|
|
||||||||
Breast Imaging |
1 From the Department of Radiology, Emory University School of Medicine, Winship Cancer Institute, 1701 Uppergate Dr, Bldg C, Suite 5018, Atlanta, GA 30322 (S.S., A.K., S. V., S.M.W., C.J.D.); and the Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology and Emory University, Atlanta, Ga (S.S., A.K.). Received April 23, 2004; revision requested July 8; revision received August 13; accepted November 8. Supported in part by National Institutes of Health grants RO1-CA88792 from the National Cancer Institute and RO1-EB002123 from the National Institute of Biomedical Imaging and Bioengineering and by a Georgia Cancer Coalition infrastructure grant from the Cancer Scholars Program. Address correspondence to A.K. (e-mail: akarell{at}emory.edu).
| ABSTRACT |
|---|
|
|
|---|
MATERIALS AND METHODS: The images used in this study were acquired with institutional review board approval and patient informed consent, both of which allowed subsequent image data analysis. Patient identification was removed from images, and the study complied with requirements of the Health Insurance Portability and Accountability Act. Masses 3, 6, and 8 mm in diameter were analytically simulated and added to clinical mammographic backgrounds. In addition, microcalcifications were extracted from a clinical mammogram and hybridized with simulated microcalcifications for use in this study. Image compression conditions of 1:1, 15:1, and 30:1 were investigated. Observer responses were recorded with a six-point rating scale, and receiver operating characteristic (ROC) analysis was performed. In addition, two well-established numeric observer models were used to study the effect of image compression under the same compression conditions as were used with human observers. Analysis of variance was performed after observer adjustment to compare the mean values for area under the ROC curve (Az) across the three compression levels for the masses and microcalcification clusters.
RESULTS: The results of the study indicated no significant differences in the Az values for masses with the compression conditions investigated. For images of microcalcifications, there were significant differences in Az values between compression ratios of 1:1 and 30:1 (P = .0005) and of 15:1 and 30:1 (P = .004); the difference between compression ratios of 1:1 and 15:1 was nonsignificant (P = .053). The observer models and human observers exhibited similar trends in detection of the masses investigated in this study.
CONCLUSION: Detection of simulated masses was not affected by the compression method with the conditions used in this study, while the detection of microcalcifications was significantly reduced with a compression ratio of more than 15:1.
© RSNA, 2005
| INTRODUCTION |
|---|
|
|
|---|
Although a variety of data compression techniques are available, the two popular compression standards that have been evaluated for medical applications are the Joint Photographic Experts Group (JPEG) and JPEG 2000 standards (11,1520). The lossy JPEG compression standard is based on methods that use the discrete cosine transform to map the image as a series of 8 x 8-pixel segments and to transform each segment into spectral coefficients that are subsequently quantized and encoded (16). The encoded image can be decoded, dequantized, and reconstructed by applying an inverse discrete cosine transform (16).
The JPEG 2000 compression standard, on the other hand, uses the discrete wavelet transform (16,18), whereby a series of high- and low-pass digital filters are applied repeatedly to the entire image, thus decomposing the image into subimages or subbands, as described in previous studies (16,18). These subbands can be encoded independently, and the image can be reconstructed at a selectable resolution by decoding bit streams that contain the appropriate subbands (16,18). The main characteristic features of the JPEG 2000 standard include higher compression efficiency compared with that of JPEG images, region-of-interest (ROI) compression, lossless and lossy compression, and multiresolution support (16). From a perceptual standpoint, the wavelet basis functions in JPEG 2000 images tend to produce smooth artifacts, unlike the blocklike artifacts produced by JPEG images, which tend to blend in with the rest of the anatomy (16).
Observer-independent metrics, such as peak signal-to-noise-ratio, are frequently used to assess the performance of compression algorithms (21,22), but for clinical images it is imperative to evaluate the quality of image compression from the end user's perspective by incorporating the human visual system in the evaluation process. Since compression techniques such as JPEG 2000 compression alter the spatial frequency information content of the images, it is critical to understand their effects on lesion detection by human observers.
