Edward J. Delp

1. The Analysis of Digital Mammograms:Spiculated Tumor Detectionand Normal Mammogram Characterization Edward J. Delp Purdue University School of Electrical and Computer Engineering Video and Image Processing Laboratory (VIPER) West Lafayette, Indiana, USA ace@ecn.purdue.edu http://www.ece.purdue.edu/~ace UCB

2. Outline • Breast Cancer and Mammography • Multiresolution Detection of Spiculated Lesions • Normal Mammogram Analysis and Characterization • Future Research UCB

3. Research Team Charles Babbs - Department of Basic Medical Sciences Zygmunt Pizlo - Department of Psychological Sciences Sheng Lui - School of Electrical and Computer Engineering Valerie Jackson - IU Department of Radiology Funding - NSF, NIH, and Purdue Cancer Center http://www.ece.purdue.edu/~ace/mammo/mammo.html UCB

4. Breast Cancer • Second major cause of cancer death among women in the United States (after lung cancer) • Leading cause of nonpreventable cancer death • 1 in 8 women will develop breast cancer in her lifetime • 1 in 30 women will die from breast cancer UCB

5. Mammography • Mammograms are X-ray images of the breast • Screening mammography is currently the best technique for reliable detection of early, non-palpable, potentially curable breast cancer • Studies show that mammogram can reduce the overall mortality from breast cancer by up to 30% UCB

6. Screening Mammography UCB

7. A Digital Mammogram (normal) UCB

8. Three Types of Breast Abnormalities Micro-calcification Circumscribed Lesion Spiculated Lesion UCB

9. Problems in Screening Mammography • Radiologists vary in their interpretation of the same mammogram • False negative rate is 4 – 20% in current clinical mammography • Only 15 – 34% of women who are sent for a biopsy actually have cancer UCB

10. Current Research in Computer Aided Diagnosis (CAD) • The goal is to increase diagnostic accuracy as well as the reproducibility of mammographic interpretation • Most work aims at detecting one of the three abnormal structures • Some have explored classifying breast lesions as benign or malignant • The implementation of CAD systems in everyday clinical applications will change the practice of radiology UCB

11. Multiresolution Detection of Spiculated Lesions in Digital Mammograms • Spiculation or a stellate appearance in mammograms indicates with near certainty the presence of breast cancer • Detection of spiculated lesions is very important in the characterization of breast cancer UCB

12. Spiculated Lesions • Spiculated lesions vary from a few millimeters to several centimeters in size • Center masses of spiculated lesions are usually irregular with ill-defined borders • Usually the larger the tumor center, the longer its spicules or “arms” UCB

13. Difficulties • Computer aided diagnosis of digital mammograms generally consists of feature extraction followed by classification • It is very difficult to determine the neighborhood size that should be used to extract features which are local • If the neighborhood is too large, small lesions may be missed • If the neighborhood is too small, one may not be able to capture features of larger lesions UCB

14. Appearance of A Spiculated Lesion at Multiple Resolutions UCB

15. Block Diagram of Multiresolution Detection of Spiculated Lesions UCB

16. Multiresolution Decomposition • Linear phase nonseparable 2D perfect reconstruction wavelet transform • does not introduce phase distortions in the decomposed images • no bias is introduced in the horizontal and vertical directions as a separable transform would • The impulse response of the analysis low pass filter UCB

17. A Spiculated Lesion Distorts the Normal Breast Duct Structure • Normal duct structures of the breast radiate from the nipple to the chest wall • Spiculated lesion radiates spicules in all directions UCB

18. Gradient Orientation Histogram • Has a peak at the ductal structure orientation near a normal pixel • Flat near a lesion pixel UCB

19. Example Histograms A normal region A spiculated region UCB

20. Notation • (i, j) — spatial location at row i and column j • f(i, j) — pixel intensity at (i, j) • Sij— some neighborhood of (i, j) • M — the number of pixels within Sij • Dy(i, j) and Dx(i, j) — estimate of the vertical and horizontal spatial derivatives of f at (i, j), respectively • (i, j) = tan-1{Dy(i, j)/Dx(i, j)}  (-/2, /2] — estimate of the gradient orientation at (i, j) UCB

21. Notation • histij — histogram of  within Sij using 256 bins • histij(n) — # of pixels in Sij that have gradient orientations , where n = 0, 1, …, 255 • — average bin height of histij UCB

22. Folded Gradient Orientation • M+(i, j) and M-(i, j) — number of positive and negative gradient orientations within Sij, respectively • and — average positive and negative gradient orientations, respectively — folded gradient orientation UCB

