title: Automated segmentation and quantification of inflammatory tissue of the hand in rheumatoid arthritis patients using magnetic resonance imaging data.
abstract: OBJECTIVE
  The aim of this paper is the development of an automated method for the segmentation and quantification of inflammatory tissue of the hand in patients suffering form rheumatoid arthritis using contrast enhanced T1-weighted magnetic resonance images.
  
  
  METHODS
  The proposed automatic method consists of four stages: (a) preprocessing of images, (b) identification of the number of clusters, by minimizing the appropriate validity index, (c) segmentation using the fuzzy C-means algorithm employing four features which are related to intensity and the location of pixels and (d) postprocessing, where defuzzification is performed and small objects and vessels are eliminated and quantification takes place.
  
  
  RESULTS
  The proposed method is evaluated using a dataset of image sequences obtained from 25 patients suffering from rheumatoid arthritis. For 17 of them we have obtained follow-up images after 1 year treatment. The obtained sensitivity and positive predictive rate is 97.71% and 83.35%, respectively. In addition, quantification of inflammation before and after treatment, as well as, comparison with manual segmentation is carried out.
  
  
  CONCLUSIONS
  The proposed method performs very well and results in high detection and quantification accuracy. However, the reduction of false positives and the identification of old inflammation must be addressed.
authors.affiliation: Unit of Medical Technology and Intelligent Information Systems, Department of Computer Science, University of Ioannina and Biomedical Research Institute - FORTH, GR 451 10 Ioannina, Greece.
authors.forename: Evanthia E
authors.initials: EE
authors.lastname: Tripoliti
authors.forename: Dimitrios I
authors.initials: DI
authors.lastname: Fotiadis
authors.forename: Maria
authors.initials: M
authors.lastname: Argyropoulou
mesh_terms: D000465:Algorithms; D018501:Antirheumatic Agents / Q000627:therapeutic use; D001172:Arthritis, Rheumatoid / Q000175:diagnosis* / Q000188:drug therapy; D016000:Cluster Analysis; D006225:Hand; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008279:Magnetic Resonance Imaging; D011237:Predictive Value of Tests; D012680:Sensitivity and Specificity
chemical_list: D018501:Antirheumatic Agents