This dissertation material provided in this work details the techniques that are developed to aid in the Classification of tumors, non-tumors, and dense masses in a Mammogram, certain characteristics such as texture in a mammographic image are used to identify the regions of interest as a part of classification. Pattern recognizing techniques such as nearest mean classifier and Support vector machine classifier are also used to classify the features. The initial stages include the processing of mammographic image to extract the relevant features that would be necessary for classification and during the final stage the features are classified using the pattern recognizing techniques mentioned above. The goal of this research work is to provide the Medical Experts and Researchers an effective method which would aid them in identifying the tumors, non-tumors, and dense masses in a mammogram. At first the breast region extraction is carried using the entire mammogram. The extraction is carried out by creating the masks and using those masks to extract the region of interest pertaining to the tumor. A chain code is employed to extract the various regions, the extracted regions could potentially be classified as tumors, non-tumors, and dense regions. Adaptive histogram equalization technique is employed to enhance the contrast of an image. After applying the adaptive histogram equalization for several times which will provide a saturated image which would contain only bright spots of the mammographic image which appear like dense regions of the mammogram. These dense masses could be potential tumors which would need treatment. Relevant Characteristics such as texture in the mammographic image are used for feature extraction by using the nearest mean and support vector machine classifier. A total of thirteen Haralick features are used to classify the three classes. Support vector machine classifier is used to classify two class problems and radial basis function (RBF) kernel is used to find the best possible (c and gamma) values. Results obtained in this research suggest the best classification accuracy was achieved by using the support vector machines for both Tumor vs Non-Tumor and Tumor vs Dense masses. The maximum accuracies achieved for the tumor and non-tumor is above 90 % and for the dense masses is 70.8% using 11 features for support vector machines. Support vector machines performed better than the nearest mean majority classifier in the classification of the classes. Various case studies were performed using two distinct datasets in which each dataset consisting of 24 patients’ data in two individual views. Each patient data will consist of both the cranio caudal view and medio lateral oblique views. From these views the region of interest which could possibly be a tumor, non-tumor, or a dense regions(mass).

Today, mammography screening is the best method of detection for breast cancer, yet many women have never been screened and underprivileged, minority and rural women have lower screening rates then other populations. The purpose of this study, through individual interviews(N=88), was to understand the cues that women perceive to have received spurring them to participate in mammogram screening. The Health Belief Model guided this research. Media influence, Health Care Practitioner recommendation, social networks, and symptoms were the cues to action explored in this research prompting compliance to mammography screening. All four of these cues were found to influence women in screening behaviors. Family history emerged as a major overarching category as well as various cross categorical and emergent subcategories. This research provides support for the Health Belief Model and by exploring the data qualitatively, provides evidences for further research in communication cues to action prompting mammogram screening.

No description available.

Background: Age estimation has attracted attention because of its various clinical and medical applications. There are many studies on human age estimation from biomedical images such as X-ray images, MRI, facial images, dental images etc. However, there is no research done on mammograms for age estimation. Therefore, in our research, we focus on age estimation from mammogram images. Objectives: The purpose of this study is to make an AI-based model for estimating age from mammogram images based on the pectoral muscle segment and check its accuracy. At first, we segment the pectoral muscle from mammograms. Then we extract deep learning features and handcrafted features from the pectoral muscle segment as well as other regions for comparison. From these features, we built models to estimate the age. Methods: We have selected an experiment method to answer our research question. We have used the U-net model for pectoral muscle segmentation. After that, we have extracted handcrafted features and deep learning features from pectoral muscle using ResNet-50 and Xception. Then we trained Support Vector Regression and Random Forest models to estimate the age based on the pectoral muscle of mammograms. Finally, we observed how accurately these models are in estimating the age by comparing the MSE and MAE values. We have considered breast region (BR) and the whole MLO to answer our research question. Results: The MAE values for both SVR and RF models from handcrafted features is around 10 in years in all cases. On the other hand, with deep learning features MAE is less as compared to handcrafted features. In our experiment, the least observed error value for MAE was around 8.4656 years for the model that extracted the features from the whole MLO using ResNet50 and SVR as the regression model. Conclusions: We have concluded that the breast region (BR) is more accurate in estimating the age compared to PM by having least MAE and MSE values in its models. Moreover, we were able to observe that handcrafted feature models are not as accurate as deep feature models in estimating the age from mammograms.

