PAPER PRESENTATION ON DIGITAL IMAGE PROCESSING

(An automated radiographic absorptiometry system for quantitative rheumatoid arthritis assessment)

PRESENTED BY
AMEER BASHA
04391A0561 (3 4!"#) ameerbasha%u&yahoo'co'in

SANJEEVIAH
05395A050$(3 4!"#) san(eev)guru4$6&yahoo'co'in

*+,-A-." #-,+-##/+-, !011#,# *A21A342+

A5"6/A!6 Medical imaging is a field which researches and devel !s " ls and "echn l g# " ac$%ire& mani!%la"e and archive digi"al images which are %sed '# "he dimensi nal f%nc"i n & f& "ha" "a(es an in!%" "w s!a"ial c rdina"es ) and # and re"%rns a val%e f*)& #+, The val%e f*)& #+ is a gra# level f "he image a" "ha" ! in", The gra# level is als called "he in"ensi"#, Digi"al images are a discre"i-ed !ar"i"i n f "he s!a"ial images in" small cells which are referred " as !i)els . !ic"%re elemen"s, Digi"al image !r cessing is a field f r !r cessing digi"al images %sing a digi"al c m!%"er, Pr cessing f digi"al images incl%de !era"i ns inv lving digi"al images s%ch as ac$%isi"i n& s" rage& re"rieval& "ransla"i n& c m!ressi n& e"c, /%an"if#ing disease !r gressi n f !a"ien"s wi"h earl# s"age Rhe%ma" id Ar"hri"is *RA+ !resen"s s!ecial challenges, Es"a'lishing a r '%s" and relia'le me"h d "ha" c m'ines "he A0R cri"eria wi"h ' ne and s f"1"iss%e meas%remen" "echni$%es& w %ld ma(e ! ssi'le "he diagn sis f earl# RA and2 r "he m ni" ring f "he !r gress f "he disease, In "his !a!er and a%" ma"ed& relia'le and r '%s" s#s"em "ha" c m'ines "he A0R cri"eria wi"h radi gra!hic a's r!"i me"r# 'ased ' ne and s f" "iss%e densi"# meas%remen" "echni$%es is !resen"ed, The s#s"em is c m!rised f an image digi"i-a"i n c m! nen" and a%" ma"ed image anal#sis c m! nen", Radi gra!hs f "he hands and "he cali'ra"i n wedges are ac$%ired and digi"i-ed f ll wing a s"andardi-ed !r ced%re, The image anal#sis s#s"em segmen"s "he relevan" 3 in"s in" s f"1"iss%e and ' ne regi ns and c m!%"es densi"# val%es f each f "hese regi ns rela"ive " "he densi"# f "he reference wedges, Each f "he 3 in"s is als sc red '# "rained radi l gis"s %sing "he well es"a'lished A0R cri"eria, The res%l"s f "his w r( indica"e "ha" %se f s"andardi-ed imaging !r ced%res and r '%s" image anal#sis "echni$%es can significan"l# im!r ve "he relia'ili"# f $%an"i"a"ive meas%remen"s f r rhe%ma" id ar"hri"is assessmen", 4%r"herm re& "he me"h d l g# has "he ! "en"ial " 'e clinicall# %sed in assessing disease c ndi"i n f earl# s"age RA s%'3ec"s, 7ey8ords9 A%" ma"ed hand image anal#sis& Hand image segmen"a"i n& Radi gra!hic a's r!"i me"r#& Rhe%ma" id ar"hri"is

c n"en"s
+ntroduction 5, Hand ' ne densi"# 6, Hand radi gra!hic a's r!"i me"r# +3A,# A!:4+"+6+0-

Enhancemen" Image and Res" ra"i n

+3A,# A-A1;"+" 5, 0 n"r l ! in" !lacemen" 6, B ne ridge delinea"i n 7, 8edge !r file c m!%"a"i n #<=#/+3#-6A1 /#"416" 3416+=4/=0"# =A!7A,# >0/ 6?# 20!60/" (0ur !ontribution in 2igita@ +mage =rocessing) 1' ,oa@ of pro(ect %' +ntroduction to important terms 3' =ro(ect definition 4' !ode for enhancing the image siAe 2+"!4""+0- A-2 !0-!14"+0/#>#/#-!#"