In a recent study, Good et al (23) evaluated JPEG image compression for scanned mammograms and showed that it did not affect the detection of masses but did affect the detection of microcalcifications at high compression ratios. Another study investigated the effect of a wavelet-based compression technique on the detection of microcalcifications in mammograms, and the authors demonstrated a threshold compression ratio of 40:1 for microcalcification detection (24). In a phantom-based study, the effect of JPEG 2000 compression on contrast-detail characteristics of digital mammograms indicated certain promising traits (25). Thus, the purpose of the current study was to evaluate retrospectively the effect of a wavelet-based compression method on the detection of simulated masses of various sizes and clustered microcalcifications on data-compressed digital mammograms.
| MATERIALS AND METHODS |
|---|
|
|
|---|
Image Preparation
The images used in this study were obtained with a clinical full-field digital mammographic system (GE Medical Systems, Milwaukee, Wis) (26). The clinical images used in this study were acquired in 2000 and 2001. For the purpose of this investigation, only craniocaudal mammograms were selected (both left and right views). Image ROIs of 256 x 256 pixels were cropped from a region of uniform thickness in each mammogram and served as backgrounds in this study. One of the authors (S.S.), who is not a radiologist but has more than 5 years of experience in mammographic imaging research, developed an automated technique to select and extract the ROIs. The technique selected backgrounds relatively close to the chest wall (within approximately 1015 mm) while ensuring that they did not cover the pectoralis, as the effect of breast tissue was of interest. Backgrounds without artifacts, microcalcifications, masses, or architectural distortion were selected. The cropped images were checked again under different window and level conditions to ensure the absence of the aforementioned structures, and those that did not meet our selection criteria were discarded. To ensure that each background was unique, the mean value of each ROI was computed and checked to ensure that no two ROIs had identical mean values. We did not try to select backgrounds of a specific type of breast tissue, and 260 backgrounds encompassing a mixture of fatty and glandular tissue were collected.
Images were hybridized with the addition of simulated masses and microcalcifications to the clinical mammographic data backgrounds. Two-dimensional masslike lesions were simulated by using an analytic equation approach to generate "designer nodules" (27). Masses 3, 6, and 8 mm in diameter were simulated for this study, and the peak amplitude of the mass was scaled in terms of digital units to achieve an area under the receiver operating characteristic (ROC) curve (Az) value well above 0.5. The same amplitude value was used for all three masses, to investigate lesion size effects. A single cluster of microcalcifications was extracted from a digital mammogram by filtering the original image to suppress the microcalcifications and subtracting the filtered image from the original. Care was taken, when filtering the original image, to avoid excessive smoothing of the background and thus to facilitate the effective removal of background structures at subtraction. Any undesirable structures that were present in the subtracted image were then removed by setting those pixel values at 0. An algorithm was developed to add simulated microcalcifications to the extracted microcalcifications from the clinical mammogram. A number of locations in the vicinity of the extracted microcalcifications were chosen, and pixels with amplitudes in the same range as the amplitudes of the extracted microcalcifications were inserted. A number of these inserted pixels were randomly grouped to mimic clinical microcalcifications, to produce a reasonable range of calcification sizes. The sizes of the individual calcifications were approximately 100300 mm. As in the case of the masses, the amplitude of the calcification cluster was scaled so as to ensure an Az value well above 0.5.
One of the authors (S.S.) prepared image data sets by randomly selecting 100 mammographic backgrounds and adding a single mass or microcalcification cluster to the central portion of half the images, producing 50 backgrounds with a lesion and 50 background-only images. Four primary image data sets (100 images in each) were prepared for each of three mass sizes (3, 6, and 8 mm) and one microcalcification cluster size range (0.10.3 mm). In addition, a separate set of 60 backgrounds was used for observer training. Each of the data sets was compressed with commercially available JPEG 2000 image compression software (Aware, Bedford, Mass). The software allowed custom scripting to perform batch compression of images. Three data compression conditionsratios of 1:1 (no compression), 15:1, and 30:1were investigated with a lossy compression method, which allowed image compression at higher ratios. Examples of a simulated mass and microcalcification cluster are shown in Figure 1 and Figure 2, respectively.
|
|
The observer study was conducted with radiologists who had approximately 532 years of experience in mammography and a 1st-year resident who had some training in clinical mammography. Five observers (four radiologists and one resident) participated in the study with the masses, and four (three radiologists and one resident) participated in the study with the microcalcification cluster.
One of the authors (C.J.D.) participated as an observer in the experiments with the masses and microcalcifications. The study was conducted in multiple sessions, in which each observer independently reviewed the displayed images and assigned confidence responses. The experiment was first conducted with simulated masses and then with the microcalcification cluster. Before each session, the observers were trained with 60 images for a specific mass size that included the three compression conditions. Similar training was provided for the microcalcification cluster. Feedback was provided to the observer in the form of a high-contrast version (reference standard) of the test image, to enable observer orientation within the experiment.