Dans le monde de la recherche, l’analyse du signal et plus particulièrement d’image, est un domaine très actif, de par la variété des applications existantes, avec des problématiques telles que la compression de données, la vidéo-surveillance ou encore l’analyse d’images médicales pour ne prendre que quelques exemples. Le mémoire s’inscrit dans ce dernier domaine particulièrement actif. Le nombre d’appareils d’acquisition existant ainsi que le nombre de clichés réalisés, entraînent la production d’une masse importante d’informations à traiter par les praticiens. Ces derniers peuvent aujourd’hui être assistés par l’outil informatique. Dans cette thèse, l’objectif est l’élaboration d’un système d’aide au diagnostic, fondé sur l’analyse conjointe, et donc la comparaison d’images médicales. Notre approche permet de détecter des évolutions, ou des tissus aberrants dans un ensemble donné, plutôt que de tenter de caractériser, avec un très fort a priori, le type de tissu cherché.Cette problématique permet d’appréhender un aspect de l’analyse du dossier médical d’un patient effectuée par les experts qui est l’étude d’un dossier à travers le suivi des évolutions. Cette tâche n’est pas aisée à automatiser. L’œil humain effectue quasi-automatiquement des traitements qu’il faut reproduire. Avant de comparer des régions présentes sur deux images, il faut déterminer où se situent ces zones dans les clichés. Toute comparaison automatisée de signaux nécessite une phase de recalage, un alignement des composantes présentes sur les clichés afin qu’elles occupent la même position sur les deux images. Cette opération ne permet pas, dans le cadre d’images médicales, d’obtenir un alignement parfait des tissus en tous points, elle ne peut que minimiser les écarts entre tissus. La projection d’une réalité 3D sur une image 2D entraîne des différences liées à l’orientation de la prise de vue, et ne permet pas d’analyser une paire de clichés par une simple différence entre images. Différentes structurations des clichés ainsi que différents champs de déformation sont ici élaborés afin de recaler les images de manière efficace.Après avoir minimisé les différences entre les positions sur les clichés, l’analyse de l’évolution des tissus n’est pas menée au niveau des pixels, mais à celui des tissus eux-mêmes, comme le ferait un praticien. Afin de traiter les clichés en suivant cette logique, les images numériques sont réinterprétées, non plus en pixels de différentes luminosités, mais en motifs représentatifs de l’ensemble de l’image, permettant une nouvelle décomposition des clichés, une décomposition parcimonieuse. L’atout d’une telle représentation est qu’elle permet de mettre en lumière un autre aspect du signal, et d’analyser sous un angle nouveau, les informations nécessaires à l’aide au diagnostic.Cette thèse a été effectuée au sein du laboratoire LIPADE de l’Université Paris Descartes (équipe SIP, spécialisée en analyse d’images) en collaboration avec la Société Fenics (concepteur de stations d’aide au diagnostic pour l’analyse de mammographies) dans le cadre d’un contrat Cifre. / In the scientific world, signal analysis and especially image analysis is a very active area, due to the variety of existing applications, with issues such as file compression, video surveillance or medical image analysis. This last area is particularly active. The number of existing devices and the number of pictures taken, cause the production of a large amount of information to be processed by practitioners. They can now be assisted by computers.In this thesis, the problem addressed is the development of a computer diagnostic aided system based on conjoint analysis, and therefore on the comparison of medical images. This approach allows to look for evolutions or aberrant tissues in a given set, rather than attempting to characterize, with a strong a priori, the type of fabric sought.This problem allows to apprehend an aspect of the analysis of medical file performed by experts which is the study of a case through the comparison of evolutions.This task is not easy to automate. The human eye performs quasi-automatically treatments that we need to replicate.Before comparing some region on the two images, we need to determine where this area is located on both pictures. Any automated comparison of signals requires a registration phase, an alignment of components present on the pictures, so that they occupy the same space on the two images. Although the characteristics of the processed images allow the development of a smart registration, the projection of a 3D reality onto a 2D image causes differences due to the orientation of the tissues observed, and will not allow to analyze a pair of shots with a simple difference between images. Different