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Retrieval of radiology reports citing critical findings with disease-specific customization. 检索引用疾病特定定制的关键发现的放射学报告。
Pub Date : 2012-01-01 Epub Date: 2012-08-10 DOI: 10.2174/1874431101206010028
Ronilda Lacson, Nathanael Sugarbaker, Luciano M Prevedello, Ip Ivan, Wendy Mar, Katherine P Andriole, Ramin Khorasani

Background: Communication of critical results from diagnostic procedures between caregivers is a Joint Commission national patient safety goal. Evaluating critical result communication often requires manual analysis of voluminous data, especially when reviewing unstructured textual results of radiologic findings. Information retrieval (IR) tools can facilitate this process by enabling automated retrieval of radiology reports that cite critical imaging findings. However, IR tools that have been developed for one disease or imaging modality often need substantial reconfiguration before they can be utilized for another disease entity.

Purpose: THIS PAPER: 1) describes the process of customizing two Natural Language Processing (NLP) and Information Retrieval/Extraction applications - an open-source toolkit, A Nearly New Information Extraction system (ANNIE); and an application developed in-house, Information for Searching Content with an Ontology-Utilizing Toolkit (iSCOUT) - to illustrate the varying levels of customization required for different disease entities and; 2) evaluates each application's performance in identifying and retrieving radiology reports citing critical imaging findings for three distinct diseases, pulmonary nodule, pneumothorax, and pulmonary embolus.

Results: Both applications can be utilized for retrieval. iSCOUT and ANNIE had precision values between 0.90-0.98 and recall values between 0.79 and 0.94. ANNIE had consistently higher precision but required more customization.

Conclusion: Understanding the customizations involved in utilizing NLP applications for various diseases will enable users to select the most suitable tool for specific tasks.

