The invention relates generally to image processing in medical applications, and in particular, to mammography CAD.
Mammography is an effective method of screening for breast cancer, a leading cause of mortality among women. However, analyzing mammograms requires skilled radiologists whose performance can be degraded by the demand of viewing a large number of images in a finite amount of time. The computer-aided detection (CAD) feature in many mammography systems has been provided to assist radiologists in capturing true-positives (TP) that might otherwise have been overlooked.
An abnormality in mammograms includes microcalcifications (MCC), which are tiny deposits of calcium in breast carcinoma. It is very difficult to distinguish between malignant and benign microcalcification clusters, even for experienced radiologists, which may lead to a high rate of unnecessary biopsies. Therefore, it is desirable to design the CAD algorithm in such a way that a high TP rate can be achieved while the number of false-positives (FPs) is kept to a minimum. It has been noted that many FP MCC candidates as selected by mammography CAD systems in the past were found to fall on the linear normal structures such as blood vessels in digital or film-based mammograms. Thus, it is believed that removing those MCC candidates that are associated with linear structures will significantly reduce the overall FP rate.
Various methods for extracting linear structures from a mammographic image have been proposed. Zwiggelaar, Parr, and Taylor (R. Zwiggelaar, T. C. Parr, and C. J. Taylor, “Finding orientated line patterns in digital mammographic images,” Proc. 7th Br. Machine Vision Conf., 1996, pp. 715-724.) have compared the performance of several different approaches (including orientated bin and line operator methods) to the detection of linear structures with synthetic mammographic images. Their results suggest significant differences between the different approaches. One approach has been implemented as a multi-scale line operator and gives intuitively convincing results. The output could be used for classifying linear structures.
The work of line operator can be described as follow: The line operator takes the average grey level of the pixels lying on an orientated local line passing through the target pixel and subtracts the average intensity of all the pixels in the locally orientated neighborhood. The line strength is compared for n orientations. Line direction is obtained from the orientation producing the maximum line strength. Scale information can be obtained by applying the line operator to images that are resealed by Gaussian smoothing and sub-sampling. For each pixel, the scale producing the maximum line strength is taken as the detected line scale.
Cerneaz et al. (N. Cerneaz and M. Brady, “Finding Curvilinear Structures in Mammograms,” Lecture Notes in Computer Science, 905, pp. 372-382, 1995) introduced a method that estimates the intensity profile of the curvilinear structures (CLS) in mammograms in a single scale. In this method, the CLS are assumed to have circular cross section when the breast is not compressed. And the cross section of CLS in mammogram is assumed to be elliptical. Candidate pixels for CLS are detected using the response of a second order difference operation which is applied in four directions. If there is a sufficient high response for one of the orientations the pixel will form part of a CLS. A measure of line strength is obtained by determining the contrast of the line profile at these pixels.
Wai et al. (A Multi-resolution CLS Detection Algorithm for Mammographic Image Analysis,” Medical Imaging Computing and Computer-Assisted Intervention, MICCAU, pp. 865-872, 2004) adopted the two-step method from Cerneaz's work and devised a multi-resolution ridge detector for structures ranging from 1800 microns to 180 microns. Wai et al. also enhanced the performance of the detector by using a local energy thresholding to suppress undesirable response from noise. The local energy is also used to determine CLS junctions.
Alexander Schneider et al., in U.S. Patent Application Publication No. US20020159622, proposed a system and method for detecting lines in medical images. In their method, a direction image array and a line image array are formed by filtering a digital image with a single-peaked filter, convolving the regular array with second-order difference operators oriented along the horizontal, vertical, and diagonal axes, and computing the direction image arrays and line image arrays as direct scalar functions of the results of the second order difference operations. As best understood, line detection based on the use of four line operator functions requires fewer computations than line detection based on the use of three line operator functions, if the four line operator functions correspond to the special orientations of 0, 45, 90 and 135 degrees.
For the issue of FP reduction, a paper by Zhang et al. (“A New False Positive Reduction Method for MCCs Detection in Digital Mammography,” Acoustics, Speech and Signal Processing 2001, Proc. IEEE Intl. Conf. on (ICASSP), V. 2, Issue 2001, pp. 1033-1036, 2001) describes a mixed feature multistage FP reduction algorithm utilizing eleven features extracted from spatial and morphology domains. These features include gray-level description, shape description and clusters description but no feature is directly related to linear structures. Wai et al. mention in their article that the results from the multi-resolution ridge detector could be beneficial to microcalcification false-positive reduction but the realization of the reduction is absent. Moreover, it is computationally inefficient to generate actual linear structures just for the purpose of confirming the association of an MCC candidate cluster with a linear structure in mammography CAD.
