RESEARCH ARTICLE

Copyright © 2014 American Scientific Publishers Journal of Medical Imaging and

All rights reserved
Printed in the United States of America
Health Informatics
Vol. 4, 92–100, 2014

A New Database for Breast Research with

Infrared Image
L. F. Silva1
∗ , D. C. M. Saade1 , G. O. Sequeiros1 , A. C. Silva2 , A. C. Paiva3 ,
R. S. Bravo4 , and A. Conci1
1
Department of Computer Science, Fluminense Federal University 24210-240, Brazil
2
Department of Electrical Engineering, Federal University of the Maranhão 65080-805, Brazil
3
Department of Informatics, Federal University of the Maranhão 65085-580, Brazil
4
Antônio Pedro University Hospital, Niterói 24033-900, Brazil

Breast cancer has been responsible for several deaths among women around the world. Its causes are unknown,
but early diagnosis increases the cure chances of the patient. Breast infrared image has been studied and
identified as a potential screening tool for the early cancer detection. However, two topics have retarded the
progress of the researches: The absence of a unique acquisition protocol and a public bank of these images.
We have revised infrared image acquisition protocols and, based on them, we have reproduced four protocols
which have been tested on volunteers of our laboratory. After tests and observations of these protocols, we have
suggestedDelivered by Publishing
a new dynamic protocol to beTechnology to: University
used as a standard. of Hong
Furthermore, Kong
this paper Libraries
describes a new infrared
image database containingIP:additional
113.95.153.188 On:and
breast exams Fri, 29 Jan
clinical data2016 19:59:52
of patients of our university hospital. This
Copyright:
can be accessed online for free American
and, presents several Scientific Publishers
search options, including the image content similarity.
We believe that such database will be particularly useful to evaluate the potential contribution of the infrared
images to breast disease detection.

Keywords: Infrared Imaging, Acquisition Protocols, Image Database, Pattern Recognition, Information
Retrieval, Breast Disease Detection, Breast Cancer, Breast Research.

1. INTRODUCTION instance, regarding specifically these two very opposite studies:

Medical application of infrared (IR) imaging is not new. How-
ever, only with the recent increase in sensitivity of the IR sensors
(approximately 0.02 degrees Celsius), the analysis of the images
generated by these begins to be an efficient and reliable method
for the study of diseases in humans.
The advantages of the IR as an auxiliary tool in medical
diagnosis are: The extremely low cost, when compared to other
technologies of medical imaging and the absence of touch or
penetration in the patient’s body; being a noninvasive technique,
entirely harmless, and using only the heat emitted by the human
body.
The main goal of breast examination using IR image is to
detect breast disease based on physiological abnormalities, which
can be related to the vascular pattern analysis and in the differ-
ences between warmer regions.
Regarding breast cancer, some authors claim that IR image
may have the potential to detect this disease ten years earlier
than mammography or any other image-based examination, while
other authors claim that it is useless for cancer detection. For
∗
Author to whom correspondence should be addressed.
Kontos et al.1 say that IR images are bad for screening, while
Whishart et al.2 show that IR image is good for young women
and conclude: The use of digital IR breast (DIB) scan is an effec-
tive test for breast cancer detection in women under 50 years
old, where maximal sensitivity (78%) and specificity (75%) were
observed. The sensitivity of 89% have been achieved, for combi-
nation of IR images and mammography in women younger than
50 years observed and. It suggests the recommendation of the
use of such imaging in younger women and, it shows that more
conclusive and objective studies are needed to enable the use of
IR images. One of the questions that may explain this inconsis-
tency is the diversity of acquisition protocols. Thus, the first goal
of this work is to standardize the process of image acquisition,
suggesting a new protocol. Moreover, to compare studies there
must be a consistent and free database of IR images. So, another
objective of this work is to present a public database available to
every involved researcher just after solicitation without any pos-
sible business trends. In addition, we have the intention that this
database be a reference for whatever possible contributions, with
the only precaution of maintenance of the same protocol and of
course having the consent of the involved patients and physicians.
Our goal is promoting the research where the beneficiaries would