背景:在护理人员之间沟通诊断程序的关键结果是联合委员会国家患者安全目标。评估关键结果交流通常需要人工分析大量数据,特别是在审查放射学发现的非结构化文本结果时。信息检索(IR)工具可以通过自动检索引用关键成像结果的放射学报告来促进这一过程。然而,为一种疾病或成像模式开发的红外工具在用于另一种疾病实体之前通常需要进行大量的重新配置。本文的目的:1)描述了自定义两个自然语言处理(NLP)和信息检索/提取应用程序的过程——一个开源工具包,一个几乎新的信息提取系统(ANNIE);以及内部开发的应用程序,使用本体利用工具包搜索内容的信息(iSCOUT),以说明不同疾病实体所需的不同级别的定制;2)评估每个应用程序在识别和检索引用三种不同疾病(肺结节、气胸和肺栓塞)的关键影像学发现的放射学报告方面的表现。结果:两种应用程序均可用于检索。iSCOUT和ANNIE的精度值在0.90 ~ 0.98之间,召回率在0.79 ~ 0.94之间。ANNIE始终具有更高的精度,但需要更多的定制。结论:了解在各种疾病中使用NLP应用程序所涉及的定制将使用户能够为特定任务选择最合适的工具。
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引用次数: 13
CKD Express © - A New IT-Software Proposed for a Paradigm Change in CKD Care. CKD Express©-为CKD护理模式改变而提出的新it软件。
Pub Date : 2012-01-01 Epub Date: 2012-08-10 DOI: 10.2174/1874431101206010026
Macaulay Ac Onuigbo
In an online MBA Class, under the auspices of the University of Wisconsin Consortium, Wisconsin, USA, the first author, who would be completing an MBA in the Spring of 2012, together with a group of three fellow MBA students have proposed the development of an IT-based System called the CKD Express © to enable a better, more efficient, more effective and cost-saving CKD care model [1]. This was in part fulfillment of the requirements of an MBA course on the development of new products - MBA 712 [1]. Treating patients with chronic kidney disease is a growing market as over 15% of the US population (approximately over 30 million) is estimated to have CKD [2]. The MBA course group completed a market analysis with primary and secondary data analysis, a market positioning and logistics evaluation, and a complete financial budgeting process that is in fact ready to take off formally as a new product-in-development [1]. This new product (a stand-alone IT module or an add-on to existing EMR) would have the appropriate artificial intelligence (AI) [3,4], decision support system (DSS) tools [3,4], and other algorithmic components to enable a trained nurse practitioner (NP), under the supervision of a nephrologist, to track and remotely manage CKD patients by tracking serum creatinine trajectories through the IT system network [1,3,4]. CKD patient care would be directed and managed by the NP after an initial full history and physical examination, to continue to carry out serum creatinine tests at stipulated intervals according to the algorithms recommended by the CKD Express © [1]. The NP will be responsible for directing frequency of laboratory tests (serum creatinine), timing of referral to specialist nephrologists or Emergency Departments, even when such CKD patients are living in remote and far flung apart rural areas, as long as they get to carry out the stipulated tests in the specified laboratory systems and the CKD Express © is able to have these laboratory data imported to it via established and secure IT networks [1]. This way, nephrologists, following timely referrals would see and manage CKD patients who require their expertise as determined by recent worsening kidney function and so on. Given the fact that by current estimates about 15% of Americans have CKD [2], and whereas we do not have enough nephrologists to attend to all CKD patients anyways [2], and whereas, if truth be told, there is no overarching reason to have all CKD patients (stage III-V) necessarily see nephrologists [5-7], and whereas quite often, even over years, a significant proportion of CKD patients do actually maintain a stable kidney function [8-11], it is our submission that this new IT-based product would introduce an efficient, effective, cost-saving and convenient new CKD care model [1]. The CKD Express © expert IT system is currently undergoing patent application and we are therefore constrained from releasing any more technical details than we have here already. N
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引用次数: 5
Integration of medical images into the digital hospital. 医学影像与数字医院的整合。
Pub Date : 2011-01-01 Epub Date: 2011-07-27 DOI: 10.2174/1874431101105010017
Xiaohong Gao, Henning Müller, Thomas M Deserno
Medical imaging has revolutionised healthcare delivery and become a hallmark of modern medicine in the last 30 years, benefiting the world to a large extent. This development coupled with the advances of information and communications technology (ICT) has enabled the delivery of high quality healthcare that had not been able to achieve before. On the other hand, the world has moved on beyond the current reactive model of ‘one-size-fits-all’ and hamstrung by the problems of fragmentation and lack of coordination of distributed data. Medical images are of a typical example. While picture archiving and communications systems (PACS) have come closely to be a universal tool in managing medical images, they only work for radiology images and are searchable by using text descriptions. With the rapidly growing of image volumes, obtaining a relevant datum using only key words is like finding a needle in a haystack. Additionally, with each clinical centre specialising in different domains, medical images collected are fragmented and of many forms. A novel data retrieval architecture should ensure queries not only being able to span to data sources of distributed collections, but also without prior standardisation of the original data, entailing each database with scope, scale, and the necessary flexibility with interoperability, i.e., the databases established today will be still in operation tomorrow in the rapidly progressing digital era With this in mind, this special issue has made a concerted effort to explore the breadth of medical imaging innovations and constitutes a suite of papers from a number of leading researchers in these fields, covering a wide range of topics that include novel imaging tools, robust image analysis software, and future sustainable data management systems, with a focus on image interpretation, IT infrastructure and database integration respectively. This issue begins with the paper on the introduction of a new, non-invasive imaging technique, phase contrast imaging (PCI), by Zhang and Luo (Paper 1). Built on X-ray phase shift, PCI has the ability of revealing soft tissues. Therefore, it has been applied in the establishment of models of hepatic fibrosis in a mouse liver, construction of a three-dimensional morphology of a segment of blood vessels, and imaging the alveoli in a lung, paving the way on diagnosis of respiratory disease in a non-invasive way in the future. In terms of interpretation of images, Paper 2, written by Su, Wang, Jiao, and Guo, has developed a novel computer aided diagnosis (CAD) system in a fully automatic manner to detect and classify breast tumours based on ultrasonic images, in assisting clinicians in arriving at a correct diagnosis, especially in distinguishing benign from malignant tumours. In addition, in order to recover vital information interlaced between frames in a series of 3D ultrasonic images, Lin and Li have developed a novel approach in their 4D echocardiography system as
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引用次数: 3
The state of the art of medical imaging technology: from creation to archive and back. 医学影像技术的最新发展:从创建到归档再到归档。
Pub Date : 2011-01-01 Epub Date: 2011-07-27 DOI: 10.2174/1874431101105010073
Xiaohong W Gao, Yu Qian, Rui Hui

