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Feature Level Fusion for Characterization of Breast Mass using Mammogram and

Ultrasound Imaging

CHAPTER I

INTRODUCTION
Breast cancer has become a significant health problem worldwide. In order to prevent the
increase of deaths caused by breast cancer, early diagnosis of the disease has been very effective.
Detected early, breast cancer is easier to treat, with fewer risks and reduces mortality by 25%[1].
This early detection can be achieved by subjecting women at risk (mainly postmenopausal
women) to a mammography every two years, since it takes about five years for a breast tumor to
reach 1 mm, two years longer to reach 5mm and one or two years to measure 2 cm, large enough
to detect by palpation. Now adays, X-Ray mammography, ultrasound, and magnetic resonance
imaging (MRI) are imaging modalities routinely used to screen for breast cancer. It is well
known that there is no technology at present, which is capable of curing cancer. But, it is well
known that early detection of cancer can aid in recovery and prolong patient life. A major reason
for these errors is due to the fact that radiologists depend on visual inspection. During manual
screening of a large number of mammograms, radiologists may get easily worn out, missing out
vital clues while studying the scans. As yet, there is no definitive literature which focuses on an
elaborate discussion on the feature extraction, feature selection and classification methodologies
used in breast cancer detection.
Increasing risk of developing breast cancer includes early menarchy, delayed menopause,
obesity, infertile mothers, contraceptives, consuming alcohol and certain inherited genetic
mutation. Despite advances in other breast imaging modalities, including ultrasound and
magnetic resonance imaging, mammography is still a method of choice. However the detection
of small malignancies is especially difficult in younger women who tend to present denser breast
tissues. Biopsy is applied for the most accurate diagnosis. However, it is an aggressive and highcost procedure with some risk and causes inconvenience to the patient.
Mammography is the best available inspection facility to detect the symptoms of breast
cancer at the early stage and it can disclose information about abnormality, such as masses,
microcalcifications, bilateral asymmetry, and architectural distortion. Mammography is the
breast image taken with a special X-ray. It uses a low-dose X-ray, high-contrast, and highresolution film. For the hundreds of mammographic images scanned by a radiologist, only a few
are cancerous. While detecting abnormalities, some of them may be missed, as the detection of
suspicious and abnormal images is a recurrent mission that causes fatigue and eyestrain. Using
enhanced images and segment the suspicious area , extract features , select more accurate
features and then classify them into appropriate category are the most important steps that
computer aided detection systems should follow. However, due to low contrast and strong noise,
digital mammograms are among the most difficult medical images to analyze.
Since the calcification have high attenuation properties and small dense tissues similar to
bones, they tend to present low contrast. Thus their visual screening is difficult for physicians. As

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Feature Level Fusion for Characterization of Breast Mass using Mammogram and
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the above difficulties prevail in the existing methodology of mammographic image processing,
the improvement of local detail discrimination and removal of noise from the images is a
requirement.

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CHAPTER 2

BREAST CANCER
This chapter gives insight into what is cancer, breast cancer, its types, associated signs,
diagnostic methods, understanding of these is one of the fundamental requirements to carry out
the work.
2.1 Cancer
Uncontrolled multiplication of a group of cells in a particular location of the body is
called cancer. Cancer results from a series of molecular events that fundamentally alter the
normal properties of cells and the normal control systems that prevent cell overgrowth
and invasion to other tissues are disabled. The uncontrolled multiplication of cells forms extra
cells which intern may form a mass of tissue called a tumor, tumors are not cancerous always,
they can be benign or malignant.
2.1.1 Benign Tumors
These are not cancerous, can be removed and in most cases, they do not appear again.
Cells in benign tumors do not spread to other parts of the body.

