral head. An automatic method was built up to manage the segmentation task according to image intensity of bone tissues, size, center, shape of the femoral heads, and other characters. The processing scheme consisted of the following five steps: 1) preprocessing, including resampling 3-D CT data by a modified Sinc interpolation to create isotropic volume and to avoid Gibbs ringing, and smoothing the resulting images by a 3-D Gaussian filter; 2) detecting bone tissues from CT images by conventional techniques including histogram-based thresholding and binary morphological operations; 3) estimating initial boundary of the femoral head and the joint space between the acetabulum and the femoral head by a new approach utilizing the constraints of the greater trochanter and the shapes of the femoral head; 4) enhancing the joint space by a Hessian filter; and 5) refining the rough boundary obtained in step 3) by a moving disk technique and the filtered images obtained in step 4). The above method was implemented in a Microsoft Windows software package and the resulting software is freely available on the Internet. The feasibility of this method was tested on the data sets of 60 clinical cases (5000 CT images).

Acetabulum↗

Automated melanoma detection: multispectral imaging and neural network approach for classification.

Our aim in the present research is to investigate the diagnostic performance of artificial neural networks (ANNs) applied to multispectral images of cutaneous pigmented skin lesions as well as to compare this approach to a standard traditional linear classification method, such as discriminant function analysis. This study involves a series of 534 patients with 573 cutaneous pigmented lesions (132 melanomas and 441 nonmelanoma lesions). Each lesion was analyzed by a telespectrophotometric system (TS) in vivo, before surgery. The system is able to acquire a set of 17 images at selected wavelengths from 400 to 1040 nm. For each wavelength, five lesion descriptors were extracted, related to the criteria of the ABCD (for asymmetry, border, color, and dimension) clinical guide for melanoma diagnosis. These variables were first reduced in dimension by the use of factor analysis techniques and then used as input data in an ANN. Multivariate discriminant analysis (MDA) was also performed on the same dataset. The whole dataset was split into two independent groups: i.e., train (the first 400 cases, 95 melanomas) and verification set (last 173 cases, 37 melanomas). Factor analysis was able to summarize the data structure into ten variables, accounting for at least 90% of the original parameters variance. After proper training, the ANN was able to classify the population with 80% sensitivity, 72% specificity, and 78% sensitivity, 76% specificity for the train and validation set, respectively. Following ROC analysis, area under curve (AUC) was 0.852 (train) and 0.847 (verify). Sensitivity and specificity values obtained by the standard discriminant analysis classifier resulted in a figure of 80% sensitivity, 60% specificity and 76% sensitivity, 57% specificity for the train and validation set, respectively. AUC for MDA was 0.810 and 0.764 for the train and verify set, respectively. Classification results were significantly different between the two methods both for diagnostic scores and model stability, which was worse for MDA.

Adolescent↗

Comparison of similarity measures for the task of template matching of masses on serial mammograms.

We conducted a study to evaluate the effectiveness of twelve different similarity measures in matching the corresponding masses on temporal pairs of current and prior mammograms. To perform this comparison we implemented each of the twelve similarity measures in the final stage of our multistage registration technique for automated registration of breast lesions in serial mammograms. The multistage technique consists of three stages. In the first stage an initial fan-shape search region was estimated on the prior mammogram based on the geometrical position of the mass on the current mammogram. In the second stage, the location of the fan-shape region was refined by warping, based on an affine transformation and simplex optimization. A new refined search region was defined on the prior mammogram. In the third stage, a search for the best match between the lesion template from the current mammogram and a structure on the prior mammogram was carried out within the search region. Our data set consisted of 318 temporal pairs. We performed three experiments, using a different subset of the 318 temporal pairs for each experiment. In each experiment we further tested how the performance of the similarity measures varied as the size of the search region increased or decreased. We evaluated the twelve similarity measures based on four criteria. The first criterion was the mean Euclidean distance, which was the average distance of the true location of the mass to the location detected by the similarity measure. The second criterion was the percentage of temporal pairs that were aligned so that 50% or more of the lesion area overlapped. The third criterion was the percentage of pairs that were aligned so that 75% or more of the lesion area overlapped. The fourth and final criterion was the robustness of the similarity measure. Our results showed that three of the similarity measures, Pearson's correlation, the cosine coefficient, and Goodman and Kruskal's Gamma coefficient, provide significantly higher accuracy (p < 0.05) in the task of matching the corresponding masses on serial mammograms than the other nine similarity measures.

