WO2012085818A1 - Mammography calcium score - Google Patents
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- WO2012085818A1 WO2012085818A1 PCT/IB2011/055778 IB2011055778W WO2012085818A1 WO 2012085818 A1 WO2012085818 A1 WO 2012085818A1 IB 2011055778 W IB2011055778 W IB 2011055778W WO 2012085818 A1 WO2012085818 A1 WO 2012085818A1
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- mammography
- calcifications
- image data
- calcium score
- calcification
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B6/00—Apparatus for radiation diagnosis, e.g. combined with radiation therapy equipment
- A61B6/50—Clinical applications
- A61B6/502—Clinical applications involving diagnosis of breast, i.e. mammography
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B6/00—Apparatus for radiation diagnosis, e.g. combined with radiation therapy equipment
- A61B6/52—Devices using data or image processing specially adapted for radiation diagnosis
- A61B6/5211—Devices using data or image processing specially adapted for radiation diagnosis involving processing of medical diagnostic data
- A61B6/5217—Devices using data or image processing specially adapted for radiation diagnosis involving processing of medical diagnostic data extracting a diagnostic or physiological parameter from medical diagnostic data
-
- G—PHYSICS
- G06—COMPUTING; CALCULATING OR COUNTING
- G06T—IMAGE DATA PROCESSING OR GENERATION, IN GENERAL
- G06T7/00—Image analysis
- G06T7/0002—Inspection of images, e.g. flaw detection
- G06T7/0012—Biomedical image inspection
-
- G—PHYSICS
- G16—INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR SPECIFIC APPLICATION FIELDS
- G16H—HEALTHCARE INFORMATICS, i.e. INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR THE HANDLING OR PROCESSING OF MEDICAL OR HEALTHCARE DATA
- G16H50/00—ICT specially adapted for medical diagnosis, medical simulation or medical data mining; ICT specially adapted for detecting, monitoring or modelling epidemics or pandemics
- G16H50/30—ICT specially adapted for medical diagnosis, medical simulation or medical data mining; ICT specially adapted for detecting, monitoring or modelling epidemics or pandemics for calculating health indices; for individual health risk assessment
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B6/00—Apparatus for radiation diagnosis, e.g. combined with radiation therapy equipment
- A61B6/02—Devices for diagnosis sequentially in different planes; Stereoscopic radiation diagnosis
- A61B6/025—Tomosynthesis
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B6/00—Apparatus for radiation diagnosis, e.g. combined with radiation therapy equipment
- A61B6/44—Constructional features of apparatus for radiation diagnosis
- A61B6/4429—Constructional features of apparatus for radiation diagnosis related to the mounting of source units and detector units
- A61B6/4452—Constructional features of apparatus for radiation diagnosis related to the mounting of source units and detector units the source unit and the detector unit being able to move relative to each other
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B6/00—Apparatus for radiation diagnosis, e.g. combined with radiation therapy equipment
- A61B6/46—Apparatus for radiation diagnosis, e.g. combined with radiation therapy equipment with special arrangements for interfacing with the operator or the patient
- A61B6/461—Displaying means of special interest
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B6/00—Apparatus for radiation diagnosis, e.g. combined with radiation therapy equipment
- A61B6/48—Diagnostic techniques
- A61B6/486—Diagnostic techniques involving generating temporal series of image data
-
- G—PHYSICS
- G06—COMPUTING; CALCULATING OR COUNTING
- G06T—IMAGE DATA PROCESSING OR GENERATION, IN GENERAL
- G06T2207/00—Indexing scheme for image analysis or image enhancement
- G06T2207/10—Image acquisition modality
- G06T2207/10116—X-ray image
-
- G—PHYSICS
- G06—COMPUTING; CALCULATING OR COUNTING
- G06T—IMAGE DATA PROCESSING OR GENERATION, IN GENERAL
- G06T2207/00—Indexing scheme for image analysis or image enhancement
- G06T2207/30—Subject of image; Context of image processing
- G06T2207/30004—Biomedical image processing
- G06T2207/30068—Mammography; Breast
Definitions
- the present invention relates to mammography.
- the present invention relates to an X-ray imaging system for providing mammography information, a method for providing tissue information for breast cancer screening, a computer program element and a computer readable medium.
- Mammography information is used, for example, for breast cancer screening.
- calcifications in 2D mammography images are taken as an indicator to provide assessment and prediction of breast cancer.
- this examination is based on image evaluation and interpretation by the doctor, for example.
- US 5,365,429 describes a method of aiding detection of breast cancer by computer identification of microcalcifications in mammographic images. It has been shown that the results thus achievable are often inaccurate.
- a method for providing tissue information for breast cancer screening comprising the following steps:
- the calcifications are micro-calcifications.
- the mammography data in step a) is provided as two-dimensional image data.
- the mammography data in step a) is provided as three-dimensional image data.
- the cumulative size of the calcifications, or the micro- calcifications is related to a three-dimensional size, i.e., it is volume-related.
- the cluster area of the calcification clusters is related to a three-dimensional area, i.e. to a volume-related feature.
- the mammography calcium score is based on a histogram for at least one of the above-mentioned features or characteristics or criteria.
- the mammography calcium scores of different acquisitions are compared over time.
- an X-ray imaging system comprising a processing unit and an interface unit.
- the processing unit is adapted to provide mammography image data.
- the processing unit is further adapted to determine calcifications in the mammography image data, and the processing unit is also adapted to calculate a mammography calcium score, wherein the calculation is based on a weighting of at least one calcification feature of the group of:
- the interface unit is adapted to provide the mammography calcium score to the user.
- an X-ray image acquisition device with an X-ray source and an X-ray detector is provided, wherein the X-ray image acquisition device is adapted to acquire the mammography image data.
- the gist of the invention can provide a mammography calcium score as an indicator for the state of the tissue in a region of interest, for example as an indicator for breast tissues.
- the indicator can then be used for further assessment of the risk of breast cancer.
- a mammography calcium score By considering one of the above-mentioned features or aspects in relation with the determined calcifications, it is possible to provide enhanced calcification information in form of the mammography calcium score.