structuring of the pictures and different deformation fields are developed here to efficiently address the registration problem.After having minimized the differences on the pictures, the analysis of tissues evolution is not performed at pixels level, but the tissues themselves, as will an expert. To process the images in this logic, they will be reinterpreted, not as pixels of different brightness, but as patterns representative of the entire image, enabling a new decomposition of the pictures. The advantage of such a representation is that it allows to highlight another aspect of the signal, and analyze under a new perspective the information necessary to the diagnosis aid.This thesis has been carried out in the LIPADE laboratory of University Paris Descartes (SIP team, specialized in image analysis) and in collaboration with the Society Fenics (designer of diagnosis aid stations in the analysis of mammograms) under a Cifre convention. The convergence of the research fields of those teams led to the development of this document.

Breast cancer is the most common form of cancer among women, with around 9000 new diagnoses in Sweden yearly. Detecting and localizing risk of breast cancer could give the opportunity for individualized examination programs and preventative measures if necessary, and potentially be lifesaving. In this study, two deep learning methods have been designed, trained and evaluated on mammograms from healthy patients whom were later diagnosed with breast cancer, to examine how well deep learning models can localize suspicious areas in mammograms. The first proposed model is a ResNet-18 regression model which predicts the pixel coordinates of the annotated target pixel in the prior mammograms. The regression model produces predictions with an average of 44.25mm between the predictions and targets on the test set, which for average sized breasts correspond to a general area of the breast, and not a specific location. The regression network is hence not able to accurately localize suspicious areas in mammograms. The second model is a U-net segmentation model that segments out a risk area in the mammograms. The segmentation model had a 25% IoU, meaning that there is on average a 25% overlap between the target area and the prediction area. 57% of the predictions of the segmentation network had some overlap with the target mask, and predictions that did not overlap with the target often marked high density areas that are traditionally associated with high risk. Overall, the segmentation model did better than the regression model, but needs further improvement before it can be considered adequate to merge with a risk value model and used in practice. However, it is evident that there is sufficient information present in many of the mammogram images to localize the risk, and the research area holds potential for future improvements. / Bröstcancer är den vanligaste cancerformen bland kvinnor, med cirka 9000 nya diagnoser i Sverige årligen. Att upptäcka och lokalisera risken för bröstcancer kan möjliggöra individualiserade undersökningsprogram och förebyggande åtgärder vid behov och kan vara livräddande. I denna studie har två djupinlärningsmodeller designats, tränats och utvärderats på mammogram från friska patienter som senare diagnostiserades med bröstcancer, för att undersöka hur väl djupinlärningsmodeller kan lokalisera misstänkta områden i mammogram. Den första föreslagna modellen är en ResNet-baserad regressionsmodell som förutsäger pixelkoordinaterna för den utmarkerade målpixeln i de friska mammogrammen. Regressionsmodellen producerar förutsägelser med ett genomsnitt på 44,25 mm mellan förutsägelserna och målpunkterna för testbilderna, vilket för medelstora bröst motsvarar ett allmänt bröstområde och inte en specifik plats i bröstet. Regressionsnätverket kan därför inte med precision lokalisera misstänkta områden i mammogram. Den andra modellen är en U-net segmenteringsmodell som segmenterar ut ett riskområde ur mammogrammen. Segmenteringsmodellen hade ett IoU på 25%, vilket innebär att det i genomsnitt fanns en 25-procentig överlappning mellan målområdet och förutsägelsen. 57% av förutsägelserna från segmenteringsnätverket hade viss överlappning med målområdet, och förutsägelser som inte överlappade med målet markerade ofta områden med hög täthet som traditionellt är förknippade med hög risk. Sammantaget presterade segmenteringsmodellen bättre än regressionsmodellen, men behöver ytterligare förbättring innan den kan anses vara adekvat nog att sammanfogas med en riskvärdesmodell och användas i praktiken. Det är dock uppenbart att det finns tillräcklig information i många av mammogrambilderna för att lokalisera risken, och att forskningsområdet har potential för framtida förbättringar.