1' +-6/024!6+00 nven"i nal e)amina"i n f "he hand radi gra!hs is well es"a'lished as a diagn s"ic as well as an %"c me meas%ree in Rhe%ma" id Ar"hri"is *RA+, I" is readil# availa'le and has 'een c rrela"ed wi"h meas%res f disease ac"ivi"# and f%nc"i n, 91 ra# changes are& h wever& his" rical ra"her "han !redic"ive& and "here is significan" 'server varia"i n in $%an"if#ing er sive changes, The earlies" radi gra!hic changes seen in "he hand are s f"1"iss%e swelling s#mme"ricall# ar %nd "he 3 in"s inv lved& 3%)"a1ar"ic%lar s"e ! r sis and er si n f "he :'are; areas f ' ne *i,e, areas lac(ing ar"ic%lar car"ilage+,These changes hel! " c nfirm "he !resence f an inflamma" r# !r cess, The !resence f earl# s f"1"iss%e swelling is easil# rec gni-ed n !lain radi gra!hs '%" n " readil# $%an"ified, Al"h %gh "he !resence f earl# s"e ! r sis is rec gni-ed in "he affec"ed hand& a mild s"e ! r sis ma# 'e e)"remel# s%'"le " "he e#es, The rec gni"i n f "he changes in s f"1"iss%e and ' ne densi"# is s%'3ec"ive and is (n wn " var# fr m assess r " assess r, Theref re& a""en"i n has 'een f c%sed n "he m re '3ec"ive er si n and 3 in" narr wing assessmen", <se f magne"ic res nance *MR+ "echni$%e has 'een sh wn " sensi"ivel# de"ec" earl# l cal edema and inflamma"i n !ri r " a ! si"ive finding n !lain film radi gra!hs, H wever& MR is an e)!ensive e)amina"i n and ma# n " 'e %sed as a r %"ine "echni$%e, Presen"l#& radi gra!hs f "he hands and wris"s are em!l #ed " assess disease !r gressi n, The !arame"ers %sed " de"ermine !r gressi n are "he changes in er si ns and 3 in"1s!ace narr wing 'served n "he radi gra!hs, There are s me !r 'lems wi"h ' "h f "hese !arame"ers, 4irs"& ' "h er si n and 3 in" narr wing are n " "he earlies" changes in RA and f%r"her "he# ma# 'e s%'s"an"iall# irreversi'le, Sec nd& "hese "w changes ma# cc%r inde!enden"l# f each "her, Third& "here is a "remend %s varia'ili"# in er sive disease= s me !a"ien"s never devel ! er si ns> s me g in" s! n"ane %s remissi n f "heir er sive disease> and f r s me& "he !r gressi n is relen"less, 4 %r"h& 3 in"1s!ace r car"ilage l ss ma# 'e ca%sed '# ei"her "he disease i"self r '# mechanical s"ress, Presen" sc ring me"h ds re$%ire "ha" an# degree f 3 in"1s!ace l ss 'e rec rded as a !r gressive change d%e " RA, /%an"i"a"ive "echni$%es c%rren"l# availa'le ma# !r vide a new a!!r ach in m ni" ring disease !r gressi n in !a"ien"s wi"h RA, Ad !"i n f "hese "echni$%es ma# have im!lica"i ns f r "he managemen" f !a"ien"s wi"h RA and f r ! ssi'le de"ec"i n f "he disease a" an earl# s"age, 1'1' ?and bone densitometry 0 nsidera'le advances have 'een made ver "he !as" "w decades in devel !ing radi l gical "echni$%es f r assessing ' ne densi"#, H wever> all f "hese "echni$%es have 'een %"ili-ed n aging1rela"ed s"e ! r sis& a !a"h l gical change inv lving general ' ne mineral red%c"i n, ?wing " "he wide availa'ili"# f D9A& recen"l# !%'lished research descri'es "he %se f Bone Mineral Density *BMD+ meas%remen"s in "he hands f !a"ien"s wi"h chr nic RA, M s" !%'lished 'serva"i ns n RA have e)amined BMD changes& f c%sing n nl# "he general ' ne l ss ar %nd "he 3 in"s, /%an"ifica"i n f "he difference f ' ne l ss 'e"ween "he 3%)"a1ar"ic%lar ' ne and "he shaf" f "%'%lar ' nes in "he hands c %ld 'e a sensi"ive inde) f r $%an"i"a"ive anal#sis f RA !a"ien"s, Hand BMD meas%remen"s ffer an 'server inde!enden" and re!r d%ci'le means f $%an"if#ing "he c%m%la"ive effec"s f l cal and s#s"emic inflamma"i n, The "echni$%e c %ld 'e f %se in "he assessmen" f !a"ien"s wi"h earl# RA& in wh m c nven"i nal meas%res f disease are n " hel!f%l %n"il disease is *irreversi'l#+ m re advanced, 1'%' ?and radiographic absorptiometry

