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Biomedical subjects

Chuan Zhou

Publications and source records attributed to Chuan Zhou.

13 recordsLinked to original sources

Mammographic density measured with quantitative computer-aided method: comparison with radiologists' estimates and BI-RADS categories.

PURPOSE: To retrospectively compare computer-aided mammographic density estimation (MDEST) with radiologist estimates of percentage density and Breast Imaging Reporting and Data System (BI-RADS) density classification. MATERIALS AND METHODS: Institutional Review Board approval was obtained for this HIPAA-compliant study; patient informed consent requirements were waived. A fully automated MDEST computer program was used to measure breast density on digitized mammograms in 65 women (mean age, 53 years; range, 24-89 years). Pixel gray levels in detected breast borders were analyzed, and dense areas were segmented. Percentage density was calculated by dividing the number of dense pixels by the total number of pixels within the borders. Seven breast radiologists (five trained with MDEST, two not trained) prospectively assigned qualitative BI-RADS density categories and visually estimated percentage density on 260 mammograms. Qualitative BI-RADS assessments were compared with new quantitative BI-RADS standards. The reference standard density for this study was established by allowing the five trained radiologists to manipulate the MDEST gray-level thresholds, which segmented mammograms into dense and nondense areas. Statistical tests performed include Pearson correlation coefficients, Bland-Altman agreement method, kappa statistics, and unpaired t tests. RESULTS: There was a close correlation between the reference standard and radiologist-estimated density (R = 0.90-0.95) and MDEST density (R = 0.89). Untrained radiologists overestimated percentage density by an average of 37%, versus 6% for trained radiologists (P < .001). MDEST showed better agreement with the reference standard (average overestimate, 1%; range, -15% to +18%). MDEST correlated better with percentage density than with qualitative BI-RADS categories. There were large overlaps and ranges of percentage density in qualitative BI-RADS categories 2-4. Qualitative BI-RADS categories correlated poorly with new quantitative BI-RADS categories, and 16 (6%) of 260 views were erroneously classified by MDEST. CONCLUSION: MDEST compared favorably with radiologist estimates of percentage density and is more reproducible than radiologist estimates when qualitative BI-RADS density categories are used. Qualitative and quantitative BI-RADS density assessments differed markedly.

Adult↗

A Bayesian mixture model for partitioning gene expression data.

In recent years there has been great interest in making inference for gene expression data collected over time. In this article, we describe a Bayesian hierarchical mixture model for partitioning such data. While conventional approaches cluster the observed data, we assume a nonparametric, random walk model, and partition on the basis of the parameters of this model. The model is flexible and can be tuned to the specific context, respects the order of observations within each curve, acknowledges measurement error, and allows prior knowledge on parameters to be incorporated. The number of partitions may also be treated as unknown, and inferred from the data, in which case computation is carried out via a birth-death Markov chain Monte Carlo algorithm. We first examine the behavior of the model on simulated data, along with a comparison with more conventional approaches, and then analyze meiotic expression data collected over time on fission yeast genes.

Bayes Theorem↗

Computer-aided diagnosis of pulmonary nodules on CT scans: segmentation and classification using 3D active contours.

We are developing a computer-aided diagnosis (CAD) system to classify malignant and benign lung nodules found on CT scans. A fully automated system was designed to segment the nodule from its surrounding structured background in a local volume of interest (VOI) and to extract image features for classification. Image segmentation was performed with a three-dimensional (3D) active contour (AC) method. A data set of 96 lung nodules (44 malignant, 52 benign) from 58 patients was used in this study. The 3D AC model is based on two-dimensional AC with the addition of three new energy components to take advantage of 3D information: (1) 3D gradient, which guides the active contour to seek the object surface, (2) 3D curvature, which imposes a smoothness constraint in the z direction, and (3) mask energy, which penalizes contours that grow beyond the pleura or thoracic wall. The search for the best energy weights in the 3D AC model was guided by a simplex optimization method. Morphological and gray-level features were extracted from the segmented nodule. The rubber band straightening transform (RBST) was applied to the shell of voxels surrounding the nodule. Texture features based on run-length statistics were extracted from the RBST image. A linear discriminant analysis classifier with stepwise feature selection was designed using a second simplex optimization to select the most effective features. Leave-one-case-out resampling was used to train and test the CAD system. The system achieved a test area under the receiver operating characteristic curve (A(z)) of 0.83 +/- 0.04. Our preliminary results indicate that use of the 3D AC model and the 3D texture features surrounding the nodule is a promising approach to the segmentation and classification of lung nodules with CAD. The segmentation performance of the 3D AC model trained with our data set was evaluated with 23 nodules available in the Lung Image Database Consortium (LIDC). The lung nodule volumes segmented by the 3D AC model for best classification were generally larger than those outlined by the LIDC radiologists using visual judgment of nodule boundaries.

