title: Computer-assisted diagnosis for early stage pleural mesothelioma: towards automated detection and quantitative assessment of pleural thickening from thoracic CT images.
abstract: OBJECTIVE
  Pleural thickenings as biomarker of exposure to asbestos may evolve into malignant pleural mesothelioma. For its early stage, pleurectomy with perioperative treatment can reduce morbidity and mortality. The diagnosis is based on a visual investigation of CT images, which is a time-consuming and subjective procedure. Our aim is to develop an automatic image processing approach to detect and quantitatively assess pleural thickenings.
  
  
  METHODS
  We first segment the lung areas, and identify the pleural contours. A convexity model is then used together with a Hounsfield unit threshold to detect pleural thickenings. The assessment of the detected pleural thickenings is based on a spline-based model of the healthy pleura.
  
  
  RESULTS
  Tests were carried out on 14 data sets from three patients. In all cases, pleural contours were reliably identified, and pleural thickenings detected. PC-based Computation times were 85 min for a data set of 716 slices, 35 min for 401 slices, and 4 min for 75 slices, resulting in an average computation time of about 5.2 s per slice. Visualizations of pleurae and detected thickenings were provided.
  
  
  CONCLUSIONS
  Results obtained so far indicate that our approach is able to assist physicians in the tedious task of finding and quantifying pleural thickenings in CT data. In the next step, our system will undergo an evaluation in a clinical test setting using routine CT data to quantify its performance.
authors.affiliation: Institute fo Imaging and Computer Vision, RWTH Aachen University, Aachen, Germany. kraisorn.chaisaowong@lfb.rwth-aachen.de
authors.forename: Kraisorn
authors.initials: K
authors.lastname: Chaisaowong
authors.forename: Til
authors.initials: T
authors.lastname: Aach
authors.forename: P
authors.initials: P
authors.lastname: Jäger
authors.forename: S
authors.initials: S
authors.lastname: Vogel
authors.forename: Achim
authors.initials: A
authors.lastname: Knepper
authors.forename: T
authors.initials: T
authors.lastname: Kraus
mesh_terms: D003936:Diagnosis, Computer-Assisted / Q000379:methods*; D042241:Early Diagnosis; D005858:Germany; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods*; D010997:Pleural Neoplasms / Q000175:diagnosis* / Q000000981:diagnostic imaging*; D013902:Radiography, Thoracic; D014057:Tomography, X-Ray Computed