Quoit filter----anew filter based on mathematical morphology to extract

the isolated shadow, and its application to automatic detection of lung

cancer in X-ray CT .
Shinji Yamamoto" Mitsuomi Matsumoto** Y ukio Tateno***
Takeshi Iinuma **** Toru Matsumoto***

* Toyohashi University of Technology, **Tokyo Metropolitan College of Allied Medical Science,

***National Institute of Radiological Science, ****Saitama Institute of Technology

Abstract having an interesting characteristics as follows ; Q trans.

Wepropose a new algorithm named "Qiroit,filter(QPlter~ " corresponds to extract feature parameter like a matched filter
to e.vtruct the isolated but low amplitude shudow located in from input image having non ideal isolated shadow and Q Inv.
the background which h a y extremely high amplitdeJuctuution. trans. corresponds to restore isolated image using extracted
@filter is a kind of mathematical morphology and its feature parameter.
formulation is quite simple. This simplicity brings about a In the next chapter, the concept and formubition of the Q-
unique merit that output from this filter is analytically filter in 2-dimensional space is discussed, and extension to 3-
eqmssivefior the case of analyical input shupes like ball, cone, dimensional space of it is discussed in the third chapter. In the
or rotation of cosine function, which have churucteristics of last chapter,this filter is applied to detect the cancer candidate
rotation qwimetry a d monotonic decreasing from the origin. regions automatically in the CT cross sections of lung area,
This Q-filter is composed of two sequential operation aiming to reduce drastically the number of cross sections to be
named Q Trans. and Q Inv. Trans. , each operation having an diagnosed by the doctor.
interesting characteristicsas follows :Q Trans. corresponds
to e-rtractfeature Imrameter like a matched filter from input
image having non ideal isolated shudow, and Q Inv. Trans. 2. Concept and formulation of 2 dimensional
correspond.Y to restore isolated image using extractedfeature Q-filterf4-61
paranieter.
Thisfilter is applied to detect the cancer candidateshadow
automatically in the CT cross sections of lung areas. aiming to The concept and formulation of the Q-filter is discussed
reduce drastically the number of cross sections to be diagnosed in the following. Figure 1 shows the concept of the Q- filter
by the doctor. which responds selectively only to the isolated shadow. The
radius of the filter is labeled r l , r2 and r3 as shown in the
figure. Consider the two structural elements shown in Fig.
1.Introduction I@), i.e., disk and ring types. By applying the elments from
upward to the isolated shadow as in the left side of Fig. 1(b),
Many algorithm? to extract the isolated shadow in the image
have been already developed. For instance, in the field of r3
medical image processing, useful algorithms are introduced
by Matsumoto.etc.11 I, shimizu,etc.[2).Suzuki,etc.l31, but of
course they are not almighty for any kind of image.
In this paper we propose a new kind of algorithm named
"Quoit filter@-filter)" toextmct the isolated but low amplitude
shadow located in the background which has extremely high
amplitude fluctuation. Q-filter is a kind of mathematical Disk Filter ( a) Ring Filter
morphology and its formulation is quite simple. This simplicity
brings about a unique merit that output from this filter is
analytically expressive for the case of analytical input shapes
like ball, cone, or rotation of cosine function, which have
characteristics of rotation symmetry and monotonic decreasing
from the origin. This mems that the design of the practical Q-
filter and its operation result are very clear, even if
mathematical morphology is a nonlinear operation. Moreover, (b)
this Q-filter i s composed of two sequential operation named Fig. I Illustration of Quoit element
Q trans. and Q Inv. trans. for practical usage, each operation

1015-4651/96 $5.00 0 1996 IEEE 3

Proceedings of ICPR '96
a difference of height q is produced between the two results.
Since the ring filter fits well to the isolated shadow, it is called
the quoit filter. On the other hand, the difference of height is
not produced if the shadow is not isolated, as in the right side
of Fig. l(b).
The processing based on the foregoing property is called Q
Trans. and Q Inv. Trans.. They are formulated as follows. The range of h(x,y) = 0 corresponds to definition domain
Some suecial notations such as @and 0 in the expressions K.
T h i s process corresponds to extract feature parameter like
a matched filter shown soon after.

0 Inv. Trans.:
This transform means that the image obtained by the
foregoing Q Trans. is regarded as the input image, and the
processing from Eqs. (1) to (3) are applied again. By this
processing, the isolated shadow is restored.
An important characteristicsof the Q-filter is that output
from this filter is analytically expressive for the case of
analytical input shapes like ball, cone, or rotation of cosine
(r-R)

The structural elments hd (x.y)(disk) and h,(x,y)(ring) (d)QuoitTrans. (RZr) (e) Quoit Inv. T m s ( R 2 r )
are represented as follows. Letting r = r3 and r3 > r2 ,
Fig.2 Quoit Trans. and Inv. Trans
Tabie.1 Output of Q Trans. and Q Inv. Trans.

