2014 International Conference on Electronics and Communication System (ICECS -2014

An Effective Automated System in Follicle
Identification for Polycystic Ovary Syndrome
Using Ultrasound Images
Ranjitha Sitheswaran
! Student" #e$artment of ECE
%& S& Ran'asamy Colle'e of (echnolo'y
)ama**al" India
rofessor" #e$artment of ECE
% &S& Ran'asamy Colle'e of (echnolo'y
)ama**al" India

Abstract—Polycystic Ovary Syndrome is a common disorder
which is caused by the formation of many follicles in the ovary. It
seriously affects womens health. An automated diagnostic
system is used to detect such follicles in the ovary region. !he
effective and automated method for the com"uter#aided
diagnosis of P$OS using ovary ultrasound images is "resented.
!he method is detecting the follicles using ob%ect growing. It
consists of two ma%or stages including "re"rocessing "hase and
follicle identification based on ob%ect growing. !he s"ec&le noise
in the in"ut P$OS ultrasound image is reduced using median
filter. After reducing the s"ec&le noise' the local minimum is
e(tracted which re"resents the "ossible follicles using enhanced
labeled watershed algorithm and the region of interest is selected
to ma&e the segmentation "art an easier one. !he ob%ect growing
algorithm selects the ob%ects that are li&ely to be follicles and thus
the follicles are detected.
Keywords— Detection of follicles; Ultrasound Images;
Polycystic Ovary Syndrome.
I& I)(R,#-C(I,)
C,S ($olycystic o.ary syndrome) / $olycystic o.ary
syndrome" is a .ery com$le0 disease that affected the o.aries&
12out 34 $ercent of $atients with this syndrome ha.e
$ro2lems with o.ulation& In this disease" amon' other thin's"
creates a num2er of cysts or small ca.ities that are filled with
li5uid& (he o.aries are enlar'ed" with a lar'e num2er of
follicles on the surface& (he follicles are filled with fluid that
surrounds the oocyte& C, are o.aries which contain an
e0cessi.e num2er of $rimordial follicles& (hese follicles are
tiny fluid-filled sacs which contain the e''s& -ltrasounds of
the o.aries durin' the re$roducti.e years usually show" on
a.era'e" 4-12 follicles in each o.ary& 6hen more num2er of
follicles is $resent" the o.ary is called 7$olycystic7. In a healthy
o.ary" it is normal to ha.e fi.e follicles de.elo$ in the o.ary
each month& (here are some conditions of the o.ary which
increase the num2er of monthly follicles to as much as
$ossi2le& (he correct num2er of follicles in the o.ary is critical
for women who are tryin' to concei.e& (oo many follicles in
the o.ary or not enou'h follicles can cause $ro2lems with
fertility& olycystic o.arian syndrome is a condition that
causes lots of small" harmless cysts to de.elo$ on your
o.aries& (he cysts are caused 2y a $ro2lem with the 2alance of
hormones that are $roduced 2y the o.aries& (he tedious and
time consumin' nature of manual o$erations for doctors may
cause the inaccuracy of the C,S dia'nosis" which could
seriously affect the women8s health& (hese $ro2lems can 2e
o.ercome 2y an intelli'ent C,S dia'nostic system which
automatically identifies follicles 2ased on o2ject 'rowin'&
II& RE91(E# 6,R%S
(he related $a$ers of follicle detection ha.e many
researches and wor*s in different as$ects in the follicle
identification was carried out& Siddharth Samsi :;< $ro$osed a
method for the detection of follicles in I=C slides 2ased on the
a$$roach of usin' color and te0ture features to identify
$otential follicle re'ions& =owe.er" fittin' an elli$se to a
follicle is not always o$timal since the sha$e of the follicles
can .ary si'nificantly de$endin' on the tissue 2y e0tendin'
the wor* 2y usin' different color and te0ture measures for
identifyin' follicles& >ollicular 9ym$homa 'radin' is 2ased on
the num2er of centro2lasts in ten random standard
microsco$ic =>s (hi'h $ower fields ) re$resentin' mali'nant
follicles in the =?E (hemato0ilin ?eosin) -stained tissue& I=C
stains hel$ identify follicle re'ions in tissue which are then
re'istered with the =?E ima'e which is used for the
dia'nosis& @ut it leads to e0cessi.e se'mentation&
In Centro2lasts detection :3< a ada$ti.e li*elihood 2ase
cell se'mentation& =?E-stain colors nuclear and cyto$lasmic
re'ions to hues of 2lue and $ur$le while $rotein-rich colla'en
structures such as e0tracellular material is colored into hues of
$in*& Initially" the in$ut ima'e is con.erted to 1-# unitone
ima'e usin' rinci$le Com$onent 1nalysis& -sin' the