92 J. Med. Imaging Health Inf. Vol. 4, No. 1, 2014 2156-7018/2014/4/092/009 doi:10.1166/jmihi.2014.1226

J. Med. Imaging Health Inf. 4, 92–100, 2014
be those who really want to make an honest research in image
processing and patients who may benefit from the study on the
technical feasibility of the possible real effects of such tool.
Acquisition protocols for mammography are very well estab-
lished, and various databases are available even for free. This
allows comparing various diagnostic image-based techniques for
early detection of non-palpable tumors and even the efficiency
of each new feature to be added to the feature vector and how it
can modify, even in decimals of percentage, the accuracy of the
diagnoses compared to the former techniques.
Based on previous works, we have rebuilt and tested four pro-
tocols two static and two dynamic. For evaluating the efficiency
of each protocol, we have used thermal images of 14 volun-
teers. Each volunteer has been submitted to all protocols, with the
room conditions kept unchanged. Advantages and disadvantages
of each protocol have been comparisons have been made under
medical examination criteria and statistical calculations. We have
concluded that dynamic protocols highlight better heated regions
and vascular patterns, and we have suggested a new dynamic pro-
tocol. The database of IR images presented here contains images
captured under the new protocol. Such database contains, in addi-
tion to IR images, breast exams and clinical data of patients from
our university hospital. Among the functionality offered by the
database, there is the image retrieval by content.
This text is structured as follows. Next section presents the
experiments developed to determine the best acquisition protocol
for visualizing thermovascular. Section 3 is related to how the
acquisition results are stored and retrieved, and the other clinical
data and exams that are Delivered
availablebyforPublishing Technology
each patient. Section 4 to:skin
IP:
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Copyright: American Scientific Publishers
2. IR IMAGE ACQUISITION PROTOCOL
IR imaging protocols in general have the following parts: Rec-
ommendations to the patient, conditions of the examination
room; preparation, cooling and positioning of the patient; cap-
turing positions and parameters. These parts are schematized in
Figure 1.
Recommendations to the patient usually adopted are: Not to
smoke and not to drink caffeine or alcohol, for a certain time
Fig. 1. Parts of the acquisition protocol.
RESEARCH ARTICLE
before the exam; and not to apply lotions or creams on the
skin of the body to be examined on the exam day. All these
actions are to prevent changes in skin temperature and, conse-
quently, inconsistent thermal data from the examined area. Some
protocols observe the patient’s menstrual cycle. Generally, best
time is within the period from the 5th to the 12th and 21th day
after beginning of the menstrual cycle, because in this period the
vascularization is at basal level with less swelling of the blood
vessels.
Conditions of the exam environment are factors that influ-
ence the test result with IR images. To control ambient temper-
ature and airflows is part of the protocol. Actions adopted are:
To block windows and any opening through which sunrays and
airflows can penetrate; to use fluorescent lamps positioned far
from the image acquisition local; to eliminate the most possi-
ble heat source; to control the amount of people in the exam
environment; and to control the air-flow that comes from the
air-conditioning.
Preparation of the patient includes procedures performed
moments before the examination, when the patient is already
inside the examination room. Often the patient is asked to remove
clothing from the top of the body, as well as laces, earrings and
other accessories that may influence the exam, and hold the hair
if necessary. Another procedure is cooling the examined region,
which may be either natural or induced. In natural cooling, the
patient rests for a certain time (10 to 15 minutes) without the
clothing from the top of the body or a garment which does not
restrict the airflow, until no further change in the temperature of
University of other
surface, in Hongwords,
Konguntil
Libraries
the stability of the tempera-
2016 19:59:52
ture. Airstream, refrigerated or airflow, directed to breasts and
alcohol applyed to the surface, are devices commonly used in
induced cooling, also known as thermal stress. There is also the
immersion of the hands in cold water, causing vasoconstriction
of the healthy tissue of the breast region, which does not occur in
cancerous tissue because the blood vessels, that nourish tumors,
do not respond to nerve stimulation.3 Regarding the positions of
the images, the most common is the front one, where the patient
is positioned in front of the camera. But some protocols, besides
the front images, they capture lateral images of both breasts.
The distance between the camera and the patient is one of
the parameters that are part of a protocol. In most protocols that