4
function, which have characteristics of rotation symmetry and
monotonic decreasing from the origin. Fig 2 shows an example
of Q Trans. and Q Inv. Trans. output, when the input image
is assumed to be a ball type function (Fig2 shows a 2-D cross
section of 3-D image ). It is observed from this figure that the
peak value of Q Trans. exists in the central part of input ball
image, and that the Q Inv. Trans. output realizes a full or part
image of input ball. So, Q Trans. will be a kind of matched
filter to extract a ball type feature, and Q Inv. Trans. a kind of
restoration process using extracted feature.
Q Trans. output is formulated as follows. Let f(x) denotes
input image and q(x) denotes Q Trans. output ,where x is a The structural element function h, (x I ,y I ,zI ) (solid ball)
vector expression and f(0) means the amplitude of input model and h,(x ,y ,zI ) (hollow ball) are represented as follows.
at the origin. Lettingr, = r 3 andr, > r z ,
(1) if R<r, then

If(:
q(x)= f(0) -f(r-lxl)

(2) if R x , then
Ixk r - R
r-Rd:x:Sr
Ixbr
(6)

f(0)-f(r-1x1) lxllr (7) The range of h(x,y,z) = 0 corresponds to definition domain

Ixlx
Q Inv. Trans. output 9-l (x) is also formulated as follows.
K.
(1) if R u , then
IxlSR (8)
4. Application of the Q-filter to automatic
IxbR diagnosis of lung cancer by CT[6]
(2) if RLr. then
(9) 4.1. Introduction
The mass screening for lung cancer is employed widely. In
Table 1 shows typical cases of formula (1)-(9) ,i.e. input the first screening, a simple chest X-ray photography and
image is ball, cone, or rotation of cosine function.

3. Extension to the 3-dimensional Q- filter[6]

Extension of the Q-filter to the 3-dimensional filter(3D-Q
)is discussed in the following. Figure 3 shows the concept of
the 3D-Q which responds selectively only to the isolated ball
type shadow. This concept is mainly developed to differentiate
I Solid
Ball Element
Hollow Original
Ball Element model

between the lung cancer shadow and the blood vessel which is
located to perpendicular to the CT slice section, because both
cases are observed to be isolated shadows in the 2 dimensional
CT slice section.
Fig 3(a) shows that structural elements are changed to a
solid ball and a hollow, instead of a disk and a Mg in the case
of 2DQ. A model of cancer shadow is assumed to be a isolated Blood vessel
0
solid ball and a blood vessel is assumed to be a cylindermitten
in the Fig 3(b). And Fig 3(b) also shows the actual operation
which is applied to 5 continuous slice sections for both
mode1s.h the caqe of lung cancer model, each ring element
which is a subset of the hollow ball element reaches to the
bottom plane in the image,and a subtractionresult between the
solid ball and hollow ball element produces hq output,in which
each element output is selected as a maximum value of the 5
slice operation results. On the other hmd,the difference of height
is not produced in the c u e of a blood vesse1,because some ring
element does not reach to the bottom plane in the
image,resulting in no difference between the blll element and
hollow element.
They we formulated as follows(Q Trans. is only written Hollow SOlld Hollow
and Qlnv. Trans. omitted). Ball Elcmcnt Ball Elenent Bill Elcnicnt Ball Elcmcni
g(x.y) = &x.y.z) - g(r' (x.y.2) ( 10)
Fig. 3 Illustration of 3D-Quoit processing.

