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Biomedical subjects

B M Hemminger

Publications and source records attributed to B M Hemminger.

11 recordsLinked to original sources

Contrast limited adaptive histogram equalization image processing to improve the detection of simulated spiculations in dense mammograms.

The purpose of this project was to determine whether Contrast Limited Adaptive Histogram Equalization (CLAHE) improves detection of simulated spiculations in dense mammograms. Lines simulating the appearance of spiculations, a common marker of malignancy when visualized with masses, were embedded in dense mammograms digitized at 50 micron pixels, 12 bits deep. Film images with no CLAHE applied were compared to film images with nine different combinations of clip levels and region sizes applied. A simulated spiculation was embedded in a background of dense breast tissue, with the orientation of the spiculation varied. The key variables involved in each trial included the orientation of the spiculation, contrast level of the spiculation and the CLAHE settings applied to the image. Combining the 10 CLAHE conditions, 4 contrast levels and 4 orientations gave 160 combinations. The trials were constructed by pairing 160 combinations of key variables with 40 backgrounds. Twenty student observers were asked to detect the orientation of the spiculation in the image. There was a statistically significant improvement in detection performance for spiculations with CLAHE over unenhanced images when the region size was set at 32 with a clip level of 2, and when the region size was set at 32 with a clip level of 4. The selected CLAHE settings should be tested in the clinic with digital mammograms to determine whether detection of spiculations associated with masses detected at mammography can be improved.

Female

Does intensity windowing improve the detection of simulated calcifications in dense mammograms?

This study attempts to determine whether intensity windowing (IW) improves detection of simulated calcifications in dense mammograms. Clusters of five simulated calcifications were embedded in dense mammograms digitized at 50-microns pixels, 12 bits deep. Film images with no windowing applied were compared with film images with nine different window widths and levels applied. A simulated cluster was embedded in a realistic background of dense breast tissue, with the position of the cluster varied. The key variables involved in each trial included the position of the cluster, contrast level of the cluster, and the IW settings applied to the image. Combining the ten IW conditions, four contrast levels and four quadrant positions gave 160 combinations. The trials were constructed by pairing 160 combinations of key variables with 160 backgrounds. The entire experiment consisted of 800 trials. Twenty student observers were asked to detect the quadrant of the image in which the mass was located. There was a statistically significant improvement in detection performance for clusters of calcifications when the window width was set at 1024 with a level of 3328, and when the window width was set at 1024 with a level of 3456. The selected IW settings should be tested in the clinic with digital mammograms to determine whether calcification detection performance can be improved.

Breast Neoplasms

The effect of intensity windowing on the detection of simulated masses embedded in dense portions of digitized mammograms in a laboratory setting.

The purpose of this study was to determine whether intensity windowing (IW) improves detection of simulated masses in dense mammograms. Simulated masses were embedded in dense mammograms digitized at 50 microns/pixel, 12 bits deep. Images were printed with no windowing applied and with nine window width and level combinations applied. A simulated mass was embedded in a realistic background of dense breast tissue, with the position of the mass (against the background) varied. The key variables involved in each trial included the position of the mass, the contrast levels and the IW setting applied to the image. Combining the 10 image processing conditions, 4 contrast levels, and 4 quadrant positions gave 160 combinations. The trials were constructed by pairing 160 combinations of key variables with 160 backgrounds. The entire experiment consisted of 800 trials. Twenty observers were asked to detect the quadrant of the image into which the mass was located. There was a statistically significant improvement in detection performance for masses when the window width was set at 1024 with a level of 3328. IW should be tested in the clinic to determine whether mass detection performance in real mammograms is improved.

Analysis of Variance

Introduction to perceptual linearization of video display systems for medical image presentation.

The perceptual linearization of video display systems should play a significant role in medical image presentation. It maximizes the faithfulness of information transfer to the human observer; it provides a method for standardizing the appearance of images across different display devices; and it allows for calculation of the inherent contrast resolution of different display devices. This paper provides insight into the process of perceptual linearization by decomposing it into the digital driving level-to-monitor luminance relationship, the monitor luminance-to-human brightness perception relationship, and the construction of a linearization function derived from these two relationships. A discussion of previous work in these areas is given. We then compare and contrast the results of previous work with recent experiments in our laboratory and related work in vision and computer science. We conclude that (1) sufficiently good visual models exist for agreeing on a standard method of calculating the perceptual linearization function; (2) improvements in the resolution and luminance distribution of the digital-to-analog circuitry in display systems are required for medical imaging; and (3), methods for calculating a linearization remapping from a perceptual linearization function currently have significant error and should be replaced with methods that minimize perceptual error.

Analog-Digital Conversion

Interpretation time of serial chest CT examinations with stacked-metaphor workstation versus film alternator.

PURPOSE: Interpretation time of serial staging chest CT cases, which each contained current and previous examinations, with a simple prototype workstation called filmstack was experimentally compared with interpretation time with a film alternator. MATERIALS AND METHODS: The filmstack displayed a "stack" of sections for each examination; user controls allowed rapid selection of preset attenuation windows and both synchronized and unsynchronized scrolling. Eight radiologists were timed as they used the filmstack and the film alternator to interpret four ergonomically complex serial CT cases. RESULTS: All reports dictated on the basis of findings with filmstack and film were of acceptable clinical accuracy. The time to examine a case with filmstack was significantly faster than the time with film, including the time to load and unload the alternator (99% confidence [P = .01]). There was no statistically significant difference in interpretation time between filmstack and prehung film. CONCLUSION: Use of a low-cost stacked CT workstation with a single 1,024 x 1,024 monitor is an effective means of interpreting cases that require comparison of multiple CT examinations.