Therefore, a need exists for an improved approach for image linear structure verification in mammography.
The present invention is designed to overcome the problems set forth above. More particularly, with the present invention, all MCC candidate clusters are assumed being associated with linear structures until verified otherwise. Therefore, the present invention provides a method for linear structure (LS) verification in mammography CAD systems with the objective of reducing microcalcification (MCC) false-positives. The method of the invention is MCC cluster driven method and verifies linear structures with a small rotatable band centered around a given MCC candidate cluster in question. The classification status of an MCC candidate cluster is changed if its association with a linear structure is confirmed through the LS verification. There are mainly four identifiable features that are extracted from the rotatable band in the gradient magnitude and Hough parameter spaces. The LS verification process applies cascade rules to the extracted features to determine if an MCC candidate cluster resides in a linear structure area.
Briefly summarized, according to one aspect of the present invention, the invention provides a method for verifying linear structures in a digital mammographic image. One embodiment of the method comprises steps of: providing a configurable linear structure verifier in mammography CAD system, optionally using an MCC candidate cluster driven linear structure verification methodology; selecting parameters for the linear structure verifier from a plurality of different parameter generating sources, at least one of which is controllable by human input; configuring the verifier according to selected parameters; and verifying linear structure using cascade rules. The cascade rules may be trained with a combination of mammographic images of cancer cases and mammographic images of normal cases.
According to another aspect of the invention, the invention resides in a method of an MCC candidate cluster driven linear structure verification in mammographic images. One embodiment of the method includes the steps of locating a plurality of MCC candidate clusters whose characteristics resemble that of true MCC clusters; extracting rotatable bands in the mammographic image with the geometric parameters of the MCC candidate clusters; processing the rotatable bands to verify the presence of linear structures; attaching a tag to a cluster if the verification process determines that linear structures are present; further analyzing the rotatable bands; and removing the tag if the analysis process concludes that said tag is attached incorrectly.
In the various embodiments of the inventive method, the mammographic image may be a digitized X-ray film mammogram, or a digital mammogram captured with a computerized radiography system, or a digital mammogram captured with a digital radiography system.
These and other aspects, objects, features and advantages of the present invention will be more clearly understood and appreciated from a review of the following detailed description of the preferred embodiments and appended claims, and by reference to the accompanying drawings.
The foregoing and other objects, features, and advantages of the invention will be apparent from the following more particular description of the embodiments of the invention, as illustrated in the accompanying drawings. The elements of the drawings are not necessarily to scale relative to each other.
The following is a detailed description of the preferred embodiments of the invention, reference being made to the drawings in which the same reference numerals identify the same elements of structure in each of the several figures.
Reference is made to commonly assigned, copending U.S. patent application Ser. No. 11/834,243 filed Aug. 6, 2007 by Chen et al entitled LINE STRUCTURE DETECTION AND ANALYSIS FOR MAMMOGRAPHY CAD.
Referring to
In
A feature of the present invention is that it provides an integrated solution to the linear structure verification problem by constructing a configurable verification system with a configurable verifier. This configurable system can be configured or reconfigured by commands from operator 168 through a command path 174. In general, the configurable verifier can be used in different positions in a workflow (or equivalently, forming different workflows). Exemplary workflows for verification step 160 are depicted in
The use of the first exemplary workflow (256 to 258) reduces the computational burden of step 258 in terms of the number of MCC clusters to be classified since step 256 removes a sizable quantity of MCC clusters from the candidate list. It does, however, require the CAD classifier in step 258 to be retrained if the linear structure verification (256) is an add-on step. The use of the second exemplary workflow (258 to 256) enables a kind of ‘plug and play’ feature for the mammography CAD system if linear structure verification step 256 is an add-on step. It does not require the CAD classifier in step 258 to be retrained. Linear structure verification step 256 only processes those MCC clusters that are classified as true positives by MCC classification step 258.
Persons skilled in the art understand that a mammography CAD system can be designed in such a way that the functionalities provided by linear structure verification step 256 can be part of the functionalities provided by the MCC classification step 258. In other words, steps 256 and 258 can be combined into a single unit. Persons skilled in the art can design an MCC classifier or the equivalent that has the capability of verifying linear structures for use in accordance with the present invention. In other words, linear structure verification step 256 and MCC classification step 258 can be combined into a single process. Known examples of linear structure verification are found in the published U.S. patent application of Schneider, et al, previously mentioned. An example of a classification step for MCC is described in an article entitled “Automatic detection of clustered microcalcifications in digital mammograms using mathematical morphology and neural networks”, by Stelios Halkiotis et al., Signal Processing, Volume 87, Issue 7, July 2007.