In c nven"i nal Radiographic Absorptiometry, radi gra!hs f "he hand are ac$%ired wi"h reference wedges !laced n "he films, The films are and s%'se$%en"l# anal#-ed %sing an !"ical densi" me"er, The res%l"ing densi"# val%es c m!%"ed '# "he densi" me"er are cali'ra"ed rela"ive " "ha" f "he reference wedge and are e)!ressed in ar'i"rar# %ni"s, Recen" im!r vemen"s in hardware and s f"ware availa'le f r digi"al image !r cessing have led " "he $%an"i"a"ive assessmen" f radi l gical a'n rmali"ies in diagn s"ic radi l g#, S%ch im!r vemen"s have als ena'led in"r d%c"i n f several radi gra!hic a's r!"i me"r# "echni$%es, ?ne s%ch "echni$%e %ses cen"rali-ed anal#sis f hand radi gra!hs and averages "he BMD f "he sec nd " f %r"h middle !halanges, An "her "echni$%e devel !ed in Ja!an %ses "he dia!h#sis f "he sec nd me"acar!al " de"ermine BMD, A "hird "echni$%e devel !ed in E%r !e meas%res "he dia!h#sis and !r )imal me"a!h#sics f "he sec nd middle !halan), Based n !%'lished sh r"1"erm !recisi n err rs& c m!%"er1assis"ed Radi gra!hic A's r!"i me"r# a!!ears " 'e s%i"a'le f r "he meas%remen"s f "he BMD f !halanges and me"acar!als& and is %sed in several h%ndred cen"ers w rldwide, In "his w r( we !resen" !reliminar# res%l"s f an ng ing research w r( aimed a" devel !ing an a%" ma"ed radi gra!hic a's r!"i me"r# s#s"em f r "he assessmen" and m ni" ring f ' "h BMD and s f" "iss%e swelling in earl# s"age RA, This !a!er f c%ses n "he re!r d%ci'ili"# and acc%rac# f "he me"h d l g# 'eing devel !ed, The !a!er is rgani-ed as f ll ws= "he ne)" sec"i n !r vides an verview f "he image ac$%isi"i n !r ced%re, In sec"i n 7 "he image anal#sis alg ri"hms %sed in "his w r( are !resen"ed, In sec"i n @ we !resen" res%l"s '"ained '# anal#-ing "he da"a c llec"ed in a small re!r d%ci'ili"# s"%d# inv lving 5A n rmal s%'3ec"s, %' +3A,# A!:4+"+6+0?ne (e# fac" r infl%encing "he %"c me f an# radi gra!hic a's r!"i me"r# "echni$%e is "he s"andardi-a"i n f "he image ac$%isi"i n "echni$%e, Varia'ili"# in ac$%isi"i n !arame"ers can significan"l# affec" "he meas%red val%es, In rder " carr# %" "his w r(& a s"andard image ac$%isi"i n !r " c l was defined, This !r " c l has 'een s%ccessf%ll# %sed in earlier large scale m%l"ina"i nal !hase 7 clinical "rials f r Rhe%a" id Ar"hr"is rela"ed dr%gs, Radi gra!hs f "he lef" and righ" hands are "a(en ne a" a "ime, Tem!la"es were devel !ed " g%ide "he ! si"i ning f "he hand wi"h res!ec" " "he cen"er f "he )1ra# 'eam, The 91ra# 'eam was cen"ered 'e"ween "he 6nd and 7rd me"acar! 1!halangeal 3 in"s and angled a" BAC " "he film s%rface, This res%l"s in a "angen"ial image f "he 3 in"s, Im!r !er 'eam cen"ering generall# res%l"s in verla!!ing 3 in" margins, The 91ra# e)! s%re !arame"ers were main"ained c ns"an" f r all s%'3ec"s, All n rmal s%'3ec"s were imaged a" "he same clinic a" <0S4, In addi"i n " !r viding a "em!la"e f r hand ! si"i ning& "w se"s f cali'ra"i n wedges were als !r vided " "he clinic, Each se" f wedges c nsis"ed f ne Acr#lic wedge& f r s f" "iss%e and ne Al%min%m wedge f r ' ne "iss%e, These wedges were c%s" m designed f r "he !%r! ses f "his research w r(,

>igure1'Tem!la"e %sed "

! si"i n "he lef" hand acc rding "

"he s"andardi-ed !r " c l,

7,Enhancemen" Image and Res" ra"i n

The image a" "he lef" f 4ig%re 5 has 'een c rr%!"ed '# n ise d%ring "he digi"i-a"i n !r cess, The DcleanD image a" "he righ" f 4ig%re 5 was '"ained '# a!!l#ing a median fil"er " "he image,

>igure 1' App@ication of the median fi@ter An image wi"h ! r c n"ras"& s%ch as "he ne a" "he lef" f 4ig%re 6& can 'e im!r ved '# ad3%s"ing "he image his" gram " !r d%ce "he image sh wn a" "he righ" f 4ig%re 6,

