Chest X-ray (CXR) is one of the most commonly prescribed medical imaging procedures, often with over 2-10x more scans than other imaging modalities such as MRI, CT scan, and PET scans. These voluminous CXR scans place significant workloads on radiologists and medical practitioners. Organ segmentation is a crucial step to obtain effective computer-aided detection on CXR. In this work, we propose Structure Correcting Adversarial Network (SCAN) to segment lung fields and the heart in CXR images. SCAN incorporates a critic network to impose on the convolutional segmentation network the structural regularities emerging from human physiology. During training, the critic network learns to discriminate between the ground truth organ annotations from the masks synthesized by the segmentation network. Through this adversarial process the critic network learns the higher order structures and guides the segmentation model to achieve realistic segmentation outcomes. Extensive experiments show that our method produces highly accurate and natural segmentation. Using only very limited training data available, our model reaches human-level performance without relying on any existing trained model or dataset. Our method also generalizes well to CXR images from a different patient population and disease profiles, surpassing the current state-of-the-art.
An active shape model segmentation scheme is presented that is steered by optimal local features, contrary to normalized first order derivative profiles, as in the original formulation [Cootes and Taylor, 1995, 1999, and 2001]. A nonlinear kNN-classifier is used, instead of the linear Mahalanobis distance, to find optimal displacements for landmarks. For each of the landmarks that describe the shape, at each resolution level taken into account during the segmentation optimization procedure, a distinct set of optimal features is determined. The selection of features is automatic, using the training images and sequential feature forward and backward selection. The new approach is tested on synthetic data and in four medical segmentation tasks: segmenting the right and left lung fields in a database of 230 chest radiographs, and segmenting the cerebellum and corpus callosum in a database of 90 slices from MRI brain images. In all cases, the new method produces significantly better results in terms of an overlap error measure (p<0.001 using a paired T-test) than the original active shape model scheme. The traditional chest radiograph is still ubiquitous in clinical practice, and will likely remain so for quite some time. Yet, its interpretation is notoriously difficult. This explains the continued interest in computer-aided diagnosis for chest radiography. The purpose of this survey is to categorize and briefly review the literature on computer analysis of chest images, which comprises over 150 papers published in the last 30 years. Remaining challenges are indicated and some directions for future research are given. This paper presents a new deformable model using both population-based and patient-specific shape statistics to segment lung fields from serial chest radiographs. There are two novelties in the proposed deformable model. First, a modified scale invariant feature transform (SIFT) local descriptor, which is more distinctive than the general intensity and gradient features, is used to characterize the image features in the vicinity of each pixel. Second, the deformable contour is constrained by both population-based and patient-specific shape statistics, and it yields more robust and accurate segmentation of lung fields for serial chest radiographs. In particular, for segmenting the initial time-point images, the population-based shape statistics is used to constrain the deformable contour; as more subsequent images of the same patient are acquired, the patient-specific shape statistics online collected from the previous segmentation results gradually takes more roles. Thus, this patient-specific shape statistics is updated each time when a new segmentation result is obtained, and it is further used to refine the segmentation results of all the available time-point images. Experimental results show that the proposed method is more robust and accurate than other active shape models in segmenting the lung fields from serial chest radiographs. In this work, a level set energy for segmenting the lungs from digital Posterior-Anterior (PA) chest x-ray images is presented. The primary challenge in using active contours for lung segmentation is local minima due to shading effects and presence of strong edges due to the rib cage and clavicle. We have used the availability of good contrast at the lung boundaries to extract a multi-scale set of edge corner feature points and drive our active contour model using these features. We found these features when supplemented with a simple region based data term and a shape term based on the average lung shape, able to handle the above local minima issues. The algorithm was tested on 1130 clinical images, giving promising results. An algorithm for detection of posterior rib borders in chest radiographs is presented. The algorithm first determines the thoracic cage boundary to restrict the area of search for the ribs. It then finds approximate rib borders using a knowledge-based Hough transform. Finally, the algorithm localizes the rib borders using an active contour model. Results of the proposed rib finding algorithm on 10 chest radiographs are presented. > The task of segmenting the posterior ribs within the lung fields of standard posteroanterior chest radiographs is considered. To this end, an