Improving performance of computer-aided detection of pulmonary embolisms by incorporating a new pulmonary vascular-tree segmentation algorithm

We developed a new pulmonary vascular tree segmentation/extraction algorithm. The purpose of this study was to assess whether adding this new algorithm to our previously developed computer-aided detection (CAD) scheme of pulmonary embolism (PE) could improve the CAD performance (in particular reducing false positive detection rates). A dataset containing 12 CT examinations with 384 verified pulmonary embolism regions associated with 24 threedimensional (3-D) PE lesions was selected in this study. Our new CAD scheme includes the following image processing and feature classification steps. (1) A 3-D based region growing process followed by a rolling-ball algorithm was utilized to segment lung areas. (2) The complete pulmonary vascular trees were extracted by combining two approaches of using an intensity-based region growing to extract the larger vessels and a vessel enhancement filtering to extract the smaller vessel structures. (3) A toboggan algorithm was implemented to identify suspicious PE candidates in segmented lung or vessel area. (4) A three layer artificial neural network (ANN) with the topology 27-10-1 was developed to reduce false positive detections. (5) A k-nearest neighbor (KNN) classifier optimized by a genetic algorithm was used to compute detection scores for the PE candidates. (6) A grouping scoring method was designed to detect the final PE lesions in three dimensions. The study showed that integrating the pulmonary vascular tree extraction algorithm into the CAD scheme reduced false positive rates by 16.2%. For the case based 3D PE lesion detecting results, the integrated CAD scheme achieved 62.5% detection sensitivity with 17.1 false-positive lesions per examination.