estimated $arameters of the unitone .alues" cellular /
li*elihood ima'e is constructed& (he 'ray-le.el run len'th
matri0 method to o2tain a statistical measure of the s$atial
or'aniAation of intensity .ariations within each cell& Initially
the detected C@ cells ha.e uni5ue te0ture features clustered
densely" while the features of non C@ cells clearly di.er'e
from this dense cluster& (he s$ec*le noise is a major
contamination of the -ltrasound ima'es which is dealt in :1<"
:2<" :4<& )oise reduction com$rises of $re-$rocessin' ste$s&
@ut in this $a$er" alon' with noise reduction R,I selection is
com$uted to ma*e the detection an easier one&
In the dia'nostic system of detectin' tumors :11<" a
method 2ased on successi.e a$$lication of le.el set cur.e
e.olution" a no.el iterati.e conca.ity inde0" and a recursi.e
2014 International Conference on Electronics and Communication System (ICECS -2014)
controlled watershed techni5ue is chosen& (hese methods are
2ased on elli$se fittin' in e0istin' systems and a conca.ity
inde0-2ased sha$e analysis" recursi.e watershed" color
identification and >ourier sha$e re$resentation are used&
Similarly se.eral other methods are used& Since there is no
$ro$er e0traction" the se'mentation may 2ecome a com$le0
one and also the 9e.el set method :4<" 2oundary .ector field
method also has their reco'nition rate in an inefficient manner&
=owe.er" the 2oundary of the o.aries is not salient and
follicles may a$$ear as local minima which ma*e these
methods unsuita2le for the $ur$ose of follicle detection& (hese
classification 2ased methods did not ta*e into account the
characteristics of the o.ary re'ion and the connecti.ity or
nei'h2ourhood 2etween follicles& (o achie.e 2etter results for
follicle identification" it needs to consider the $ro$erties of
follicles" the 2oundary information of the o.ary and the
different re'ion information in the o.ary ultrasound ima'e&
III& 1ER ,BERBIE6 1)# C,)(RI@-(I,)
(he $rocess consists of .arious ste$s as follows"
• (he first ste$ includes the $re $rocessin' $hase in
reducin' the s$ec*le noise reduction&
• (he ne0t ste$ in.ol.es the e0traction of local minima&
• (hen the ne0t ste$ follows the Re'ion of Interest
• 6ith the selected R,I" the follicle identification
2e'ins with Cost ma$ construction&
• (he final ste$ in.ol.es the o2ject 'rowin' sta'e
where the o2jects are 'rown and the follicles are
detected& =ere the o2jects are referred as follicles&
(he o.erall wor*flow is shown in >i'& 1
A. Median Filtering
(o enhance the 5uality of the ima'e" re-$rocessin' is
done& (he $re$rocessin' $hase includes median filterin' for
s$ec*le noise reduction" e0tractin' the local minimum to find
the $ossi2le follicles and findin' the re'ion of interest& =ere
the median filter is used to su$$ress s$ec*le noise for
e0traction of local minima&
B. Local Minima Extraction
(o e0tract local minima where the follicles can $ossi2ly
a$$ear" enhanced la2eled watershed al'orithm is used& It
2e'ins with So2el ed'e detection of the des$ec*led ima'e& 1n
Euclidean transform is a$$lied to o2tain IminCdist which is used
as a la2el mas*& (o com$ute the watershed 2oundary"
mor$holo'ical closin' o$eration is done usin' D0D structurin'
element& (he watershed 2oundary of the resultin' ima'e is
com$uted& (he e0tracted watershed 2oundaries are the
contours of o2jects and some may contain follicles&
>ollicle Identification
>i'ure& 1& ,.erall >low #ia'ram
C. Region Of Interest
@y analyAin' the lo'-s$ectrum of an in$ut ima'e" the
s$ectral residual a$$roach e0tracts the s$ectral residual of an
ima'e in the s$ectral domain" which contains the saliency
information of the ima'e& (o increase the $erformance of the
s$ectral residual a$$roach" an iterati.e R,I selection
al'orithm 2ased on the s$ectral residual a$$roach is used& (he
result of the enhanced la2eled watershed al'orithm is used as
the in$ut ima'e of the iterati.e R,I selection al'orithm&
(he ste$s in.ol.ed in R,I is as follows"
• Calculatin' the saliency ma$ of the in$ut ima'e with
the s$ectral residual a$$roach&
• @ased on the lar'est $i0el .alue in he saliency ma$"
the in$ut ima'e is resiAed usin'
+edian >ilterin'
9ocal +inimum E0traction
re$rocessin' Ste$s
In$ut -ltrasound C,S Ima'e
R,I Selection
Cost +a$ Construction
,2ject !rowin'
#etection of >ollicles
2014 International Conference on Electronics and Communication System (ICECS -2014)