- a weighting of the features i.e. by considering the importance of the features in relation to each other, it is possible to consider as many aspects as desired in order to improve the accuracy of the information presented in form of the mammography calcium score.
- the user is provided with a score that facilitates the steps and decisions performed afterwards by a doctor, for example.
- Fig 1 schematically illustrates an X-ray imaging system according to an
- FIG. 2 schematically illustrates a further embodiment of an X-ray imaging system according to the invention.
- Fig. 3 shows basic steps of a method according to the invention.
- Fig. 4 shows a further embodiment of a method according to the invention.
- Fig. 5 shows a further embodiment of a method according to the invention.
- Fig. 6 shows a further embodiment of a method according to the invention.
- Fig. 7 shows a further embodiment of a method according to the invention.
- Fig. 8 shows a further embodiment of a method according to the invention.
- Fig. 9 shows a further embodiment of a method according to the invention.
- Fig. 10 shows a further embodiment of a method according to the invention.
- Fig. 11 shows an exemplary embodiment of mammography image data.
- Fig. 12 shows a table indicating further information to the image of Fig. 11.
- Fig. 13 shows a first exemplary embodiment of features of determined
- Fig. 14 shows a further exemplary embodiment of features of the determined calcifications.
- Fig. 15 shows a further exemplary embodiment of features based on the
- Fig. 16 shows a further exemplary embodiment of calcification features
- Fig. 17 shows a further exemplary embodiment of calcification features
- Fig. 18 shows a further exemplary embodiment of a calcification feature
- Fig. 1 schematically shows an X-ray imaging system 10 for providing mammography information according to the invention, the system comprising a processing unit 12 and an interface unit 14.
- the processing unit 12 is adapted to provide mammography image data, to determine calcifications in the mammography image data, and to calculate a mammography calcium score, wherein the calculation is based on a weighting of at least one calcification feature of the group of number of the calcifications, cumulative size of the calcifications, cluster area of the calcification clusters, position of the calcifications in relation to anatomy, morphology criteria of the calcification clusters, or classified / assigned morphology groups.
- the interface unit 14 is adapted to provide the mammography calcium score to a user.
- the X-ray imaging system 10 comprises an X-ray image acquisition device 16 with an X-ray source 18 and an X-ray detector 20.
- the X-ray image acquisition device 16 is adapted to acquire the mammography image data.
- the example shown is a so-called stand-up investigation system where, for example, a patient in an upright position can stand while, for example, the breast is examined.
- the X-ray detector is provided as a sort of a paddle or small table upon which a breast can be received. Further, a moveable compression paddle 22 is provided with an adaptable distance D to the detector 20 in order to be able to act with a desired pressing force on the breast arranged detector 20 and the compression paddle 22.
- the compression paddle 22 is attached to an adjusting mechanism
- the X-ray source 18 is generating X-ray radiation emanating towards the detector 20. Therefore, the compression paddle 22 is X-ray transparent.
- the X-ray source 18 and the detector 20 are attached to an adjustable support 26 allowing for a vertical adjustment such that the height of the detector can be adapted to different sizes of the patient. Further, a rotational movement is possible to acquire X-ray images not only in a vertical direction, but also in a direction with an angle to the vertical direction, such as 30° or any freely chooseable angulation as well as an X-ray viewing direction in a horizontal way. Further, a base 28 is provided which is securely fixed to a floor of an examination room, for example.
- the X-ray imaging system 10 also comprises a display 30 provided on a separate base 32, which base comprises, for example the processing unit 12 and the interface unit 14 mentioned in relation with Fig. 1.
- any data connection is not further shown, which data connection can be provided as wire connection or wireless connection between the respective parts of the system 10.
- the X-ray imaging system shown is a so-called stand type. It is further noted that the present invention also comprises other types for X-ray imaging, for example moveable or stationary X-ray imaging systems or X-ray imaging systems with a table upon which a patient can be received in order to acquire X-ray images while the patient is lying on the table, for example facing downwards.
- the mammography image data provided by the processing unit is a mammogram image.
- the mammography image data is based on CT data acquired by the X-ray image acquisition device, for example by a CT image acquisition system.
- a method 100 for providing tissue information for breast cancer screening is shown with the following steps:
- mammography image data 112 is provided.
- calcifications 116 in the mammography image data are determined.
- a mammography calcium score 120 is calculated based on a weighting 122 of at least one calcification feature of the group of number of the calcifications 124, cumulative size of the calcifications 126, cluster area of the calcification clusters 128, position of the calcifications in relation to anatomy 130, morphology criteria of the calcification clusters 132, or classified / assigned morphology groups 134.
- the calcifications 124 are micro-calcifications.
- the mammography calcium score 120 is provided to a user.
- the mammography data in the first providing step 110 is provided as two-dimensional image data.
- the first providing step 110 is also referred to as step a), the determination step 114 as step b), the calculating step 118 as step c), and the second providing step 136 as step d).
- the cumulative size of the calcifications is related to a two-dimensional size.
- the cluster area of the calcification clusters is related to a two-dimensional area.
- the weighting 122 is adaptable to be able to adjust the method for different situations.
- step a) at least one 2D mammogram image is provided.
- the data in step a) is provided by data derived by a forward projection 142 of tomosynthesis data 144.
- the data in step a) is provided by data derived by a forward projection of 3D data acquired by CT (computed tomography).
- the mammography data is provided as three-dimensional image data 112' as for example acquired by breast CT or breast MRI.
- the cumulative size of the calcifications 126 is related to a three-dimensional size, i.e. the respective feature is volume-related.
- the cluster area of the calcification clusters 128 is also related to a three-dimensional area, i.e. also this feature is volume-related.
- the data in step a) is based on CT image data for providing the three-dimensional information.
- Fig. 5 the respective features are shown with an apostrophe as an index in order to illustrate that at least some of them are related to the volume, i.e. to the three-dimensional aspect. It is further noted that instead of the six features of Fig. 3, only five boxes are shown for step c) in Fig. 5, but only for illustrational purposes. It is further noted that of course more or less boxes in step c) can be provided, as indicated with dotted lines 146.