Computer Systems

How many screens does a CT workstation need?

A considerable number of prototype and commercial workstations have been developed during the last 10 years for electronic display of computed tomographic (CT) images during clinical interpretation. These CT workstations have varied widely in the number and size of monitors available for the display of the medical images ranging from a single 1,024 x 1,204-pixel monitor, to eight 2,500 x 2,000-pixel monitors. Image display times also have varied considerably, ranging from as fast as .11 seconds, to as slow as 26 seconds to fill a single monitor. No consensus has formed in the workstation community with regard to display area and response time requirements. To address this issue, we have constructed a time-motion model of CT interpretation. Model accuracy is experimentally verified with three workstations as well as with the film alternator. In general, CT interpretations with an electronic workstation become faster as display area increases and display time decreases. Results can be used by workstation designers and purchasers to roughly estimate differences in interpretation speeds among contending CT workstation designs.

Computer Peripherals

Computed tomography interpretations with a low-cost workstation: a timing study.

An ergonomically simple prototype workstation with two 900 x 1,100-pixel monitors capable of displaying eight full-resolution computed tomography (CT) images in 0.2 seconds, was compared with film for interpretation of computed tomographic images of the chest and abdomen. The hardware platform for this workstation cost less than $11,500 in 1993. A repeated-measures experiment was used to generate average interpretation times of 6.17 minutes for the workstation and 6.03 minutes for the film, including loading and unloading films, with three of the four subjects averaging about a minute longer for each workstation interpretation. All dictated reports were of clinically acceptable accuracy. All radiologists stated that workstations based on this design would be an acceptable clinical tool. However, observation suggested human working-memory strain among infrequent CT readers that could indicate the need for additional training. These data suggest that low-cost workstations can have practical application in interpretation of digital medical images such as CT, with the possibility of small increases in interpretation time.

Adult

A method for determination of optimal image enhancement for the detection of mammographic abnormalities.

We present a paradigm for empirical evaluation of digital image enhancement algorithms for mammography that uses psychophysical methods for implementation and analysis of a clinically relevant detection task. In the experiment, the observer is asked to detect and assign to a quadrant, or indicate the absence of, a simulated mammographic structure characteristic of cancer embedded in a background image of normal breast tissue. Responses are indicated interactively on a computer workstation. The parameter values for the enhancement applied to the composite image may be varied on each trial, and structure detection performance is estimated for each enhancement condition. Preliminary investigations have provided insight into an appropriate viewing duration, and furthermore, suggest that nonradiologists may be used under this methodology for the tasks investigated thus far, for predicting parameter values for clinical investigation. We are presently using this method in evaluating several contrast enhancement algorithms of possible benefit in mammography. These methods enable an objective, clinically relevant evaluation, for the purpose of optimal parameter determination or performance assessment, of digital image-processing methods potentially used in mammography.

Algorithms

Real-time radiologist review of remote ultrasound using low-cost video and voice.

RATIONALE AND OBJECTIVES: A radiologist practicing remote ultrasound occasionally needs to review a case in real time before releasing the patient. The authors conducted a pilot study to evaluate one solution in which the radiologist views real-time images on a video monitor while conversing with the technologist via a headset telephone. METHODS: Two experienced ultrasonographers and five technologies participated in a 5-week pilot study in adjacent rooms. RESULTS: Subjective assessment indicated that the system could function well enough for use at a remote site. CONCLUSIONS: Although this technology appears effective, an ongoing training environment is recommended.

Attitude of Health Personnel

Interpretation of CT studies: single-screen workstation versus film alternator.

A prototype single-screen workstation with a 2,048 x 2,560-pixel high-brightness monitor, 0.11-second image display time, and simple ergonomic design was compared to a conventional horizontal film alternator in diagnostic interpretation of chest computed tomography (CT) studies. Four radiologists used either the workstation or film alternator in interpretation of studies obtained in 10 patients. A counterbalanced within-subject repeated measures experimental design was used. Response times were analyzed for both methods of interpretation. Grades of excellent, acceptable, and unacceptable were assigned by a blinded "grader" to reports of the radiologists. The average time needed for an interpretation at the workstation was 5.65 minutes. No interpretations were graded unacceptable. Retrospective power analysis showed that 16 observers rather than four would have been required to show that use of the workstation was faster than the alternator. With this 95% confidence interval, the workstation interpretation time is clinically equivalent to that with the alternator. These data show that this type of workstation has practical application in interpretation of CT, magnetic resonance imaging, and ultrasound studies.

Humans

Image presentation in digital radiology: perspectives on the emerging DICOM display function standard and its application.

DICOM (Digital Imaging and Communications in Medicine) Working Group XI, formerly called ACR/NEMA (American College of Radiology/National Electrical Manufacturers' Association) Working Group XI, is currently developing a display function standard. The main objective of the standard is to define mathematically a display function for all image presentation systems. As a secondary objective, the standard aims at providing similarity in gray-scale perception for a given image between display systems of different luminance and at facilitating efficient utilization of the available digital input levels of a display system. The design of the display function incorporates the concept of perceptual linearization. The proposed standard applies to monochrome image presentation devices such as cathode ray tube monitor-display controller systems and digital laser image printers. The standard does not eliminate the use of application-specific display functions but rather ensures their effectiveness. Neither does the standard guarantee equal information transfer between image presentation devices with different physical properties; it does, however, from the basis for applying image processing to compensate for such differences.

Data Display