Biopsy↗

Joint two-view information for computerized detection of microcalcifications on mammograms.

We are developing new techniques to improve the accuracy of computerized microcalcification detection by using the joint two-view information on craniocaudal (CC) and mediolateral-oblique (MLO) views. After cluster candidates were detected using a single-view detection technique, candidates on CC and MLO views were paired using their radial distances from the nipple. Candidate pairs were classified with a similarity classifier that used the joint information from both views. Each cluster candidate was also characterized by its single-view features. The outputs of the similarity classifier and the single-view classifier were fused and the cluster candidate was classified as a true microcalcification cluster or a false-positive (FP) using the fused two-view information. A data set of 116 pairs of mammograms containing microcalcification clusters and 203 pairs of normal images from the University of South Florida (USF) public database was used for training the two-view detection algorithm. The trained method was tested on an independent test set of 167 pairs of mammograms, which contained 71 normal pairs and 96 pairs with microcalcification clusters collected at the University of Michigan (UM). The similarity classifier had a very low FP rate for the test set at low and medium levels of sensitivity. However, the highest mammogram-based sensitivity that could be reached by the similarity classifier was 69%. The single-view classifier had a higher FP rate compared to the similarity classifier, but it could reach a maximum mammogram-based sensitivity of 93%. The fusion method combined the scores of these two classifiers so that the number of FPs was substantially reduced at relatively low and medium sensitivities, and a relatively high maximum sensitivity was maintained. For the malignant microcalcification clusters, at a mammogram-based sensitivity of 80%, the FP rates were 0.18 and 0.35 with the two-view fusion and single-view detection methods, respectively. When the training and test sets were switched, a similar improvement was obtained, except that both the fusion and single-view detection methods had superior test performances on the USF data set than those on the UM data set. Our results indicate that correspondence of cluster candidates on two different views provides valuable additional information for distinguishing FPs from true microcalcification clusters.

Breast↗

Computer aided detection of clusters of microcalcifications on full field digital mammograms.

We are developing a computer-aided detection (CAD) system to identify microcalcification clusters (MCCs) automatically on full field digital mammograms (FFDMs). The CAD system includes six stages: preprocessing; image enhancement; segmentation of microcalcification candidates; false positive (FP) reduction for individual microcalcifications; regional clustering; and FP reduction for clustered microcalcifications. At the stage of FP reduction for individual microcalcifications, a truncated sum-of-squares error function was used to improve the efficiency and robustness of the training of an artificial neural network in our CAD system for FFDMs. At the stage of FP reduction for clustered microcalcifications, morphological features and features derived from the artificial neural network outputs were extracted from each cluster. Stepwise linear discriminant analysis (LDA) was used to select the features. An LDA classifier was then used to differentiate clustered microcalcifications from FPs. A data set of 96 cases with 192 images was collected at the University of Michigan. This data set contained 96 MCCs, of which 28 clusters were proven by biopsy to be malignant and 68 were proven to be benign. The data set was separated into two independent data sets for training and testing of the CAD system in a cross-validation scheme. When one data set was used to train and validate the convolution neural network (CNN) in our CAD system, the other data set was used to evaluate the detection performance. With the use of a truncated error metric, the training of CNN could be accelerated and the classification performance was improved. The CNN in combination with an LDA classifier could substantially reduce FPs with a small tradeoff in sensitivity. By using the free-response receiver operating characteristic methodology, it was found that our CAD system can achieve a cluster-based sensitivity of 70, 80, and 90 % at 0.21, 0.61, and 1.49 FPs/image, respectively. For case-based performance evaluation, a sensitivity of 70, 80, and 90 % can be achieved at 0.07, 0.17, and 0.65 FPs/image, respectively. We also used a data set of 216 mammograms negative for clustered microcalcifications to further estimate the FP rate of our CAD system. The corresponding FP rates were 0.15, 0.31, and 0.86 FPs/image for cluster-based detection when negative mammograms were used for estimation of FP rates.

