Automated detection of breast mass spiculation levels and evaluation of scheme performance.

RATIONALE AND OBJECTIVES Although the spiculation levels of breast mass boundaries are a primary sign of malignancy for masses detected on mammography, developing an automated computerized method to detect spiculation levels and quantitatively evaluating the performance of such a method is a difficult task. The objectives of this study were to (1) develop and test a new method to improve mass segmentation and detect mass boundary spiculation levels and (2) assess the performance of this method using a relatively large imaging data set. MATERIALS AND METHODS The fully automated method developed for this study includes three image-processing steps. In the first step, the principle of maximum entropy is applied in the selected region of interest (ROI) after correcting the background trend to enhance the initial outlines of a mass. In the second step, an active-contour model is used to refine the initial outlines. In the third step, spiculated lines connected to the mass boundary are detected and identified using a special line detector. A quantitative spiculation index is computed to assess the degree of spiculation. To develop and evaluate this automated method, 211 ROIs depicting masses were extracted from a publicly available image database. Among these ROIs, 106 depicted circumscribed mass regions and 105 involved spiculated mass regions. The performance of the method was evaluated using receiver-operating characteristic (ROC) analysis. RESULTS The computed area under the ROC curve, when applying the method to the data set, was 0.701 +/- 0.027. By setting up a threshold at a spiculation index of 5.0, the method achieved an overall classification accuracy of 66.4%, with 54.3% sensitivity and 78.3% specificity. CONCLUSIONS In this study, a new computerized method with a number of unique characteristics was developed to detect spiculated mass regions, and a simple spiculation index was applied to quantify mass spiculation levels. Although this quantitative index can be used to distinguish between spiculated and circumscribed masses, the results also suggest that the automated detection of mass spiculation levels remains a technical challenge.