Locally adaptive decision in detection of clustered microcalcifications in mammograms

In computer-aided detection or diagnosis of clustered microcalcifications (MCs) in mammograms, the performance often suffers from not only the presence of false positives (FPs) among the detected individual MCs but also large variability in detection accuracy among different cases. To address this issue, we investigate a locally adaptive decision scheme in MC detection by exploiting the noise characteristics in a lesion area. Instead of developing a new MC detector, we propose a decision scheme on how to best decide whether a detected object is an MC or not in the detector output. We formulate the individual MCs as statistical outliers compared to the many noisy detections in a lesion area so as to account for the local image characteristics. To identify the MCs, we first consider a parametric method for outlier detection, the Mahalanobis distance detector, which is based on a multi-dimensional Gaussian distribution on the noisy detections. We also consider a non-parametric method which is based on a stochastic neighbor graph model of the detected objects. We demonstrated the proposed decision approach with two existing MC detectors on a set of 188 full-field digital mammograms (95 cases). The results, evaluated using free response operating characteristic (FROC) analysis, showed a significant improvement in detection accuracy by the proposed outlier decision approach over traditional thresholding (the partial area under the FROC curve increased from 3.95 to 4.25, p-value  <10^-4). There was also a reduction in case-to-case variability in detected FPs at a given sensitivity level. The proposed adaptive decision approach could not only reduce the number of FPs in detected MCs but also improve case-to-case consistency in detection.