Medical imaging has learnt itself well into modern medicine and revolutionized medical industry in the last 30 years. Stemming from the discovery of X-ray by Nobel laureate Wilhelm Roentgen, radiology was born, leading to the creation of large quantities of digital images as opposed to film-based medium. While this rich supply of images provides immeasurable information that would otherwise not be possible to obtain, medical images pose great challenges in archiving them safe from corrupted, lost and misuse, retrievable from databases of huge sizes with varying forms of metadata, and reusable when new tools for data mining and new media for data storing become available. This paper provides a summative account on the creation of medical imaging tomography, the development of image archiving systems and the innovation from the existing acquired image data pools. The focus of this paper is on content-based image retrieval (CBIR), in particular, for 3D images, which is exemplified by our developed online e-learning system, MIRAGE, home to a repository of medical images with variety of domains and different dimensions. In terms of novelties, the facilities of CBIR for 3D images coupled with image annotation in a fully automatic fashion have been developed and implemented in the system, resonating with future versatile, flexible and sustainable medical image databases that can reap new innovations.

在过去的 30 年中,医学影像技术已融入现代医学,并彻底改变了医疗行业。诺贝尔奖获得者威廉-伦琴(Wilhelm Roentgen)发现 X 射线后,放射学应运而生,从而产生了大量数字图像,而非胶片介质。虽然这些丰富的图像提供了无法估量的信息,而这些信息在其他情况下是不可能获得的,但医学影像的存档却面临着巨大的挑战,既要避免损坏、丢失和误用,又要能从具有不同元数据形式的庞大数据库中检索,还要在有了新的数据挖掘工具和新的数据存储介质时能重复使用。本文总结了医学影像断层扫描的创建、图像存档系统的发展以及现有图像数据池的创新。本文的重点是基于内容的图像检索(CBIR),特别是三维图像的检索,我们开发的在线电子学习系统 MIRAGE 就是一个例子,该系统拥有一个不同领域和不同维度的医学图像库。就新颖性而言,该系统开发并实施了针对三维图像的 CBIR 设施以及全自动的图像注释,这与未来多功能、灵活和可持续的医学图像数据库产生了共鸣,可带来新的创新。
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引用次数: 0
Application study of vascular interventional robotic mechanism for remote steering. 血管介入机器人机构远程转向应用研究。
Pub Date : 2011-01-01 Epub Date: 2011-07-27 DOI: 10.2174/1874431101105010046
Zengmin Tian, Bo Jia, Wangsheng Lu, Rui Hui

Background: Recently, robotic systems have been introduced as a useful method for surgical procedures. But in the field of vascular interventional therapy, the development of robotic system is slower.

Objective: The purpose of the study is to verify the reliability and safety of vascular interventional robotic system used in angiography, by the way of in vitro preliminary experiments and animal experiments.

Method: The approach is to employ a proprietary vascular interventional robot system to complete glass vessel models and animal angiogram experiments. This robot system consists of a console port (remote steering system), an assistant port (propelled and rotation system) and a hydraulic fixing device, upon which surgeons control remotely to make go forward and rotate in the glass vessel models and animal vessels, on the 3D operation interface. Consequently, the operation time and success rate are counted and evaluated.

Result: In the glass vessel model experiments, the Catheter can enter various kinds of vessel models with inside diameter length greater than 3mm and angle less than 90(o). In the animal (adult dogs) experiments, surgeons can accomplish smoothly the angiogram of the renal artery, the vertebral renal and the arteria carotis communis, without any complications of surgery.

Conclusion: The angiogram by using vascular interventional robot system is safe and reliable. Surgeons can finish the angiogram in part by remote operation, and the result of angiogram can meet a number of simple expectations. However without wire control and force feedback systems, the applicability of this kind of robot system is not flexible enough and need to be improved in the future.

