title: Curvelet based automatic segmentation of supraspinatus tendon from ultrasound image: a focused assistive diagnostic method.
abstract: BACKGROUND
  Disorders of rotator cuff tendons results in acute pain limiting the normal range of motion for shoulder. Of all the tendons in rotator cuff, supraspinatus (SSP) tendon is affected first of any pathological changes. Diagnosis of SSP tendon using ultrasound is considered to be operator dependent with its accuracy being related to operator's level of experience.
  
  
  METHODS
  The automatic segmentation of SSP tendon ultrasound image was performed to provide focused and more accurate diagnosis. The image processing techniques were employed for automatic segmentation of SSP tendon. The image processing techniques combines curvelet transform and mathematical concepts of logical and morphological operators along with area filtering. The segmentation assessment was performed using true positives rate, false positives rate and also accuracy of segmentation. The specificity and sensitivity of the algorithm was tested for diagnosis of partial thickness tears (PTTs) and full thickness tears (FTTs). The ultrasound images of SSP tendon were taken from medical center with the help of experienced radiologists. The algorithm was tested on 116 images taken from 51 different patients.
  
  
  RESULTS
  The accuracy of segmentation of SSP tendon was calculated to be 95.61% in accordance with the segmentation performed by radiologists, with true positives rate of 91.37% and false positives rate of 8.62%. The specificity and sensitivity was found to be 93.6%, 94% and 95%, 95.6% for partial thickness tears and full thickness tears respectively. The proposed methodology was successfully tested over a database of more than 116 US images, for which radiologist assessment and validation was performed.
  
  
  CONCLUSIONS
  The segmentation of SSP tendon from ultrasound images helps in focused, accurate and more reliable diagnosis which has been verified with the help of two experienced radiologists. The specificity and sensitivity for accurate detection of partial and full thickness tears has been considerably increased after segmentation when compared with existing literature.
authors.forename: Rishu
authors.initials: R
authors.lastname: Gupta
authors.affiliation: Department of Electrical and Electronic Engineering, Universiti Teknologi PETRONAS, Tronoh, Malaysia. irraivan_elamvazuthi@petronas.com.my.
authors.forename: Irraivan
authors.initials: I
authors.lastname: Elamvazuthi
authors.forename: Sarat Chandra
authors.initials: SC
authors.lastname: Dass
authors.forename: Ibrahima
authors.initials: I
authors.lastname: Faye
authors.forename: Pandian
authors.initials: P
authors.lastname: Vasant
authors.forename: John
authors.initials: J
authors.lastname: George
authors.forename: Faizatul
authors.initials: F
authors.lastname: Izza
mesh_terms: D000328:Adult; D000465:Algorithms; D001331:Automation; D001696:Biomechanical Phenomena; D002114:Calcinosis / Q000473:pathology; D003936:Diagnosis, Computer-Assisted / Q000379:methods*; D005189:False Positive Reactions; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods*; D008875:Middle Aged; D018482:Muscle, Skeletal / Q000473:pathology; D011871:Radiology / Q000379:methods; D015203:Reproducibility of Results; D017006:Rotator Cuff / Q000000981:diagnostic imaging* / Q000473:pathology; D013708:Tendon Injuries / Q000473:pathology*; D013710:Tendons / Q000000981:diagnostic imaging* / Q000473:pathology; D014463:Ultrasonography; D055815:Young Adult