- the mammography calcium score 120 is based on a histogram 148 for at least one of the above-mentioned features. This is indicated in Fig. 6 as an example only for the number of calcifications 124. For the further features, as already mentioned above, the possibility to provide a histogram 148 is indicated with respective dotted lines 150.
- the cumulative size of the calcifications comprises calculating an area score.
- clustering is provided and the clustering comprises determining distance between calcifications and determining a directional spreading.
- the classified / assigned morphology groups comprise a smooth area boundary group, a frayed area boundary group and an isolated calcifications group.
- the calcifications can be classified, for example, in either single / isolated or cluster / grouped.
- the calcifications can be classified with respect to morphology by distinguishing calcifications with smooth boundary and calcifications with rough boundary contours.
- the mammography calcium score 120 is displayed 152 on a display.
- the mammography calcium score 120 is displayed in combination with the mammography image data 112. This is indicated by a combination box 154 which receives the mammography calcium score 120 from providing box 136 and the mammography image data 112 from the first providing box 110. From the combination box 154, the display data is then provided to a display where it is displayed, indicated with a common display box 156.
- the combination display can be provided as a display arrangement next to each other of the different information types, or as an overlaid image type where the calcium score is displayed in overlay manner or otherwise integrated manner with a mammography image data.
- step b) comprises selecting calcifications from the detected calcifications.
- the detection and sizing of the calcifications is done automatically.
- the detection and sizing of the calcifications is done manually or supported manually.
- calculating the mammography calcium score as a weighted mean of the number of calcifications for each class of cluster morphologies is provided.
- a graphical representation 158 is generated 160 of at least one of the determined features, which is exemplarily shown for the right box of the row of boxes of step c).
- a graphical representation can also be generated for one or more of the other feature boxes in step c).
- the different features are indicated with four boxes only, but of course more than these can be provided, as already mentioned above.
- the graphical representation 158 is displayed in combination with the mammography image data and/or the mammography calcium score 120. This is indicated by a further combination box 162 which receives, as an example, the graphical representation 158 from box 160 as well as the mammography calcium score 120 from the providing box 136.
- the mammography image data 112 with a graphical representation and/or the mammography calcium score 120 which is indicated by a dotted line 164 connecting the providing box 110 with the second combination box 162.
- the result of the combination 162 is then displayed which is indicated by a display box 164.
- the graphical representation is displayed without the mammography image data.
- the mammography image data is a mammography image.
- the mammography calcium score 120 is provided as a comparison of the mammography calcium scores of different acquisitions. It is noted that this example is not further shown.
- the mammography calcium score is compared between different breasts, for example between the left and the right breast.
- the mammography calcium score is provided as a number indicator.
- the mammography calcium score is provided as a colour code.
- the mammography calcium scores of different acquisitions over time are compared. This is indicated by different acquisition boxes 166 indicated with an indices 1 et seq., providing different calcium scores 120, also with indices. The possibility to provide as many calcium scores as necessary is indicated with a dotted line structure 168.
- the acquisition boxes 166 comprise a method to one of the above-mentioned exemplary embodiments and aspects of the invention discussed so far.
- the calcium scores can then be compared in a comparison step 170.
- the calcium scores are presented by a graphical indicator such that a user can easily perceive the respective information of an increasing or decreasing or other relative changing over time.
- a graph indicating a development, which is very useful information to a doctor, for example.
- the calcium scores are simply presented in spreadsheet manner, for example by a number representation for the calcium score.
- the number, position and size of the calcifications are determined. For example, this is done in a fully automatic manner based on digital or digitized mammograms.
- the detection can be based on image features, simple thresholding, or can include spectral acquisitions.
- the interpretation by the radiologist is an indicator for the risk of breast cancer.
- the data may be compared between the different acquisitions per breast
- Fig. 11 shows a mammography image 172 as an example for mammography image data 112.
- the mammography image 172 shows a tissue structure 174 of a breast.
- a number of calcifications 116 have been determined. Further, the calcifications 116 have already been analyzed with respect to the above-mentioned calcification feature aspects.
- the result of the identification is marked with a coded surrounding frame.
- a first frame 174 comprises a cluster-type calcification.
- a second frame 176 comprises a single-type calcification, and a third frame 178 comprises a double-type calcification.
- a table is shown indicating different information to the identified calcification structures in the mammography image 172.
- a first column the respective image parts are shown in an enlarged manner.
- the first column is indicated with reference numeral 180.
- type information, number of calcifications, the size, morphologic aspects and others, such as area of cluster region are listed.
- weighting factors 186 the respective weighting factors 186.
- the calcium score R is computed as:
- v l denotes a risk number as percentage value ( 0 ⁇ v l ⁇ 1 ) for each considered feature such as for example size, number, morpholgy or any other of the mentioned calcification features.
- weights may depend on a classification of the particular finding, e.g.
- M3 ⁇ 4 may be higher for a finding classified as a cluster of micro-calcifications than for a finding classified as a single medium-sized calcification.
- a number L k of features are considered, dependent on the classification of the finding, e.g. the features considered for the category 'micro- calcifications' may be different from the features evaluated for the category 'single medium- sized calcifications'.
- a mammographic calcium score can be calculated by applying equation (1) which results for this particular example in
- Fig. 14 shows a further exemplary embodiment of a mammography image 290 showing a tissue structure of a breast 292.
- a number of calcifications 294 has been detected and marked with small circular or ellipsoid-shaped frames 296. Further, in order to provide information about the cumulative size of the calcifications, the sum of the area in square millimetres occupied by the calcifications can be calculated by applying the following equation.
- a ca c tot ai denotes the area on the detector covered by calcifications.
- n ca c is the number of detector pixel measuring calcifications and
- f p i x is the area of a detector pixel in mm 2 .
- the number of pixel measuring line integrals through calcifications can be determined e.g. by thresh holding with a value t calc or by another suitable segmentation or classification technique:
- n calc ⁇ d, I d 9 ⁇ '%0 ⁇ i ⁇ nb row ,0 ⁇ j ⁇ nb
- Fig. 15 shows a further example of a mammography image 390 showing a tissue structure 392 of a breast.
- calcifications 394 have been detected and marked with respective frames 396.