Algorithms↗

Evaluating concentration estimation errors in ELISA microarray experiments.

BACKGROUND: Enzyme-linked immunosorbent assay (ELISA) is a standard immunoassay to estimate a protein's concentration in a sample. Deploying ELISA in a microarray format permits simultaneous estimation of the concentrations of numerous proteins in a small sample. These estimates, however, are uncertain due to processing error and biological variability. Evaluating estimation error is critical to interpreting biological significance and improving the ELISA microarray process. Estimation error evaluation must be automated to realize a reliable high-throughput ELISA microarray system. In this paper, we present a statistical method based on propagation of error to evaluate concentration estimation errors in the ELISA microarray process. Although propagation of error is central to this method and the focus of this paper, it is most effective only when comparable data are available. Therefore, we briefly discuss the roles of experimental design, data screening, normalization, and statistical diagnostics when evaluating ELISA microarray concentration estimation errors. RESULTS: We use an ELISA microarray investigation of breast cancer biomarkers to illustrate the evaluation of concentration estimation errors. The illustration begins with a description of the design and resulting data, followed by a brief discussion of data screening and normalization. In our illustration, we fit a standard curve to the screened and normalized data, review the modeling diagnostics, and apply propagation of error. We summarize the results with a simple, three-panel diagnostic visualization featuring a scatterplot of the standard data with logistic standard curve and 95% confidence intervals, an annotated histogram of sample measurements, and a plot of the 95% concentration coefficient of variation, or relative error, as a function of concentration. CONCLUSIONS: This statistical method should be of value in the rapid evaluation and quality control of high-throughput ELISA microarray analyses. Applying propagation of error to a variety of ELISA microarray concentration estimation models is straightforward. Displaying the results in the three-panel layout succinctly summarizes both the standard and sample data while providing an informative critique of applicability of the fitted model, the uncertainty in concentration estimates, and the quality of both the experiment and the ELISA microarray process.

Algorithms↗

A completely automated CAD system for mass detection in a large mammographic database.

Mass localization plays a crucial role in computer-aided detection (CAD) systems for the classification of suspicious regions in mammograms. In this article we present a completely automated classification system for the detection of masses in digitized mammographic images. The tool system we discuss consists in three processing levels: (a) Image segmentation for the localization of regions of interest (ROIs). This step relies on an iterative dynamical threshold algorithm able to select iso-intensity closed contours around gray level maxima of the mammogram. (b) ROI characterization by means of textural features computed from the gray tone spatial dependence matrix (GTSDM), containing second-order spatial statistics information on the pixel gray level intensity. As the images under study were recorded in different centers and with different machine settings, eight GTSDM features were selected so as to be invariant under monotonic transformation. In this way, the images do not need to be normalized, as the adopted features depend on the texture only, rather than on the gray tone levels, too. (c) ROI classification by means of a neural network, with supervision provided by the radiologist's diagnosis. The CAD system was evaluated on a large database of 3369 mammographic images [2307 negative, 1062 pathological (or positive), containing at least one confirmed mass, as diagnosed by an expert radiologist]. To assess the performance of the system, receiver operating characteristic (ROC) and free-response ROC analysis were employed. The area under the ROC curve was found to be Az = 0.783 +/- 0.008 for the ROI-based classification. When evaluating the accuracy of the CAD against the radiologist-drawn boundaries, 4.23 false positives per image are found at 80% of mass sensitivity.

Algorithms↗

BioVision: an application for the automated image analysis of histological sections.