distance is approximately one meter. Other common parameters
are the temperature of the environment, relative humidity and the
emissivity coefficient of the human skin which is equal to 0.98.
All of them are required in order that the acquisition device deter-
mine the actual temperature of each point of the scene.
Protocols for thermal imaging can be categorized based on
the behavior of the body in relation to heat transfer, as static
or dynamic.4 In static acquisitions the body of the patient must
achieve thermal stability inside the acquisition environment; usu-
ally in this protocol type is used natural cooling. The patient is
requested to rest for a certain time (between 10 and 15 minutes)
for adequate cooling to basal metabolic rate, resulting in minimal
changes in skin temperature during acquisition. Dynamic acqui-
sition is used to monitor the skin temperature recovery caused by
thermal stress, for example, after cooling the patient by electric
fan.4
Chronologically an acquisition protocol can be summarized
as follows: Recommendations to the patient, preparation of the
patient and the image acquisition (Fig. 1), with the environment
93
RESEARCH ARTICLE
conditions and the parameters of the capture being part of the
whole process.
2.1. Related Works
The work of Arora et al.5 describes a protocol, but in this descrip-
tion, the recommendations to the patient and the conditions of
the environment are not mentioned. In preparation, the patient is
undressed from the waist up and positioned in a specific equip-
ment set composed by a chair with mirrors, for lateral views,
a cooler and a digital IR camera. The patient remains in the
forward position relative to the camera, but with the aid of a mir-
ror, side views are also present in the image. It does not specify
the distance between the camera and the patient. The protocol is
dynamic, 100 images are captured during the thermal stress (cold
air directed to the breasts). Images are acquired in 320 × 240 pix-
els, sensitivity to 0.08  C, and an operating spectral (wave-length)
range by 7–12
m.
In the protocol used by Kapoor and Prasad,6 recommendations
to the patient are: To avoid alcohol, caffeine and nicotine for
at least two hours before the test and not to use lotions or creams
in the region of the body which will be viewed by the ther-
mal camera. Regarding conditions of the environment, the room
temperature is maintained at approximately 22  C and darkened
during the examination to avoid interference from heat sources.
In the preparation of the patient, the region of the thorax is cooled
by an electric fan during 7 to 10 minutes. It is not specified the
distance between the patient and the camera. After thermal stress
with the fan, images are captured. Despite the cooling of the tho-
rax, it is unclear whetherDelivered by Publishing
a sequence of images is Technology
acquired, so to:28University
IP: 113.95.153.188
it is not possible to classify the protocol On: Fri, 29 Jan 2016 19:59:52
as dynamic or static.
Apparently, only three images are acquired: Copyright:
One frontalAmerican
and two Scientific
others diagonal at 45 degrees, one of each breast.
Another protocol is described by Antonini et al.7 In the
description there are no recommendations to the patient.
The room temperature is maintained between 22 and 24 degrees
Celsius. In the preparing of the patients, it is not informed if ther-
mal stress is administered, or simply they rest without the top
part of the clothes. The patients are asked to position their hands
on their head and remain immobile. From each patient, a total
of 5 images are obtained (frontal, right and left semi-oblique and
right and left oblique). The distance between the camera and the
patient is 0.9 m. It is not possible to say whether the protocol is
static or dynamic.
In the Kontos’1 protocol, is not mentioned recommendations
for the patient. Regarding the exam environment, the tempera-
ture is maintained stable at approximately 22  C. In addition,
the room has no windows and its openings are muffled avoid-
ing directional airflow to the patient. The room lighting is kept
with fluorescent bulbs and it stays distant from the capture area
of the image. Regarding preparation of the patient, the patient
is asked to take off the clothes above the waist and rest during
10 to 15 minutes in order to achieve a steady temperature state.
Earrings and necklace are removed. After, the patient sits on a
backless bench; the patient puts his hands on the top of the head
and remains immobile. Three images of the patient are obtained:
One frontal and two oblique to 45 from a centerline for an opti-
mal exposure of all aspects of the breasts. The distance between
the camera and the patient is one meter. This is a typical static
protocol.
Ng and Kee describe a protocol8 in which the recommenda-
tions to patients are: No alcohol drinking, no smoking and no
94
J. Med. Imaging Health Inf. 4, 92–100, 2014
use of drugs that can affect the biological system of the body and
cause temperature changes. In addition, the chest region must be
free from any ointment or talcum powder. In relation to the envi-