iterative, pixel-based, supervised, statistical classification method is used, which is called iterated contextual pixel classification (ICPC). Starting from an initial rib segmentation obtained from pixel classification, ICPC updates it by reclassifying every pixel, based on the original features and, additionally, class label information of pixels in the neighborhood of the pixel to be reclassified. The method is evaluated on 30 radiographs taken from the JSRT (Japanese Society of Radiological Technology) database. All posterior ribs within the lung fields in these images have been traced manually by two observers. The first observer's segmentations are set as the gold standard; ICPC is trained using these segmentations. In a sixfold cross-validation experiment, ICPC achieves a classification accuracy of 0.86 spl plusmn 0.06, as compared to 0.94 spl plusmn 0.02 for the second human observer. We describe a new method of matching statistical models of appearance to images. A set of model parameters control modes of shape and gray-level variation learned from a training set. We construct an efficient iterative matching algorithm by learning the relationship between perturbations in the model parameters and the induced image errors. A new generic model-based segmentation algorithm is presented, which can be trained from examples akin to the active shape model (ASM) approach in order to acquire knowledge about the shape to be segmented and about the gray-level appearance of the object in the image. Whereas ASM alternates between shape and intensity information during search, the proposed approach optimizes for shape and intensity characteristics simultaneously. Local gray-level appearance information at the landmark points extracted from feature images is used to automatically detect a number of plausible candidate locations for each landmark. The shape information is described by multiple landmark-specific statistical models that capture local dependencies between adjacent landmarks on the shape. The shape and intensity models are combined in a single cost function that is optimized noniteratively using dynamic programming, without the need for initialization. The algorithm was validated for segmentation of anatomical structures in chest and hand radiographs. In each experiment, the presented method had a significant higher performance when compared to the ASM schemes. As the method is highly effective, optimally suited for pathological cases and easy to implement, it is highly useful for many medical image segmentation tasks.   A fully automatic method is presented to detect abnormalities in frontal chest radiographs which are aggregated into an overall abnormality score. The method is aimed at finding abnormal signs of a diffuse textural nature, such as they are encountered in mass chest screening against tuberculosis (TB). The scheme starts with automatic segmentation of the lung fields, using active shape models. The segmentation is used to subdivide the lung fields into overlapping regions of various sizes. Texture features are extracted from each region, using the moments of responses to a multiscale filter bank. Additional "difference features" are obtained by subtracting feature vectors from corresponding regions in the left and right lung fields. A separate training set is constructed for each region. All regions are classified by voting among the k nearest neighbors, with leave-one-out. Next, the classification results of each region are combined, using a weighted multiplier in which regions with higher classification reliability weigh more heavily. This produces an abnormality score for each image. The method is evaluated on two databases. The first database was collected from a TB mass chest screening program, from which 147 images with textural abnormalities and 241 normal images were selected. Although this database contains many subtle abnormalities, the classification has a sensitivity of 0.86 at a specificity of 0.50 and an area under the receiver operating characteristic (ROC) curve of 0.820. The second database consist of 100 normal images and 100 abnormal images with interstitial disease. For this database, the results were a sensitivity of 0.97 at a specificity of 0.90 and an area under the ROC curve of 0.986.  Abstract Rationale and Objectives The authors performed this study to evaluate an algorithm developed to help identify lungs on chest radiographs. Materials and Methods Forty clinical posteroanterior chest radiographs obtained in adult patients were digitized to 12-bit gray-scale resolution. In the proposed algorithm, the authors simplified the current approach of edge detection with derivatives by using only the first derivative of the horizontal and or vertical image profiles. In addition to the derivative method, pattern classification and image feature analysis were used to determine the region of interest and lung boundaries. Instead of using the traditional curve-fitting method to delineate the lung, the authors applied an iterative contour-smoothing algorithm to each of the four detected boundary segments (costal, mediastinal, lung apex, and hemidiaphragm edges) to form a smooth lung boundary. Results The algorithm had an average accuracy of 96.0 for the right lung and 95.2 for the left lung and was especially useful in the delineation of hemidiaphragm edges. In addition, it took about 0.775 second per image to identify the lung boundaries, which is much faster than that of other algorithms noted in the literature. Conclusion The computer-generated segmentation results can be used directly in the detection and compensation of rib structures and in lung nodule detection. 