We describe a computer application, "BioVision", that can be trained to quickly and effectively classify and quantify user definable histological objects (e.g., senile plaques, neurofibrillary tangles) within single or double-labeled immunocytochemically stained sections. For a given image population, BioVision is interactively trained (in Independent User Mode) by an investigator to perform the desired classifications. This training yields a statistical model of the different types of objects occurring in the target image population. The resulting model can then be used (in Automated User Mode) to classify all objects in any image or images from the target population. BioVision simplifies the quantification of complex visual objects and improves inter-rater reliability. The program accomplishes classification in two major stages: pixel classification and blob classification. In pixel classification, each pixel is assigned to one of some number of substance classes, based on its chromatic properties and local context, reflecting basic histological distinctions of interest. In the blob classification phase, the image's pixels are first partitioned into "blobs": maximal connected sets of pixels assigned to the same substance class. Then, based on its size, shape, textural and contextual properties, each blob is assigned to a histological object class. A Bayesian classifier is used in each of the pixel and blob classification stages. We report several tests of BioVision. First, we applied BioVision to classify senile plaques and neurofibrillary tangles in several test cases of Alzheimer's brain immunostained for beta-amyloid and PHF-tau and compared the results to those produced by experienced investigators. BioVision was trained to classify Plaque-type blobs as either plaques or plaque-type nonentities, and tangle-type blobs as either tangles or tangle-type nonentities. BioVision classified the objects with an accuracy comparable to the trained investigator. Next, we applied BioVision to the task of counting all the tangles in hippocampal images from 22 Alzheimer's disease (AD) cases selected to span a broad range of dementia levels from the tissue repository of UC Irvine's Center for the study of Brain Aging and Dementia. The tangle counts produced by BioVision proved to be significantly better predictors of the cases' adjusted MMSE scores than any of tangle load, age at death, post mortem interval or the interval between the last MMSE score and death.

Alzheimer Disease↗

Single-trial lambda wave identification using a fuzzy inference system and predictive statistical diagnosis.

The aim of the study was to automate the identification of a saccade-related visual evoked potential (EP) called the lambda wave. The lambda waves were extracted from single trials of electroencephalogram (EEG) waveforms using independent component analysis (ICA). A trial was a set of EEG waveforms recorded from 64 scalp electrode locations while a saccade was performed. Forty saccade-related EEG trials (recorded from four normal subjects) were used in the study. The number of waveforms per trial was reduced from 64 to 22 by pre-processing. The application of ICA to the resulting waveforms produced 880 components (i.e. 4 subjects x 10 trials per subject x 22 components per trial). The components were divided into 373 lambda and 507 nonlambda waves by visual inspection and then they were represented by one spatial and two temporal features. The classification performance of a Bayesian approach called predictive statistical diagnosis (PSD) was compared with that of a fuzzy logic approach called a fuzzy inference system (FIS). The outputs from the two classification approaches were then combined and the resulting discrimination accuracy was evaluated. For each approach, half the data from the lambda and nonlambda wave categories were used to determine the operating parameters of the classification schemes while the rest (i.e. the validation set) were used to evaluate their classification accuracies. The sensitivity and specificity values when the classification approaches were applied to the lambda wave validation data set were as follows: for the PSD 92.51% and 91.73% respectively, for the FIS 95.72% and 89.76% respectively, and for the combined FIS and PSD approach 97.33% and 97.24% respectively (classification threshold was 0.5). The devised signal processing techniques together with the classification approaches provided for an effective extraction and classification of the single-trial lambda waves. However, as only four subjects were included, it will be valuable to further evaluate the methods on a larger group of subjects.

Adult↗

Attenuation compensation in cerebral 3D PET: effect of the attenuation map on absolute and relative quantitation.

It is generally well accepted that transmission (TX)-based non-uniform attenuation correction can supply more accurate absolute quantification; however, whether it provides additional benefits in routine clinical diagnosis based on qualitative interpretation of 3D brain positron emission tomography (PET) images is still the subject of debate. The aim of this study was to compare the effect of the two major classes of method for determining the attenuation map, i.e. uniform versus non-uniform, using clinical studies based on qualitative assessment as well as absolute and relative quantitative volume of interest-based analysis. We investigated the effect of six different methods for determining the patient-specific attenuation map. The first method, referred to as the uniform fit-ellipse method (UFEM), approximates the outline of the head by an ellipse assuming a constant linear attenuation factor (mu=0.096 cm(-1)) for soft tissue. The second, referred to as the automated contour detection method (ACDM), estimates the outline of the head from the emission sinogram. Attenuation of the skull is accounted for by assuming a constant uniform skull thickness (0.45 cm) within the estimated shape and the correct micro value (0.151 cm(-1)) is used. The usual measured transmission method using caesium-137 single-photon sources was used without (MTM) and with segmentation of the TX data (STM). These techniques were finally compared with the segmented magnetic resonance imaging method (SMM) and an implementation of the inferring attenuation distributions method (IADM) based on the digital Zubal head atlas. Several image quality parameters were compared, including absolute and relative quantification indexes, and the correlation between them was checked. The qualitative evaluation showed no significant differences between the different attenuation correction techniques as assessed by expert physicians, with the exception of ACDM, which generated artefacts in the upper edges of the head. The mean squared error between the different attenuation maps was also larger when using this latter method owing to the fact that the current implementation of the method significantly overestimated the head contours on the external slices. Correlation between the mean regional cerebral glucose metabolism (rCGM) values obtained with the various attenuation correction methods and those obtained with the gold standard (MTM) was good, except in the case of ACDM (R(2)=0.54). The STM and SMM methods showed the best correlation (R(2)=0.90) and the regression lines agreed well with the line of identity. Relative differences in mean rCGM values were in general less than 8%. Nevertheless, ANOVA results showed statistically significant differences between the different methods for some regions of the brain. It is concluded that the attenuation map influences both absolute and relative quantitation in cerebral 3D PET. Transmission-less attenuation correction results in a reduced radiation dose and makes a dramatic difference in acquisition time, allowing increased patient throughput.