Este trabalho apresenta um estudo de classificação de nódulos em mamograma digitalizados através de um classificador de rede neural artificial (RNA). O algoritmo de treinamento de \"backpropagation\" foi utilizado para ajustar os pesos da RNA. O objetivo principal deste trabalho foi determinar um método para analisar e selecionar a melhor configuração de atributos e topologia da RNA para classificar lesões mamárias do tipo nódulo. Foram escolhidas 118 imagens de regiões de interesse (ROI), sendo 68 benignas e 50 malignas de duas bases de imagens: uma do Hospital das Clínicas de Ribeirão Preto, da Universidade de São Paulo, e outra do MIAS-UK (Mammographic Image Analysis Society). O processo completo envolveu quatro etapas: detecção, extração e seleção de atributos, e classificação. Na etapa de detecção, as imagens foram submetidas ao processo combinado das técnicas segmentação de thresholding, morfologia matemática e crescimento de região. Foram extraídos 14 atributos de textura e 14 atributos de forma. Para selecionar os atributos mais discriminantes, foi utilizado o método de Jeffries-Matusita. Foram selecionados três grupos de atributos de forma, três de atributos de textura e três de atributos combinados. Análise pela curva ROC foram dirigidas para avaliar o desempenho do classificador de rede neural artificial (RNA). Os melhores resultados obtidos foram: para o grupo de atributos de forma com 5 unidades escondidas, a área dentro da curva ROC foi de 0.99, taxa de acerto de 98,21%, taxa de especificidade de 98,37% e taxa de sensibilidade de 98.00%; para o grupo de atributos de textura com 4 unidades escondidas, a área dentro da curva foi de 0.98, taxa de acerto de 97,08%, taxa de especificidade de 98,53% e taxa de sensibilidade de 95.11%; para o grupo de atributos combinados de textura e forma com 3 unidades escondidas, a área dentro da curva foi de 0.99, taxa de acerto de 98,21%, taxa de especificidade de 100.00% e taxa de sensibilidade de 95.78%. / This work presents a study of masses classification in digitized mammograms by means of artificial neural network (ANN). The backpropagation training algorithm was used to adjust the weights of ANN. The aim of this work was to determine a methodology to analyze and selection of the best feature subset and ANN topology to classify masses lesions. A total of 118 regions of interest images were chosen (68 benign and 50 malignant lesions) from two image databases: one from \"Hospital das Clínicas de Ribeirão Preto\", at the University of São Paulo, and other from Mammographic lmage Analysis Society (MIAS-UK). The whole process involved four steps: segmentation, feature extraction, selection, and classification. In the first step, the images were submitted to a combined process of thresholding, mathematical morphology, and region growing techniques. In the second step, fourteen texture features and fourteen shape features were extracted. The Jeffries-Matusita method was used to select the best features. The results of this stage were the selection of three shape feature sets, three texture feature sets, and three combined feature sets. The Receiver Operating Characteristic (ROC) analysis were conducted to evaluated the ANN classifier performance. The best result obtained for shape feature set was obtained using a ANN with 5 hidden units, the area under ROC curve was of 0.99, classification rate of 98.21%, specificity rate of 98.37% and sensitivity rate of 98.00%. For texture feature set, the best result was using a ANN with 4 hidden units, the area under ROC curve was of 0.98, classification rate of 97.08%, specificity rate of 98.53% and sensitivity rate of 95.11%. Finally, for the combined feature set (texture and shape) the best result obtained was using a ANN with 3 hidden units, the area under ROC curve was of 0.99, classification rate of 98.21%, specificity rate of 100.00% and sensitivity rate of 95.78%.

