title: Multipurpose contrast enhancement on epiphyseal plates and ossification centers for bone age assessment.
abstract: BACKGROUND
  The high variations of background luminance, low contrast and excessively enhanced contrast of hand bone radiograph often impede the bone age assessment rating system in evaluating the degree of epiphyseal plates and ossification centers development. The Global Histogram equalization (GHE) has been the most frequently adopted image contrast enhancement technique but the performance is not satisfying. A brightness and detail preserving histogram equalization method with good contrast enhancement effect has been a goal of much recent research in histogram equalization. Nevertheless, producing a well-balanced histogram equalized radiograph in terms of its brightness preservation, detail preservation and contrast enhancement is deemed to be a daunting task.
  
  
  METHODS
  In this paper, we propose a novel framework of histogram equalization with the aim of taking several desirable properties into account, namely the Multipurpose Beta Optimized Bi-Histogram Equalization (MBOBHE). This method performs the histogram optimization separately in both sub-histograms after the segmentation of histogram using an optimized separating point determined based on the regularization function constituted by three components. The result is then assessed by the qualitative and quantitative analysis to evaluate the essential aspects of histogram equalized image using a total of 160 hand radiographs that are implemented in testing and analyses which are acquired from hand bone online database.
  
  
  RESULTS
  From the qualitative analysis, we found that basic bi-histogram equalizations are not capable of displaying the small features in image due to incorrect selection of separating point by focusing on only certain metric without considering the contrast enhancement and detail preservation. From the quantitative analysis, we found that MBOBHE correlates well with human visual perception, and this improvement shortens the evaluation time taken by inspector in assessing the bone age.
  
  
  CONCLUSIONS
  The proposed MBOBHE outperforms other existing methods regarding comprehensive performance of histogram equalization. All the features which are pertinent to bone age assessment are more protruding relative to other methods; this has shorten the required evaluation time in manual bone age assessment using TW method. While the accuracy remains unaffected or slightly better than using unprocessed original image. The holistic properties in terms of brightness preservation, detail preservation and contrast enhancement are simultaneous taken into consideration and thus the visual effect is contributive to manual inspection.
authors.affiliation: IJN-UTM Cardiovascular Engineering Centre, Biotechnology Research Alliance, Faculty of Biosciences and Medical Engineering, Universiti Teknologi Malaysia, 81310 UTM Skudai, Johor Bahru, Johor, Malaysia. ychum2@live.utm.my
authors.forename: Hum Yan
authors.initials: HY
authors.lastname: Chai
authors.forename: Tan Tian
authors.initials: TT
authors.lastname: Swee
authors.forename: Gan Hong
authors.initials: GH
authors.lastname: Seng
authors.forename: Lai Khin
authors.initials: LK
authors.lastname: Wee
mesh_terms: D000365:Age Determination by Skeleton / Q000379:methods*; D000465:Algorithms; D001842:Bone and Bones / Q000502:physiology*; D016208:Databases, Factual; D006132:Growth Plate / Q000502:physiology*; D006801:Humans; D007089:Image Enhancement / Q000379:methods*; D008954:Models, Biological
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