DIGITAL RADIOGRAPHIC IMAGE ENHANCEMENT FOR IMPROVED VISUALIZATION

Nisar Ahmed, Waqas Ahmed and Sheikh M. Arshad HIEC University Taxila Cantonment, Pakistan. E-Mail: nisarahmedrana@yahoo.com ABSTRACT Digital radiographic image enhancement techniques are used to accentuate and sharpen image features for enhanced visualization and better quality images. Image enhancement does not try to quash the artifacts it just makes it easier to interpret by improving visualization. Different techniques are available to reduce visual noise, enhance edges and display improved contrast images. Digital radiographic images with low contrast, visual noise due to electrical noise or X-ray scattering and blurring caused by complexity of body tissues, can worsen the result of diagnostic. So it is necessary to enhance radiographic images to improve their visual quality, including contrast enhancement and feature enhancement. Different techniques to enhance digital radiographic images have been presented in this paper. Furthermore a graphical user interface has been made in MATLAB to show the results of digital radiographic image enhancement techniques. The objective is to incorporate radiologists to optimize the diagnostic quality of radiographic images. KEYWORDS Image Processing, Image denoising, Image enhancement, Biomedical image processing, Biomedical imaging, Mammography, Medical diagnostic imaging, X-ray tomography. INTRODUCTION In radiographic imaging, such as digital x-rays, CT scan or mammogram, images of different organs and tissues are produced. There are many sources of interference in the production of radiographic images, such as insufficient performance, noise of imaging device and the movement of patient. The quality of many images is poor in their contrast, and to improve their quality for better visualization, to see clearly enough critical details and reduce the noise for diagnostic purposes, methods of enhancement are used. The purpose of image enhancement is thus to improve a digital image quality and to support the human perception. Image processing technology is used by planetary scientists to enhance images of celestial objects such as Mars, Venus, or other planets. Doctors use this technology to manipulate digital radiographic images such as CAT scans, MRI images and digital X-rays. [1] Diagnostic radiographic imaging is the medical assessment of body tissues and organs by means of static or dynamic radiologic images. Electromagnetic radiation in the form of ionizing radiation has been the predominant energy source for diagnostic radiology. The use of ionizing radiation in diagnostic radiology involves passing a localized beam of X-rays through the part of the body being examined. This produces a static image on film. The image, called a radiograph, or X-ray picture, can take several forms. It may be a plain radiograph, such as the common chest X ray; a mammogram, an X-ray image of the female breast used to scan for cancerous tumors; a tomograph, which produces an image of the entire complexity of an anatomical structure with a series of X rays; or a computed tomography scan, a computer analysis of a cross-sectional image of the body. [2] Direct Radiography In this process the image is captured directly on the reusable storage phosphor plate and the image is transmitted directly to the computer. No intermediate steps or additional processes are required to capture the image. This
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process provides a direct feed from panel to imaging workstation. The two main types of direct radiology are discussed hare. Digital X-ray In X-ray image enhancement the process of enhancing edges progressively until optimal levels of clarity is reached is used. Basically the edge segments of the image are enhanced by making its light parts lighter and its dark parts darker along the edges, preserving interior textures at their original gray level values. Digital Mammograms Mammography is currently the only proven and cost-effective method to detect early breast cancer. A mammographic examination generally contains four images, two views for each breast. These two views are designed to include most of the breast tissues within the X-ray images. In mammography a radiologist first screens the mammograms for abnormalities. If a suspicious abnormality is detected, further diagnostic workup is then performed to estimate the likelihood that the abnormality is malignant. [3]. It is very difficult to interpret the X-ray mammograms because of the small differences in image density of various breast tissues. The individual particle of microcalcifications may be under 0.5mm in diameter with irregular and heterogeneous shape. Therefore careful diagnosis should be performed for the clustered microcalcifications that may cause an early stage cancer. [4]. Different image enhancement techniques have been applied on digital mammogram to improve the visibility of mammographic lesions on a computer monitor. CT scans Computed Tomography scans are special x-ray tests that produce cross-sectional images of the body using x-rays and a computer. These images allow the radiologist to look at the inside of the body. This type of special x-ray, in a sense, takes "pictures" of slices of the body so doctors can look right at the area of interest. CT scans are frequently used to evaluate the brain, neck, spine, chest, abdomen, pelvis, and sinuses.