Algorithms↗

Preliminary investigation of computer-aided detection of pulmonary embolism in three-dimensional computed tomography pulmonary angiography images.

RATIONALE AND OBJECTIVES: We sought to develop a computer-aided diagnosis (CAD) system for assisting radiologists in the detection of pulmonary embolism (PE) on computed tomography pulmonary angiographic (CTPA) images. MATERIALS AND METHODS: An adaptive three-dimensional (3D) voxel clustering method was developed based on expectation-maximization (EM) analysis to extract vessels from their surrounding tissues. Using a connected component analysis, the vessel tree was reconstructed by tracking the vessel and its branches in 3D space. The tracked vessels were prescreened for suspicious PE areas using a second EM analysis. A rule-based false-positive (FP) reduction method was designed to detect true PE based on the features of PE and vessels. In this preliminary study, 14 patients with positive CTPA for PE were studied. CT scans were performed at 1.25-mm collimation using a GE LightSpeed CT scanner; eight of these patients also had extensive lung parenchymal or pleural disease. One hundred sixty-three emboli were identified by two experienced thoracic radiologists. The emboli identified by the radiologists were used as the "gold standard." For each embolus, the percent diameter occlusion (clot) and conspicuity of embolus (rating of 1 to 5, with 5 being the most conspicuous) were visually estimated. One hundred one emboli were identified in the six patients without lung diseases; 57 were proximal to the subsegmental and 44 were subsegmental. For the eight patients with lung diseases, 62 emboli were identified, of which 37 were proximal to the subsegmental and 25 were subsegmental. A computer-detected volume was counted as true-positive when it overlapped with an embolus volume identified by the radiologists. RESULTS: In the cases without lung diseases, if the PE had a conspicuity of >2 and only partially (20%-80%) occluded the vessel, our method detected 92.0% of proximal emboli and 77.8% of subsegmental emboli, with an average of 18.3 FPs/case. In the cases containing extensive lung disease, 66.7% and 40.0% of the PEs were detected with an average of 11.4 FPs/case under the same conditions. For the 14 PE cases, 13 of them were diagnosed as positive PE cases (case sensitivity was 92.9%). CONCLUSION: This preliminary study indicates that our automated method is a promising approach to CAD of PE on CTPA. Further study is under way to collect a larger data set and to improve the detection accuracy for PE, especially those with <20% or >80% occlusion, and for very subtle PE. A fully developed CAD system is expected to provide a useful aid for PE detection on CTPA.

Angiography↗

Nonparametric estimation of ROC curves in the absence of a gold standard.

In the evaluation of diagnostic accuracy of tests, a gold standard on the disease status is required. However, in many complex diseases, it is impossible or unethical to obtain such a gold standard. If an imperfect standard is used, the estimated accuracy of the tests would be biased. This type of bias is called imperfect gold standard bias. In this article we develop a nonparametric maximum likelihood method for estimating ROC curves and their areas of ordinal-scale tests in the absence of a gold standard. Our simulation study shows that the proposed estimators for the ROC curve areas have good finite-sample properties in terms of bias and mean squared error. Further simulation studies show that our nonparametric approach is comparable to the binormal parametric method, and is easier to implement. Finally, we illustrate the application of the proposed method in a real clinical study on assessing the accuracy of seven specific pathologists in detecting carcinoma in situ of the uterine cervix.

Algorithms↗

Computer-aided detection of lung nodules: false positive reduction using a 3D gradient field method and 3D ellipsoid fitting.

