Classification of Regional Radiographic Emphysematous Patterns Using Low-Attenuation Gap Length Matrix

The standard computer-tomography-based method for measuring emphysema uses percentage of area of low attenuation which is called the pixel index (PI). However, the PI method is susceptible to the problem of averaging effect and this causes the discrepancy between what the PI method describes and what radiologists observe. Knowing that visual recognition of the different types of regional radiographic emphysematous tissues in a CT image can be fuzzy, this paper proposes a low-attenuation gap length matrix (LAGLM) based algorithm for classifying the regional radiographic lung tissues into four emphysema types distinguishing, in particular, radiographic patterns that imply obvious or subtle bullous emphysema from those that imply diffuse emphysema or minor destruction of airway walls. Neural network is used for discrimination. The proposed LAGLM method is inspired by, but different from, former texture-based methods like gray level run length matrix (GLRLM) and gray level gap length matrix (GLGLM). The proposed algorithm is successfully validated by classifying 105 lung regions that are randomly selected from 270 images. The lung regions are hand-annotated by radiologists beforehand. The average four-class classification accuracies in the form of the proposed algorithm/PI/GLRLM/GLGLM methods are: 89.00%/82.97%/52.90%/51.36%, respectively. The p-values from the correlation analyses between the classification results of 270 images and pulmonary function test results are generally less than 0.01. The classification results are useful for a followup study especially for monitoring morphological changes with progression of pulmonary disease.