- the calcifications are marked e.g. by their centre of mass and if n calcifications belong to a cluster of calcifications each cluster is marked by a coordinate in the detector plane m ; cafc MX;
- the cluster area can be calculated by estimating the bounding box or e.g. using the Gaussian trapezoidal formula
- a cluster 398 is indicated with a polygon-like frame 399.
- the marking of the calcifications has been applied with respect to the aspect of clusters.
- the area in pixels or square millimetres occupied by the bounding polygon of the cluster can be calculated by applying the following equation.
- Fig. 16 shows a further example of a mammography image 490 with a tissue structure 492 of a breast. Also here, calcifications 494 are detected and marked with respective frames or labelling structures 496.
- Fig. 16 also shows anatomy information 498, for example dense and adipose breast tissue coding (not further shown).
- anatomy information 498 for example dense and adipose breast tissue coding (not further shown).
- this type of calculation could also be applied to anatomy information related to ductile system or any other anatomy type visible on mammograms or tomosynthesis slices, for example.
- Fig. 17 shows a further example for a mammography image 590 with a tissue structure 592 of a breast. Calcifications 594 have been detected and also labelled with frame structures 596. As can be seen, three different morphology structures 598a, 598b, and 598c have been identified.
- the cluster 598a shows calcification cluster with a line-like structure which indicates a tubular morphology.
- Cluster 598b shows calcifications with circular morphology.
- Cluster 598c shows calcifications with a star-like morphology.
- the weighting for the different aspects i.e. the weighting for the different features can be based on statistical data.
- FIG. 18 an example for a histogram 202 is shown.
- the cluster size is increasing in the direction indicated with the arrow at the right end of the horizontal line 204.
- the number of the respective cluster sizes is indicated.
- a first indicator 208 shows the number for a first cluster size
- a second indicator 210 shows the number for a second cluster size
- a third indicator 212 shows the number for the respective third cluster size
- a fourth indicator 214 shows the number for a fourth cluster size.
- a computer program or a computer program element is provided that is characterized by being adapted to execute the method steps of the method according to one of the preceding embodiments, on an appropriate system.
- the computer program element might therefore be stored on a computer unit, which might also be part of an embodiment of the present invention.
- This computing unit may be adapted to perform or induce a performing of the steps of the method described above. Moreover, it may be adapted to operate the components of the above described apparatus.
- the computing unit can be adapted to operate automatically and/or to execute the orders of a user.
- a computer program may be loaded into a working memory of a data processor.
- the data processor may thus be equipped to carry out the method of the invention.
- This exemplary embodiment of the invention covers both, a computer program that right from the beginning uses the invention and a computer program that by means of an up-date turns an existing program into a program that uses the invention.
- the computer program element might be able to provide all necessary steps to fulfil the procedure of an exemplary embodiment of the method as described above.
- a computer readable medium such as a CD-ROM
- the computer readable medium has a computer program element stored on it which computer program element is described by the preceding section.
- the computer program may also be presented over a network like the World Wide Web and can be downloaded into the working memory of a data processor from such a network.
- a medium for making a computer program element available for downloading is provided, which computer program element is arranged to perform a method according to one of the previously described embodiments of the invention.
Abstract
The present invention relates to mammography, in particular to providing mammography information. In order to provide better information to the user that can be used for further diagnostic purposes, in a first step mammography image data (112) is provided (110). In a next step, calcifications (116) in the mammography image data are determined (114). Further, a mammography calcium score (120) calculated (118); wherein the calculation is based on a weighting (122) of at least one calcification feature of the group of number of the calcifications (124), cumulative size of the calcifications (126), cluster area of the calcification clusters (128), position of the calcifications in relation to anatomy (130), morphology criteria of the calcification clusters (132), or classified / assigned morphology groups (134). Then, the mammography calcium score (120) is provided (136) to a user.
Description
MAMMOGRAPHY CALCIUM SCORE
FIELD OF THE INVENTION
The present invention relates to mammography. In particular, the present invention relates to an X-ray imaging system for providing mammography information, a method for providing tissue information for breast cancer screening, a computer program element and a computer readable medium.
BACKGROUND OF THE INVENTION
Mammography information is used, for example, for breast cancer screening. For example, calcifications in 2D mammography images are taken as an indicator to provide assessment and prediction of breast cancer. Currently, this examination is based on image evaluation and interpretation by the doctor, for example. US 5,365,429 describes a method of aiding detection of breast cancer by computer identification of microcalcifications in mammographic images. It has been shown that the results thus achievable are often inaccurate.
SUMMARY OF THE INVENTION
It may be an object of the present invention to provide better information to the user that can be used for further diagnostic purposes.
The object of the present invention is solved by the subject-matter of the independent claims, wherein further embodiments are incorporated in the dependent claims. It should be noted that the following described aspects of the invention apply also for the X- ray imaging system, the method, the computer program element and the computer readable medium.
According to an exemplary embodiment of the invention, a method for providing tissue information for breast cancer screening is provided, the method comprising the following steps:
a) providing mammography image data;
b) determining calcifications in the mammography image data;
c) calculating a mammography calcium score; wherein the calculation is based
on a weighting of at least one calcification feature of the group of:
number of the calcifications;
cumulative size of the calcifications;
cluster area of the calcification clusters;
- position of the calcifications in relation to anatomy;
morphology criteria of the calcification clusters; or
classified / assigned morphology groups; and
d) providing the mammography calcium score to a user.
According to an exemplary embodiment of the inventions, the calcifications are micro-calcifications.
According to an exemplary embodiment of the invention, the mammography data in step a) is provided as two-dimensional image data.
According to a further exemplary embodiment of the invention, the mammography data in step a) is provided as three-dimensional image data.
For example, the cumulative size of the calcifications, or the micro- calcifications, is related to a three-dimensional size, i.e., it is volume-related. As a further example, the cluster area of the calcification clusters is related to a three-dimensional area, i.e. to a volume-related feature.
According to a further exemplary embodiment, the mammography calcium score is based on a histogram for at least one of the above-mentioned features or characteristics or criteria.
According to a further exemplary embodiment of the invention, the mammography calcium scores of different acquisitions are compared over time.
