Multiscale Intensity Homogeneity Transformation Method and its Application to Computer-Aided Detection of Pulmonary Embolism in Computed Tomographic Pulmonary Angiography (CTPA)

摘要

A 3D multiscale intensity homogeneity transformation (MIHT) method was developed to reduce false positives (FPs) in our previously developed CAD system for pulmonary embolism (PE) detection. In MIHT, the voxel intensity of a PE candidate region was transformed to an intensity homogeneity value (IHV) with respect to the local median intensity. The IHVs were calculated in multiscales (MIHVs) to measure the intensity homogeneity, taking into account vessels of different sizes and different degrees of occlusion. Seven new features including the entropy, gradient, and moments that characterized the intensity distributions of the candidate regions were derived from the MIHVs and combined with the previously designed features that described the shape and intensity of PE candidates for the training of a linear classifier to reduce the FPs. 59 CTPA PE cases were collected from our patient files (UM set) with IRB approval and 69 cases from the PIOPED II data set with access permission. 595 and 800 PEs were identified as reference standard by experienced thoracic radiologists in the UM and PIOPED set, respectively. FROC analysis was used for performance evaluation. Compared with our previous CAD system, at a test sensitivity of 80%, the new method reduced the FP rate from 18.9 to 14.1/scan for the PIOPED set when the classifier was trained with the UM set and from 22.6 to 16.0/scan vice versa. The improvement was statistically significant (p<0.05) by JAFROC analysis. This study demonstrated that the MIHT method is effective in reducing FPs and improving the performance of the CAD system.