In step 256, the linear structure verifier itself can be configured or reconfigured to have various functional combinations by commands from operator 168 through command path 174 via parameter selection step 158. Step 158 sends the selected parameters to step 160 through path 176. For example, to be detailed later, the linear structure verifier for step 160 can be configured so that a function of true positive protection is activated in the linear structure verification process. The linear structure verifier can also be configured by commands from operator 168 so that different operational points can be realized. Exemplary operational points are numerical thresholds that are used in cascade rule based verification.
In step 304, rotatable bands are defined with the geometric parameters of the MCC candidate clusters located in the image. The defined bands enclose all or part of the microcalcification candidate spots of the candidate clusters. In step 306, various algorithms are applied to the rotatable band to determine if linear structures present. An exemplary algorithm is the cascade rule based evaluation of features extracted from rotatable bands discussed in the present invention. An exemplary technique is described in detail later in this specification. The classification of MCC as a potential cancerous site is desirable. However, the configuration of multiple sites can be indicative of normal or non-cancerous condition. This subsequent analysis is further requirement and is not in conflict with the classification process. Step 310 attaches a tag to the candidate cluster based on the evaluation results in step 306. The tag signifies the presence of linear structures. Step 312 further analyzes the band with image analysis algorithms such as topological analysis to assess the correctness of the tag. The tag will be removed if it is attached to the cluster incorrectly.
Curvilinear structures appear in the mammographic images due to the curvilinear appearance of blood vessels, lactation ducts, and ligaments of the breast as projected on a mammogram. Vascular lines are large calcified blood vessels on a mammogram. Microcalcifications are bright spots on mammograms and usually the only signs indicating early breast cancers. Microcalcification spots appear usually in clusters, and malignant microcalcification spots usually have irregular shapes. The curvilinear structure is a net of massive and complex curvilinear markings on a given mammogram. Due to the projection of three-dimensional breast into a two-dimensional mammogram, different parts of the curvilinear structure may have different appearances with varying width, lengths and different contrasts to the surrounding breast tissue. The option of pre-classification global mask generation to extract curvilinear structure may be of limited use because global curvilinear marking is a massive structure, and accurate mask extraction is not an easy task. Global mask tends to extract only small portion of linear structure or extract too many “lines”.
In accordance with the invention, an alternative is, after initial MCC candidate classification, to identify linear structures only in the neighborhood where the MCC candidate clusters reside. For each of the candidate clusters that have passed initial classification, a region of interest (ROI) is defined that encloses the MCC candidate spots of each of the candidate clusters. An MCC FP reduction procedure is applied to a small region (ROI) centered around each MCC candidate cluster to avoid the unnecessary influence from the rest of the breast. It reduces processing time since the number of MCC candidate clusters is limited and only a small portion of the breast area needs to be processed, in comparison to global line mask approach.
The workflow depicted in
As stated previously, not all MCC candidate clusters are subject to linear structure verification. A test in step 808 evaluates the rank of each MCC candidate cluster after classification and sends those candidate clusters that are classified as abnormal to the linear structure verification step 810. Note that in
The MCC cluster driven linear structure verification method of the present invention employs mainly four identifiable features that are extracted from the gradient magnitude and Hough parameter domains. The linear structure verification process applies cascade rules to the extracted features to determine if an MCC candidate cluster is associated with a linear structure. The method is discussed in depth next.
Features of Ensemble Average of Lines in Gradient Magnitude Space
In the linear structure verification step, an intensity ROI 404 as in
Denote the rotatable verification band by B(α) that contains W lines lk(α):
B(α)={lk(α)};kε[1, . . . , W] (1)
Denote the line center of line lk(α) by ol
Those skilled in the art may notice that the bands B(α) at different angles are not extracted through the conventional method of interpolation but through a simple sampling procedure that is quite adequate for the present application.
Various features can be generated from the processing of the bands. Two main features are introduced in the present invention. One of the features is a maximum relative magnitude of the ensemble average curves. The relative magnitude of the ensemble average curve of a set of lines in the band at a particular angle is simply defined as
In practice, angle α is chosen at a few discrete orientations. Therefore, the relative magnitude of the ensemble average curve can be expressed as Ψ(αj)=max(s(αj))−min(s(αj)); jε[1, . . . , Nα]. It can be further simplified as Ψj=max(sj)−min(sj); jε[1, . . . , Nα].
