Mass segmentation plays a crucial role in computer-aided diagnosis (CAD) systems for classification of suspicious regions as normal, benign, or malignant. In this article we present a robust and automated segmentation technique?based on dynamic programming?to segment mass lesions from surrounding tissue. In addition, we propose an efficient algorithm to guarantee resulting contours to be closed. The segmentation method based on dynamic programming was quantitatively compared with two other automated segmentation methods (region growing and the discrete contour model) on a dataset of 1210 masses. For each mass an overlap criterion was calculated to determine the similarity with manual segmentation. The mean overlap percentage for dynamic programming was 0.69, for the other two methods 0.60 and 0.59, respectively. The difference in overlap percentage was statistically significant. To study the influence of the segmentation method on the performance of a CAD system two additional experiments were carried out. The first experiment studied the detection performance of the CAD system for the different segmentation methods. Free-response receiver operating characteristics analysis showed that the detection performance was nearly identical for the three segmentation methods. In the second experiment the ability of the classifier to discriminate between malignant and benign lesions was studied. For region based evaluation the area Az under the receiver operating characteristics curve was 0.74 for dynamic programming, 0.72 for the discrete contour model, and 0.67 for region growing. The difference in Az values obtained by the dynamic programming method and region growing was statistically significant. The differences between other methods were not significant.
A new 2D segmentation method based on dynamic programming applied to computer aided detection in mammography
S. Timp and N. Karssemeijer
Medical Physics 2004;31(5):958-971.