Algorithms↗

Phantom validation of coregistration of PET and CT for image-guided radiotherapy.

Radiotherapy treatment planning integrating positron emission tomography (PET) and computerized tomography (CT) is rapidly gaining acceptance in the clinical setting. Although hybrid systems are available, often the planning CT is acquired on a dedicated system separate from the PET scanner. A limiting factor to using PET data becomes the accuracy of the CT/PET registration. In this work, we use phantom and patient validation to demonstrate a general method for assessing the accuracy of CT/PET image registration and apply it to two multi-modality image registration programs. An IAEA (International Atomic Energy Association) brain phantom and an anthropomorphic head phantom were used. Internal volumes and externally mounted fiducial markers were filled with CT contrast and 18F-fluorodeoxyglucose (FDG). CT, PET emission, and PET transmission images were acquired and registered using two different image registration algorithms. CT/PET Fusion (GE Medical Systems, Milwaukee, WI) is commercially available and uses a semi-automated initial step followed by manual adjustment. Automatic Mutual Information-based Registration (AMIR), developed at our institution, is fully automated and exhibits no variation between repeated registrations. Registration was performed using distinct phantom structures; assessment of accuracy was determined from registration of the calculated centroids of a set of fiducial markers. By comparing structure-based registration with fiducial-based registration, target registration error (TRE) was computed at each point in a three-dimensional (3D) grid that spans the image volume. Identical methods were also applied to patient data to assess CT/PET registration accuracy. Accuracy was calculated as the mean with standard deviation of the TRE for every point in the 3D grid. Overall TRE values for the IAEA brain phantom are: CT/PET Fusion = 1.71 +/- 0.62 mm, AMIR = 1.13 +/- 0.53 mm; overall TRE values for the anthropomorphic head phantom are: CT/PET Fusion = 1.66 +/- 0.53 mm, AMIR = 1.15 +/- 0.48 mm. Precision (repeatability by a single user) measured for CT/PET Fusion: IAEA phantom = 1.59 +/- 0.67 mm and anthropomorphic head phantom = 1.63 +/- 0.52 mm. (AMIR has exact precision and so no measurements are necessary.) One sample patient demonstrated the following accuracy results: CT/PET Fusion = 3.89 +/- 1.61 mm, AMIR = 2.86 +/- 0.60 mm. Semi-automatic and automatic image registration methods may be used to facilitate incorporation of PET data into radiotherapy treatment planning in relatively rigid anatomic sites, such as head and neck. The overall accuracies in phantom and patient images are < 2 mm and < 4 mm, respectively, using either registration algorithm. Registration accuracy may decrease, however, as distance from the initial registration points (CT/PET fusion) or center of the image (AMIR) increases. Additional information provided by PET may improve dose coverage to active tumor subregions and hence tumor control. This study shows that the accuracy obtained by image registration with these two methods is well suited for image-guided radiotherapy.

Algorithms↗

An evaluation of GO annotation retrieval for BioCreAtIvE and GOA.