23. Why Folded Gradient Orientation? So that is not sensitive to the nominal value of , but to the actual gradient orientation variances • The gradient orientation distance between /2 and -/4 is the same as that between /2 and /4, however • ([/2, -/4]) = 2.8 • ([/2, /4]) = 0.3 • -/4 folds to 3/4, now • ’([/2, -/4]) = ’([/2, /4]) = 0.3 UCB

24. Features Differentiate Spiculated Lesions from Normal Tissue • Mean pixel intensity in Sij — • Standard deviation of pixel intensities in Sij — UCB

25. Features Differentiate Spiculated Lesions from Normal Tissue • Standard deviation of gradient orientation histogram in Sij — • Standard deviation of the folded gradient orientations in Sij — UCB

26. Multiresolution Feature Analysis • Choose a neighborhood that is small enough to capture the smallest possible spiculated lesion in the finest resolution • Fix this neighborhood size for feature extraction at all resolutions • Larger lesions will be detected at a coarser resolution • Smaller lesions can be detected at a finer resolution UCB

27. Test Pattern at Multiple Resolutions An ideal spiculated lesion and normal duct structures embedded in uncorrelated Gaussian distributed noise UCB

28. Feature ’ at Multiple Resolutions UCB

29. Feature hist at Multiple Resolutions UCB

30. Feature at Multiple Resolutions UCB

31. Feature f at Multiple Resolutions UCB

32. A Simple Binary Tree Classifier UCB

33. Advantages ofTree-Structured Approach • Robust with respect to outliers and misclassified points in the training set • The classifier can be efficiently represented • Once trained, classification is very fast • Provides easily understood and interpreted information regarding the predictive structure of the data • Classifier used is described in a paper by Gelfand, Ravishankar, and Delp (PAMI 1991) UCB

34. Multiresolution Detection • At each resolution, five features are used: the four features extracted at that resolution plus the feature hist extracted from the next coarser resolution • Detection starts from the second coarsest resolution • A positive detection at a coarser resolution eliminates the need for both feature extraction and detection at the corresponding pixel locations at all finer resolutions • A negative result at a coarser resolution will be combined with those at finer resolutions via weighted sum UCB

35. Database • MIAS database provided by the Mammographic Image Analysis Society in the UK • 50  resolution • A total of 19 mammograms containing spiculated lesions • Smallest lesion extends 3.6 mm in radius • Largest lesion extends 35 mm in radius UCB

36. Half/Half Training Methodology • The 19 mammograms containing spiculated lesions together with another 19 normal mammograms are random split into two sets with approximately an equal number of lesion and normal mammograms in each set • Each set was used separately as a training set to generate two BCTs • A BCT trained by one set was used to classify mammograms in the other set, and vice versa UCB

37. Detection Results A 35.0mm lesion detected at the coarsest resolution Automatic Detection Ground Truth UCB

38. Detection Results A 12.4mm lesion detected at the second coarsest resolution Automatic Detection Ground Truth UCB

39. Detection Results A 6.6mm lesion detected at the finest resolution Automatic Detection Ground Truth UCB

40. Summary • Multiresolution detection eliminates the problem of choosing a neighborhood size a priori to capture features of lesions of varying sizes • Using features across resolutions simultaneously helps capture spiculated lesions of sizes that exist between the resolutions • Top-down approach requires less computation by starting with the least amount of data and propagating detection results to finer resolutions UCB

41. Normal Mammograms Characterization • Better understanding of normal mammograms can greatly help reduce the “misses” in cancer detection • Little work has been done on characterizing normal mammograms UCB

42. Density 1 Density 2 Density 3 Density 4 Very Different Normal Mammograms UCB

43. General Normal Characteristics • Unequivocally normal areas have lower density than abnormal ones • no spikes indicating microcalcifications • no large bright areas indicating masses • Normal areas have “quasi-parallel” linear markings UCB

44. Normal Linear Markings • Shadow of normal ducts and connective tissue elements • Appear slightly curved • Approximately linear over short segments • Can be observed as straight line segments of dimensions 1 to 2 mm or greater in length and 0.1 to 1.0 mm in width • Low contrast in very noisy background UCB

45. Recognizing Normal Structures UCB

46. Background Subtraction UCB

47. Problems in Extracting Linear Markings • Edge detection based line detectors • generate very dense edge maps due to small spatial extent of most local edge operators • miss “thick” lines • Hough transform based line detectors • do not provide locations of lines • not suitable for grayscale images UCB

48. A New Model For Lines • There exists a string of pixels with similar graylevels along a certain direction • The surrounding pixels have different graylevels • The length of a line is greater than its width UCB

49. Line Detection Block Diagram UCB

50. Advantages Given minimum length l, our new line detector can detect • lines of very different width, from single pixel wide up to l • lines of any length that is greater than l • lines with varying width, provided that the changes are “slower” than l • curves, provided that over short segment, they can be approximated as lines of length greater than l UCB