2.1.2 Malignant Tumors


These are cancerous, can invade nearby tissues and spread to other parts of the body.
Among broad categories of cancer types, the breast cancer mainly belongs to the type carcinoma
the cancer that begins in the skin or in tissues that line or cover internal organs. In rare cases
breast cancer belongs to the type sarcoma the cancer that starts in connective tissues such as
muscle tissue, fat tissues or blood vessels.
2.2 Breast Anatomy:
The breast of an adult woman is a milk-producing, tear-shaped gland. The front of
the chest wall supports and attached to breast on either side of the sternum by ligaments.
Breasts are positioned over the pectoral muscles of the chest wall and attached to chest wall by
Coopers ligaments, the fibrous strands.

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Fig 2.1 Breast anatomy.


Breast is mainly composed of glandular, fatty, and fibrous tissues and contains no
muscle tissue. A fat layer surrounds the gland and extends throughout the breast, which gives
the breast a soft consistency. The mammary glands or milk producing areas lie between the
pectoralis major muscle and skin, each breast consist of 15-25 clusters called lobes, with each
lobule connected by ducts, that opens into the nipples, which are made up of erectile tissue.
The pigmented areas around nipple are called the areola. Size of the breast is primarily decided
by heredity and also depends on the existing fat and glandular tissue. Prior to menstruation
breasts exhibit cyclical changes, including increased swelling and tenderness. Benign breast
changes refer to fibrocystic disease, lumps or masses that are cancerous.
Breast is divided into four different quadrants as shown in fig 3.2, it is important to
know quadrants of breast because, the possible chances of breast cancer in different quadrants
are different.

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Fig 2.2. Breast quadrant labels.

2.3 Breast Cancer and its stages


Breast cancer is a malignant tumor that starts in the cells or tissues of the breasts. The
stages of breast cancer depends on the size of the breast tumors and whether it has spread to
lymph nodes or to other parts of the body. Based on these considerations, breast cancer can be
divided into following stages:
Stage 0: Abnormal cells are in the walls of breast duct, but not have invaded nearby
tissues or spread outside the duct.
Stage IA: The lump is smaller than or equal to 2 centimeters and has not spread to the
lymph nodes.
Stage IB: The tumor is no more than 2 centimeters and cancer cells are found in lymph
nodes.
Stage IIA: The lump is smaller than 2 centimeters and the cancer has spread to lymph
nodes at armpit.
Stage IIIA: The tumor is smaller than 5 centimeters and the cancer may have spread to
lymph nodes behind breastbone.
Stage IIIB: The tumor can be of any size, and it has grown into the walls of chest or the
breast skin. The breast may be swollen.
Stage IIIC: The cancer has spread to lymph nodes above or below the collarbone.
Stage IV: The lump can be of any size, the cancer cells have spread to other parts of the
body such as lungs, liver, bones or brain.

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2.4 Types of Breast Cancer


Three are different types of breast cancer, the most commonly observed breast cancer
types are:
2.4.1 Ductal Carcinoma In Situ (DCIS)
DCIS is considered as non-invasive or pre-invasive breast cancer, which begins in the
lining of the milk ducts. About 1 in 5 new breast cancer cases will be DCIS. Almost all
women diagnosed at this stage can be cured.

2.4.2 Lobular Carcinoma


The cancer which begins in the lobules of the breast.
2.4.3 Invasive Ductal Carcinoma (IDC)
The most common type of breast cancer starts in a milk duct of the breast, breaks
through the walls of the duct and grows into the fatty tissues of the breast.
2.4.4 Invasive Lobular Carcinoma (ILC)
ILC starts in the milk producing glands, can spread to other parts of the body. ILC may
be difficult to detect by a mammogram.
There are many other less common types and special types of breast cancer such as,
inflammatory breast cancer, angiosarcoma, adenoid cystic carcinoma etc.
2.5 Signs of breast cancer and their appearances
Breast cancer is detected by identifying either of four signatures associated with
breast, its cells and tissues.
2.5.1 Calcifications
Calcifications are tiny deposits of mineral within breast tissue, which appear as
small white spots on the films of breast images. There are two types of calcifications:

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Macrocalcifications: Calcifications which are coarse calcium deposits caused by aging of


the breast arteries, old injuries or inflammation. These are non-cancerous deposits, about half
the women above 50 and 1 of 10 women under 50 have macrocalcifications.