>igure %' Ad(usting the image histogram to improve image contrast

3'+3A,#A-A1;"+" ?ne f "he ma3 r diffic%l"ies in anal#-ing hand radi gra!h images is "he high level f n ise !resen" in "he images, Addi"i nall# "he "ra'ec%lar "e)"%re f "he hand in "he vicini"# f "he 3 in"s increases "he n ise in edge ma!s f "his regi ns, <se f n n1 s"andard ac$%isi"i n !r " c l can add addi"i nal challenges a" i" can res%l" in f%r"her degrada"i n f image $%ali"#, This las" challenge is minimi-ed in "his w r(& as a s"andard image ac$%isi"i n !r " c l is f ll wed, Eiven a !ar"ic%lar a!!lica"i n var#ing degrees f acc%rac# in ana" m# segmen"a"i n can 'e c nsidered acce!"a'le, 4 r ins"ance in de"ec"ing 3 in"1s!ace narr wing "here is a need f r acc%ra"e and relia'le de"ermina"i n f "he 3 in"1s!ace f an# finger and "he ' ne edges in "his regi n, H wever& acc%ra"e delinea"i n f "he ' ne edges in "he vicini"# f "he 3 in" is n " as relevan", De!ending %! n "he a!!lica"i n "here can 'e addi"i nal c ns"rain"s n !erf rmance iss%es as well, In an a!!lica"i n f r which ff1line !r cessing f "he da"a is acce!"a'le& m re s !his"ica"ed alg ri"hms can 'e em!l #ed, This !ar"ic%lar a!!lica"i n re$%ires "ha" "he verall !r cess 'e fas"& acc%ra"e and re!r d%ci'le en %gh f r n1line !r cessing, Acc%ra"e es"ima"i n f "he ' ne edges in "he middle shaf" and in "he 3 in" vicini"# f high relevance in "his w r(, This is !rimaril# 'eca%se "he disease !r gressi n f ll ws differen" !a""erns in "he 3 in" area as c m!ared " "he middle !halange area, Als & "he manifes"a"i ns f "he disease s#m!" ms in i"s earl# s"age have differen" effec"s n s f"1"iss%e and ' ne as well& which re$%ire relia'le segmen"a"i n f "hese "w "#!es f "iss%e a" differen" "ime ! in"s, The alg ri"hm f r hand segmen"a"i n can 'e %"lined in" "he f ll wing main s"ages= F Hand %"line delinea"i n F J in" iden"ifica"i n F B ne %"line delinea"i n F Segmen"a"i n f s f" "iss%e and ' ne The firs" s"age f "he alg ri"hm has 'een well s"%died in "he li"era"%re and is n " descri'ed here, The sec nd s"age can 'e m re challenging& es!eciall# when dealing wi"h hands f !a"ien"s in advanced s"age f disease !r gressi n, As "his s#s"em will 'e a!!lied " a !a"ien" ! !%la"i n "ha" is in "heir earl# disease s"age i" is e)!ec"ed "ha" "he 3 in"s will 'e well defined, The s#s"em !r vided " "he radi l gis"s all ws "hem " ad3%s" "he l ca"i n f "he a%" ma"icall# iden"ified 3 in"s, Res%l"s

!resen"ed in "his w r( were '"ained '# having "he radi l gis"s !lace c n"r l ! in"s " iden"if# "he 3 in"s& ra"her "han having "hem a%" ma"icall# c m!%"ed '# "he s#s"em, 3'1' !ontro@ point p@acement A sim!le %ser in"erface was !r vided " ena'le !lacemen" f c n"r l ! in"s n "he 3 in"s, This was !rimaril# d ne " inves"iga"e "he sensi"ivi"# f "he s#s"em " "he ini"ial c n"r l ! in" ! si"i ning& which in an a%" ma"ed s#s"em w %ld invaria'l# 'e "he same f r "he same image, The %ser !laced 5G c n"r l ! in"s n each image, These 3 in"s are sh w in 4ig%re @, In addi"i n " !lacing "he c n"r l ! in"s f r "he 3 in"s& "he c n"r l ! in"s f r "he "w wedges are als !laced '# "he radi l gis"s, 4 r each wedge& si) c n"r l ! in"s are !laced wi"h f %r a" "he c rners and "w in "he middle, ?nce all "he c n"r l ! in"s are !laced& "he remaining s"e!s f "he generali-ed alg ri"hm s"a"ed a' ve are carried %" a%" n m %sl#, The middle !halange r c r"e) c n"r l ! in"s are c m!%"ed a%" ma"icall# and are l ca"ed a" "he middle f s"raigh" line c nnec"ing "he "w 3 in"s& ne a' ve and ne 'el w "he middle !halange, The diame"ers f "he circ%lar regi ns f in"eres" !laced ar %nd each 3 in" are c m!%"ed !r ! r"i nall# " "he leng"h f "he fingers, He" ji 'e "he c n"r l ! in"s !laced a" "he 3 in"s and mi 'e "he c n"r l ! in"s !laced a" "he c r"e) f "he !halanges, The dis"ance di 'e"ween 3 in" ji and ji+4 is given '#= *5+ In "he e$%a"i n a' ve jix and jiy are "he x and y c rdina"es f "he c n"r l ! in" j res!ec"ivel#, Als i and i+4 are inde)es f r "w 3 in"s n "he same finger& as nl# "he 3 in"s n "he fingers are %sed in "his w r( and n " "he "h%m', <sing "he dis"ance c m!%"a"i ns a' ve "he radi%s rij f r "he Region of Interest *R?I+ !laced a" "he 3 in" ji and rim f r "he R?I !laced ar %nd "he c r"e) mi is given '#=
i