CONTRAST ENHANCEMENT Image Contrast is the difference in appearance of two or more parts of an image seen simultaneously. An image must have good brightness contrast for proper vision. In a low contrast image we cant distinguish clearly between different objects. Increasing the contrast makes the light areas become lighter and dark areas become darker. Contrast enhancement increases the visual perception of difference between different parts of an image. We use different techniques of histogram modification to improve the visual contrast of the image. The histogram of an image with the intensity levels in the range [0, L-1] is a discrete function. ( Where sk is the intensity value. Nk is the number of pixels in the image with intensity sk. f(sk) is the histogram of the digital image with Gray Level sk )

Linear Contrast Stretching In linear histogram stretching the histogram of image matrix is linearly stretched over the entire range of spectrum. This technique maps the intensities to new values such that the data is stretched to the whole range. This technique produces useful results when the histogram of original image is concentrated in a narrow range of spectrum. The equation used for linear contrast stretching is equation of line. Whereas m is gradient and c is y intercept.

Histogram Equalization Histogram equalization generates a gray map which changes the histogram of the image. It redistributes all pixels values such as to produce uniform histogram. This technique is especially important when the usable data
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is represented by close contrast values. Histogram equalization spread out the most frequent intensity values to allow the areas of lower contrast to gain a higher contrast. The principle disadvantages with histogram equalization are: The histogram equalization method may result in over enhancement and saturation artifacts. Histogram equalization can be found on the fact that it may significantly alter the brightness of an image. The histogram equalization method does not take the mean brightness of an image into account. The mean brightness of the histogram-equalized image is always the middle gray level regardless of the input mean.

Brightness Preserving Histogram Equalization BPHE (Brightness preserving histogram equalization) is used to overcome the problem with simple histogram equalization. It compute the mean of the image and decomposes the image into two sub images based on the mean of the image. One of them is set of samples less than or equal to the mean whereas the other is the set of samples greater than the mean. Then the technique equalizes the sub images independently based on their respective histograms with the restriction that the samples in the first sub-image are mapped into the range from the minimum gray level to the input mean and the samples in the latter sub-image are mapped into the range from the mean to the maximum gray level. Thus the resulting equalized sub images are bounded by each other around the mean, which has an effect of preserving mean brightness. Contrast Limited Adaptive Histogram Equalization CLAHE (Contrast limited adaptive histogram equalization) computes multiple histograms, each corresponding to a distinct section to increase local contrast, rather than overall contrast. The image is divided into tiles and it operates on tiles rather than the entire image. Contrast of each tile is enhanced by histogram equalization and then all the tiles are combined using bilinear interpolation to eliminate the artificially induced boundaries. The contrast especially in homogeneous areas is limited to avoid noise amplification. REMOVING NOISE Radiographic images are prone to a variety of types of noise. Noise is the result of errors in the image acquisition process that result in pixel values that do not reflect the true intensities of the real scene. Noise can occur in digital radiographic images due to several reasons such as If the image is scanned from an X-Ray film or CT image, the film grain is a source of noise. It can be a result of a damaged film or due to the scanner itself. If the image is captured directly from digital X-Ray scanner or a CT scanner it can be due to mechanism of gathering the data.

Sigma Filter Linear Filtering is easiest method to remove certain type of noise. Averaging or Gaussian filter can be used to accomplish this job. In averaging filter each pixel gets set to the average of its neighboring pixels. The problem with averaging filter is that edges of image get blurred. To overcome this problem there are some selective techniques. Sigma filter is a selective mean filter. It preserves edges better and is less sensitive to outliers. The filter smoothes an image by taking an average over the neighboring pixels, but only includes those pixels that have a value not deviating from the current pixel by more than a given range. Outliers having a value very different from the surrounding are not included in the average and, thus, completely eliminated from blurring. Median Filter Median filter works in a similar way as averaging filter, the only difference is the output value of a pixel is determined by the median of the neighboring pixel rather than mean. The principle advantage of median filtering over averaging is that it is much less sensitive to extreme values. Therefore median filtering is better able to remove noise without blurring the edges.
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Wiener filter Wiener filter often produce much better results than linear filtering. Wiener filter preserve edges and other high frequency information of an image so it is more selective then linear or median filters. This filter produces best output when noise is AWGN. The only problem of this method over the previous is it requires more computational time. Anisotropic diffusion is a technique which reduces image noise without removing significant contents of the image, typically details that are important for the interpretation of the image such as lines or edges. [5] IMAGE SHARPENING In radiology, we want the recorded image to be a faithful representation of the organs that we want to see but every image is more or less blurry because it is unavoidable that scene information spills over to neighboring pixels. When the image does not shows sharp details of its features it is called blurred image. Thus, image sharpening is fundamental in making images clear and useful. Image sharpening using Laplacian of Gaussian filter has been used for CT or MRI images and high frequency component boosting has been used in X-Ray and mammographic images. RESULTS AND DISCUSSION MATLAB is used to test and compare the results of algorithms discussed in the paper. A graphical user interface is designed in MATLAB to help in applying these techniques and analyze the results. It shows the original image as well as processed image in the same window. Histogram of the processed image is continuously updated to analyze the result. These techniques are applied to high dynamic range images. This set includes digital radiographic images taken from a radiologist and some scans of X-Ray and CT images.

