Journal of Digital Imaging

, Volume 27, Issue 2, pp 237–247 | Cite as

Level Set Segmentation of Breast Masses in Contrast-Enhanced Dedicated Breast CT and Evaluation of Stopping Criteria

  • Hsien-Chi Kuo
  • Maryellen L. Giger
  • Ingrid Reiser
  • John M. Boone
  • Karen K. Lindfors
  • Kai Yang
  • Alexandra Edwards


Dedicated breast CT (bCT) produces high-resolution 3D tomographic images of the breast, fully resolving fibroglandular tissue structures within the breast and allowing for breast lesion detection and assessment in 3D. In order to enable quantitative analysis, such as volumetrics, automated lesion segmentation on bCT is highly desirable. In addition, accurate output from CAD (computer-aided detection/diagnosis) methods depends on sufficient segmentation of lesions. Thus, in this study, we present a 3D lesion segmentation method for breast masses in contrast-enhanced bCT images. The segmentation algorithm follows a two-step approach. First, 3D radial-gradient index segmentation is used to obtain a crude initial contour, which is then refined by a 3D level set-based active contour algorithm. The data set included contrast-enhanced bCT images from 33 patients containing 38 masses (25 malignant, 13 benign). The mass centers served as input to the algorithm. In this study, three criteria for stopping the contour evolution were compared, based on (1) the change of region volume, (2) the average intensity in the segmented region increase at each iteration, and (3) the rate of change of the average intensity inside and outside the segmented region. Lesion segmentation was evaluated by computing the overlap ratio between computer segmentations and manually drawn lesion outlines. For each lesion, the overlap ratio was averaged across coronal, sagittal, and axial planes. The average overlap ratios for the three stopping criteria ranged from 0.66 to 0.68 (dice coefficient of 0.80 to 0.81), indicating that the proposed segmentation procedure is promising for use in quantitative dedicated bCT analyses.


3D segmentation Breast Computer-aided diagnosis (CAD) Dedicated breast CT 



This work was supported in part by NIH grants R01-EB002138 and S10-RR021039. M.L.G. is a stockholder in R2 Technology/Hologic and receives royalties from Hologic, GE 740 Medical Systems, MEDIAN Technologies, Riverain Medical, Mitsubishi and Toshiba. It is the University of Chicago Conflict of Interest Policy that investigators disclose publicly actual or potential significant financial interest that would reasonably appear to be directly and significantly affected by the research activities.


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Copyright information

© Society for Imaging Informatics in Medicine 2013

Authors and Affiliations

  • Hsien-Chi Kuo
    • 1
    • 2
  • Maryellen L. Giger
    • 2
  • Ingrid Reiser
    • 2
  • John M. Boone
    • 3
  • Karen K. Lindfors
    • 3
  • Kai Yang
    • 3
  • Alexandra Edwards
    • 2
  1. 1.Department of BioengineeringUniversity of Illinois at ChicagoChicagoUSA
  2. 2.Department of RadiologyThe University of ChicagoChicagoUSA
  3. 3.Department of RadiologyUniversity of California at DavisSacramentoUSA

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