Microcalcifications: Tiny specks of calcium in the breast are called microcalcifications.


These may appear as alone or in clusters, presence of these do not always mean the
3
cancer is present. The presence of at least five microcalcifications within a 1 cm volume
define a cluster, which is considered as cancerous one. Considering the shapes, thin
linear, curvilinear and branching shapes suggests malignancy. Fig2.3 (a) and fig2.3 (b) shows
view of macrocalcifications and microcalcifications respectively.

(a)

(b)

Fig. 2.3 (a) macrocalcifications, (b) microcalcifications


2.5.2 Mass
Masses are areas that look abnormal and they include cysts, the non-cancerous, fluid
filled sacs and non-cancerous solid tumors. Masses are also defined as a space occupying
lesion. Masses have different density such as fat containing masses, low density
isodense and high density masses.

Masses are with different margins like circumscribed, micro lobular, obscured,
indistinct and speculated margins and the different shapes associated with mass are
round, oval, lobular and irregular shapes. Round and oval shaped masses with smooth and
circumscribed margins indicate benign changes. However, a malignant mass usually has a
speculated, rough and blurry boundary. Fig 3.4 (a) and fig 3.4 (b) shows circumscribed and
speculated masses.

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(a)

(b)

Fig 2.4 (a) circumscribed mass with smooth margin, (b) speculated mass with
branching margins [1].

2.5.3 Architectural Distortion


Breast Imaging Reporting and Data Systems (BI-RADs) define architectural distortion
as the normal architecture of the breast is distorted with no definite mass visible. This
includes speculates radiating from a point and focal retraction or distortion at the edge of the
parenchyma, architectural distortion can also be an associated finding. Architectural
distortion is the third most common sign of non-palpable breast cancer, but due to this
subtlety and variable presentation, it is very often missed during detection procedure.
Architectural distortion accounts for 12% to 45% of breast cancers, the improvement in the
detection of architectural distortion could lead to an effective improvement in the prognosis of
breast cancer patients.

2.5.4 Bilateral Asymmetry


Humans are considered bilaterally symmetrical, if an individual is exposed to genetic
mutations or environmental stresses, the homeostatic mechanisms that maintain symmetry of
paired structures tend to breakdown, consequently increased fluctuating asymmetry of paired
structures could be an indication of poor health. Bilateral morphological breast asymmetry
correlates with the presence of breast cancer. The BI- RADs definition of asymmetry indicates
the presence of a greater volume or density of breast tissue without a distinct mass or more
prominent ducts, in one breast as compared to the corresponding area in the other breast. The
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slight asymmetries in distribution of normal parenchyma occurs frequently and that even
substantial asymmetry is seen in 3%-5% of totally normal breasts.
Bilateral asymmetry and architectural distortion are considered as indirect signs of
breast cancer. Along with the four signs of breast cancer mentioned above, there are few less
observed signs such as single dilated duct, developing density etc.

2.6 Detection and diagnosis of breast cancer: imaging techniques


Detection and diagnosis of breast cancer can be
and biopsy, the procedure in which small amount
under a microscope to confirm whether cancer is
breast imaging. There are various imaging techniques
and limitations, the most common among them are:

done by various imaging techniques


of tissue removed and looked at
present. The first step involved is
available with their own advantages

2.6.1 Magnetic Resonance Imaging (MRI) Imaging


2.6.1.1 Breast cancer diagnosis with high field MRI (1.5 T)
uses magnetic fields and radio waves to diagnose disease.
Takes about 30 minutes for test.
The main advantage is the contrast between soft tissues in the breast is 10 to 100
times greater than that obtained with X-rays
The main disadvantage of breast MRI is its cost, which is about 5 times that of X- ray
mammography.

