Lung cancer remains the leading cause of cancer deaths in the developed world. There is no widely accepted method to screen for this cancer. The most commonly used method remains conventional sputum cytology, but this method is hampered by low sensitivity. We tested the hypothesis that sensitivity of sputum cytology for early lung cancer can be greatly improved by using image analysis of sputum cells, at a modest reduction of specificity.The study was double-blinded and used sputum samples from subjects with well-characterized clinical diagnoses. There were 177 cancers, 98 dysplasias, and 558 normals. The study samples were separated into two independent sets: training set and test set. Sputum samples were collected prospectively from subjects with a high probability of having lung cancer. Seven institutions from five countries participated in the study. All subjects had complete clinical diagnoses which included, as a minimum, negative chest x-rays for all negative cancers, while all cancers had confirmed tissue pathology. Samples were prepared according to the Saccomanno method. For conventional cytology, slides were stained using Papanicolaou stain. For image analysis, slides were stained using a DNA-specific (Feulgen-Thionin) stain. An automated, high-resolution image cytometer was used for measurements.At 90% specificity, sensitivity of 60% can be achieved for adenocarcinoma, compared to only 14% sensitivity of conventional cytology (at 99% specificity). Similarly, 45% sensitivity at 90% specificity can be reached for stages 0 and I lung cancer, compared to only 14% (at 99% specificity) using conventional cytology.Cytometry combined with conventional cytology shows an increase in sensitivity to early-stage cancer and to adenocarcinomas compared to conventional cytology alone. While the results are encouraging, the sensitivity to detect early lung cancer should be further improved to 70 -80% at 90 -95% specificity before this test can be considered for screening of high-risk individuals for lung cancer. Cytometry (Clin. Key terms: lung cancer; sputum cytology; image analysis; sensitivity; specificity; screening for lung cancer; early lung cancer; adenocarcinoma Despite the fact that advances have been made in sputum cytology over the last 30 years (1,2), the literature contains mixed results about the efficacy of using it as the primary method for detection of lung cancer. Although approximately 50 studies employing a range of preparation techniques reported sensitivities ranging from 40 -80% at high specificities (95-99%) (3), they suffer from a limited number of samples and are demonstrated by latestage cancer. Large-scale studies, such as the NCI-sponsored study (the Cooperative Early Lung Cancer Detection Program, carried out by Memorial Sloan-Kettering, the Mayo Clinic, and Johns Hopkins University) (4 -6), did not confirm such results despite the fact that the most experienced cytopathologists of the day were carrying out the sputum cytology. Sputum cytology alone detected only 23% of the cancers in th...
We define the separation of figure from ground as a visual-attribute-dependent and task-dependent representation of sensory information in higher-level visual processes. A computer model for adaptive segmentation of 2-D visual objects (Dudkin et al, 1995 Proceedings of SPIE 122) was developed in these studies. The description and separation of figure from ground are implemented by spatial frequency filters and feature detectors performing as self-organising mechanisms. The simulation of control processes caused by attention (top - down), and lateral, frequency-selective, and cross-orientation inhibition (bottom - up) determines the adaptive image processing. The first stage is the estimation of input image produced by the analysis of the spatial brightness distribution by algorithms calculating the vector of primary descriptive attributes. These results provide the synthesis of control processes based on several algorithms, each of which transforms descriptive attributes into separate control parameters. The creation of two primary descriptions: ‘sustained’ (contours) and ‘transient’ (fragments with homogeneous intensity), and the selection of feature-detection operators are governed by the complete set of control parameters. The primary descriptions allow formation of the intermediate image description in which similar elements are grouped by identical brightness, colour, spatial position, curvature, and texture according to Gestalt concepts. To divide the image into basic areas and to extract fragments which belong to a putative figure, all these descriptions are combined into the final integrated image representation. The model has been tested on various images.
The effect of three primary fixation procedures, used in the preparation of routine cytological samples: air-drying, Delaunay, and Saccomanno fixation, with postfixation in modified Böhm–Sprenger fixative, on nuclear features as a function of hydrolysis time is reported. Three different cell types: lymphatic cells (tonsil), epithelial cells (buccal mucosa) and mesenchymal cells (uterine myometrium) were used for the study. Our findings show, that generally not all features have the same plateau times as the IOD (integrated optical density), and that many features show different values depending on cell type and fixation method. It is therefore recommended that for any primary fixative used in routine clinical work and for each cell type, the hydrolysis curve for all nuclear features to be used in sample analysis should be established.
The aim of this study was to confirm the existence of specific nuclear texture feature alterations of histologically normal epithelial borders nearby invasive laryngeal cancer (NC).Paraffin sections of NC and of chronic inflammations unrelated to cancer (CI) were analysed for nuclear texture and for integrated optical density (IOD‐index) and were compared to normal epithelium of patients without evidence of cancer (NE). Several discriminant functions based on nuclear texture features were trained to separate different subgroups.As the most important result, specific nuclear texture feature shifts were only found in NC with high‐density lymphocytic stroma infiltrate (NC+). Classification of nuclei of NE versus NC+ was correct in 70%. The same classifier was correct in only 58% when nuclei of NE were classified versus CI. We also found lower values of IOD‐Index within the NC+ group when compared to NE (p < 0:001).
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