背景:最近,机器人系统作为一种有用的外科手术方法被引入。但在血管介入治疗领域,机器人系统的发展较为缓慢。目的:通过体外初步实验和动物实验,验证血管介入机器人系统用于血管造影术的可靠性和安全性。方法:采用自主研发的血管介入机器人系统完成玻璃血管模型和动物血管造影实验。该机器人系统由控制口(远程操纵系统)、辅助口(推进和旋转系统)和液压固定装置组成,外科医生通过该装置在3D操作界面上远程控制玻璃容器模型和动物容器的前进和旋转。计算手术时间和手术成功率。结果:在玻璃血管模型实验中,导管可以进入内径长度大于3mm,角度小于90°的各种血管模型。在动物(成年犬)实验中,外科医生可以顺利完成肾动脉、椎体肾动脉和公共颈动脉血管造影,无任何手术并发症。结论:利用血管介入机器人系统进行血管造影是安全可靠的。外科医生可以通过远程操作部分完成血管造影,血管造影的结果可以满足一些简单的期望。然而,由于没有线控和力反馈系统,这种机器人系统的适用性不够灵活,需要在未来进一步提高。
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引用次数: 2
The research of sequential images: rebuilding of gray (position) ~ time function on direction lines and their applications. 序列图像的研究:方向线上的灰度(位置)~时间函数重建及其应用。
Pub Date : 2011-01-01 Epub Date: 2011-07-27 DOI: 10.2174/1874431101105010038
Qiang Lin, Wei Li

Contrasted with other information carriers, such as speech and text, images contains larger amount of information, especially in sequential images, that is waiting to be exploited, in particular the dynamic information of correlation, difference, and temporal relationship between different frames. This dynamic information contributes a great deal in analysis of 4D images. This paper proposes a method for detecting dynamic information from sequential images, based on the rebuilding of their gray (position)~time function on direction lines, an approach that has been analyzed and studied extensively on the setting of various direction lines. This method is based on motion that is presented on sequential images. In particular, the method, Omni directional M-mode Echocardiography system, which we have studied extensively, will be described leading to a robust way of diagnosing heart diseases.

与语音、文本等其他信息载体相比,图像尤其是序列图像中蕴含着更多的有待开发的信息,特别是不同帧之间的相关、差异、时间关系等动态信息。这种动态信息对四维图像的分析有很大的帮助。本文提出了一种基于重建序列图像在方向线上的灰度(位置)~时间函数的动态信息检测方法,该方法在各种方向线上的设置上得到了广泛的分析和研究。该方法基于连续图像上呈现的运动。特别是,我们广泛研究的全方位m型超声心动图系统,将被描述为一种诊断心脏病的强大方法。
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引用次数: 0
Combining textual and visual information for image retrieval in the medical domain. 结合文本和视觉信息的医学领域图像检索。
Pub Date : 2011-01-01 Epub Date: 2011-07-27 DOI: 10.2174/1874431101105010050
Yiannis Gkoufas, Anna Morou, Theodore Kalamboukis

In this article we have assembled the experience obtained from our participation in the imageCLEF evaluation task over the past two years. Exploitation on the use of linear combinations for image retrieval has been attempted by combining visual and textual sources of images. From our experiments we conclude that a mixed retrieval technique that applies both textual and visual retrieval in an interchangeably repeated manner improves the performance while overcoming the scalability limitations of visual retrieval. In particular, the mean average precision (MAP) has increased from 0.01 to 0.15 and 0.087 for 2009 and 2010 data, respectively, when content-based image retrieval (CBIR) is performed on the top 1000 results from textual retrieval based on natural language processing (NLP).

在本文中,我们汇集了过去两年中参与imageCLEF评估任务所获得的经验。通过结合图像的视觉和文本来源,尝试利用线性组合进行图像检索。从我们的实验中我们得出结论,混合检索技术以可互换的重复方式应用文本检索和视觉检索,提高了性能,同时克服了视觉检索的可伸缩性限制。特别是,当对基于自然语言处理(NLP)的文本检索的前1000个结果进行基于内容的图像检索(CBIR)时,2009年和2010年数据的平均精度(MAP)分别从0.01提高到0.15和0.087。
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引用次数: 12
Evaluation of quantitative EEG by classification and regression trees to characterize responders to antidepressant and placebo treatment. 用分类和回归树评价定量脑电图对抗抑郁药和安慰剂治疗的反应。
Pub Date : 2011-01-01 Epub Date: 2011-02-11 DOI: 10.2174/1874431101105010001
M Rabinoff, C M R Kitchen, I A Cook, A F Leuchter