According to a further exemplary embodiment of the invention, an X-ray imaging system is provided, comprising a processing unit and an interface unit. The processing unit is adapted to provide mammography image data. The processing unit is further adapted to determine calcifications in the mammography image data, and the processing unit is also adapted to calculate a mammography calcium score, wherein the calculation is based on a weighting of at least one calcification feature of the group of:
- number of the calcifications;
cumulative size of the calcifications;
cluster area of the calcification clusters;
position of the calcifications in relation to anatomy;
morphology criteria of the calcification clusters; or
classified / assigned morphology groups.
The interface unit is adapted to provide the mammography calcium score to the user.
According to a further exemplary embodiment, an X-ray image acquisition device with an X-ray source and an X-ray detector is provided, wherein the X-ray image acquisition device is adapted to acquire the mammography image data.
It can be seen as the gist of the invention to provide a mammography calcium score as an indicator for the state of the tissue in a region of interest, for example as an indicator for breast tissues. For example, the indicator can then be used for further assessment of the risk of breast cancer. By considering one of the above-mentioned features or aspects in relation with the determined calcifications, it is possible to provide enhanced calcification information in form of the mammography calcium score. By a weighting of the features, i.e. by considering the importance of the features in relation to each other, it is possible to consider as many aspects as desired in order to improve the accuracy of the information presented in form of the mammography calcium score. Thus, instead of having to visually interpret a provided X-ray image, for example a mammography image, the user is provided with a score that facilitates the steps and decisions performed afterwards by a doctor, for example.
It is noted that the calcium score is acting as one of many sources or basis for further diagnostic purposes, wherein the present invention is not related to any diagnostic step itself.
These and other aspects of the present invention will become apparent from and elucidated with reference to the embodiments described hereinafter.
BRIEF DESCRIPTION OF THE DRAWINGS
Exemplary embodiments of the invention will be described in the following with reference to the following drawings.
Fig 1 schematically illustrates an X-ray imaging system according to an
exemplary embodiment of the invention.
Fig. 2 schematically illustrates a further embodiment of an X-ray imaging system according to the invention.
Fig. 3 shows basic steps of a method according to the invention.
Fig. 4 shows a further embodiment of a method according to the invention. Fig. 5 shows a further embodiment of a method according to the invention. Fig. 6 shows a further embodiment of a method according to the invention. Fig. 7 shows a further embodiment of a method according to the invention. Fig. 8 shows a further embodiment of a method according to the invention. Fig. 9 shows a further embodiment of a method according to the invention. Fig. 10 shows a further embodiment of a method according to the invention. Fig. 11 shows an exemplary embodiment of mammography image data.
Fig. 12 shows a table indicating further information to the image of Fig. 11. Fig. 13 shows a first exemplary embodiment of features of determined
calcifications.
Fig. 14 shows a further exemplary embodiment of features of the determined calcifications.
Fig. 15 shows a further exemplary embodiment of features based on the
determined calcification.
Fig. 16 shows a further exemplary embodiment of calcification features
according to the invention.
Fig. 17 shows a further exemplary embodiment of calcification features
according to the invention.
Fig. 18 shows a further exemplary embodiment of a calcification feature
according to the invention.
DETAILED DESCRIPTION OF EMBODIMENTS
Fig. 1 schematically shows an X-ray imaging system 10 for providing mammography information according to the invention, the system comprising a processing unit 12 and an interface unit 14.
The processing unit 12 is adapted to provide mammography image data, to determine calcifications in the mammography image data, and to calculate a mammography calcium score, wherein the calculation is based on a weighting of at least one calcification feature of the group of number of the calcifications, cumulative size of the calcifications, cluster area of the calcification clusters, position of the calcifications in relation to anatomy, morphology criteria of the calcification clusters, or classified / assigned morphology groups.
The interface unit 14 is adapted to provide the mammography calcium score to
a user.
A further exemplary embodiment of an X-ray imaging system according to the invention is shown in Fig. 2. The X-ray imaging system 10 comprises an X-ray image acquisition device 16 with an X-ray source 18 and an X-ray detector 20. The X-ray image acquisition device 16 is adapted to acquire the mammography image data.
The example shown is a so-called stand-up investigation system where, for example, a patient in an upright position can stand while, for example, the breast is examined.
Therefore, the X-ray detector is provided as a sort of a paddle or small table upon which a breast can be received. Further, a moveable compression paddle 22 is provided with an adaptable distance D to the detector 20 in order to be able to act with a desired pressing force on the breast arranged detector 20 and the compression paddle 22.
Therefore, the compression paddle 22 is attached to an adjusting mechanism
24 allowing the necessary movement of the compression paddle.
The X-ray source 18 is generating X-ray radiation emanating towards the detector 20. Therefore, the compression paddle 22 is X-ray transparent.
Further, the X-ray source 18 and the detector 20 are attached to an adjustable support 26 allowing for a vertical adjustment such that the height of the detector can be adapted to different sizes of the patient. Further, a rotational movement is possible to acquire X-ray images not only in a vertical direction, but also in a direction with an angle to the vertical direction, such as 30° or any freely chooseable angulation as well as an X-ray viewing direction in a horizontal way. Further, a base 28 is provided which is securely fixed to a floor of an examination room, for example.
In addition to the X-ray image acquisition device 16, the X-ray imaging system 10 also comprises a display 30 provided on a separate base 32, which base comprises, for example the processing unit 12 and the interface unit 14 mentioned in relation with Fig. 1.
It is noted that any data connection is not further shown, which data connection can be provided as wire connection or wireless connection between the respective parts of the system 10.
It must be noted that the X-ray imaging system shown is a so-called stand type. It is further noted that the present invention also comprises other types for X-ray imaging, for example moveable or stationary X-ray imaging systems or X-ray imaging systems with a table upon which a patient can be received in order to acquire X-ray images while the patient is lying on the table, for example facing downwards.
According to a further aspect of the invention, the mammography image data provided by the processing unit is a mammogram image.
According to a further aspect of the invention, the mammography image data is based on CT data acquired by the X-ray image acquisition device, for example by a CT image acquisition system.
In the following, exemplary embodiments of a method for providing tissue information for breast cancer screening are explained with reference to Figs. 3 et seq.
