Modeling uncertainty in classification design of a computer-aided detection system

A computerized image analysis technology suffers from imperfection, imprecision and vagueness of the input data and its propagation in all individual components of the technology including image enhancement, segmentation and pattern recognition. Furthermore, a Computerized Medical Image Analysis System (CMIAS) such as computer aided detection (CAD) technology deals with another source of uncertainty that is inherent in image-based practice of medicine. While there are several technology-oriented studies reported in developing CAD applications, no attempt has been made to address, model and integrate these types of uncertainty in the design of the system components, even though uncertainty issues directly affect the performance and its accuracy. In this paper, the main uncertainty paradigms associated with CAD technologies are addressed. The influence of the vagueness and imprecision in the classification of the CAD, as a second reader, on the validity of ROC analysis results is defined. In order to tackle the problem of uncertainty in the classification design of the CAD, two fuzzy methods are applied and evaluated for a lung nodule CAD application. Type-1 fuzzy logic system (T1FLS) and an extension of it, interval type-2 fuzzy logic system (IT2FLS) are employed as methods with high potential for managing uncertainty issues. The novelty of the proposed classification methods is to address and handle all sources of uncertainty associated with a CAD system. The results reveal that IT2FLS is superior to T1FLS for tackling all sources of uncertainty and significantly, the problem of inter and intra operator observer variability.