*6+

and *7+

The res%l"ing R?Is are larger ar %nd "he 3 in"s and are smaller ar %nd in "he middle !halange& #e" "he# all c ver ' ne and s f"1"iss%e evenl#, 3'%' 5one ridge de@ineation Ini"iall# "he en"ire hand image is e$%ali-ed %sing "he gra# scale dis"ri'%"i n f "he regi n f in"eres" ar %nd 5s" M0P, This !r ced%re enhances "he ' ne areas and s f"1"iss%e areas f "he hand and s%!!resses an# "her de"ails, This !r vided an image wi"h "he 'es" c n"ras" 'e"ween ' ne and s f" "iss%e regi ns, ?nce "he image is e$%ali-ed a s"andard S 'el gradien" de"ec"i n alg ri"hm is a!!lied, The res%l"ing image has well defined ridges f "he ' ne al ng wi"h "her edges "ha" re!resen" "he ' ne "ra'ec%lar s"r%c"%re,

4 r each middle !halange c n"r l ! in" mi& "he ' ne ridges are iden"ified '# "raversing "he finger a)is f rmed '# c nnec"ing 3i and 3i+4& in a direc"i n !er!endic%lar " "ha" f "he a)is& as sh wn in 4ig%re 6, The finger ana" m# is ver# well defined in "his regi n, A !i)el is defined " 'e n "he ridge& if a" "ha" each !i)el "he in"ensi"# ranges f "he edge ma! and f "he riginal image& is ma)imal c m!ared " all "her !i)els 'e"ween "his ne and "he ne f "he finger a)is,

>igure %' 0 m!%"a"i n f a ! in" n "he ' ne edge, He" rk 'e "he ! in"s n "he ridge c rres! nding " a se" f ! in"s m k "ha" are in a neigh' rh d f "he ! in" mi and n "he finger a)is, Then "he average f "he dis"ance 'e"ween mk and mk is %sed " define "he ' %nds wi"hin which a ' %ndar# "racing alg ri"hm can 'e %sed " "rac( "he res" f "he ' ne ridge f r "his sec"i n f "he finger, The s#s"em f ll ws "he shaf" f "he finger fr m "he middle !halange " "he 3 in" a' ve and scans !er!endic%lar " "his direc"i n and iden"ifies "he ridge ! in"s, The same !r ced%re is re!ea"ed f r "he !ar" "ha" c nnec"s "he middle !halange " "he 3 in" 'el w, A" "he end f "hese !r ced%res an ini"ial es"ima"e f "he finger;s ' ne ' %ndar# is de"ec"ed, The ne)" s"e! is " scan "he ' %ndar# ! in"s and discard an# %"liers, ?wing " "he sm "hness f "he ' ne c n" %rs& a I"h rder Be-ier S!line is fi" " "he c n" %r da"a, ?nce "his is c m!le"ed& "he res%l"ing ridge c n" %rs are !resen"ed " "he radi l gis", A" "his ! in" "he radi l gis" is als !r vided wi"h a " l " Jfi)K an# severe err rs "ha" are 'served in "he ' ne %"lines, These err rs are generall# f %nd cl se " "he 3 in"& where "he edge dis"ri'%"i n is $%i"e n is#, This sim!lis"ic a!!r ach !r vides a ver# fas" and acc%ra"e mechanism " genera"e "he ' ne ' %ndar# %"lines, Perha!s a m re s !his"ica"ed alg ri"hm can 'e em!l #ed& a" "he e)!ense f l nger e)ec%"i n "ime& " f%r"her im!r ve "he ' %ndar# in "he vicini"# f "he 3 in", H wever "he res%l"s '"ained n "he n rmal ! !%la"i n s%gges" "ha" "his me"h d is s%fficien" " !r vide a high degree f re!r d%ci'ili"#, ?nce "he c n" %rs are acce!"ed& "he s#s"em a%" ma"icall# segmen"s "he ' ne regi n and "he s f"1"iss%e regi ns %sing "he %"lined c n" %rs and !r vides an es"ima"e f "he average densi"# f each f "hese regi ns in %ni"s f e$%ivalen" densi"# c m!%"ed fr m "he cali'ra"i n wedges, 3'3' Bedge profi@e computation The "w reference wedges imaged al ng wi"h "he hand !r vide an e$%ivalen" densi"# val%e f r each R?I n "he hand, The Acr#lic wedge is %sed " c m!%"e "he s f"1"iss%e densi"# while "he Al%mini%m wedge is %sed " c m!%"e ' ne densi"#, In rder " '"ain relia'le es"ima"es f "he e$%ivalen" densi"ies an average !r file is c m!%"ed f r each wedge, He" !k 'e a vec" r f !i)el in"ensi"ies acr ss a line inside

"he wedge& !arallel " "he l ng edge f "he wedge, The average !r file f r "he wedge is given '#

