Effective identification and localization of immature precursors in bone marrow biopsy

Abnormal localization of immature precursors (ALIP) aggregating and clustering in bone marrow biopsy appears earlier than that of bone marrow smears in detection of the relapse of acute myelocytic leukemia (AML). But traditional manual ALIP recognition has many shortcomings such as prone to false alarms, neglect of distribution law before three immature precursor cells gathered, and qualitative analysis instead of quantitative one. So, it is very important to develop a novel automatic method to identify and localize immature precursor cells for computer-aided diagnosis, to disclose their patterns before ALIP with the development of AML. The contributions of this paper are as follows. (1) After preprocessing the image with Otsu method, we identify both precursor cells and trabecular bone by multiple morphological operations and thresholds. (2) We localize the precursors in different regions according to their distances with the nearest trabecular bone based on chamfer distance transform, followed by discussion for the presumptions and limitations of our method. The accuracy of recognition and localization is evaluated based on a comparison with visual evaluation by two blinded observers.