2.6.1.2 MR guided biopsy with open systems


MRI systems consists of a low-field (0.5 T), very expensive and still in the
experimental stage.
2.6.2 Digital Imaging
In digital imaging, the digital image is formed when a detector absorbs the X-rays and
converts them to an electrical signal corresponding to each pixel. When images are digitally
acquired and displayed, film is eliminated. There are several imaging techniques under this

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category, the most common and most used are


2.6.2.1 Full Field Digital Mammography

Mammography is a specific type of imaging that uses a low-dose X-ray system to


examine the breast and is currently the most effective method for detection of breast cancer
before it becomes clinically palpable.
Mammography offers high quality images at a low radiation dose and is currently the
only widely accepted method used for routine breast cancer screening.
Digital mammography is potentially advantageous over film mammography such as it
has wider dynamic range, lower noise, improved contrast and lower X-ray dose.
screening mammography generally consists of four views, with two views of each
breasts: the Cranio- Caudal (CC) view and the Medio Lateral Oblique (MLO) view. Fig2.5 (a)
and fig2.5 (b) shows CC and MLO views of breast respectively.

(a)

(b)

Fig 2.5 (a) Cranio-Caudal (CC) (b) Medio Lateral Oblique (MLO) views of
mammograms [21].

2.6.2.2 Tomosysnthesis
In this method multiple images are acquired as the X-ray tube is moved in an arc
above the stationary breast and digital detector.
The total reduction dose required for imaging the entire breast being
approximately equal to the dose used for a single film-screen mammogram.
The method is benefited for women with radiographically dense breasts.
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The less used and uncommon digital imaging techniques involves stereotactic imaging,
single energy X-ray technique and 3D digital reconstruction.
2.2.3 Ultra Sound (US) Imaging
Involves identification of pathological vascularization in the breast with
Doppler imaging.
More accurately map the extent of tumor within breast than possible with
mammography.
Contrast imaging method among the various methods under ultra sound
imaging is more beneficial.
Involves less cost than MRI.
Usually done in combination with mammography.

The other less common imaging techniques involves nuclear imaging, Positron
Emission Tomography (PET) imaging, sestamibi imaging, bioelectric imaging, optical
diffusion imaging.
2.7 Statistics
2.7.1 Statistics based on age group
Figure below shows percentage distribution of breast cancer among different age
group.

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Fig 2.6 percentage of breast cancer among different age groups .


2.7.2 Statistics based on different quadrants of breast
The percentage distribution of possible occurrence of breast cancer at different
quadrants of breast is as show in fig 2.7.

Fig 2.7 percentage of breast cancer associated with different quadrants of breast

2.7.3 Gender wise and 2014 statistics


In 2014, the new cases involve 232,670 among female and 2360 among male.
In 2014, numbers of deaths are 40,000 among female and 430 among male.
about 1 in 8 women in United States will develop invasive breast cancer during their
lifetime.

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CHAPTER III

CONCEPTUAL DESIGN
It is well known that there is no technology at present, which is capable of curing cancer.
But, early detection of breast cancer can aid in recovery and also prolong patient life. A major
reason for errors in reading mammograms is due to the fact that radiologists depend on visual
inspection. During manual screening of a large number of mammograms, radiologists may get
easily worn out, missing out vital clues while studying the scans. As yet, there are very less
efficient models of CAD which incorporates feature extraction, feature selection and
classification methodologies used in breast cancer detection. As double reading of mammograms
and diagnosis by imaging techniques other than mammography, such as MRI, are expensive, the
costs incurred is very high for the patients, the project proposes the development of ComputerAided Detection(CAD) and diagnosis method, by developing efficient algorithms for early
identification of breast masses with low cost mammography & ultrasound images.
3.1 Proposed System
We propose to preprocess the mammogram image, segment the suspicious mass region and
extract features before classifying it into benign or malignant. We use Contrast Limited Adaptive
Histogram Equalization(CLAHE) method for preprocessing the mammogram image before
extracting the lesion. Support vector machine (SVM) classifiers are used to classify the fused
features.

