title: Automatic detection of osteoporosis based on hybrid genetic swarm fuzzy classifier approaches.
abstract: OBJECTIVE
  This study proposed a new automated screening system based on a hybrid genetic swarm fuzzy (GSF) classifier using digital dental panoramic radiographs to diagnose females with a low bone mineral density (BMD) or osteoporosis.
  
  
  METHODS
  The geometrical attributes of both the mandibular cortical bone and trabecular bone were acquired using previously developed software. Designing an automated system for osteoporosis screening involved partitioning of the input attributes to generate an initial membership function (MF) and a rule set (RS), classification using a fuzzy inference system and optimization of the generated MF and RS using the genetic swarm algorithm. Fivefold cross-validation (5-FCV) was used to estimate the classification accuracy of the hybrid GSF classifier. The performance of the hybrid GSF classifier has been further compared with that of individual genetic algorithm and particle swarm optimization fuzzy classifiers.
  
  
  RESULTS
  Proposed hybrid GSF classifier in identifying low BMD or osteoporosis at the lumbar spine and femoral neck BMD was evaluated. The sensitivity, specificity and accuracy of the hybrid GSF with optimized MF and RS in identifying females with a low BMD were 95.3%, 94.7% and 96.01%, respectively, at the lumbar spine and 99.1%, 98.4% and 98.9%, respectively, at the femoral neck BMD. The diagnostic performance of the proposed system with femoral neck BMD was 0.986 with a confidence interval of 0.942-0.998. The highest mean accuracy using 5-FCV was 97.9% with femoral neck BMD.
  
  
  CONCLUSIONS
  The combination of high accuracy along with its interpretation ability makes this proposed automatic system using hybrid GSF classifier capable of identifying a large proportion of undetected low BMD or osteoporosis at its early stage.
authors.affiliation: 1 School of Electronics Engineering, Kyungpook National University, Daegu, Korea.
authors.forename: Muthu Subash
authors.initials: MS
authors.lastname: Kavitha
authors.affiliation: 2 Department of Information Technology, Anna University Regional Campus, Coimbatore, India.
authors.forename: Pugalendhi
authors.initials: P
authors.lastname: Ganesh Kumar
authors.affiliation: 3 School of Computer Science and Engineering, Kyungpook National University, Daegu, Korea.
authors.forename: Soon-Yong
authors.initials: SY
authors.lastname: Park
authors.affiliation: 4 Department of Oral and Maxillofacial Radiology, School of Dentistry, Seoul National University, Seoul, Korea.
authors.forename: Kyung-Hoe
authors.initials: KH
authors.lastname: Huh
authors.affiliation: 4 Department of Oral and Maxillofacial Radiology, School of Dentistry, Seoul National University, Seoul, Korea.
authors.forename: Min-Suk
authors.initials: MS
authors.lastname: Heo
authors.affiliation: 5 Graduate School of Engineering, Hiroshima University, Hiroshima, Japan.
authors.forename: Takio
authors.initials: T
authors.lastname: Kurita
authors.affiliation: 6 Faculty of Informatics, Kansai University, Osaka, Japan.
authors.forename: Akira
authors.initials: A
authors.lastname: Asano
authors.affiliation: 7 Department of Oral and Maxillofacial Radiology, School of Dentistry, Kyungpook National University, Daegu, Korea.
authors.forename: Seo-Yong
authors.initials: SY
authors.lastname: An
authors.affiliation: 1 School of Electronics Engineering, Kyungpook National University, Daegu, Korea.
authors.forename: Sung-Il
authors.initials: SI
authors.lastname: Chien
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000465:Algorithms; D015519:Bone Density / Q000502:physiology; D001851:Bone Diseases, Metabolic / Q000000981:diagnostic imaging; D000071556:Cancellous Bone / Q000000981:diagnostic imaging; D000071538:Cortical Bone / Q000000981:diagnostic imaging; D003936:Diagnosis, Computer-Assisted; D005260:Female; D005272:Femur Neck / Q000000981:diagnostic imaging; D017709:Fractals; D017143:Fuzzy Logic; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000706:statistics & numerical data*; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging; D008334:Mandible / Q000000981:diagnostic imaging; D008875:Middle Aged; D015663:Osteoporosis, Postmenopausal / Q000000981:diagnostic imaging*; D011237:Predictive Value of Tests; D011862:Radiography, Panoramic / Q000706:statistics & numerical data; D012680:Sensitivity and Specificity
keywords: computer-assisted image processing; osteoporosis; panoramic radiograph