Figure 1. Application of different enhancement techniques on chest X-Ray.

contrast

Figure 2. Application of Noise reduction techniques on a portion of CLAHE image.

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Figure 3. Application of contrast enhancement techniques on Digital X-Ray of hand and Neck and Mammogram.

Figure 4. Contrast Enhancement result on CT Scan image.

Figure 5. Noise reduction results on Figure.4(c) image.

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Table 1: Contrast Enhancement Advantages

Linear Contrast HE Can produce good result by linear stretching. This technique is best for visual perception especially when image have close contrast data. This technique produces good results when histogram equalization cant produce attractive results. Produce best results when HE produces brightness shift.

Disadvantages
Cant produce much attractive results in many cases. This technique may result in brightness shift because it does not take mean brightness. This technique produce limited contrast enhancement due to local enhancement. Take more time duce to separation into two images and appending after their enhancement.

CLAHE

BPHE

The best among the above discussed technique is BPHE (brightness preserving histogram equalization) it produces good result while preserving the image mean brightness. Table 2: Noise Reduction Advantages
Median Filtering Sigma Filter Wiener Filter Easy to implement. Easy to implement by adding threshold in averaging filter. Produce best output when the noise is additive white Gaussian noise.

Disadvantages
Image edges get blurred. Cant be used for salt & pepper noise. Require high computational time.

Sigma filter produce better result for CT and MRI images. It preserves the edges while removing the noise. Radios and threshold can be adjusted to acquire the desired performance. However median filter also reduce noise effectively. Its results become good if we apply image sharpening filter after median filtering. CONCLUSION Contrast enhancement using histogram processing is an effective method, four techniques of histogram processing has been applied on a large number of digital radiographic images. BPHE has shown best results among the four. Three techniques have been used for noise reduction and sigma filter has shown better result among them. However median filter followed by image sharpening also show good results. REFERENCES [1] Image Processing and Image Enhancement, Dr. William L. Joyner, East Tennessee State University Johnson City, Texas, 1996 [2] Microsoft Encarta 2009. 1993-2008 Microsoft Corporation. [3] Medical Image Analysis Methods, Edited By Lena Costaridou Published By Taylor and Francis Group [4] Adaptive Mammographic Image Enhancement Using First Derivative and Local Statistics, Jong Kook Kim, JeongMi Park, KounSik Song, and Hyun Wook Park, IEEE TRANSACTIONS ON MEDICAL IMAGING, VOL. 16, NO. 5, OCTOBER 1997 [5] Anisotropic diffusion, Perona and Malik in 1987 [6] The Application of Image Enhancement on Color and Grayscale Images, Nisar Ahmed, Waqas Ahmed, HITEC University Taxila, All Pakistan Technical Paper Competition, CIIT Lahore. [7] Digital Applications of Radiography, Ramesh J. Patel, Qatargas Operating Company Limited, Doha Qatar, 3rd MENDT - Middle East Nondestructive Testing Conference & Exhibition - 27-30 Nov 2005 Bahrain, Manama. [8] Enhancement of Images Using Histogram Processing Techniques, Komal Vij & Yaduvir Singh, Thapar University, Patiala, India. [9] Radiographic Image Enhancement, M Analoui, Oral and Maxillofacial Imaging Research Facility, School of Dentistry, Indiana University, Indiana, USA [10] Application of Image Enhancement Techniques to Magnetic Resonance Imaging, Michael L. W ood, Val M. Runge, The Radiographical Society of North America.
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