We are developing a computer-aided detection system to assist radiologists in the detection of lung nodules on thoracic computed tomography (CT) images. The purpose of this study was to improve the false-positive (FP) reduction stage of our algorithm by developing features that extract three-dimensional (3D) shape information from volumes of interest identified in the prescreening stage. We formulated 3D gradient field descriptors, and derived 19 gradient field features from their statistics. Six ellipsoid features were obtained by computing the lengths and the length ratios of the principal axes of an ellipsoid fitted to a segmented object. Both the gradient field features and the ellipsoid features were designed to distinguish spherical objects such as lung nodules from elongated objects such as vessels. The FP reduction performance in this new 25-dimensional feature space was compared to the performance in a 19-dimensional space that consisted of features extracted using previously developed methods. The performance in the 44-dimensional combined feature space was also evaluated. Linear discriminant analysis with stepwise feature selection was used for classification. The parameters used for feature selection were optimized using the simplex algorithm. Training and testing were performed using a leave-one-patient-out scheme. The FP reduction performances in different feature spaces were evaluated by using the area Az under the receiver operating characteristic curve and the number of FPs per CT section at a given sensitivity as accuracy measures. Our data set consisted of 82 CT scans (3551 axial sections) from 56 patients with section thickness ranging from 1.0 to 2.5 mm. Our prescreening algorithm detected 111 of the 116 solid nodules (nodule size: 3.0-30.6 mm) marked by experienced thoracic radiologists. The test Az values were 0.95 +/- 0.01, 0.88 +/- 0.02, and 0.94 +/- 0.01 in the new, previous, and combined feature spaces, respectively. The number of FPs per section at 80% sensitivity in these three feature spaces were 0.37, 1.61, and 0.34, respectively. The improvement in the test Az with the 25 new features was statistically significant (p<0.0001) compared to that with the previous 19 features alone.

Algorithms↗

Computer-aided detection of breast masses on full field digital mammograms.

We are developing a computer-aided detection (CAD) system for breast masses on full field digital mammographic (FFDM) images. To develop a CAD system that is independent of the FFDM manufacturer's proprietary preprocessing methods, we used the raw FFDM image as input and developed a multiresolution preprocessing scheme for image enhancement. A two-stage prescreening method that combines gradient field analysis with gray level information was developed to identify mass candidates on the processed images. The suspicious structure in each identified region was extracted by clustering-based region growing. Morphological and spatial gray-level dependence texture features were extracted for each suspicious object. Stepwise linear discriminant analysis (LDA) with simplex optimization was used to select the most useful features. Finally, rule-based and LDA classifiers were designed to differentiate masses from normal tissues. Two data sets were collected: a mass data set containing 110 cases of two-view mammograms with a total of 220 images, and a no-mass data set containing 90 cases of two-view mammograms with a total of 180 images. All cases were acquired with a GE Senographe 2000D FFDM system. The true locations of the masses were identified by an experienced radiologist. Free-response receiver operating characteristic analysis was used to evaluate the performance of the CAD system. It was found that our CAD system achieved a case-based sensitivity of 70%, 80%, and 90% at 0.72, 1.08, and 1.82 false positive (FP) marks/image on the mass data set. The FP rates on the no-mass data set were 0.85, 1.31, and 2.14 FP marks/image, respectively, at the corresponding sensitivities. This study demonstrated the usefulness of our CAD techniques for automated detection of masses on FFDM images.

Algorithms↗

[Clinical research on 2228 cases of thyroid gland tumors].

OBJECTIVE: To discuss outcome of thyroid tumor patients treated with surgery. METHODS: Total number of patients was 2228. These patients of thyroid tumors from 1992-2004 (2072 cases of benign thyroid diseases and 156 cases of thyroid carcinoma) were recruited. The clinical and follow-up datum were retrospective analyzed. RESULTS: (1) Benign thyroid tumors with near-total thyroidectomy including 1761 thyroid adenoma, 207 nodular goiter and 104 Hashimoto thyroiditis, the incidence of recurrent laryngeal nerve paralysis was 0.2%, 55 cases (2.6%) received secondary surgery. All the patients have no hypocalcemia or hemorrhage after operation. (2) Eighty-one cases of papillary carcinoma of the thyroid ( > 1 cm) and 60 cases of microcarcinoma. Unilateral thyroidectomy, contralateral near-total thyroidectomy and ipsilateral modified neck dissection were performed in unilateral papillary carcinoma of thyroid. Among the 9 cases of follicular carcinoma of thyroid, 7 were performed of near-total thyroidectomy without neck dissection, others were the same as papillary carcinoma. Bilateral total thyroidectomy and bilateral modified neck dissection were performed in 2 cases of the medullary thyroid cancer and 1 case of the undifferentiated thyroid cancer. By direct method the 5-year survival was 95.5% (64/67), and by Kaplan-Meier method, it was 98.0%. The treatment of microcarcinoma are multiple. There is no relapse or metastases in 60 cases of papillary thyroid microcarcinoma. The 5-year survival was 100.0%, 1 cases occurred recurrent laryngeal nerve paralysis in thyroid cancer. No hypocalcemia or hemorrhage. Eight case relapsed in 156 cases of thyroid carcinoma,3 cases died. CONCLUSION: The correct surgical management for the patients with thyroid tumor should benefit for the prognosis and reduce the complications and the recurrence of the operation.