The study objective was to evaluate the usefulness of Classification and Regression Trees (CART), to classify clinical responders to antidepressant and placebo treatment, utilizing symptom severity and quantitative EEG (QEEG) data. Patients included 51 adults with unipolar depression who completed treatment trials using either fluoxetine, venlafaxine or placebo. Hamilton Depression Rating Scale (HAM-D) and single electrodes data were recorded at baseline, 2, 7, 14, 28 and 56 days. Patients were classified as medication and placebo responders or non-responders. CART analysis of HAM-D scores showed that patients with HAM-D scores lower than 13 by day 7 were more likely to be treatment responders to fluoxetine or venlafaxine compared to non-responders (p=0.001). Youden's index γ revealed that CART models using QEEG measures were more accurate than HAM-D-based models. For patients given fluoxetine, patients with a decrease at day 2 in θ cordance at AF2 were classified by CART as treatment responders (p=0.02). For those receiving venlafaxine, CART identified a decrease in δ absolute power at day 7 at the PO2 region as characterizing treatment responders (p=0.01). Using all patients receiving medication, CART identified a decrease in δ absolute power at day 2 in the FP1 region as characteristic of nonresponse to medication (p=0.003). Optimal trees from the QEEG CART analysis primarily utilized cordance values, but also incorporated some δ absolute power values. The results of our study suggest that CART may be a useful method for identifying potential outcome predictors in the treatment of major depression.

研究目的是评估分类和回归树(CART)的有效性,利用症状严重程度和定量脑电图(QEEG)数据对抗抑郁药和安慰剂治疗的临床反应者进行分类。患者包括51名患有单相抑郁症的成年人,他们完成了使用氟西汀、文拉法辛或安慰剂的治疗试验。分别于基线、2、7、14、28和56 d记录汉密尔顿抑郁评定量表(HAM-D)和单电极数据。患者被分为药物和安慰剂反应者和无反应者。HAM-D评分的CART分析显示,与无反应者相比,第7天HAM-D评分低于13的患者更有可能对氟西汀或文拉法辛治疗有反应(p=0.001)。约登指数γ显示,使用QEEG测量的CART模型比基于ham - d的模型更准确。在给予氟西汀治疗的患者中,第2天AF2 θ关联度下降的患者被CART分类为治疗应答者(p=0.02)。对于那些接受文拉法辛治疗的患者,CART发现第7天PO2区的δ绝对功率下降是治疗应答的特征(p=0.01)。在所有接受药物治疗的患者中,CART发现第2天FP1区域δ绝对功率的下降是对药物治疗无反应的特征(p=0.003)。从QEEG CART分析中得到的最优树主要利用了关联度值,但也包含了一些δ绝对功率值。我们的研究结果表明,CART可能是一种有效的方法,用于识别治疗重度抑郁症的潜在结果预测因素。
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引用次数: 20
Prototypes for content-based image retrieval in clinical practice. 临床实践中基于内容的图像检索原型。
Pub Date : 2011-01-01 Epub Date: 2011-07-27 DOI: 10.2174/1874431101105010058
Adrien Depeursinge, Benedikt Fischer, Henning Müller, Thomas M Deserno

Content-based image retrieval (CBIR) has been proposed as key technology for computer-aided diagnostics (CAD). This paper reviews the state of the art and future challenges in CBIR for CAD applied to clinical practice.We define applicability to clinical practice by having recently demonstrated the CBIR system on one of the CAD demonstration workshops held at international conferences, such as SPIE Medical Imaging, CARS, SIIM, RSNA, and IEEE ISBI. From 2009 to 2011, the programs of CADdemo@CARS and the CAD Demonstration Workshop at SPIE Medical Imaging were sought for the key word "retrieval" in the title. The systems identified were analyzed and compared according to the hierarchy of gaps for CBIR systems.In total, 70 software demonstrations were analyzed. 5 systems were identified meeting the criterions. The fields of application are (i) bone age assessment, (ii) bone fractures, (iii) interstitial lung diseases, and (iv) mammography. Bridging the particular gaps of semantics, feature extraction, feature structure, and evaluation have been addressed most frequently.In specific application domains, CBIR technology is available for clinical practice. While system development has mainly focused on bridging content and feature gaps, performance and usability have become increasingly important. The evaluation must be based on a larger set of reference data, and workflow integration must be achieved before CBIR-CAD is really established in clinical practice.