In Fig. 3, a method 100 for providing tissue information for breast cancer screening is shown with the following steps:
In a first providing step 110, mammography image data 112 is provided.
In a determination step 114, calcifications 116 in the mammography image data are determined.
Further, in a calculation step 118, a mammography calcium score 120 is calculated based on a weighting 122 of at least one calcification feature of the group of number of the calcifications 124, cumulative size of the calcifications 126, cluster area of the calcification clusters 128, position of the calcifications in relation to anatomy 130, morphology criteria of the calcification clusters 132, or classified / assigned morphology groups 134.
For example, the calcifications 124 are micro-calcifications.
Further, in second providing step 136, the mammography calcium score 120 is provided to a user.
According to an exemplary embodiment, the mammography data in the first providing step 110 is provided as two-dimensional image data.
The first providing step 110 is also referred to as step a), the determination step 114 as step b), the calculating step 118 as step c), and the second providing step 136 as step d).
According to a further aspect of the invention, the cumulative size of the calcifications is related to a two-dimensional size.
According to a further aspect, the cluster area of the calcification clusters is related to a two-dimensional area.
According to a further exemplary embodiment, the weighting 122 is adaptable to be able to adjust the method for different situations.
It is further noted that the calculation based on one or more of the above- mentioned features is indicated by using dotted lines 138 in Fig. 3 to illustrate that one or
more of the calcification features can be considered for the weighting in order to provide the data for the calculation 118. By showing a through line 140 connecting box 114 with box 128 with box 120, this only illustrates that at least one feature is used for the calculation.
However, it is not necessary that it is the cluster area of the calcification clusters 128 that is used as indicated by the through- line 140.
According to a further aspect, in step a), at least one 2D mammogram image is provided.
According to a further exemplary embodiment, shown in Fig. 4, the data in step a) is provided by data derived by a forward projection 142 of tomosynthesis data 144.
According to a further aspect, not shown, the data in step a) is provided by data derived by a forward projection of 3D data acquired by CT (computed tomography).
According to a further exemplary embodiment, in step a), the mammography data is provided as three-dimensional image data 112' as for example acquired by breast CT or breast MRI.
According to a further exemplary embodiment, shown in Fig. 5, the cumulative size of the calcifications 126 is related to a three-dimensional size, i.e. the respective feature is volume-related.
According to a further aspect, the cluster area of the calcification clusters 128 is also related to a three-dimensional area, i.e. also this feature is volume-related.
According to a further aspect, the data in step a) is based on CT image data for providing the three-dimensional information.
It is noted that in Fig. 5, the respective features are shown with an apostrophe as an index in order to illustrate that at least some of them are related to the volume, i.e. to the three-dimensional aspect. It is further noted that instead of the six features of Fig. 3, only five boxes are shown for step c) in Fig. 5, but only for illustrational purposes. It is further noted that of course more or less boxes in step c) can be provided, as indicated with dotted lines 146.
According to a further exemplary embodiment, schematically illustrated in Fig. 6, the mammography calcium score 120 is based on a histogram 148 for at least one of the above-mentioned features. This is indicated in Fig. 6 as an example only for the number of calcifications 124. For the further features, as already mentioned above, the possibility to provide a histogram 148 is indicated with respective dotted lines 150.
According to a further aspect (not shown), the cumulative size of the calcifications comprises calculating an area score.
According to a further aspect, not shown, clustering is provided and the clustering comprises determining distance between calcifications and determining a directional spreading.
According to a further aspect of the invention, the classified / assigned morphology groups comprise a smooth area boundary group, a frayed area boundary group and an isolated calcifications group. The calcifications can be classified, for example, in either single / isolated or cluster / grouped. Furthermore, the calcifications can be classified with respect to morphology by distinguishing calcifications with smooth boundary and calcifications with rough boundary contours.
According to a further exemplary embodiment, shown in Fig. 7, the mammography calcium score 120 is displayed 152 on a display.
According to a further exemplary embodiment, shown in Fig. 8, the mammography calcium score 120 is displayed in combination with the mammography image data 112. This is indicated by a combination box 154 which receives the mammography calcium score 120 from providing box 136 and the mammography image data 112 from the first providing box 110. From the combination box 154, the display data is then provided to a display where it is displayed, indicated with a common display box 156.
It must be noted that the combination display can be provided as a display arrangement next to each other of the different information types, or as an overlaid image type where the calcium score is displayed in overlay manner or otherwise integrated manner with a mammography image data.
According to a further aspect, step b) comprises selecting calcifications from the detected calcifications.
According to a further aspect, the detection and sizing of the calcifications is done automatically.
According to an alternative aspect, the detection and sizing of the calcifications is done manually or supported manually.
According to a further aspect of the invention, not shown, calculating the mammography calcium score as a weighted mean of the number of calcifications for each class of cluster morphologies is provided.
According to a further exemplary embodiment, shown in Fig. 9, a graphical representation 158 is generated 160 of at least one of the determined features, which is exemplarily shown for the right box of the row of boxes of step c). Of course, a graphical representation can also be generated for one or more of the other feature boxes in step c).
Again, the different features are indicated with four boxes only, but of course more than these can be provided, as already mentioned above.
As can be further seen in Fig. 9, the graphical representation 158 is displayed in combination with the mammography image data and/or the mammography calcium score 120. This is indicated by a further combination box 162 which receives, as an example, the graphical representation 158 from box 160 as well as the mammography calcium score 120 from the providing box 136.
As an alternative or addition to the calcium score, it is also provided to combine the mammography image data 112 with a graphical representation and/or the mammography calcium score 120 which is indicated by a dotted line 164 connecting the providing box 110 with the second combination box 162. The result of the combination 162 is then displayed which is indicated by a display box 164.
As mentioned above, according to a further aspect, the graphical representation is displayed without the mammography image data.
According to a further aspect, the mammography image data is a mammography image.
According to a further aspect, the mammography calcium score 120 is provided as a comparison of the mammography calcium scores of different acquisitions. It is noted that this example is not further shown.
According to a further aspect of the invention (not shown), the mammography calcium score is compared between different breasts, for example between the left and the right breast.
According to a further aspect of the invention, the mammography calcium score is provided as a number indicator.