ronment, the temperature is maintained between 20  C and 22  C
and the relative humidity of 60%. Heat sources such as sunshine
and other electrical devices are reduced to minimum because they
affect the environment temperature. Twenty minutes before the
examination the patient is required to abstain from any physical
activity in order to reduce the metabolism rate and to achieve a
steady temperature state. After this, the patient takes off clothing
from the top part of the body and puts the hands behind the head.
Three images are captured, one frontal and two laterals. Like the
previous one, this protocol is static.
The same protocol is described in the Ng et al.9–12 and Acharya
et al.’s13 works. It is assured that the patient is within the period
from the 5th to the 12th and 21th day after beginning of the men-
strual cycle. No recommendation to patients is specified. In rela-
tion to the environment, the temperature is controlled, 20  C to
22  C, with relative humidity of 60% (± 5%). In the prepara-
tion of the patients, they rest for 15 minutes in order to achieve
a steady temperature state. During the rest, the patient wears a
loose smock, which does not restrict the airflow. It is not speci-
fied how many images are captured and in which positions, but
apparently one frontal. The distance between camera and patient
is one meter. This protocol is static.
The images used in the work of Araújo et al.14 have been
captured under a protocol where recommendations to the patient
are not specified. The room temperature (between 25  C and
 of Hong
C) and relative Kong
humidity Libraries
of air are considered parameters and
they are inserted in the camera settings during the examination.
Publishers
Furthermore, the airflows are controlled and deviated from the
patient. The patient rests during 10 minutes approximately in
order to achieve a steady temperature state. At least 8 images
are captured in 8 different positions, however extra images can
be captured if needed. The standard positions are: Frontal with
hands on hips (hands on hips and elbows away from the body);
frontal with hands upon the head; only the right breast; only
the left breast; outer side of the right breast; outer side of the
left breast; inner side of the right breast and inner side of the
left breast. The distance between the camera and the patient is
variable. This protocol is static, as well.
Koay et al.15 describes a protocol, which the patient is
instructed to avoid alcohol, caffeine, lotions for pain and not to
smoke for at least two hours before the examination, and the test
is carried out in the following week to menstruation or between
the 6th and 10th day of the cycle, until the 13th day. The room is
kept at 22  C and darkened during the examination. The region
of the breasts is cooled by an electric fan for about 10 minutes
before recording; however there are no details on positioning the
patient during the examination. Regarding the images, it is not
specified how many positions and which positions used. It is also
not informed the distance between the patient and the camera.
Despite the thermal stress using the fan, it is not possible to say
if this protocol is dynamic, because it is not informed whether
it is captured only one or a sequence of images at the end of
thermal stress. According to the authors, this protocol offered
greater temperature contrast between the hot and cold regions of
the body.
Wishart et al.2 carry out a protocol in which the recommen-
dations to the patient and conditions of the environment are not
J. Med. Imaging Health Inf. 4, 92–100, 2014
specified. Prior to the acquisition, the patient is undressed from
the waist up and properly positioned in an ergonomic chair with
arms resting on the eye level. A controlled temperature airflow
is directed to the breasts for 5 minutes. 250 images are captured
during cooling. It is not specified the distance between the patient
and the camera. This protocol is considered static.
Ohashi and Uchida16 17 have carried out two protocols, one
static and another dynamic. For these protocols are not described
recommendations to the patient. The room temperature is main-
tained at 21  C. For static acquisition, the patient remains immo-
bile with the hands on his head and images are captured from
three directions: Frontal, left oblique and right oblique. It is not
informed the rest time in order to achieve a steady tempera-
ture state. In the dynamic protocol, the region of the breast is
cooled with an electric fan during 2 minutes. After this time,
a sequence of images is captured with intervals of 15 seconds
between them. A subtraction thermography (examination using
IR images) is obtained from this sequence. It is not informed the
distance between the camera and the patient.
In the protocol described by Amalu3 there are not recommen-
dations to the patient. The entire examination environment is cov-
ered by a carpet, to create isolation from IR external sources, and
is maintained at 19–20 degrees Celsius. The patient immerses his
hands on 6 inches of water with floating ice (approx. 5 degrees