) 2 E 1 (
where i denotes the iteration num2er
(hen the resiAed ima'e is used as a new in$ut and the
iterati.e $rocess is terminated when the results of two
consecuti.e iterations are close enou'h&
D. Cost Ma Constr!ction
In order to detect follicles that are inside the o.ary" the
cost ma$ is constructed usin' the three concatenatin' factors&
(he cost ma$ is 'i.en 2y
CF IR,I ed'e & IR,I o.ary mas* & IR,I mean (2)
IR,I ed'e is o2tained 2y a$$lyin' So2el ed'e detection to the
re'ion of interest& (he factor IR,I ,.ary mas* is defined for such
$ur$ose" which is o2tained 2y dilatin' the mas* IR,I& >inally"
the factor IR,I mean is the result of filterin' IR,I with a mean filter
of siAe DGD& (hus the cost ma$ is constructed usin' the three
concatenatin' factors as shown in >i'& 2&
(he cost ma$ is constructed usin' the concatenation
factors namely IR,I ed'e" IR,I o.ary mas* and IR,I mean re$resent
different features of the ima'e& In order to detect follicles that
are inside the o.ary" the cost ma$ should ha.e different .alues
de$endin' on the $i0el8s relati.e location with res$ect to the
o.ary 2oundary& +ore s$ecifically" $i0els inside the o.ary
should ha.e lower costs than their counter$arts outside the
o.ary& =ere IR,I min is from local minima e0traction&
>i'ure& 2& Cost +a$ Construction
>i'ure& D& 6or* flow of ,2ject !rowin'
E. Ob"ect #ro$ing Algorit%m
(he cost of o2ject i inside and outside the con.e0 hull of
the n o2jects is defined as followsH
) " (
) " (

Ω ∈ & x
& x C

(D) coste0ternalF
& x
& x C

Ω ∈ ) " (
) " (
C( F

Ψ ∈ ) " (
) " (
& x
& x C
I - (unin' $arameter
C( - Cost (hreshold
Roi min
Roi +ean
R,I in$ut
Roi o.ary
So2el Ed'e
Roi ed'e

Cost ma$
,2ject !rowin'
Com$ute Con.e0 hull and
cost of the hull
1dd the o2ject and
recalculate C(
Remo.e the
o2ject and
(o find three o2jects
>ollicle #etection
2014 International Conference on Electronics and Communication System (ICECS -2014)