8here w L Acr#lic r Al%mini%m *@+ ?nce "he average !r file is c m!%"ed a linear regressi n m del is c m!%"ed " re!resen" "he average wedge !r file as a f%nc"i n f "he heigh" f "he wedge, <sing "his regressi n m del& f r an# given gra# val%e an e$%ivalen" heigh" n "he wedge can 'e c m!%"ed& and "his can 'e in i"self ass cia"ed " "he e$%ivalen" densi"# f "he wedge f r "ha" gra# val%e,

>igure 3' Vari %s s"ages f "he ' ne delinea"i n s"e!, 4r m lef" " righ"= riginal image& "w 3 in" and ne middle !halange c n"r l ! in"s& his" gram e$%ali-ed image& S 'el gradien" edge ma!& edges c m!%"ed al ng wi"h I"h rder Be-ier c%rve fi"& segmen"ed ' ne and s f" "iss%e regi ns, 4' #<=#/+3#-6A1 /#"416" A small s"%d#& inv lving 5A n rmal s%'3ec"s& was c nd%c"ed a" <0S4 " de"ermine "he re!r d%ci'ili"# and acc%rac# f "he "echni$%e 'eing devel !ed, The average age f "he !a"ien"s was @I,5 #ears, The # %nges" and ldes" s%'3ec"s were 76 and MN #ears ld res!ec"ivel#, Hef" and righ" hands f each s%'3ec" were imaged "wice, 4 r ne f "he s%'3ec"s d%ring "he firs" ac$%isi"i n ne se" f wedges was em!l #ed& and d%ring "he sec nd ac$%isi"i n a differen" se" f wedges was re$%ired, This was d ne " 'serve an# varia'ili"# in"r d%ced '# changing "he wedges, Tw dis"inc" %sers& ne radi l gis" and ne "echnician anal#-ed "he se" f @A images, 8hile "he radi l gis" was a "rained e)!er"& "he "echnician was "rained nl# n "he %se f "he s#s"em, In 4ig%re Ga and G' "he final ' ne ridge %"lines and segmen"a"i n res%l"s f r a lef" hand are sh wn, As "he res%l"s f r lef" and righ" hands were similar& nl# res%l"s f r "he lef" hand are !resen"ed, The c efficien" f variance *0V+ was c m!%"ed as f ll ws67= *M+ The s#s"em %sed in "his w r( was devel !ed %sing "he NIH1Image2J s f"ware, A se" f J!l%ginK m d%les were wri""en f r "he Image2J !ac(age& and s me c%s" mi-a"i n f "ha" s %rce c de was d ne " acc mm da"e m%l"i!le regi n1 f1 in"eres"s, The e$%ali-a"i n and edge de"ec"i n r %"ines descri'ed in sec"i n 7 are all !ar" f "he s"andard ImageJ !ac(age, In"ra1reader varia'ili"# was accessed '# c m!aring "he res%l"s f each reader f r reading each R?I and als !er !a"ien", 4ig%re @a and @' sh w "he 0V f r each R?I and each !a"ien" res!ec"ivel# f r "he e)!er" reader, In"er1reader varia'ili"# was accessed '# c m!aring "he res%l"s f ne reader agains" "ha" f "he "her, 4ig%re Ma and M'& sh w "he in"er1reader 0Vs f r each R?I and f r each !a"ien" res!ec"ivel#, In each f "hese char"s& 0V1S f"av and 0VOB neav re!resen" "he 0Vs c m!%"ed n

average gra#1scale meas%remen"s n s f" "iss%e and ' ne regi ns in "he segmen"ed R?Is, Meanwhile& "he 0VOS f"Od and 0VOB neOd re!resen" "he c rrec"ed val%es f 0VOS f"av and 0VOB neav %sing "he Acr#lic and Al%m#ni%m wedge !r files res!ec"ivel#, As an verall es"ima"e f r an# given !a"ien"& "he average 0V f r an individ%al reader is 7,AP and "he average 0V f r in"erreader acc%rac# is a' %" @,A P, >igure 5b' Hef" hand in"er1reader 0Vs !er !a"ien", Each se" f 'ars in ' "h f "he char"s a' ve is gr %!ed fr m lef" " righ" as 0VOS f"av& 0VOB neOav& 0VOS f"Od&

!*)bone)d' >igure 6a' A sam!le lef" hand wi"h all "he ' ne ridges %"lined '# "he s#s"em and "he "w wedges %"lined '# "he radi l gis",

>igure 6b' Segmen"a"i n res%l" f "he hand in 4ig%re Ga,

6' 3416+=4/=0"# =A!7A,# >0/ 6?# 20!60/" (0ur !ontribution in 2igita@ +mage =rocessing) This is a !r 3ec" we are w r(ing a", This !r d%c" will 'e %sef%l f r "he d c" rs w r(ing in vari %s s!eciali-a"i ns, 8e have rgani-ed %r !r 3ec" in "he f ll wing wa#s=1