Each session was divided into three sections for the three compression conditions (after training), and only masses of a specific size were reviewed in a given session. The selection and order of the displayed backgrounds were randomized between sections to prevent observer familiarization with the images. Further, the order of mass size and compression condition were varied across observers to prevent reader order effects (30). For the microcalcification cluster, only the order of the compression condition was varied across observers, as only a single cluster was evaluated.
No restrictions were placed on the observers in terms of viewing distances and time, but on average the observers completed each section in about 15 minutes. The use of a magnifier was restricted for visualization of masses but was allowed to all observers for visualization of microcalcifications. One of the observers, who wore contact lenses for vision correction, was permitted to use a magnifier also for visualization of masses, as this observer used a magnifier for this purpose in the clinic. Data with regard to image order and observer confidence responses were recorded and later analyzed.
Observer Models
Two numeric observer modelsnamely, nonprewhitening matched filter with an eye filter (NPWE) (27,31) and Laguerre-Gauss channelized Hotelling observer (LG-CHO) (32)were used to study the effect of image compression on lesion detection. The models were applied to study the detection of masses under the conditions investigated. The general process for both observer models included template generation and detection index computation from test statistics. Six Laguerre-Gaussian channels were used for the LG-CHO model. A detailed description of these numeric observer models is provided elsewhere (27,3133). Five hundred twelve digital mammographic backgrounds were used to generate the templates, and a different set of 512 backgrounds were used to compute the percentage of correct detections for each mass size and compression condition by randomly selecting backgrounds with and without the signal (33). The percentages of correct detections were transformed into indexes of detection and later transformed into an Az value according to the relation derived by Barrett et al (34).
Statistical Analysis
The recorded human observer data for masses and microcalcifications for all the compression conditions were imported into a software program (ROCKIT; Charles E. Metz, University of Chicago, Chicago, Ill), and corresponding Az values were computed. Forty-five Az values (five observers x three mass sizes x three compression conditions) were obtained for the masses, and 12 Az values (four observers x one cluster x three compression conditions) were obtained for the microcalcification cluster. Statistical analysis was performed with analysis of variance after observer adjustment to compare the mean Az values across the three compression levels for each mass diameter (3, 6, and 8 mm). Similar analysis was performed for the microcalcification cluster. When the overall test for comparison of the Az estimated values at each compression ratio showed statistically significant differences (P < .05), pairwise comparisons were performed between the compression ratios (1:1 vs 15:1, 1:1 vs 30:1, and 15:1 vs 30:1). All statistical tests were two sided and unadjusted for multiple comparisons.
| RESULTS |
|---|
|
|
|---|
|
|
|
|
|
| DISCUSSION |
|---|
|
|
|---|
The results of this study suggest that image compression with use of the JPEG 2000 standard does not affect the detection of subtle simulated masses in digital mammographic backgrounds but does affect the detection of microcalcifications at compression ratios of more than 15:1 and with the conditions investigated. Our results agree with those reported by Good et al (23), who demonstrated the effect of JPEG image compression for digitized mammographic film images. Many compression techniques, such as JPEG 2000, use frequency decomposition of the image data with visual weighting that could potentially lead to a loss of high-frequency information, especially at higher compression ratios (16).
Typical mammographic masses and the simulated masses investigated in this study predominantly have low-frequency content with smooth edges and tend to blend in with the surrounding tissue structures. This property may well have played a role in preserving their detectability. On the other hand, microcalcifications are rich in high-spatial-frequency content because of their small size and relatively abrupt edges, and compression at higher ratios could have filtered the high-frequency information from the signal (microcalcification), thereby affecting its detection.
The decrease in Az values for masses with increasing size and constant amplitude could be attributed to the background spatial statistics of mammograms. The variation in image noise as a frequency (noise power spectrum) has an effect on detection trends. For constant-amplitude lesions like those in this study, a reduction in signal-to-noise ratio has been shown to occur in power lawrelated noise as lesion size is increased (27). Mammograms have been shown to exhibit a power lawdependent noise power spectrum in which the shape of the spectrum has a spatial frequency dependence of 1/
3 (27), and it was not surprising that we observed a general degradation in the detection of the constant-amplitude masses as their size increased. It is interesting to note that such a trend appears to be valid even for data-compressed mammograms. In another study, Lucier et al (35) found morphologic distortion of microcalcifications caused by a specific type of wavelet compression at high compression levels, which led to higher variability in diagnosis.