Celsius) for 1 minute. After that, seven images are captured. This
protocol is dynamic.
2.2. Used Protocols for Experimentation
As noted in the previousDelivered
section,by Publishing
there IR imaging to:captured.
are many Technology
protocols for breast examination. Each IP:research
113.95.153.188 On: Fri, 29 Jan 2016 19:59:52
group and ther-
mography centers use its own protocol. Copyright:
As far as we American
know, Scientific
never previously a comparison between the existing protocols
was made. The absence of a unique protocol is probably the
major factor of inconsistency in breast IR image works.
To contribute to the solution of this issue, we have reviewed
various protocols in the literature. And based on this review, four
protocols have been reproduced, tested and compared. From the
results of the tests and observations a new protocol has been
suggested. We recommend this new protocol as a standard.
The objective of the tests has been to found the protocol which
highlights better elements for thermo vascular analysis. Initially,
protocols of the same category have been compared. The best
protocols of each category, i.e., the best static protocol and the
best dynamic protocol have been compared with each other.
Regarding static protocols, the variant is the rest time in order
to achieve the stable temperature state. In this case, two proto-
cols have been reproduced, the first with 10 minutes for rest and
another with 15 minutes. However, in relation to the dynamic
protocols there are some variants, including: The thermal stress
type, the thermal stress time and the acquisition moment of the
images, i.e., if during the thermal stress or during the temperature
recovering.
Among the thermal stress types we have tested: Cooling by
electric fan; cooling by alcohol application only; cooling by alco-
hol application added to the use of electric fan; and immersion
of the hands in ice water.
Among the period times of the thermal stress we have tested:
10, 5 and 2 minutes, using electric fan; 2 minutes and 30 sec-
onds using electric fan after alcohol application on the breast and
armpit by spraying; and 1 minute and 20 seconds of immersion
of the hands in ice water.
RESEARCH ARTICLE
We have analyzed the captured image sequence. After the ther-
mal stress, the camera captures IR images during 10 minutes, at
intervals of 15 seconds between each of the two images. We have
concluded that the IR images captured after approximately 5 min-
utes are the ones that have highlighted the warm regions better.
Facing the results of the previous tests, we have reproduced
and compared four protocols, two static and two dynamic.
In all reproduced protocols, the initial procedures are equal to
each volunteer:
(i) To check the central temperature by a clinical thermometer;
(ii) To check whether the volunteer followed the recommenda-
tions of the protocol which are at least two hours before:
(a) Not to smoke;
(b) Not to consume caffeine or alcohol;
(c) Not to practice physical exercises;
(d) Not to apply any cream or oil type in the region of the
breast and armpit.
(iii) To ask the patient to remove beads, earrings and other acces-
sories which can be viewed in the thermal images and hold the
hair with a cap; and
(iv) To ask the patient to remove clothing from the waist up.
In all protocols the volunteer stays with his hands on his head
during the whole process.
2.2.1. First Static Protocol
The volunteer rests for 10 minutes to stabilize the skin temper-
ature of the breasts and armpit. After that, a frontal image is
University of Hong Kong Libraries
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2.2.2. Second Static Protocol
Similar procedures of the previous protocol, but in this, the vol-
unteer rests per 15 minutes.
2.2.3. First Dynamic Protocol
An electric fan is turned on and directed to the volunteer’s breasts
and armpits per 2 minutes. After this, six images are captured,
one each minute.
2.2.4. Second Dynamic Protocol
Alcohol is applied at the region of the volunteer’s breasts and
armpits, and then an electric fan is turned on and guided to this
region per 30 seconds. After this, six images are captured, one
each minute.
2.3. Protocol Evaluations and Discussions
We have carried out the protocols on 14 volunteers and the
images have been analyzed by radiologists of the Antônio Pedro
University Hospital, Fluminense Federal University, Brazil.
When comparing the two static protocols, no differences were
found. The main advantage of the static protocols is the uniform
cooling of the skin of the breasts and armpits, avoiding the for-
mation of warm or cold false regions. Its major disadvantage is
the long resting time in order to get skin temperature stabiliza-
tion. Figure 2 shows two images of the static protocols, the left
image has been captured under the First Static Protocol and the
right image has been captured under the Second Static Protocol.
Visually the images are very similar.
The dynamic protocols presented greater possibilities high-
lighting vascular patterns and temperature variation among
95
RESEARCH ARTICLE J. Med. Imaging Health Inf. 4, 92–100, 2014