1 @
>i'ure 4& (he sets defined for com$utin' costs and cost threshold with a-'
o2jects and 1-C as re'ions&
Lint - (he intersection 2etween 1 and @" re$resents the
re'ion induced 2y addin' o2ject i to the tar'et set (&
Le0t - (he set Le0t for o2ject a consists of $i0els in the
re'ion 1&
M - (he set M consists of $i0els in the re'ions @ and C
e0cludin' follicles&
+ore formally" it is 2ased on the con.e0 hull which is the
smallest con.e0 $oly'on containin' the $oints" which is a
re'ion of the $lane 2ounded 2y a cycle of line se'ments"
called ed'es" joined end-to-end&
(he al'orithm consists of followin' ste$sH
a) >ind three o2jects as local minima which is around the
center of the re'ion of interest and include them in the tar'et
set (& InitialiAe the cost threshold C( accordin' to (4)&
2) (hen Com$ute the con.e0 hull for the elements of the
set (& Calculate the cost of o2jects outside the con.e0 hull
accordin' to (D)& If the costs of some o2jects are less than or
e5ual to the cost threshold C(" add the one with the low cost to
the set (&
c) If any o2ject is added to the set (" recalculate the cost
threshold C( and 'o to ste$ 2& ,therwise 'o to ste$ 4&
d) Calculate the cost of each o2ject inside the con.e0 hull
accordin' to (4)& Remo.e the o2jects whose costs are 'reater
than the cost threshold C( from the set (&
e) If any o2ject is remo.ed from the set (" recalculate C(
and 'o to ste$ 2& ,therwise sto$& (he added o2jects are the
detected follicles found 2y the o2ject 'rowin' al'orithm& 1nd
the flow of the al'orithm is re$resented usin' >i'& D& ,2jects
la2eled as a" 2" c" d" e" f and ' re$resent candidates of follicles&
It is further assumed that 2" c" d" e" f and ' are in the tar'et set
(& 1nd 1" @ ?C are the re'ions re$resented in >i'& 4&
A. 're 'rocessing
(he C,S -ltrasound ima'e is used as the in$ut and the
$re $rocessin' is done& S$ec*le noise is reduced 2y the median

a 2

c d

e f

' h i j

* l

>i'ure& 4& (he Results of the automated dia'nostic system& (a) ,ri'inal
-ltrasound C,S Ima'e" (2) +edian filtered ima'e" (c) Ed'e filtered ima'e
(d) Result of Enhanced 6atershed al'orithm" (e) R,I selected ima'e" (f) Cost
ma$" ('-j) Barious sta'es of o2ject 'rowin'" (*-m) #etected follicles at
IF2"4"; res$ecti.ely&
filter which is shown in >i'& 4(2)& 1nd then the local minimum
e0traction is done usin' enhanced la2eled watershed al'orithm
with the ed'e filtered ima'e usin' so2el ed'e detector and the
result of enhanced watershed al'orithm is shown in >i'& 4(c)
2014 International Conference on Electronics and Communication System (ICECS -2014)
(1@9E I& RES-9(S ,> (=E #I1!),S(IC SNS(E+ 1( #I>>ERE)( (-)I)!
)esults with different values of *
()* ()+ (), (),., β= ()-
Reco'nition rate 1; 1;&02 23&3 23&34 +,.-, O4&04
4 4&41 4&3 4&304 ../ P&O
>1 score 0&2 0&23 0&4D 0&4D -.++ 0&O;4
and (d) res$ecti.ely& (hen the $re $rocessin' ends with the
re'ion of interest which is shown in >i'& 4(e)&
B. Follicle Identification
In this sta'e" Cost ma$ is constructed 2ased on the
concatenatin' factors as shown in >i'& 4(f) and usin' the
o2ject 'rowin' al'orithm the initial o2jects and .arious sta'es
of o2jects are 'rown as shown in >i'& 4('-j)& (he detection of
follicles at .arious I .alues are shown in >i'& 4(*-m)& (he
(a2le I shows the different .alues of +isidentification rate
and Reco'nition rate with different tunin' $arameter& I .alue
ensures that increase in .alue will increase the detection rate
which is shown in >i'& 4('-j)& 1nd in (a2le I" >1 score is
calculated usin'
) 1 (
) 1 &( & 2
− +