According to an alternative aspect of the invention, the mammography calcium score is provided as a colour code.
According to a further exemplary embodiment shown in Fig. 10, the mammography calcium scores of different acquisitions over time are compared. This is indicated by different acquisition boxes 166 indicated with an indices 1 et seq., providing different calcium scores 120, also with indices. The possibility to provide as many calcium scores as necessary is indicated with a dotted line structure 168.
The acquisition boxes 166 comprise a method to one of the above-mentioned exemplary embodiments and aspects of the invention discussed so far.
The calcium scores can then be compared in a comparison step 170. For example, the calcium scores are presented by a graphical indicator such that a user can easily perceive the respective information of an increasing or decreasing or other relative changing over time. Of course, it is also possible to provide a graph indicating a development, which is very useful information to a doctor, for example. According to a further example, the calcium scores are simply presented in spreadsheet manner, for example by a number representation for the calcium score.
In order to be able to provide the mammography calcium score by calculation, in a mammography image data, for example in a 2D mammogram, the number, position and size of the calcifications are determined. For example, this is done in a fully automatic manner based on digital or digitized mammograms. The detection can be based on image features, simple thresholding, or can include spectral acquisitions.
As an advantage of the present invention, a quantitative number, or other type of quantitative display, for each mammogram can result which, next to the image
interpretation by the radiologist, is an indicator for the risk of breast cancer. As an additional advantage, the data may be compared between the different acquisitions per breast
(MLO/CC), from left to right side, and especially a comparison over time is feasible.
In the following, some examples for the above-mentioned calcification features are be described.
Fig. 11 shows a mammography image 172 as an example for mammography image data 112. The mammography image 172 shows a tissue structure 174 of a breast. A number of calcifications 116 have been determined. Further, the calcifications 116 have already been analyzed with respect to the above-mentioned calcification feature aspects. The result of the identification is marked with a coded surrounding frame. For example, a first frame 174 comprises a cluster-type calcification. A second frame 176 comprises a single-type calcification, and a third frame 178 comprises a double-type calcification.
Further, for the calculation step 118 with different weighting factors for the weighting 122, a table is shown indicating different information to the identified calcification structures in the mammography image 172.
For example, in a first column, the respective image parts are shown in an enlarged manner. The first column is indicated with reference numeral 180. Further, in a second column 182, type information, number of calcifications, the size, morphologic aspects and others, such as area of cluster region, are listed. In a third column 184, the respective
weighting is indicated by weighting factors 186. In the third column 184, there is also provided a total risk indicator 188 for each of the calcification group or aspect.
In general, the calcium score R is computed as:
(1) 1 1 with k=l ,. .. ,N calcification findings with weights M¾ and normalization constant: N
k=l
Furthermore, vl denotes a risk number as percentage value ( 0≤ vl≤ 1 ) for each considered feature such as for example size, number, morpholgy or any other of the mentioned calcification features.
Here the weights may depend on a classification of the particular finding, e.g.
M¾may be higher for a finding classified as a cluster of micro-calcifications than for a finding classified as a single medium-sized calcification.
For each finding k=l ,. ..N a number Lk of features are considered, dependent on the classification of the finding, e.g. the features considered for the category 'micro- calcifications' may be different from the features evaluated for the category 'single medium- sized calcifications'.
As a further example, based on the exemplary listed risk numbers of Fig. 12, a mammographic calcium score can be calculated by applying equation (1) which results for this particular example in
54% [ 26/48=1x3/6 + lxl/6 + 2x9/12)/4 ]
Fig. 13 shows a further mammography image 190 in which a tissue structure 192 of a breast is shown. Further, a number of calcifications 194 is determined and counted which is indicated by providing a respective circular marking 196. In the image shown as an example, the number of detected calcifications is ntotai = 10.
Fig. 14 shows a further exemplary embodiment of a mammography image 290 showing a tissue structure of a breast 292. A number of calcifications 294 has been detected and marked with small circular or ellipsoid-shaped frames 296. Further, in order to provide information about the cumulative size of the calcifications, the sum of the area in square millimetres occupied by the calcifications can be calculated by applying the following equation.
A calc calc r
total J pix
Here, Aca c totai denotes the area on the detector covered by calcifications. nca c is the number of detector pixel measuring calcifications and fpix is the area of a detector pixel in mm2. The number of pixel measuring line integrals through calcifications can be determined e.g. by thresh holding with a value tcalc or by another suitable segmentation or classification technique:
ncalc = {d, I d9≥ '%0≤ i < nbrow,0≤ j < nb
Fig. 15 shows a further example of a mammography image 390 showing a tissue structure 392 of a breast. As before, calcifications 394 have been detected and marked with respective frames 396. The calcifications are marked e.g. by their centre of mass and if n calcifications belong to a cluster of calcifications each cluster is marked by a coordinate in the detector plane m; cafc MX;
=
my,
and the cluster area can be calculated by estimating the bounding box or e.g. using the Gaussian trapezoidal formula
n
i=l
or any other method estimating the covered area.
A cluster 398 is indicated with a polygon-like frame 399. In order to provide information about the cluster area of the calcifications, the marking of the calcifications has been applied with respect to the aspect of clusters. The area in pixels or square millimetres occupied by the bounding polygon of the cluster can be calculated by applying the following equation.
Areac = JJ all - pixel - inside - polygon
Fig. 16 shows a further example of a mammography image 490 with a tissue structure 492 of a breast. Also here, calcifications 494 are detected and marked with respective frames or labelling structures 496.
Fig. 16 also shows anatomy information 498, for example dense and adipose breast tissue coding (not further shown). In order to provide information about the position of the calcifications in relation to anatomy, for example, a number of calcifications positioned inside dense and adipose breast tissue is calculated for njense = 6 and
= 4.
According to a further aspect, not shown, this type of calculation could also be applied to anatomy information related to ductile system or any other anatomy type visible on mammograms or tomosynthesis slices, for example.
Fig. 17 shows a further example for a mammography image 590 with a tissue structure 592 of a breast. Calcifications 594 have been detected and also labelled with frame structures 596. As can be seen, three different morphology structures 598a, 598b, and 598c have been identified. The cluster 598a shows calcification cluster with a line-like structure which indicates a tubular morphology. Cluster 598b shows calcifications with circular morphology. Cluster 598c shows calcifications with a star-like morphology.