Fig. 2. Images of the static protocols.

regions than the static protocols, therefore better when compared

to static protocols (Fig. 4). In Figure 4, the (a) image has been
captured under the First Static Protocol and (b)–(h) images cap-
tured under the First Dynamic Protocol. Note that the warm
regions in the left breast are more highlighted in the last
image ((h) image) of the dynamic sequence than in the image
((a) image) of the static protocol. This volunteer in fact has an
abnormality in the left breast confirmed by conventional tests.
The major problems of the dynamic protocols have been
detected in the cooling with alcohol, excessive cooling in some
volunteers (Fig. 3) and no guarantee of uniformity in the appli-
cation (Fig. 5). But also problems have been detected in cooling
with fan only. We have observed that the surface of the skin of
the breasts and armpits of some volunteers has cooled more than
of the others with same cooling time (2 minutes).
Considering the cited problems, we propose a new dynamic
protocol which was performed on the same volunteers of the tests
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of the reproduced protocols.
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Copyright: American Scientific Publishers
2.4. New Dynamic IR Acquisition Protocol
We have established a dynamic protocol where its main advan-
tage, over the previous dynamic protocols, is not having a fixed
time cooling. The cooling stopping criterion is conditioned to
skin temperature of the region between the breasts. Thus, the
Fig. 4. Static and dynamic protocol comparison.
acquisition of the IR image sequence starts approximately at the
same temperature for all patients. When the average temperature
of this region goes down to 30.5  C, the thermal stress ceases If this temperature is not reached, the thermal stress stops after
and the sequential acquisition starts. This temperature (30.5  C) 5 minutes from its beginning. This time has been determined
has been one that highlighted better the vascular behavior and through tests, because in all volunteers, after this time, there was
the warm regions during tests. The temperature is monitored no variation in temperature of the skin surface of the breasts and
by an automatic tool of the camera. This tool creates a rect- armpits. Only 20% of the volunteers have achieved the maximum
angular region of 72 × 155 pixels, where several measures can time of 5 minutes.
be taken. When the average temperature in this region reaches In the Figure 7, the left image has been captured under First
30.5  C, the thermal stress ceases. Figure 6 shows such region. Dynamic Protocol and the right image under our protocol. Note
the higher contrast (warm regions most highlighted) in the image
acquired under our protocol.

Fig. 5. Uniform alcohol application, left image, before the application, right
Fig. 3. Exaggerated cooling. image, after application.

96
J. Med. Imaging Health Inf. 4, 92–100, 2014
Fig. 6. Monitoring the average temperature to begin the sequential
acquisition.
2.4.1. Description of the Protocol
The proposed protocol consists of the following steps:
(a) Recommendations to the patient. At least two hours before
the examination the patient should avoid: Alcohol, caffeine,
physical exercises, nicotine and, on the day of the exam, to apply
any type of cream, oil or deodorant in the breasts and armpits.
(b) Conditions of the examination room. Room temperature must
 
