title: An artifacts removal post-processing for epiphyseal region-of-interest (EROI) localization in automated bone age assessment (BAA).
abstract: BACKGROUND
  Segmentation is the most crucial part in the computer-aided bone age assessment. A well-known type of segmentation performed in the system is adaptive segmentation. While providing better result than global thresholding method, the adaptive segmentation produces a lot of unwanted noise that could affect the latter process of epiphysis extraction.
  
  
  METHODS
  A proposed method with anisotropic diffusion as pre-processing and a novel Bounded Area Elimination (BAE) post-processing algorithm to improve the algorithm of ossification site localization technique are designed with the intent of improving the adaptive segmentation result and the region-of interest (ROI) localization accuracy.
  
  
  RESULTS
  The results are then evaluated by quantitative analysis and qualitative analysis using texture feature evaluation. The result indicates that the image homogeneity after anisotropic diffusion has improved averagely on each age group for 17.59%. Results of experiments showed that the smoothness has been improved averagely 35% after BAE algorithm and the improvement of ROI localization has improved for averagely 8.19%. The MSSIM has improved averagely 10.49% after performing the BAE algorithm on the adaptive segmented hand radiograph.
  
  
  CONCLUSIONS
  The result indicated that hand radiographs which have undergone anisotropic diffusion have greatly reduced the noise in the segmented image and the result as well indicated that the BAE algorithm proposed is capable of removing the artifacts generated in adaptive segmentation.
authors.affiliation: Centre for Biomedical Engineering, Faculty of Health Science and Biomedical Engineering, Universiti Teknologi Malaysia, Skudai, 81310 Johor, Malaysia. ychum2@live.utm.my
authors.forename: Hum Yan
authors.initials: HY
authors.lastname: Chai
authors.forename: Lai Khin
authors.initials: LK
authors.lastname: Wee
authors.forename: Tan Tian
authors.initials: TT
authors.lastname: Swee
authors.forename: Sh-Hussain
authors.initials: ShH
authors.lastname: Salleh
authors.forename: Lim Yee
authors.initials: LY
authors.lastname: Chea
mesh_terms: D000293:Adolescent; D000365:Age Determination by Skeleton / Q000379:methods*; D000465:Algorithms; D016880:Anisotropy; D016477:Artifacts; D002648:Child; D002675:Child, Preschool; D016000:Cluster Analysis; D004058:Diffusion; D004838:Epiphyses / Q000000981:diagnostic imaging*; D006225:Hand / Q000000981:diagnostic imaging; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods; D007223:Infant; D010363:Pattern Recognition, Automated / Q000379:methods*