Digital imaging colposcopy: corrected area measurements using shape-from-shading.

The quantitative measurement of areas on the cervix is of interest to researchers studying the natural history of human papilloma viral lesions. Measurement of areas from images obtained through a colposcope are, however, inherently in error due to the image being a two-dimensional projection of a three-dimensional object. The ability to correct for these errors through use of digital imaging colposcopy and a practical application of a shape from shading algorithm was developed in this study. The shape from shading technique requires empirical measurement of the relationship between observed light intensity and the viewing angle (referred to as a reflection map). It was found that a population mean reflection map provided a correction that was about as accurate as using an individual's own reflection map (making it unnecessary to measure a map for each exam). Digital red filtering of the images increased accuracy and precision of measurement.

Digital imaging colposcopy: basic concepts and applications.

The technique of colposcopy has changed little since the introduction of the green filter to improve viewing of vascular structures. However, the recent dramatic improvements in computer technology now make it practical to combine computerized image processing with colposcopy, which we have termed "digital imaging colposcopy." Image processing techniques permit contrast enhancement of features, such as white epithelium and abnormal vasculature. The digital colposcope allows rapid measurement of the cervical area involved with visible lesions, providing an improved means of following the progression of these lesions over time.

Computer-assisted analysis of transrectal ultrasound images.

We have developed a microcomputer based system with an application specific software package which permits the direct digitization and analysis of transrectal ultrasound (TRUS) images. The system is highly flexible and enables access to a wide range of image analysis tools through relatively simple software modifications, which cannot be implemented using a standard ultrasound instrument. We have demonstrated the capability of the system by an analysis of a number of morphometric parameters and by a correlation of these measurements with the presence of prostatic cancer. We found that the measurement of the ratio of the anterior-posterior axis to transverse axis and the presumed circular area ratio (PCAR) were significant predictors of prostatic cancer. The sensitivity of the PCAR measurement was 93%, the specificity was 50%, the positive predictive value was 57%, and the negative predictive value was 91%. The high negative predictive values of these parameters may provide objective criteria to allow for selective biopsy of patients. This system provides researchers with an efficient, economical, and flexible method to aid in the analysis of TRUS images in a quantitative manner.

Comparison of conventional fluorescein angiography film images with a cathode ray tube display.

We evaluated the effectiveness of cathode ray tube (CRT) displays in the transfer of diagnostic information to the ophthalmologist. Retinal fluorescein angiography images were used and data were taken using the receiver operating characteristic experimental paradigm. Three ophthalmologists with experience ranging from two to 12 years participated in the study. Sixty-eight images were selected from proof sheets of 800 original images. Next, these images were digitized, then each set was shown on its respective display (slide projection for the proof sheet images and CRT for the digital images). These 68 images were from a variety of patients and represented a broad range of normal and abnormal retinas (including diabetic retinopathy, hypertension independent of diabetes, and sickle-cell disease). Results show (1) that there is no difference between the systems in terms of diagnostic accuracy; (2) that certainty of diagnosis was not a function of the system; and (3) that although there was an effect due to experience of the ophthalmologist, it did not affect diagnosis accuracy. We conclude that CRT displays at conventional video resolutions can deliver the needed diagnostic information as well as film. We also hypothesize that digital enhancement techniques can increase the available diagnostic information beyond that of film.