基于内容的图像检索(CBIR)已被提出作为计算机辅助诊断(CAD)的关键技术。本文回顾了应用于临床实践的计算机辅助诊断(CAD)中基于内容的图像检索(CBIR)技术的现状和未来挑战。我们通过最近在国际会议(如 SPIE 医学影像、CARS、SIIM、RSNA 和 IEEE ISBI)上举办的计算机辅助诊断(CAD)演示研讨会之一上演示 CBIR 系统来定义对临床实践的适用性。从 2009 年到 2011 年,我们对 CADdemo@CARS 和 SPIE 医学影像会议 CAD 演示研讨会的程序进行了搜索,以查找标题中的关键词 "检索"。根据 CBIR 系统的差距等级,对确定的系统进行了分析和比较。确定了 5 个符合标准的系统。应用领域包括:(i) 骨龄评估;(ii) 骨折;(iii) 肺间质疾病;(iv) 乳房 X 线照相术。在特定应用领域,CBIR 技术可用于临床实践。虽然系统开发主要集中在弥补内容和特征方面的不足,但性能和可用性也变得越来越重要。在 CBIR-CAD 真正应用于临床实践之前,评估必须基于更大的参考数据集,并且必须实现工作流程的整合。
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引用次数: 0
Automatic detection and classification of breast tumors in ultrasonic images using texture and morphological features. 基于纹理和形态学特征的超声图像乳腺肿瘤自动检测与分类。
Pub Date : 2011-01-01 Epub Date: 2011-07-27 DOI: 10.2174/1874431101105010026
Yanni Su, Yuanyuan Wang, Jing Jiao, Yi Guo

Due to severe presence of speckle noise, poor image contrast and irregular lesion shape, it is challenging to build a fully automatic detection and classification system for breast ultrasonic images. In this paper, a novel and effective computer-aided method including generation of a region of interest (ROI), segmentation and classification of breast tumor is proposed without any manual intervention. By incorporating local features of texture and position, a ROI is firstly detected using a self-organizing map neural network. Then a modified Normalized Cut approach considering the weighted neighborhood gray values is proposed to partition the ROI into clusters and get the initial boundary. In addition, a regional-fitting active contour model is used to adjust the few inaccurate initial boundaries for the final segmentation. Finally, three textures and five morphologic features are extracted from each breast tumor; whereby a highly efficient Affinity Propagation clustering is used to fulfill the malignancy and benign classification for an existing database without any training process. The proposed system is validated by 132 cases (67 benignancies and 65 malignancies) with its performance compared to traditional methods such as level set segmentation, artificial neural network classifiers, and so forth. Experiment results show that the proposed system, which needs no training procedure or manual interference, performs best in detection and classification of ultrasonic breast tumors, while having the lowest computation complexity.

由于乳腺超声图像存在严重的斑点噪声,图像对比度差,病变形状不规则,因此建立一个全自动的乳腺超声图像检测与分类系统是一个挑战。本文提出了一种新的、有效的计算机辅助方法,包括感兴趣区域的生成、乳腺肿瘤的分割和分类,而无需人工干预。首先结合纹理和位置的局部特征,利用自组织地图神经网络检测感兴趣区域;然后提出了一种考虑加权邻域灰度值的改进归一化切割方法,将感兴趣区域划分成簇并得到初始边界。此外,利用区域拟合的主动轮廓模型对少量不准确的初始边界进行调整,从而达到最终分割的目的。最后,从每个乳腺肿瘤中提取3个纹理和5个形态特征;利用高效的亲和传播聚类方法,在不进行任何训练的情况下,实现对现有数据库的良性和恶性分类。通过132例病例(67例良性肿瘤和65例恶性肿瘤)对该系统进行了验证,并将其性能与传统方法(如水平集分割、人工神经网络分类器等)进行了比较。实验结果表明,该系统不需要训练程序和人工干扰,在超声乳腺肿瘤的检测和分类中表现最好,同时具有最低的计算复杂度。
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引用次数: 58
期刊
The open medical informatics journal
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