Contrary to our observations with JPEG image compression, with JPEG 2000 compression we did not notice any block or discrete artifacts, and none of the observers noticed any differences between the uncompressed and compressed images. Compression was limited to a ratio of 30:1. Beyond this ratio, a visual smoothing effect was noticeable with the ROI images used in this study. The study was conducted with extracted ROIs from clinical digital mammograms, since we sought only a relative comparison of detection with respect to lesion size and compression ratio rather than absolute detection rates. The general trend of our results agrees with those of Good et al (23) and Kocsis et al (24), who conducted studies with clinical mammograms but with a different image compression technique.
This study was limited in that only ROIs were used and the signal location was known a priori to the observer. In a clinical situation, the radiologist would not have this luxury and would have to go through a search-and-find process to identify lesions. Further, the study did not incorporate a variety of mass and microcalcification types, as might be observed clinically. In addition, it was designed to evaluate the effect of image compression only on lesion detection. Evaluation of lesion characterization was beyond the scope of this investigation, and the effect of our compression technique on the morphologic features of malignant lesions needs to be investigated.
Task-specific optimization of the compression algorithm was beyond the scope of this investigation. However, the similarity in detection trends between human and numeric observers for the mass-type lesions is encouraging, and such models or their variants may offer a viable method for evaluating image compression techniques. The LG-CHO model could not be applied to the microcalcification data, as stable template estimation was constrained with nonsymmetric signals. The performance of the NPWE observer model also was not a good predictor of human detection of microcalcifications, because of restrictions in template estimation, especially after image compression. However, numeric observer models have been investigated to analyze the performance of compression algorithms for other applications with objective metrics (36,37). Optimization of compression transformation and quantization strategies could improve the performance of data compression, especially for high-frequency objects such as microcalcifications (37,38). Furthermore, the effect of image compression on computer-aided diagnosis needs to be studied in great detail (39). Much work is needed to clarify the intricate mechanisms by which image compression could affect lesion visualization and detection on mammograms. Further, similar studies with other types of digital mammography systems will provide useful insights into system-specific image compression performance.
On the basis of the tested conditions and results in this study, it appears that (a) image data compression at ratios up to 30:1 might be applicable for digital mammograms with masses; (b) it may become feasible to use a compression ratio of as much as 15:1 for mammograms with microcalcifications, without degrading the diagnostic value of the image; (c) numeric observer models can be an efficient method to optimize compression techniques; and (d) this study serves as a precursor for comprehensive clinical studies to evaluate JPEG 2000 image compression for digital mammography. It should be noted, however, that the results of this study are limited to lesion detection, and lower compression ratios might be required for lesion characterization to be preserved. By optimizing compression parameters, it may be possible to improve observer performance substantially. It may be appropriate to evaluate whether it is feasible to store uncompressed mammograms for a specific period (eg, 2 years), after which a compression of those mammograms would be performed with a modest compression ratio. Greater image compression may be appropriate for mammograms older than 5 years. Overall, the results of this study suggest that JPEG 2000 compression is a promising technique for the compression of clinical digital mammographic data.
| ACKNOWLEDGMENTS |
|---|
| FOOTNOTES |
|---|
Abbreviations: Az = area under the ROC curve JPEG = Joint Photographic Experts Group LG-CHO = Laguerre-Gauss channelized Hotelling observer NPWE = nonprewhitening matched filter with an eye filter ROC = receiver operating characteristic ROI = region of interest
The contents are solely the responsibility of the authors and do not necessarily represent the official views of the National Cancer Institute, the National Institute of Biomedical Imaging and Bioengineering, or the National Institutes of Health.
Authors stated no financial relationship to disclose.
Author contributions: Guarantor of integrity of entire study, S.S.; study concepts, S.S., A.K., S.V., C.J.D.; study design, S.S., A.K., C.J.D.; literature research, S.S., A.K., S.V.; experimental studies, S.S., A.K., S.V., C.J.D.; data acquisition, S.S., C.J.D.; data analysis/interpretation, S.S., S.M.W.; statistical analysis, S.S., S.M.W.; manuscript preparation, S.S., A.K., S.V., S.M.W.; manuscript definition of intellectual content, S.S., A.K.; manuscript editing, all authors; manuscript revision/review and final version approval, A.K., C.J.D.
| References |
|---|
|
|
|---|
This article has been cited by other articles:
![]() |
B. F. Branstetter IV Basics of Imaging Informatics: Part 1 Radiology, June 1, 2007; 243(3): 656 - 667. [Abstract] [Full Text] [PDF] |
||||
| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
| RADIOLOGY | RADIOGRAPHICS | RSNA JOURNALS ONLINE |