be maintained between 20 C and 22 C, no windows, no open-
ings, no airflow directed to the patient. Only fluorescent bulbs
must be used in the room illumination. Finally, maximum heat
sources must be reduced.
(c) Preparation of the patient. Inside the examination room, the
patient is asked to remove earrings, necklaces or other accessory
Delivered by Publishing Technology
which can interfere in the thermal image. The patient’s body tem- to: University of Hong Kong Libraries
IP: 113.95.153.188
perature is checked by clinical thermometer
and her hair stuck
Copyright: American
with a cap. The patient is positioned in front of the camera with
the hands on the head (Fig. 8) and the thorax area and armpits are
cooled by an electric fan until the stopping criterion is satisfied.
(d) Capturing positions. After finishing the thermal stress, a 20
image sequence is captured per 5 minutes (while the cold region
temperature returns to the balance). The same time interval
between each image acquisition is used. Finally, two IR images

are captured, one to 90 from the right breast and another to 90
from the left breast.
(e) Parameters. The standard distance between the camera and
the patient is 1 m. However, depending on the size of the patient,
a distance of 0.8 m or 1.2 m is adopted for a better frame of
the region of interest (breast and armpit) in the image. The dis-
tance, room temperature and the relative humidity of the air are
recorded and inserted as parameters in the IR camera settings.
The next section presents the IR database which has been
developed, containing images captured with the protocol pro-
posed in this work.
Fig. 7. Left image, first dynamic protocol, right image, our protocol with
warm regions more highlighted.
RESEARCH ARTICLE
Fig. 8. Camera and patient position.
3. IR DATABASE FOR BREAST RESEARCH
An IR database, nominated by us, as Database for Mamma
Research with Infrared Image18 (DMR-IR), has been developed.
The DMR-IR contains IR images, digitalized mammograms and
clinical data, obtained from patients of the Antônio Pedro Uni-
versity Hospital. These patients are from the screening depart-
ment, as well as gynecologic department. So in the DMI-IR
there are data of healthy patients and of patients with breast
diseases, including cancer. The IR images are captured by a
FLIR thermal camera, model SC620, which has sensitivity of
less than 0.04  C range and capture standard −40  C to 500  C.
The IR images present dimension of 640 ×480 pixels. The acqui-
sition of the images and the use of them in research, have been
approved by the Ethical Committee of the hospital and regis-
On: Fri,tered
at the
29 Jan Brazilian
2016 Ministry of Health under number CAAE:
19:59:52
01042812.0.0000.5243.
Scientific Publishers The DMR-IR is accessible through an
online user-friendly interface (http://visual.ic.uff.br/dmi) for man-
aging and retrieving information from breast exams and clinical
data from voluntary patients. The next section contains details of
the DMR-IR.
3.1. Overview of the Database
 At the time this paper was written, there were 149 patients with
reports in it. Each patient is subjected to two protocols: The static
with 10 minutes of rest and the new dynamic protocol proposed
in this paper, both described in the previous section. In the exam-
ination room the first protocol to be carried out is the static one,
where 5 images are captured (one frontal, two laterals of the left
at 45 and 90 , and two laterals of the right at 45 and 90 ).
After that, the dynamic protocol which produces 20 sequential
images in Front position and additionally 2 lateral images (Right
Lateral 90 , Left Lateral 90 ), is carried out. The amount of IR
images, in the DMI-IR is 3749 images, an average of 27 images
per patient.
In Figure 9, the small square (2.5 cm across), located between
the breasts, is a reference to calculate the pixel size. Knowing
this value, it is possible to determine the area of skin in warm
regions, for example.
In addition to the IR images, the DMR-IR has, so far 62 mam-
mographs, each one with its respective set of four standard views
(medium-lateral oblique and cranium caudal for each breast) and
its respective report. Ultrasound images are also being acquired
by the group. The DMR-IR also storages patient information that
could be useful for diagnosis, such as: Age, race, complaints,
symptoms, eating habits, personal and family history, medical
history and report.
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RESEARCH ARTICLE J. Med. Imaging Health Inf. 4, 92–100, 2014

Fig. 9. Positions: (a) left lateral 90 ; (b) front; (c) right lateral 90 ; (d) left lateral 45 , (e) right lateral 45 .