5
sputum cytological test usually are carried out. At present, save of the time.
however, the detection ability of X-ray observation is not At the next step, 3D-Q is applied in the nearly central point
sufficiently high for early detection of lung cancer. It is known of ROI's which are detected by 2D-Q. This operation results
that the false-negativeratio of X-ray observation is considerably in the 3 dimensional shape differentiation especially between
high [8,9]. From such a viewpoint, we proposed lung cancer cancer candidates and blood vessels.
screening CT (LSCT) to replace the present tests for the first To tell the truth,one more filter called MIP-2D-Q is
time [ 10,111, which has the highest possibility of solving those developed for screening CT system written in the Fig 4,which
problems. is necessary in the screening system having more than 10 mm
But one essential problem of new LSCT system is the slice thickness(reso1ution of one slice is 1 mm ,so resolution
increase of image information to about 30 slices per person between each slice is 10 times rough compared with that in the
from 1 X-ray film It is almost impossible for a single doctor each slice).Explanation of MIP-2D-Q will be omitted here for
to make the diagnosis for the data composed of 30 slices for the simplicityI61.
each person in the mass-screening system. This is the reason
why a new computer-aided diagnosis system should be
developed. 4.3. Experiment for automatic extraction of cancer
In the next section ,a new method will be introduced which candidate areas
automatically recognizes the candidate regions for the
pathological shadows. By displayingonly the slices containing Using the seven patients samples including total 139 CT
the candidates regions for the doctor, the number of cross slices, the automatic extraction experiment is executed. They
sections to be diagnosed can be drastically reduced. contain typical lung cancer regions (mean actual diameter is
15 mm , corresponding to 15 pixels on the image). One slice
cross section has 320x320 pixels(reso1ution of 1 mm) and
4.2. Flow diagram of computer aided diagnosis thickness of 10 mA sample is composed of 10 to 32 slices
per patient. The candidate regions to be detected is assumed to
(CAD) be 10 mm( 10 pixels) to 30 mm(3Opurels) in diameter.
The shadow of the lung caner which exists in the lung field
appears isolated and with a small area [12]. By utilizing this
property, 2-D and 3-D Q- filters are applied to extract the
isolated shadow automatically.
Fig 4 shows a flow diagram of the algorithm, we adopted.
Lung regions are extracted at first from each original CT
slice one by one to specify the search areas. And opening
operation is applied for each image which is a typical operation
of the mathematical morphology for noise reduction. A
disadvantage of the Q- filter is that the noise component (such
as a vessel perpendicular to the image plane) of size less than
10 mm produces a certain output, as long as it is isolated.From
such a viewpoint, the isolated component of size 10 mm or (a) Original (d) 2D-Quoit Process
less regarded as a noise, and the intensity is reduced. In other
words, a smoothing is applied by opening operation.
After that, 2D-Q is applied to the each image to specify the
region of interest(RO1) to small areas. These processes are
performed for each slice in the 2 dimensional spaces for the

(b)Lung Region (e) 3BQuoit Process

I Lung Cancer Region 1 (c) Opening (flMP-2D-Quoit Process

Fig.4 Automatic lung cancer detection flow chart. Fig.5 A sample of result images.

6
 Table.2 Result of 2D,3D,MIP-2W u o i t processing.
For this purpose, parameterrI ,r2,r3,and ro which is a disk
type structural element utilized at the opening operation, are
selected as follows;
r, = rJ = 17, r2 = 15, ro = 4.
Fig. 5 shows an example of the result. Images at various
stages in the flow of Fig.4 are shown for one ofthe samples.
A smoothing effect is shown by the (c) and the extracted ROI
by the 2-D quoit process (d) and the final candidate area by
the 3-D quoit process (e). And the corresponding slice cross
section is shown to the doctor.
However, it also happens that some blood vessel regions
having considerablydubious shadow are extracted other than
the lung cancer regions. Thus, the number of cross sections
presented to the doctor is slightly larger than those actually
containing the abnormal shadows, including those dubious
regions.
Table 2 shows the result of seven samples ,139 slices
experiment. Among those, the 8 cancer regions are extracted
correctly and 1 region missedin seven samples, and there are
total 12 regions where the blood vessels are detected
incorrectly. Then it is expected that the number of displayed
images to be diagnosed by the doctor will be reduced to only
2-3 slices from about 20-30 slices per patient.
5. Conclusion
The concept ,formulation and characteristics of 2D- and
3D-Quoit filters are discussed, which are new kinds of
mathematical morphology and sensitive to extract isolated
shadows like cancer regions. No output is produced from the
2D or 3D images not containing an isolated shadow. These
filters are nonlinear type filters, but output from these filters
are analytically expressive for the case of analytical input
shapes iike bdl, cone, or rotation of cosine function, which
have characteristics of rotation symmetry and monotonic
decreasing from the origin.
These filters are applied to detect cancer candidate regions
automatically in the CT cross sections of lung areas, aiming
to reduce drastically the number of cross sections to be
diagnosed by the doctor. By applying this process to seven
patients samples which have I O to 32 cross sections and 1 or
2 cancer regions per each person. Among those, the 8 cancer
regions are extracted correctly and 1 region missed in seven
samples, und there m total 12 regions where the blood vessels
are detected incorrectly. Then it is expected that the number
of displayed images to be diagnosed by the doctor will be
reduced to only 2-3 slices from about 20-30 slices per patient.
Acknowledgment.
The authors are p t e f u l for the useful advice and assistance
given to this study by Pr0f.J. Toriwaki, Nagoya Univ., Mr.
K.Suzuki, Director of Hitachi Medico Co., Mr. H. Takagi,
Chief Erg., and Mr. K. Coike, Chief Erg., Hitachi Medico
Tech. Lab. A part of this study was supported by Ski. Go.
Min. Educe., and Go. Cancer Ryes. , Min. Health We.
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