Fig. 3.1: Process Flow


3.2 Implementation
The proposed algorithms are mainly developed using MATLAB 2013a, LabVIEW 2013 and
Vision Assistant (2013). MATLAB is a high performance language for technical computing. It
integrates computation, visualization and programming environment. MATLAB has
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sophisticated data structures, contains built-in editing and debugging tools, and supports objectoriented programming. MATLAB is an interactive system whose basic data element is an array
which does not need dimensioning. In this work, image processing toolbox is used implement
segmentation, Contrast Limited Adaptive Histogram Equalization(CLAHE), and image
arithmetic parts of proposed algorithms. Scripts to obtain GUI and other techniques such as
Gaussian pyramid, log transformation, canny edge detection, morphological operations,
dimension measurements etc., the LabVIEW Vision Assistant is used.

Fig. 3.2: Overview of the system


The mammogram images when wavelet transformed, can be experimented with various
techniques such as Singular Value Decomposition(SVD), Identification of Chebyshev
moments, log Polar transform & Binary PSO.
The objective is to enable Computer Aided Detection and to provide statistical analysis of
parameters such as
Entropy
Correlation
Information Measure
Variance
PSNR
Sum of Variance
Also, a modeling of the process is to be performed merged with Support Vector
machine/Learning machine.

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Fig. 3.3: Detailed Block Diagram


3.3 Dual Modality
We can characterize the breast mass as malignant or benign by investigating the features
retrieved from dual modalities: Mammograms and Ultrasound.
We consider the features such as:
Spiculated feature.
Acoustic shadowing.
Elliptical shape feature.
Entropy and standard deviation for discrimination.
We plan to use three well-known normalization methods:
Min-Max (MM)
Z-score (ZS)
Tanh (TH)
3.4 Preprocessing & Segmentation Outputs

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Fig3.4 : Ultrasound and Preprocessing Outputs


The proposed dual modality system combines the structural and functional behavioural trait of
mammogram and ultrasound modalities as shown in Fig 3. We have extracted texture features
and directional features from mammograms using Gabor filters, gradient orientation and phase
portraits. Using angle of curvature method and intensity based method functional features like
acoustic shadow and shape features are retrieved from ultrasound. As Mammogram and
Ultrasound are independent modalities, we need to normalize the features. Feature Normalization
is done using Z-score, Min-Max and Tanh (TH) methods for feature level fusion. Support vector
machine (SVM) classifiers are used to classify the fused features.
Ultrasound (US) is an important adjunct to mammography in breast cancer detection as it
doubles the rate of detection in dense breasts and also does dynamic analysis of moving
structures in breast. Architectural distortions and spiculated masses with Architectural distortions
on mammography are considered to be one of the most indicators of breast cancer. But recently
AD and AD with spiculated mass has been detected via ultrasonography also. Distortion refers to
presence of radiating structure concentrated at a point. The features we have considered are
discriminative and effective in characterizing the mass in ultrasound images. Using a single
feature as parameter to discriminate is always a tradeoff between the sensitivity and specificity.
The tradeoff is due to that each feature parameter is mainly related to its nature. So we have
considered the features like spiculated feature, acoustic shadowing, elliptical shape feature,
entropy and standard deviation for discrimination.

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Fig 3.5: Different techniques for Preprocessing

The features retrieved from mammogram are structural features and that from ultrasound are
functional features and they are dissimilar in terms of dimension. For fusion of features we
needed coherent dataset from both modalities which belong to a same person. Data set was
created by collecting and getting the ground truth marked images from expert radiologists trained
with those kinds of images. All images in our dataset contained only one abnormality (AD with

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spiculated mass). As discussed in previous sections both modalities will output a collection of
features. The fusion process fuses this collection of features into a single feature set.
Feature level fusion is a medium level fusion strategy which performs well, if the features are
homogenous. If the features are heterogeneous, then it requires normalization to convert them
into a range that makes them more similar. We have used three well-known normalization
methods:

Min-Max (MM)
Z-score (ZS)
Tanh (TH)

Support vector machines (SVM) are a learning tool based on modern statistical learning method
that classifies binary classes. SVM has been shown to perform better than many other
classification algorithms due to several reasons:

SVM has good capacity of generalization.


