PurposeIn digital breast tomosynthesis (DBT), radiologists need to review a stack of 20 to 80 tomosynthesis images, depending upon breast size. This causes a significant increase in reading time.... Show morePurposeIn digital breast tomosynthesis (DBT), radiologists need to review a stack of 20 to 80 tomosynthesis images, depending upon breast size. This causes a significant increase in reading time. However, it is currently unknown whether there is a perceptual benefit to viewing a mass in the 3D tomosynthesis volume. To answer this question, this study investigated whether adjacent lesion-containing planes provide additional information that aids lesion detection for DBT-like and breast CT-like (bCT) images.MethodHuman reader detection performance was determined for low-contrast targets shown in a single tomosynthesis image at the center of the target (2D) or shown in the entire tomosynthesis image stack (3D). Using simulations, targets embedded in simulated breast backgrounds, and images were generated using a DBT-like (50 deg angular range) and a bCT-like (180 deg angular range) imaging geometry. Experiments were conducted with spherical and capsule-shaped targets. Eleven readers reviewed 1600 images in two-alternative forced-choice experiments. The area under the receiver operating characteristic curve (AUC) and reading time were computed for the 2D and 3D reading modes for the DBT and bCT imaging geometries and for both target shapes.ResultsSpherical lesion detection was higher in 2D mode than in 3D, for both DBT- and bCT-like images (DBT: AUC2D = 0.790, AUC3D = 0.735, P = 0.03; bCT: AUC2D = 0.869, AUC3D = 0.716, P < 0.05), but equivalent for capsule-shaped signals (DBT: AUC2D = 0.891, AUC3D = 0.915, P = 0.19; bCT: AUC2D = 0.854, AUC3D = 0.847, P = 0.88). Average reading time was up to 134% higher for 3D viewing (P < 0.05).ConclusionsFor the detection of low-contrast lesions, there is no inherent visual perception benefit to reviewing the entire DBT or bCT stack. The findings of this study could have implications for the development of 2D synthetic mammograms: a single synthesized 2D image designed to include all lesions present in the volume might allow readers to maintain detection performance at a significantly reduced reading time. Show less
Heutink, F.; Koch, V.; Verbist, B.; Woude, W.J. van der; Mylanus, E.; Huinck, W.; ... ; Caballo, M. 2020
Background and objective: Performing patient-specific, pre-operative cochlea CT-based measurements could be helpful to positively affect the outcome of cochlear surgery in terms of intracochlear... Show moreBackground and objective: Performing patient-specific, pre-operative cochlea CT-based measurements could be helpful to positively affect the outcome of cochlear surgery in terms of intracochlear trauma and loss of residual hearing. Therefore, we propose a method to automatically segment and measure the human cochlea in clinical ultra-high-resolution (UHR) CT images, and investigate differences in cochlea size for personalized implant planning.Methods: 123 temporal bone CT scans were acquired with two UHR-CT scanners, and used to develop and validate a deep learning-based system for automated cochlea segmentation and measurement. The segmentation algorithm is composed of two major steps (detection and pixel-wise classification) in cascade, and aims at combining the results of a multi-scale computer-aided detection scheme with a U-Net-like architecture for pixelwise classification. The segmentation results were used as an input to the measurement algorithm, which provides automatic cochlear measurements (volume, basal diameter, and cochlear duct length (CDL)) through the combined use of convolutional neural networks and thinning algorithms. Automatic segmentation was validated against manual annotation, by the means of Dice similarity, Boundary-F1 (BF) score, and maximum and average Hausdorff distances, while measurement errors were calculated between the automatic results and the corresponding manually obtained ground truth on a per-patient basis. Finally, the developed system was used to investigate the differences in cochlea size within our patient cohort, to relate the measurement errors to the actual variation in cochlear size across different patients.Results: Automatic segmentation resulted in a Dice of 0.90 +/- 0.03, BF score of 0.95 +/- 0.03, and maximum and average Hausdorff distance of 3.05 +/- 0.39 and 0.32 +/- 0.07 against manual annotation. Automatic cochlear measurements resulted in errors of 8.4% (volume), 5.5% (CDL), 7.8% (basal diameter). The cochlea size varied broadly, ranging between 0.10 and 0.28 ml (volume), 1.3 and 2.5 mm (basal diameter), and 27.7 and 40.1 mm (CDL).Conclusions: The proposed algorithm could successfully segment and analyze the cochlea on UHR-CT images, resulting in accurate measurements of cochlear anatomy. Given the wide variation in cochlear size found in our patient cohort, it may find application as a pre-operative tool in cochlear implant surgery, potentially helping elaborate personalized treatment strategies based on patient-specific, image-based anatomical measurements. (C) 2020 Elsevier B.V. All rights reserved. Show less
