Computer-aided diagnosis of pulmonary nodules using a two-step approach for feature selection and classifier ensemble construction

Computer-aided diagnosis systems for lung cancer: challenges and methodologies

This paper overviews one of the most important, interesting, and challenging problems in oncology, the problem of lung cancer diagnosis. Developing an effective computer-aided diagnosis (CAD) system for lung cancer is of great clinical importance and can increase the patient's chance of survival. For this reason, CAD systems for lung cancer have been investigated in a huge number of research studies. A typical CAD system for lung cancer diagnosis is composed of four main processing steps: segmentation of the lung fields, detection of nodules inside the lung fields, segmentation of the detected nodules, and diagnosis of the nodules as benign or malignant. This paper overviews the current state-of-the-art techniques that have been developed to implement each of these CAD processing steps. For each technique, various aspects of technical issues, implemented methodologies, training and testing databases, and validation methods, as well as achieved performances, are described. In addition, the paper addresses several challenges that researchers face in each implementation step and outlines the strengths and drawbacks of the existing approaches for lung cancer CAD systems.

A review of computer-aided diagnosis in thoracic and colonic imaging

Medical imaging has been indispensable in medicine since the discovery of x-rays. Medical imaging offers useful information on patients' medical conditions and on the causes of their symptoms and diseases. As imaging technologies advance, a large number of medical images are produced which physicians/radiologists must interpret. Thus, computer aids are demanded and become indispensable in physicians' decision making based on medical images. Consequently, computer-aided detection and diagnosis (CAD) has been investigated and has been an active research area in medical imaging. CAD is defined as detection and/or diagnosis made by a radiologist/physician who takes into account the computer output as a "second opinion". In CAD research, detection and diagnosis of lung and colorectal cancer in thoracic and colonic imaging constitute major areas, because lung and colorectal cancers are the leading and second leading causes, respectively, of cancer deaths in the U.S. and also in other countries. In this review, CAD of the thorax and colon, including CAD for detection and diagnosis of lung nodules in thoracic CT, and that for detection of polyps in CT colonography, are reviewed.

Fissures segmentation using surface features: content-based retrieval for mammographic mass using ensemble classifier

RATIONALE AND OBJECTIVES

Accurate classification is critical in mammography computer-aided diagnosis using content-based image retrieval approaches (CBIR CAD). The objectives of this study were to: 1) develop an accurate ensemble classifier based on domain knowledge and a robust feature selection method for CBIR CAD; 2) propose three new features; and 3) assess the performance of the proposed method and new features by using a relatively large imaging data set.

MATERIALS AND METHODS

The data set used in this study consisted of 2114 regions of interest (ROI) extracted from a publicly available image database. The proposed ensemble classifier method we called E-DGA-KNN included four steps. In the first step, 804 ROIs depict masses were divided into five classes according to their boundary types. Then, each class of ROI with an equal number of negative ROIs were put together to create a sub-database. Second, a dual-stage genetic algorithm, which was called DGA, was applied on those five sub-databases for feature selection and weights determination respectively. In the third step, five base K-nearest neighbor (KNN) classifiers were created by using the results of the second step on 2114 ROIs, and five detection scores for a given queried ROI were obtained. Finally, these classifiers are combined to yield a final classification. The performances of the proposed methods were evaluated by using receiver operating characteristic (ROC) analysis. A comparison with eight different methods on the data set was provided which include the stepwise linear discriminative analysis algorithm (SLDA) and particle swarm optimization (PSO) algorithm with KNN classifier.

RESULTS

When four hybrid feature selection methods were applied with single KNN classifier (ie, DGA-KNN, SLDA-WGA-KNN, SLDA-PSO-KNN, GA-PSO-KNN) and the proposed E-DGA-KNN method to the data set, the computed areas under the ROC curve (Az) were 0.8782 ± 0.0080, 0.8675 ± 0.0081, 0.8623 ± 0.0083, 0.8725 ± 0.0079, and 0.8927 ± 0.0073, respectively. If all features and single KNN classifier were used, the Az value was 0.8478 ± 0.0088. Az values were 0.8592 ± 0.0083 and 0.8632 ± 0.0081 when SLDA or GA algorithm used alone.

CONCLUSIONS

In this study, an ensemble classifier based on domain knowledge and a dual-stage feature selection method was proposed. Evaluation results indicated that the proposed method achieved largest value of ROC compared to other algorithms. The proposed method shows better performance and has the potential to improve the performance of CBIR CAD in interpreting and analyzing mammograms.

Prediction of intraoperative complexity from preoperative patient data for laparoscopic cholecystectomy

OBJECTIVE

Different reasons may cause difficult intraoperative surgical situations. This study aims to predict intraoperative complexity by classifying and evaluating preoperative patient data. The basic prediction problem addressed in this paper involves the classification of preoperative data into two classes: easy (Class 0) and complex (Class 1) surgeries.

METHODS AND MATERIAL

preoperative patient data were collected from 337 patients admitted to the Klinikum rechts der Isar hospital in Munich, Germany for laparoscopic cholecystectomy (LAPCHOL) in the period of 2005-2008. The data include the patient's body mass index (BMI), sex, inflammation, wall thickening, age and history of previous surgery, as well as the name and level of experience of the operating surgeon. The operating surgeon was asked to label the intraoperative complexity after the surgery: '0' if the surgery was easy and '1' if it was complex. For the classification task a set of classifiers was evaluated, including linear discriminant classifier (LDC), quadratic discriminant classifier (QDC), Parzen and support vector machine (SVM). Moreover, feature-selection was applied to derive the optimal preoperative patient parameters for predicting intraoperative complexity.

RESULTS

Classification results indicate a preference for the LDC in terms of classification error, although the SVM classifier is preferred in terms of results concerning the area under the curve. The trained LDC or SVM classifier can therefore be used in preoperative settings to predict complexity from preoperative patient data with classification error rates below 17%. Moreover, feature-selection results identify bias in the process of labelling surgical complexity, although this bias is irrelevant for patients with inflammation, wall thickening, male sex and high BMI. These patients tend to be at high risk for complex LAPCHOL surgeries, regardless of labelling bias.

CONCLUSIONS

Intraoperative complexity can be predicted before surgery according to preoperative data with accuracy up to 83% using an LDC or SVM classifier. The set of features that are relevant for predicting complexity includes inflammation, wall thickening, sex and BMI score.