3.2. Information and Image retrieval Textual based information is not enough in some cases, espe-
A relational model was used to construct the database cially when user’s search requirements are about visual features
and a client-server application for data management. Typical of the image. To solve this, we are conducting research on
information system retrieval has been implemented. A client- content based image retrieval—CBIR system. Until now we have
side application provides a search dialog that lets users dynam- implemented some functions using the Bag of Words (BoW).
ically compose search Delivered
requests. Anbyapplication
Publishing executes to:BoW
Technology
server is used of
University forHong
image Kong
representation as local visual feature.19
Libraries
IP: 113.95.153.188
the queries on a data source and returns On: Fri,The
the results to the client 29 basic
Jan 2016
idea of19:59:52
BoW is that a set of local image patches is
application, where they are shown. Copyright: American Scientific Publishers
sampled using some key point detector and a vector of visual

Fig. 10. (a) Pre-processing stage, (b) CBIR based in bag of words model.

98
J. Med. Imaging Health Inf. 4, 92–100, 2014
Fig. 11. User interface of DMR-IR database.
descriptors is evaluated on each patch independently. Patches
created are quantized into a set of visual words which constitute
a codebook. After that, an image is described as a histogram-
based representation, on which a classifier, such as Support Vec-
tor Machine (SVM), is used.
Figure 10 shows the CBIR model retrieving similar images
from a given example (front positions of IR images were used for
experiments). According Delivered
to Figure by
10, Publishing a pre- to:ture
Technology
after segmentation,
IP: 113.95.153.188
processing stage is applied over the gray-scale image. Firstly,On:
the Fri, 29 Jan 2016 19:59:52
Copyright: American
image must be cropped discarding the background that is outside
the boundaries of Region of Interest (ROI). After that, morphol-
ogy operation of erosion is applied in the boundary of the ROI,
by using square structuring element of 3 × 3. Then, a process to
smooth the background is performed. Finally a normalization of
the contrast is used to enhance the gray-scale of the ROI.
For image retrieval, points of interest are extracted. A point
of interest of an object represents a specific point around which
the local image structure is rich in terms of local information
content. The Affine Scale-Invariant Feature Transform (ASIFT)
proposed by Morel and Yu20 that is fully affine invariant for
image comparison is used. 128 elements compose the feature
vector per point of interest and each image has 127 average
points. These ASIFT features are then clustered with a k-means
algorithm using the Euclidean Distance. All information for each
patch except its corresponding closest cluster center identifier
is discarded. The clusters represent a codebook and, based on
this, each image is represented as a frequency vector, using a
Term Frequency–Inverse Document Frequency (TF-IDF) weight-
ing technique.21 Finally a K-nearest neighbors (KNN) approach
with cosine measure is performed to retrieve k similar images to
a sample given by the user.
3.3. Accessing the DMI-IR
The URL http://visual.ic.uff.br/dmi allows user registration and
then access to all functionalities of the database cited above.
Figure 11 illustrates one of the navigation pages for retrieval of
IR images. IR images can be downloaded in JPG and mammo-
grams in BMP format. Furthermore, float temperature matrix of
the IR images or information about the exam can be downloaded
RESEARCH ARTICLE
in txt or xml format. In future work, all this information will
be together in a unique DICOM file per patient and available in
DMI-IR.
4. CONCLUSIONS
IR image acquisition protocols have been reviewed in the litera-
and a newofdynamic
University Hong Kong protocol has been proposed to be used
Libraries
as a standard. Also,
a new database for breast studies with IR
Scientific
images hasPublishers
been described. Our goal is to present an open access
database to the scientific community, interested in conducting
research in early detection of breast disease such as cancer. This
database can be used to compare diverse image analysis tech-
niques, generating solid conclusions. We believe that this will
promote the use of breast image for the image processing com-
munity. In future we intent to develop computing methods to
analyze these data, providing information to help physicians on
diagnosis.
Acknowledgments: Thanks to Brazilian CAPES, CNPq
and FAPEMA agencies. This research has also been partially
supported by projects Pro-Engenharia 021-2008 and Pro Cad-NF.
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Received: 20 June 2013. Accepted: 16 September 2013.