1' ,oa@ of pro(ect9 Medical imaging is a field which researches and devel !s " ls and "echn l g# " ac$%ire& mani!%la"e and archive digi"al images which are %sed '# "he medical !r fessi n " !r vide 'e""er care " "he !a"ien"s, The g al f %r !r 3ec" is " '%ild a !ac(age %sef%l f r d c" rs w r(ing in vari %s s!eciali-a"i ns, This !r d%c" is aimed " enhance "he image si-e '# "a(ing "he image in 'lac( and whi"e m de, Th%s aimed " iden"if# and enhance "he e)is"ence f an# flaws in "he ' nes& !im!les n face and even "he s! "s and mar(s n face e"c, %' +ntroduction to important terms9 Pr cessing f digi"al images incl%de !era"i ns inv lving digi"al images s%ch as ac$%isi"i n& s" rage& re"rieval& "ransla"i n& c m!ressi n& e"c, Image Ac$%isi"i n= image is ac$%ired and 'r %gh" in" "he s#s"em *digi"al camera& 0AT scan+ %s%all# re$%ires !re!r cessing& e,g,& scaling& sam!ling Image Enhancemen"= image is made clear " "he %ser '# enhancing s me f "he fea"%res f "he image "his is a s%'3ec"ive !era"i n *i" l (s g d+ Image Res" ra"i n= image is im!r ved1 "his !era"i n is '3ec"ive *e,g,& n ise rem val+ 0 l r Pr cessing= image c l rs and c l r "ransf rma"i n e,g,& fr m dis!la# c l r s!ace *red green and 'l%e+ in" hardc !# !rin"ing s!ace *c#an& magen"a and #ell w+, 0 m!ressi n= image archive si-e is red%ced *s" rage& "ransmissi n+ err r free& and err r !r%ne c m!ressi n Segmen"a"i n= image is !ar"i"i ned in" fea"%res *e,g,& ' %ndar# f '3ec"s+ Re!resen"a"i n= e)"rac" fea"%res are s" red %"side "he image Rec gni"i n= image '3ec"s are 'eing iden"ified *e,g,& liver& (idne#s& s!ine+ 3' =ro(ect definition 8e are !lanning %r !r 3ec" " 'e ver# %sef%l f r "he d c" rs w r(ing in vari %s s!eciali-a"i ns& in s!i"e f "heir illi"erac# " "he c m!%"er, ?%r !ac(age will all w "he d c" rs " c nver" "he gre# scale image in" "he 'inar# image and iden"if# "he flaws, A ver# %ser friendl# E<I s%!! r" will 'e "here, 4irs" "he image will 'e c nver"ed in" "he !i)el n%m'ering and "hen "he n%m'ering will 'e %sed f r "he 'inar# image genera"i n, 4 r "his we will 'e %sing "he f ll wing me"h ds1 5, Binar# image '# median= "he median val%e f "he !i)el val%es is iden"ified and "he val%es "ha" are grea"er "han "he median are given high in"ensi"# and "ha" having less "han "ha" will 'e given "he l w in"ensi"#, Th%s we will '"ain "he 'inar# image which will 'e %sed f r enhancing "echni$%es, 6, Binar# image '# Thresh ld= The "hresh ld is iden"ified '# rand m n%m'er !ic(ing r "he average f "he !i)el val%es is iden"ified and "ha" is %sed f r "he f%r"her !r cessing, 7, Ere# level image wi"h 76 differen" levels= The range f r "he levels fr m A " B and A " V are given and "he !i)els are given val%es acc rding " "he regi ns in" which "he# fall in" , And an image is genera"ed which is having a less reflec"i n c m!ared " "he riginal high res l%"i n gre# levels image, 4' !ode for enhancing the image siAe9 The c de we have genera"ed will "a(e "he val%es f !i)els fr m a file f !i)els and %ses "hem " genera"e "he 'inar# image, Here we have f ll wed "he "hresh ld me"h d and "he "hresh ld val%e is iden"ified acc rdingl#,

The c de %sef%l in c lang%age is Q 22This is "he m d%le f r c nver"ing "he gre# level image " a 'inar# image '# "hresh ld me"h d, Rincl%deSs"di ,hT Rincl%deSc ni ,hT Rincl%deSgra!hics,hT main*+ U in" i&3&"h&gd&gm&'in> in" imageVG@WVG@W> l ng in" s%mLA> char ch> fl a" avg> 4IHE Xf!> gdLDETE0T> ini"gra!h*Ygd&Ygm&KK+> f!Lf !en*Jd=Zlin,")"K&KrK+> if*f!LLN<HH+ !rin"f*J4ile N " ?!enK+ f r*iLA>iSG@>i[[O f r*3LA>3SG@>3[[+ U chLge"c*f!+> imageViWV3WLch> s%mLs%m[ch> 22S%m f gre# levels \ avgL*ingZ"+*s%m2*G@XG@,A++>22Thresh ld genera"i n f r*3LA>3SG@>3[[+ U if*imageViWV3WTavg+ 'inLA> else 'inL5M> !%"!i)el*i[6A&3[6A&'in+> \ ge"ch*+> cl segra!h*+> fcl se*f!+> \