Adolescent↗

Correlation between mammographic density and volumetric fibroglandular tissue estimated on breast MR images.

Previous studies have found that mammographic breast density is highly correlated with breast cancer risk. Therefore, mammographic breast density may be considered as an important risk factor in studies of breast cancer treatments. In this paper, we evaluated the accuracy of using mammograms for estimating breast density by analyzing the correlation between the percent mammographic dense area and the percent glandular tissue volume as estimated from MR images. A dataset of 67 cases having MR images (coronal 3-D SPGR T1-weighted pre-contrast) and corresponding 4-view mammograms was used in this study. Mammographic breast density was estimated by an experienced radiologist and an automated image analysis tool, Mammography Density ESTimator (MDEST) developed previously in our laboratory. For the estimation of the percent volume of fibroglandular tissue in breast MR images, a semiautomatic method was developed to segment the fibroglandular tissue from each slice. The tissue volume was calculated by integration over all slices containing the breast. Interobserver variation was measured for 3 different readers. It was found that the correlation between every two of the three readers for segmentation of MR volumetric fibroglandular tissue was 0.99. The correlations between the percent volumetric fibroglandular tissue on MR images and the percent dense area of the CC and MLO views segmented by an experienced radiologist were both 0.91. The correlation between the percent volumetric fibroglandular tissue on MR images and the percent dense area of the CC and MLO views segmented by MDEST was 0.91 and 0.89, respectively. The root-mean-square (rms) residual ranged from 5.4% to 6.3%. The mean bias ranged from 3% to 6%. The high correlation indicates that changes in mammographic density may be a useful indicator of changes in fibroglandular tissue volume in the breast.

Absorptiometry, Photon↗

Computerized nipple identification for multiple image analysis in computer-aided diagnosis.

Correlation of information from multiple-view mammograms (e.g., MLO and CC views, bilateral views, or current and prior mammograms) can improve the performance of breast cancer diagnosis by radiologists or by computer. The nipple is a reliable and stable landmark on mammograms for the registration of multiple mammograms. However, accurate identification of nipple location on mammograms is challenging because of the variations in image quality and in the nipple projections, resulting in some nipples being nearly invisible on the mammograms. In this study, we developed a computerized method to automatically identify the nipple location on digitized mammograms. First, the breast boundary was obtained using a gradient-based boundary tracking algorithm, and then the gray level profiles along the inside and outside of the boundary were identified. A geometric convergence analysis was used to limit the nipple search to a region of the breast boundary. A two-stage nipple detection method was developed to identify the nipple location using the gray level information around the nipple, the geometric characteristics of nipple shapes, and the texture features of glandular tissue or ducts which converge toward the nipple. At the first stage, a rule-based method was designed to identify the nipple location by detecting significant changes of intensity along the gray level profiles inside and outside the breast boundary and the changes in the boundary direction. At the second stage, a texture orientation-field analysis was developed to estimate the nipple location based on the convergence of the texture pattern of glandular tissue or ducts towards the nipple. The nipple location was finally determined from the detected nipple candidates by a rule-based confidence analysis. In this study, 377 and 367 randomly selected digitized mammograms were used for training and testing the nipple detection algorithm, respectively. Two experienced radiologists identified the nipple locations which were used as the gold standard. In the training data set, 301 nipples were positively identified and were referred to as visible nipples. Seventy six nipples could not be positively identified and were referred to as invisible nipples. The radiologists provided their estimation of the nipple locations in the latter group for comparison with the computer estimates. The computerized method could detect 89.37% (269/301) of the visible nipples and 69.74% (53/76) of the invisible nipples within 1 cm of the gold standard. In the test data set, 298 and 69 of the nipples were classified as visible and invisible, respectively. 92.28% (275/298) of the visible nipples and 53.62% (37/69) of the invisible nipples were identified within 1 cm of the gold standard. The results demonstrate that the nipple locations on digitized mammograms can be accurately detected if they are visible and can be reasonably estimated if they are invisible. Automated nipple detection will be an important step towards multiple image analysis for CAD.

Algorithms↗