According to a further aspect of the invention, the weighting for the different aspects, i.e. the weighting for the different features can be based on statistical data.
In Fig. 18, an example for a histogram 202 is shown. On a horizontal axis 204, the cluster size is increasing in the direction indicated with the arrow at the right end of the horizontal line 204. On a vertical line 206, the number of the respective cluster sizes is indicated. A first indicator 208 shows the number for a first cluster size, a second indicator 210 shows the number for a second cluster size, a third indicator 212 shows the number for the respective third cluster size, and a fourth indicator 214 shows the number for a fourth cluster size.
In another exemplary embodiment of the present invention, a computer program or a computer program element is provided that is characterized by being adapted to execute the method steps of the method according to one of the preceding embodiments, on an appropriate system.
The computer program element might therefore be stored on a computer unit, which might also be part of an embodiment of the present invention. This computing unit may be adapted to perform or induce a performing of the steps of the method described above. Moreover, it may be adapted to operate the components of the above described apparatus. The computing unit can be adapted to operate automatically and/or to execute the orders of a user. A computer program may be loaded into a working memory of a data processor. The data processor may thus be equipped to carry out the method of the invention.
This exemplary embodiment of the invention covers both, a computer program that right from the beginning uses the invention and a computer program that by means of an up-date turns an existing program into a program that uses the invention.
Further on, the computer program element might be able to provide all necessary steps to fulfil the procedure of an exemplary embodiment of the method as
described above.
According to a further exemplary embodiment of the present invention, a computer readable medium, such as a CD-ROM, is presented wherein the computer readable medium has a computer program element stored on it which computer program element is described by the preceding section.
However, the computer program may also be presented over a network like the World Wide Web and can be downloaded into the working memory of a data processor from such a network. According to a further exemplary embodiment of the present invention, a medium for making a computer program element available for downloading is provided, which computer program element is arranged to perform a method according to one of the previously described embodiments of the invention.
It has to be noted that embodiments of the invention are described with reference to different subject matters. In particular, some embodiments are described with reference to method type claims whereas other embodiments are described with reference to the device type claims. However, a person skilled in the art will gather from the above and the following description that, unless otherwise notified, in addition to any combination of features belonging to one type of subject matter also any combination between features relating to different subject matters is considered to be disclosed with this application.
However, all features can be combined providing synergetic effects that are more than the simple summation of the features.
While the invention has been illustrated and described in detail in the drawings and foregoing description, such illustration and description are to be considered illustrative or exemplary and not restrictive. The invention is not limited to the disclosed embodiments. Other variations to the disclosed embodiments can be understood and effected by those skilled in the art in practicing a claimed invention, from a study of the drawings, the disclosure, and the dependent claims. In the claims, the word "comprising" does not exclude other elements or steps, and the indefinite article "a" or "an" does not exclude a plurality. A single processor or other unit may fulfil the functions of several items re-cited in the claims. The mere fact that certain measures are re-cited in mutually different dependent claims does not indicate that a combination of these measures cannot be used to advantage. Any reference signs in the claims should not be construed as limiting the scope.
Claims
1. An X-ray imaging system (10) comprising :
- a processing unit (12); and
- an interface unit (14);
wherein the processing unit (12) is adapted to provide mammography image data; and wherein the processing unit is further adapted to determine calcifications in the mammography image data; and wherein the processing unit is further adapted to calculate a mammography calcium score; wherein the calculation is based on a weighting of at least one calcification feature of the group of:
- number of the calcifications;
- cumulative size of the calcifications;
- cluster area of the calcification clusters;
- position of the calcifications in relation to anatomy;
- morphology criteria of the calcification clusters; or
- classified / assigned morphology groups; and
wherein the interface unit (14) is adapted to provide the mammography calcium score to a user.
2. X-ray system according to claim 1, wherein an X-ray image acquisition device (16) with an X-ray source (18) and an X-ray detector (20) is provided; and wherein the X-ray image acquisition device is adapted to acquire the mammography image data.
3. A method (100) for providing tissue information for breast cancer screening, the method comprising the following steps:
a) providing (110) mammography image data (112);
b) determining (114) calcifications (116) in the mammography image data; c) calculating (118) a mammography calcium score (120); wherein the calculation is based on a weighting (122) of at least one calcification feature of the group of:
- number of the calcifications (124);
- cumulative size of the calcifications (126);
- cluster area of the calcification clusters (128);
- position of the calcifications in relation to anatomy (130); - morphology criteria of the calcification clusters (132); or
- classified / assigned morphology groups (134);
and
d) providing (136) the mammography calcium score (120) to a user.
4. Method according to claim 3, wherein in step a) the mammography data is provided as two-dimensional image data.
5. Method according to claim 3 or 4, wherein in step a) at least one 2D mammogram image is provided.
6. Method according to claim 3, 4 or 5, wherein the data in step a) is provided by data derived by a forward projection (142) of tomosynthesis data (144).
7. Method according to claim 3, wherein in step a) the mammography data is provided as three-dimensional image data (112').
8. Method according to one of the claims 3 to 7, wherein the mammography calcium score is based on a histogram (148) for at least one of the above-mentioned features.
9. Method according to one of the claims 3 to 8, wherein the mammography calcium score is displayed (152) on a display.
10. Method according to one of the claims 3 to 9, wherein the mammography calcium score is displayed in combination (154) with the mammography image data.
11. Method according to one of the claims 3 to 10, wherein a graphical representation (158) of at least one of the determined features is generated (160) and wherein the graphical representation is displayed (164) in combination with the mammography image data and / or the mammography calcium score (120).
12. Method according to one of the claims 3 to 11, wherein the mammography calcium score is provided as a colour code.
13. Method according to one of the claims 3 to 12, wherein the mammography calcium scores of different acquisitions (166) over time are compared (170).
14. Computer program element for controlling an apparatus according to one of the claims 1 to 2, which, when being executed by a processing unit, is adapted to perform the method steps of one of the claims 3 to 13.
15. Computer readable medium having stored the program element of claim 14.
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