Balta, C.; Bouwman, R.W.; Broeders, M.J.M.; Karssemeijer, N.; Veldkamp, W.J.H.; Sechopoulos, I.; Engen, R.E. van 2019
The channelized-Hotelling observer (CHO) was investigated as a surrogate of human observers in task-based image quality assessment. The CHO with difference-of-Gaussian (DoG) channels has shown... Show moreThe channelized-Hotelling observer (CHO) was investigated as a surrogate of human observers in task-based image quality assessment. The CHO with difference-of-Gaussian (DoG) channels has shown potential for the prediction of human detection performance in digital mammography (DM) images. However, the DoG channels employ parameters that describe the shape of each channel. The selection of these parameters influences the performance of the DoG CHO and needs further investigation. The detection performance of the DoG CHO was calculated and correlated with the detection performance of three humans who evaluated DM images in 2-alternative forced-choice experiments. A set of DM images of an anthropomorphic breast phantom with and without calcification-like signals was acquired at four different dose levels. For each dose level, 200 square regions-of-interest (ROIs) with and without signal were extracted. Signal detectability was assessed on ROI basis using the CHO with various DoG channel parameters and it was compared to that of the human observers. It was found that varying these DoG parameter values affects the correlation (r(2)) of the CHO with human observers for the detection task investigated. In conclusion, it appears that the the optimal DoG channel sets that maximize the prediction ability of the CHO might be dependent on the type of background and signal of ROIs investigated. (C) 2019 Society of Photo-Optical Instrumentation Engineers (SPIE) Show less
PurposeTo study the feasibility of a channelized Hotelling observer (CHO) to predict human observer performance in detecting calcification-like signals in mammography images of an anthropomorphic... Show morePurposeTo study the feasibility of a channelized Hotelling observer (CHO) to predict human observer performance in detecting calcification-like signals in mammography images of an anthropomorphic breast phantom, as part of a quality control (QC) framework.MethodsA prototype anthropomorphic breast phantom with inserted gold disks of 0.25 mm diameter was imaged with two different digital mammography x-ray systems at four different dose levels. Regions of interest (ROIs) were extracted from the acquired processed and unprocessed images, signal-present and signal-absent. The ROIs were evaluated by a CHO using four different formulations of the difference of Gaussian (DoG) channel sets. Three human observers scored the ROIs in a two-alternative forced-choice experiment. We compared the human and the CHO performance on the simple task to detect calcification-like disks in ROIs with and without postprocessing. The proportion of correct responses of the human reader (PCH) and the CHO (PCCHO) was calculated and the correlation between the two was analyzed using a mixed-effect regression model. To address the signal location uncertainty, the impact of shifting the DoG channel sets in all directions up to two pixels was evaluated. Correlation results including the goodness of fit (r(2)) of PCH and PCCHO for all different parameters were evaluated.ResultsSubanalysis by system yielded strong correlations between PCH and PCCHO, with r(2) between PCH and PCCHO was found to be between 0.926 and 0.958 for the unshifted and between 0.759 and 0.938 for the shifted channel sets, respectively. However, the linear fit suggested a slight system dependence. PCCHO with shifted channel sets increased CHO performance but the correlation with humans was decreased. These correlations were not considerably affected by of the DoG channel set used.ConclusionsThere is potential for the CHO to be used in QC for the evaluation of detectability of calcification-like signals. The CHO can predict the PC of humans in images of calcification-like signals of two different systems. However, a global model to be used for all systems requires further investigation. Show less
Balta, C.; Bouwman, R.W.; Veldkamp, W.J.H.; Broeders, M.J.M.; Sechopoulos, I.; Engen, R.E. van 2018