[Truncated abstract] In this thesis, we introduce a mammogram analysis system developed for the automatic segmentation and analysis of mammograms. This original system has been designed to aid radiologists to detect breast cancer on mammograms. The system embodies attribute-driven segmentation in which the attributes of an image are extracted progressively in a step-by-step, hierarchical fashion. Global, low-level attributes obtained in the early stages are used to derive local, high-level attributes in later stages, leading to increasing refinement and accuracy in image segmentation and analysis. The proposed system can be characterized as: • a bootstrap engine driven by the attributes of the images; • a solid framework supporting the process of hierarchical segmentation; • a universal platform for the development and integration of segmentation and analysis techniques; and • an extensible database in which knowledge about the image is accumulated. Central to this system are three major components: 1. a series of applications for attribute acquisition; 2. a standard format for attribute normalization; and 3. a database for attribute storage and data exchange between applications. The first step of the automatic process is to segment the mammogram hierarchically into several distinctive regions that represent the anatomy of the breast. The adequacy and quality of the mammogram are then assessed using the anatomical features obtained from segmentation. Further image analysis, such as breast density classification and lesion detection, may then be carried out inside the breast region. Several domain-specific algorithms have therefore been developed for the attribute acquisition component in the system. These include: 1. automatic pectoral muscle segmentation; 2. adequacy assessment of positioning and exposure; and 3. contrast enhancement of mass lesions. An adaptive algorithm is described for automatic segmentation of the pectoral muscle on mammograms of mediolateral oblique (MLO) views

Purpose Study explored the relationships of ethnic identity, culture, and social cohesion to mammography, cancer screening, and preventive medical visits among African-American and Afro-Caribbean women in Broward County, FL. Purpose was to understand non-compliance to screening recommendations for breast cancer among disadvantaged Black women in an area of high prevalence. Methods A bounded convenience sample of 117 women (49% African-American and 51% Afro-Caribbean) completed a cross-sectional survey and a subset (n=87) participated in semi-structured discussion groups. Both measured perceptions related to breast cancer, defined ethnic identity or culture, and suggested social and cultural factors influence of ethnic identity, culture, and social cohesion on participation with mammograms and preventive medical care visits. Survey included the Multi-Group Ethnic Identity Measure (MEIM) and Other-Group Orientation Scale (OGO) for ethnic identity and the Risk Behavior Diagnosis Scale for cancer perceptions. Methods were bivariate, Mann-Whitney U, linear, and logistic regression. Results Half of participants (51%) self-identified as Caribbean. OGO was positively associated with overall attitudes (p< 0.01), perceived urgency (p = 0.05), and perceived benefit related to breast cancer. Linear regression indicated that Afro-Caribbean women (referent) would perceive less urgency to screen (p = 0.05) and lower risk for breast cancer (p = 0.03) than African-American women. Participants explained that personal and neighborhood cultural norms along with health perceptions along with structural factors connected to access and use of medical services influence Black women’s participation in preventive medical services and cancer screening. Conclusions Ethnic identity was associated with women’s perceptions of risk, urgency, and benefit for breast cancer screenings. These perceptions may have had a greater influence on the decisions of Afro-Caribbean women not to comply with screening recommendations or participate in preventive medical care actives than for African-American women. Compliance was also mediated by cultural perceptions of fear, relevance, motivation, and sense of support along with other structural factors. All had contributed to the varying degrees that Black women had sought medical care in this community. Thus, tailoring health interventions to account for variations in within-group characteristics is warranted. [This research was supported in part by NIH/NIGMS R25 GM061347.]