SVM is highly robust and work well with images.
The theory of SVM is well defined and has a very good base of mathematics and
statistics.
Over training problem is less compared to other neural network classifiers.

Thus we have used SVM classifiers to classify the fused feature vector. Implementation is done
using MATLAB. For experimentation we have randomly partitioned the dataset training and
testing data with the proportion of 70% and 30% respectively. We have used receiver operating
characteristic curve (ROC) to evaluate the performance. FROC graphically represents the true
positive rate as a function of false positives rate.
In this study information from multiple modalities such as mammogram and ultrasound was used
to classify the breast mass as benign or malignant. The features retrieved from mammogram are
spiculation feature and denseness texture feature and that from ultrasound are spiculation feature,
shape feature and shadowing feature. From both modalities we have retrieved some additional
features like: standard deviation, entropy and homogeneity. Both modalities supply
complementary information which is helpful in discriminating benign from malignant mass.
Results show that the multimodal fusion improves the performance to classify breast mass more
accurately. Accuracy can still be improved if standard dataset is made available for fusion.
Comparative study in ultrasound methods can be made more accurate if standard dataset is
available. Research towards multimodality in breast cancer analysis is very less. We can work in
different directions of multimodality to improve the sensitivity rate in detecting breast cancer as
early as possible.

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Multimodality information system provides complementary information to radiologists and has a


great benefit for diagnosis and therapy. Radiologists in a normal follow-up face lot of difficulties
in interpreting mammograms or ultrasonograms due to which more than half of breast biopsies
turn out to be negative. Thus it is desirable to have an alternative approach as a second line of
defence. Towards that we have embarked on developing a dual modality model which fuses the
features retrieved from mammogram and ultrasound.
Any of the single modality used to analyse breast cancer is not rich enough to capture all
classification information available in the image. Thus in normal medical diagnoses, images
from different modalities are used to get a complete picture or information of abnormality. For
example mammogram provides textural and morphological information where as ultrasound
images give functional and metabolic information. Hence most of the limitations imposed by
unimodal systems can be overcome by including multiple sources of information. Images from
different modalities may be taken at different time, different resolutions and may be from
different viewpoints so it is very difficult to simply overlay different images from different
modalities to fuse the information. Integration of information in multimodality can occur at
feature level or at decision level. Feature level methods combine several feature sets into a single
fused one which is then used by any conventional classifier. Decision level fusion combines
several classifiers resulting in strong final classifier.

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Fig 3.6: Different Techniques for Image Segmentation

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CHAPTER IV
RESULT ANALYSIS
4.1 Histogram Equalization
The idea behind Histogram Equalization is that we try to evenly distribute the occurrence of
pixel intensities so that the entire range of intensities is used more fully. We are trying to give
each pixel intensity equal opportunity; thus, equalization. Especially for images with a wide
range of values with detail clustered around a few intensities, histograms will improve the
contrast in the image.
In MATLAB, the function to perform Histogram Equalization is histeq(I).
An image lacks contrast when there are no sharp differences between black and white.
Brightness refers to the overall lightness or darkness of an image.
To change the contrast or brightness of an image, the Adjust Contrast tool performs contrast
stretching. In this process, pixel values below a specified value are displayed as black, pixel
values above a specified value are displayed as white, and pixel values in between these two
values are displayed as shades of gray. The result is a linear mapping of a subset of pixel values
to the entire range of grays, from black to white, producing an image of higher contrast.

Fig 4.1 : Contrast Adjustment between pixels


The Histogram Equalization algorithm enhances the contrast of images by transforming the
values in an intensity image so that the histogram of the output image is approximately flat. See
the picture below.

