title: Age-based computer-aided diagnosis approach for pancreatic cancer on endoscopic ultrasound images.
abstract: OBJECTIVE
  The aim was to develop a high-performance computer-aided diagnosis (CAD) system with image processing and pattern recognition in diagnosing pancreatic cancer by using endosonography images.
  
  
  METHODS
  On the images, regions of interest (ROI) of three groups of patients (<40, 40-60 and >60) were extracted by experts; features were obtained from images using three different techniques and were trained separately for each age group with an Artificial Neural Network (ANN) to diagnose cancer. The study was conducted on endosonography images of 202 patients with pancreatic cancer and 130 noncancer patients.
  
  
  RESULTS
  122 features were identified from the 332 endosonography images obtained in the study, and the 20 most appropriate features were selected by using the relief method. Images classified under three age groups (in years; <40, 40-60 and >60) were tested via 200 random tests and the following ratios were obtained in the classification: accuracy: 92%, 88.5%, and 91.7%, respectively; sensitivity: 87.5%, 85.7%, and 93.3%, respectively; and specificity: 94.1%, 91.7%, and 88.9%, respectively. When all the age groups were assessed together, the following values were obtained: accuracy: 87.5%, sensitivity: 83.3%, and specificity: 93.3%.
  
  
  CONCLUSIONS
  It was observed that the CAD system developed in the study performed better in diagnosing pancreatic cancer images based on classification by patient age compared to diagnosis without classification. Therefore, it is imperative to take patient age into consideration to ensure higher performance.
authors.forename: Murat
authors.initials: M
authors.lastname: Ozkan
authors.forename: Murat
authors.initials: M
authors.lastname: Cakiroglu
authors.forename: Orhan
authors.initials: O
authors.lastname: Kocaman
authors.affiliation: Department of Gastroenterology, Abant Izzet Baysal University, Bolu, Turkey.
authors.forename: Mevlut
authors.initials: M
authors.lastname: Kurt
authors.forename: Bulent
authors.initials: B
authors.lastname: Yilmaz
authors.forename: Guray
authors.initials: G
authors.lastname: Can
authors.forename: Ugur
authors.initials: U
authors.lastname: Korkmaz
authors.forename: Emre
authors.initials: E
authors.lastname: Dandil
authors.forename: Ziya
authors.initials: Z
authors.lastname: Eksi