6here" RR- Reco'nition Rate
+R-+isidentification Rate

1 lar'e .alue of >1 score is desira2le so that the reco'nition
rate and misidentification rate are reasona2le com$arin' to
other .alues& >rom the (a2le I" it is shown that com$ared to all
other .alues at IF;" >1 score is desira2le with OOQ and >i'& ;
shows the $ictorial re$resentation amon' .arious I .alues& It
is clear that at IF;" the >1 score is a reasona2le one whereas
the other .alues ha.e hi'h +R& (he results of other automatic
system $u2lished are re$orted as ;0Q RR and D0Q +R for :O<
whereas the $ro$osed system is more effecti.e with that
B& C,)C9-SI,)
In this $a$er" o2jects are used as follicle candidates and are
detected& @ased on the cost ma$" the con.e0 hull of $ossi2le
follicles is used to search the most $ossi2le set of o2jects as
follicles& (his $rocess utiliAes the s$atial connecti.ity of
follicles and the contour of the o.ary which contains follicles&
(he future wor* will deal with the clusterin' 2ased a$$roach
to identify the follicles and the result is to 2e com$ared with
the o2ject 'rowin' followed 2y classifyin' the detected
follicles 2ased on their features&
>i'ure ;& (he Results of >1 score for different tunin' $arameter&
:1< Nu N" 1cton S("R S$ec*le reducin' anisotro$ic
diffusionR" IEEE (ransactions on Ima'e rocessin'
:2< Ninhui #en'a"1" Nuanyuan 6an'a" NuAhon' Shen2" T1n
automated dia'nostic system of $olycystic o.ary
syndrome 2ased on o2ject 'rowin'R 1rtificial Intelli'ence
in +edicine 41 (2011) 1PP/20P&
:D< %ri.ane* 1" Son*a +"R ,.arian ultrasound ima'e
analysisH follicle se'mentationR"IEEE (ransactions on
+edical Ima'in' 1PPOS 13HPD4/44&
:4< =ojjatoleslami S1" %ittler U"R Re'ion 'rowin'H a new
methodR" IEEE (ransactions on Ima'e rocessin'
:4< Nan' JS" 6an' NN" 6an' N" 6an' N& @oundary
e0traction of ultrasonic 2reast tumor ima'e 2ased on
im$ro.ed .ariational le.el set methods& S$ace +edicine
? +edical En'ineerin' 200OS12H400/4&
:;< Siddharth Samsi" R#etection of >ollicles >rom I=C-
Stained Slides of >ollicular 9ym$homa -sin' Iterati.e
6atershedR" IEEE (ransactions ,n @iomedical
En'ineerin'" Bol& 43" )o& 10" ,cto2er 2010&
:3< ,lcay Sertel" RCom$uter-1ided #etection of Centro2lasts
for >ollicular 9ym$homa !radin' -sin' 1da$ti.e
9i*elihood-@ased Se'mentationR" IEEE (ransactions ,n
@iomedical En'ineerin'" Bol& 43" )o&10" ,cto2er 2010&
:O< Ci'ale @" VaAula #"R Se'mentation of o.arian ultrasound
ima'es usin' cellularneural networ*sR International
Uournal of attern Reco'nition and 1rtificial Intelli'ence
:P< 1ndrew UanowcAy*" T=i'h-(hrou'h$ut @iomar*er
Se'mentation on ,.arian Cancer (issue +icroarrays .ia
=ierarchical )ormaliAed CutsR" IEEE (ransactions on
@iomedical En'ineerin'" Bol& 4P" )o& 4" +ay 2012&
:10< Vhihon' +an"R 1 )ew 1da$ti.e @ac*$ro$a'ation
1l'orithm @ased on 9ya$uno. Sta2ility (heory for
1 2 3 4 5 6 7
0 . 2
0 . 3
0 . 4
0 . 5
0 . 6
0 . 7
0 . 8
0 . 9
f1 s c o re of t h e obj ec t g ro wi ng m e t h o d wi t h di ffere n t b e t a va l ue s
B e t a val ue

2014 International Conference on Electronics and Communication System (ICECS -2014)
)eural )etwor*sR" IEEE (ransactions ,n )eural
)etwor*s" Bol& 13" )o& ;" )o.em2er 200;&
:11< %& @el*acem-@oussaida" S& Samsi2" !& 9oAans*ic" +&)&
!urcana"R 1utomatic detection of follicular re'ions in
=?E ima'es usin' iterati.e sha$e inde0R" Com$uteriAed
+edical Ima'in' and !ra$hics D4 (2011) 4P2/ ;02&