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Fig4.2 : An example of Histogram Stretching


A histogram is a graphical representation of the distribution of data. It is an estimate of the
probability distribution of a continuous variable (quantitative variable) and was first introduced
by Karl Pearson.[11] To construct a histogram, the first step is to "bin" the range of valuesthat
is, divide the entire range of values into a series of small intervalsand then count how many
values fall into each interval. A rectangle is drawn with height proportional to the count and
width equal to the bin size, so that rectangles abut each other. A histogram may also be
normalized displaying relative frequencies. It then shows the proportion of cases that fall into
each of several categories, with the sum of the heights equaling 1. The bins are usually specified
as consecutive, non-overlapping intervals of a variable. The bins (intervals) must be adjacent,
and usually equal size.[12] The rectangles of a histogram are drawn so that they touch each other
to indicate that the original variable is continuous.
4.2 Contrast Limited Adaptive Histogram Equalization
While performing AHE if the region being processed has a relatively small intensity range then
the noise in that region gets more enhanced. It can also cause some kind of artifacts to appear on
those regions. To limit the appearance of such artifacts and noise, a modification of AHE called
Contrast Limited AHE can be used. The amount of contrast enhancement for some intensity is
directly proportional to the slope of the CDF function at that intensity level. Hence contrast
enhancement can be limited by limiting the slope of the CDF. The slope of CDF at a bin location
is determined by the height of the histogram for that bin. Therefore if we limit the height of the
histogram to a certain level we can limit the slope of the CDF and hence the amount of contrast
enhancement.
The only difference between regular AHE and CLAHE is that there is one extra step to clip the
histogram before the computation of its CDF as the mapping function is performed.
Following is the overview of the algorithm for this function:
1. Calculate a grid size based on the maximum dimension of the image. The minimum grid
size is 32 pixels square.
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2. If a window size is not specified chose the grid size as the default window size.
3. Identify grid points on the image, starting from top-left corner. Each grid point is
separated by grid size pixels.
4. For each grid point calculate the histogram of the region around it, having area equal to
window size and centered at the grid point.
5. If a clipping level is specified clip the histogram computed above to that level and then
use the new histogram to calculate the CDF.
6. After calculating the mappings for each grid point, repeat steps 6 to 8 for each pixel in the
input image.
7. For each pixel find the four closest neighboring grid points that surround that pixel.
8. Using the intensity value of the pixel as an index, find its mapping at the four grid points
based on their cdfs.
9. Interpolate among these values to get the mapping at the current pixel location. Map this
intensity to the range [min:max) and put it in the output image.
Clipping the histogram itself is not quite straight forward because the excess after clipping has to
be redistributed among the other bins, which might increase the level of the clipped histogram.
Hence the clipping should be performed at a level lower than the specified clip level so that after
redistribution the maximum histogram level is equal to the clip level.
The below diagram shows the preprocessing output of the input mammogram image. We observe
that the preprocessed image clearly shows the masses visible which can now be sent for
segmentation.

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Fig 4.3 : CLAHE method preprocessing output


Fuzzy C-Means Clustering
Fuzzy c-means (FCM) is a method of clustering which allows one piece of data to belong to two
or more clusters. This method (developed by Dunn in 1973 and improved by Bezdek in 1981) is
frequently used in pattern recognition. It is based on minimization of the following objective
function:

where m is any real number greater than 1, uij is the degree of membership of xi in the cluster j,
xi is the ith of d-dimensional measured data, cj is the d-dimension center of the cluster, and ||*|| is
any norm expressing the similarity between any measured data and the center.
Fuzzy partitioning is carried out through an iterative optimization of the objective function
shown above, with the update of membership uij and the cluster centers cj by:

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This iteration will stop when


where is a termination criterion
between 0 and 1, whereas kare the iteration steps. This procedure converges to a local minimum
or a saddle point of Jm. The algorithm is composed of the following steps:
1.
2.

Initialize U=[uij] matrix, U(0)


At k-step: calculate the centers vectors C(k)=[cj] with U(k)

3.

Update U(k) , U(k+1)

4.