5' 2+"!4""+0- A-2 !0-!14"+0In "his !a!er a radi gra!hic a's r!"i me"r# 'ased me"h d l g# was !resen"ed " acc%ra"el# and relia'l# es"ima"e "he densi"# f s f"1"iss%e and ' ne, The res%l"s !resen"ed here f c%sed n "he re!r d%ci'ili"# f s%ch meas%remen"s in a n rmal s%'3ec" in1viv s"%d#, ?ne as!ec" " n "e is "ha" ne f "he readers in "his w r( was a

"echnician, This s%gges"s "ha" in a r %"ine clinical se""ing& "here w %ld 'e n need " inv lve a radi l gis" " carr# %" s%ch a !r ced%re, A "rained "echnician w %ld 'e a'le " !r vide es"ima"es as relia'le as an e)!er" reader w %ld, The res%l"s !resen"ed here are !reliminar# and f c%sed nl# "he re!r d%ci'ili"# as!ec"s f "he "echni$%e, I" sh %ld 'e n "ed h wever& "ha" des!i"e having man%al in!%"s in "he c n"r l ! in" !lacemen" s"age& "he meas%remen"s were highl# re!r d%ci'le, 8hile "here is alread# w r( d ne " a%" ma"e "he !lacemen" f "he 3 in" c n"r l ! in"s& f%r"her w r( incl%des a%" ma"ing "he wedge !r file c n"r l ! in" !lacemen", B# "a(ing "hese s"e!s i" is e)!ec"ed "ha" "he re!r d%ci'ili"# f "he s#s"em will 'e f%r"her enhanced, I" is als n " clear if "here is a need f r s f"1"iss%e densi"# c rrec"i n " 'e a!!lied " "he ' ne densi"# es"ima"es, This is 'eca%se "he densi"# val%es f "he ' ne incl%de s me frac"i n f s f"1"iss%e densi"ies as well, M s" e)is"ing c rrec"i n "echni$%es re$%ire "he %se f a m del f r "he fingers& and "ha" in i"self can lead " in"r d%cing m re err rs in "he densi"# es"ima"e, The sensi"ivi"# f "he "echni$%e in $%an"if#ing changes %nderg ne '# a s%'3ec" d%ring "he earl# s"ages f "he disease is als n " #e" well defined, This "echni$%e is 'eing a!!lied " wards m ni" ring earl# s"age rhe%ma" id ar"hri"is !a"ien"s in an ng ing clinical "rial, Res%l"s '"ained fr m "he clinical "rial da"a sh %ld !r vide a 'e""er %nders"anding f s%ch sensi"ivi"# !arame"ers, /#>#/#-!#" 5, 4ries J,4,& Bl c( D,A,& Shar! J,T, e" al, Assesment of radiologic progression in rhe"matoid arthritis# A randomi$ed, controlled trial, Ar"hri"is Rhe%m 5BNG>%9>51B 6, Shar! J,T,& 8 lfe 4,& Mi"chell D,M,& Bl ch D,A,& %he progression of erosion and joint space narro&ing scores in rhe"matoid arthritis d"ring the first t&enty'fi(e years of disease# Ar"hri"is1Rhe%m, 5BB5> 34> GGA1N 7, Van Hee%wen M,A& van Ri3swi3( M,H& vander Hei3de D,M& e" al # %he ac"te'phase response in relation to radiographic progression in early rhe"matoid arthritis) a prospecti(e st"dy d"ring the first three years of the disease , Br J, Rhe%ma" l 5BB7> 3%*s%!!l, 7+> B157 @, E'erhard" ],B& Tr%edss n H& Pe""erss n H,& e", al, Disease acti(ity and joint damage progression in early rhe"matoid arthritis) relation to Ig*, IgA, and IgM rhe"matoid factor# Ann Rhe%m Dis 5BBA> 49> BAG1B M, Van Hee%wen M,A& vander Hei3de D,M& van Ri3swi3( M,H, e" al # Interrelationship o"tcome meas"res and process (ariables in early rhe"matoid arthritis# A comparison of radiologic damage, physcial disability, joint co"nts, and ac"te phase reactants# +# Rhe"matol 5BB@> %1> @6M1B G, Ma(isara E,H,& Ma(isara P,& ,rognosis of f"nctional capacity and &ork capacity in rhe"matoid arthritis# 0lin, Rhe%m, 5BN6>1=55I16M I, N^rgaard& 4,& -arliest roentgenological changes in polyarthritis of the rhe"matoid type) rhe"matoid arthritis# Radi l g#& 5BGM>$5= !, 76M16B, N, Mar"el& 8,& J,T, Ha#es& and I,4, D%ff& %he pattern of bone erosion in the hand and &rist in rhe"matoid arthritis Radi l g#,& 5BGM>$4= !, 6A@15@,