Este trabalho apresenta um estudo de classificação de nódulos em mamograma digitalizados através de um classificador de rede neural artificial (RNA). O algoritmo de treinamento de \"backpropagation\" foi utilizado para ajustar os pesos da RNA. O objetivo principal deste trabalho foi determinar um método para analisar e selecionar a melhor configuração de atributos e topologia da RNA para classificar lesões mamárias do tipo nódulo. Foram escolhidas 118 imagens de regiões de interesse (ROI), sendo 68 benignas e 50 malignas de duas bases de imagens: uma do Hospital das Clínicas de Ribeirão Preto, da Universidade de São Paulo, e outra do MIAS-UK (Mammographic Image Analysis Society). O processo completo envolveu quatro etapas: detecção, extração e seleção de atributos, e classificação. Na etapa de detecção, as imagens foram submetidas ao processo combinado das técnicas segmentação de thresholding, morfologia matemática e crescimento de região. Foram extraídos 14 atributos de textura e 14 atributos de forma. Para selecionar os atributos mais discriminantes, foi utilizado o método de Jeffries-Matusita. Foram selecionados três grupos de atributos de forma, três de atributos de textura e três de atributos combinados. Análise pela curva ROC foram dirigidas para avaliar o desempenho do classificador de rede neural artificial (RNA). Os melhores resultados obtidos foram: para o grupo de atributos de forma com 5 unidades escondidas, a área dentro da curva ROC foi de 0.99, taxa de acerto de 98,21%, taxa de especificidade de 98,37% e taxa de sensibilidade de 98.00%; para o grupo de atributos de textura com 4 unidades escondidas, a área dentro da curva foi de 0.98, taxa de acerto de 97,08%, taxa de especificidade de 98,53% e taxa de sensibilidade de 95.11%; para o grupo de atributos combinados de textura e forma com 3 unidades escondidas, a área dentro da curva foi de 0.99, taxa de acerto de 98,21%, taxa de especificidade de 100.00% e taxa de sensibilidade de 95.78%. / This work presents a study of masses classification in digitized mammograms by means of artificial neural network (ANN). The backpropagation training algorithm was used to adjust the weights of ANN. The aim of this work was to determine a methodology to analyze and selection of the best feature subset and ANN topology to classify masses lesions. A total of 118 regions of interest images were chosen (68 benign and 50 malignant lesions) from two image databases: one from \"Hospital das Clínicas de Ribeirão Preto\", at the University of São Paulo, and other from Mammographic lmage Analysis Society (MIAS-UK). The whole process involved four steps: segmentation, feature extraction, selection, and classification. In the first step, the images were submitted to a combined process of thresholding, mathematical morphology, and region growing techniques. In the second step, fourteen texture features and fourteen shape features were extracted. The Jeffries-Matusita method was used to select the best features. The results of this stage were the selection of three shape feature sets, three texture feature sets, and three combined feature sets. The Receiver Operating Characteristic (ROC) analysis were conducted to evaluated the ANN classifier performance. The best result obtained for shape feature set was obtained using a ANN with 5 hidden units, the area under ROC curve was of 0.99, classification rate of 98.21%, specificity rate of 98.37% and sensitivity rate of 98.00%. For texture feature set, the best result was using a ANN with 4 hidden units, the area under ROC curve was of 0.98, classification rate of 97.08%, specificity rate of 98.53% and sensitivity rate of 95.11%. Finally, for the combined feature set (texture and shape) the best result obtained was using a ANN with 3 hidden units, the area under ROC curve was of 0.99, classification rate of 98.21%, specificity rate of 100.00% and sensitivity rate of 95.78%.