If || U(k+1) - U(k)||<

then STOP; otherwise return to step 2.

Fuzzy C-means (FCM) algorithm is one of the most popular fuzzy clustering methods widely
used in various tasks of pattern recognition, data mining, image processing, gene expression data
Recognition etc. Modifying and generalizing the FCM algorithm is a prevailing research stream
in fuzzy clustering in recent decades.

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Fig4.4 : Multicluster display output


Choose a number of clusters
Assign randomly to each point coefficients for being in the clusters
Repeat until the algorithm has converged (that is, the coefficients' change between two iterations
is no more than , the given sensitivity threshold)
Compute the centroid for each cluster, using the formula
above
For each point, compute its coefficients of being in the clusters, using the formula above

Fig 4.5 :Cluster outputs

K-means clustering

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Clustering is the process of partitioning a group of data points into a small number of clusters.
For instance, the items in a supermarket are clustered in categories (butter, cheese and milk are
grouped in dairy products). Of course this is a qualitative kind of partitioning. A quantitative
approach would be to measure certain features of the products, say percentage of milk and
others, and products with high percentage of milk would be grouped together. In general, we
have n data points xi,i=1...n that have to be partitioned in k clusters. The goal is to assign a
cluster to each data point. K-means is a clustering method that aims to find the positions
i,i=1...k of the clusters that minimize the distance from the data points to the cluster. K-means
clustering solves
argminci=1kxcid(x,i)=argminci=1kxcixi22
where ci is the set of points that belong to cluster i. The K-means clustering uses the square of
the Euclidean distance d(x,i)=xi22. This problem is not trivial (in fact it is NP-hard), so the
K-means algorithm only hopes to find the global minimum, possibly getting stuck in a different
solution.
K-means algorithm
The Lloyd's algorithm, mostly known as k-means algorithm, is used to solve the k-means
clustering problem and works as follows. First, decide the number of clusters k. Then:
1. Initialize the center of the clusters

i= some value ,i=1,...,k

2. Attribute the closest cluster to each data point

ci={j:d(xj,i)d(xj,l),li,j=1,...,n}

3. Set the position of each cluster to the mean of all data


points belonging to that cluster

i=1|ci|jcixj,i

4. Repeat steps 2-3 until convergence


Notation

|c|= number of elements in c

The algorithm eventually converges to a point, although it is not necessarily the minimum of the
sum of squares. That is because the problem is non-convex and the algorithm is just a heuristic,
converging to a local minimum. The algorithm stops when the assignments do not change from
one iteration to the next.
Deciding the number of clusters
The number of clusters should match the data. An incorrect choice of the number of clusters will
invalidate the whole process. An empirical way to find the best number of clusters is to try Kmeans clustering with different number of clusters and measure the resulting sum of squares.

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Initializing the position of the clusters


It is really up to you! Here are some common methods:

Forgy: set the positions of the k clusters to k observations chosen randomly from the
dataset.
Random partition: assign a cluster randomly to each observation and compute means as
in step 3.

Since the algorithm stops in a local minimum, the initial position of the clusters is very
important.

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CHAPTER VI

CONCLUSION
Mammography and Ultrasound are the best available inspection facility to detect the
onslaught of breast cancer at the early stage. It can disclose information about abnormality, such
as masses, microcalcifications, bilateral asymmetry, and architectural distortion. For the
hundreds of mammographic images scanned by a radiologist, only a few are cancerous. While
detecting abnormalities, some of them may be missed due to human error, as the detection of
suspicious and abnormal images is a recurrent mission that causes fatigue and eyestrain. Using
CAD to enhance images, segment & extract the suspicious area, more accurate features can be
viewed. Furthermore, they can be classified into appropriate category are the most important
steps that computer aided detection systems can contribute leading to significant reduce in the
false diagnosis of Breast Cancer.
The early detection of Breast Cancer based on image processing techniques is reliable
and can prove to be an important investigative tool in the clinical evaluation of detection of
cancer in early stages

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