BACKGROUND: The Gene Ontology Annotation (GOA) database http://www.ebi.ac.uk/GOA aims to provide high-quality supplementary GO annotation to proteins in the UniProt Knowledgebase. Like many other biological databases, GOA gathers much of its content from the careful manual curation of literature. However, as both the volume of literature and of proteins requiring characterization increases, the manual processing capability can become overloaded. Consequently, semi-automated aids are often employed to expedite the curation process. Traditionally, electronic techniques in GOA depend largely on exploiting the knowledge in existing resources such as InterPro. However, in recent years, text mining has been hailed as a potentially useful tool to aid the curation process. To encourage the development of such tools, the GOA team at EBI agreed to take part in the functional annotation task of the BioCreAtIvE (Critical Assessment of Information Extraction systems in Biology) challenge. BioCreAtIvE task 2 was an experiment to test if automatically derived classification using information retrieval and extraction could assist expert biologists in the annotation of the GO vocabulary to the proteins in the UniProt Knowledgebase. GOA provided the training corpus of over 9000 manual GO annotations extracted from the literature. For the test set, we provided a corpus of 200 new Journal of Biological Chemistry articles used to annotate 286 human proteins with GO terms. A team of experts manually evaluated the results of 9 participating groups, each of which provided highlighted sentences to support their GO and protein annotation predictions. Here, we give a biological perspective on the evaluation, explain how we annotate GO using literature and offer some suggestions to improve the precision of future text-retrieval and extraction techniques. Finally, we provide the results of the first inter-annotator agreement study for manual GO curation, as well as an assessment of our current electronic GO annotation strategies. RESULTS: The GOA database currently extracts GO annotation from the literature with 91 to 100% precision, and at least 72% recall. This creates a particularly high threshold for text mining systems which in BioCreAtIvE task 2 (GO annotation extraction and retrieval) initial results precisely predicted GO terms only 10 to 20% of the time. CONCLUSION: Improvements in the performance and accuracy of text mining for GO terms should be expected in the next BioCreAtIvE challenge. In the meantime the manual and electronic GO annotation strategies already employed by GOA will provide high quality annotations.

Animals↗

Computerized detection of colorectal masses in CT colonography based on fuzzy merging and wall-thickening analysis.

In recent years, several computer-aided detection (CAD) schemes have been developed for the detection of polyps in CT colonography (CTC). However, few studies have addressed the problem of computerized detection of colorectal masses in CTC. This is mostly because masses are considered to be well visualized by a radiologist because of their size and invasiveness. Nevertheless, the automated detection of masses would naturally complement the automated detection of polyps in CTC and would produce a more comprehensive computer aid to radiologists. Therefore, in this study, we identified some of the problems involved with the computerized detection of masses, and we developed a scheme for the computerized detection of masses that can be integrated into a CAD scheme for the detection of polyps. The performance of the mass detection scheme was evaluated by application to clinical CTC data sets. CTC was performed on 82 patients with helical CT scanners and reconstruction intervals of 1.0-5.0 mm in the supine and prone positions. Fourteen patients (17%) had a total of 14 masses of 30-50 mm, and sixteen patients (20%) had a total of 30 polyps 5-25 mm in diameter. Four patients had both polyps and masses. Fifty-six of the patients (68%) were normal. The CTC data were interpolated linearly to yield isotropic data sets, and the colon was extracted by use of a knowledge-guided segmentation technique. Two methods, fuzzy merging and wall-thickening analysis, were developed for the detection of masses. The fuzzy merging method detected masses with a significant intraluminal component by separating the initial CAD detections of locally cap-like shapes within the colonic wall into mass candidates and polyp candidates. The wall-thickening analysis detected nonintraluminal masses by searching the colonic wall for abnormal thickening. The final regions of the mass candidates were extracted by use of a level set method based on a fast marching algorithm. False-positive (FP) detections were reduced by a quadratic discriminant classifier. The performance of the scheme was evaluated by use of a leave-one-out (round-robin) method with by-patient elimination. All but one of the 14 masses, which was partially cut off from the CTC data set in both supine and prone positions, were detected. The fuzzy merging method detected 11 of the masses, and the wall-thickening analysis detected 3 of the masses including all nonintraluminal masses. In combination, the two methods detected 13 of the 14 masses with 0.21 FPs per patient on average based on the leave-one-out evaluation. Most FPs were generated by extrinsic compression of the colonic wall that would be recognized easily and quickly by a radiologist. The mass detection methods did not affect the result of the polyp detection. The results indicate that the scheme is potentially useful in providing a high-performance CAD scheme for the detection of colorectal neoplasms in CTC.

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