Accordingly, band Bj that produces maximum relative magnitude is denoted by BΨ.
With the relative magnitude of the ensemble average curve, another feature, ensemble average ratio can be computed as:
It will be clear that if an MCC candidate cluster is not associated with a linear structure the ensemble average ratio is close to 1, which signifies the ‘isotropic’ nature of the underlying structure measured by using the ensemble averaging. On the other hand, if an MCC candidate cluster is associated with a linear structure the ensemble average ratio
moves away from 1, which signifies the ‘anisotropic’ nature of the underlying structure.
Features in Hough Transformation Domain
Two features from the Hough Transformation domain are used in the linear structure verification process in the present invention. It will be detailed later that the present method utilizes a set of cascade rules to accomplish the verification task. The relative magnitude of the ensemble average curve and the ensemble average ratio are the first two features that are evaluated. This first evaluation process tags a cluster with a status of being associated with linear structures (LS), not being associated with linear structures (non-LS), or uncertain. As a result, any MCC candidate cluster in an uncertain status will be further evaluated by the rules that are applied to the features of Hough parameters.
The first evaluation operation on ensemble averages is, in general, not orthogonal to the second evaluation operation on Hough parameter in the present application. In other words, these two operations may explore the same underlying evidence to support the linear structure verification process. It is true, however, from the computational complexity point of view, that the computation of ensemble averaging is linear while Hough Transformation is nonlinear in nature. Also, the execution of ensemble averaging of lines in multiple angles is applied to all MCC candidate clusters. The Hough Transform is only applied to a handful clusters (gROIs) in a single angle position that is determined by the first evaluation operation of ensemble averaging of lines in the rotatable band.
Those skilled in the are understand that Hough Transform maps points on a line in Cartesian space to curves (sinusoids) in the Hough parameter space. Points that are collinear in the Cartesian space generate curves that intersect at a common point (forming a peak in the Hough parameter space).
Referring to
For the exemplary gROI 902 shown in
Denote the Hough peak array by H={hi,j} and its corresponding angle array by Θ={θi,j}; where iε[1, . . . , Nr]; jε[1, . . . , Nθ]. Nr is the number of quantized length intervals and Nθ is the number of quantized angle intervals.
Collect a subset Hs={hi,js} of H; the elements hi,js all have values above percent of the highest peak value in H. Corresponding to the subset Hs, there is a subset Θs={θi,js} of Θ. The angle spread δθ can be readily computed as
If there are parallel thin lines presented in a band B(α), the angle spread δθ for that band must be zero or close to zero. On the other hand, if random structures are presented in a band B(α), the angle spread δθ will be large.
Another feature from Hough space is the normalized maximum Hough peak that is simply defined as
Additional Measure for TP Protection
The inventors have observed that some of the true-positive MCC clusters may reside in an area where linear structure-like objects are present and can be verified as FPs. It also has been observed that true-positive MCC clusters may possess topological ring-like structures surrounding some of the spots (see a gROI 1102 in
Using the spot as the origin, perform a search along a ray that radiates from the origin until the ray hits the ring or reaches a predefined distance without a hit. The search process can be formulated as following (referring to graph 1104 in
Denote a ray by Rkβ and its opposite ray by Rkβ+π, where β=π/NR; kε[1, . . . , NR]. NR is a positive integer greater than one. Denote a hit array by T={tk}. The array elements tk are initialized as zero. Only if both Rkβ and Rkβ+π hit a ring, the corresponding array element tk will be set to one, otherwise, the corresponding array element tk remains zero.
A simple measure is therefore defined as the sum of hits ξt that a hit array has. The measure is simply computed as
Cascade Rule Based Linear Structure Verification
The features (or measures) described in the above sections are used in a cascade rule based verification algorithm that is summarized below. The paragraphs following the algorithm summary explain the workings of the algorithm:
); where j ε[1, ... ,N]
);
Function rankChk(clst, rankThd) returns a Boolean ‘true’ if an MCC cluster clst has a rank indicating its potential cancer status by comparing with a predefined threshold value rankThd based on the analysis of classification ROC curve.
Function gROIgnrt(clst, img, gROi) simply crops a region of interest (gROi) from the input gradient magnitude mammogram (img) using the position information of the underlying cluster (clst). The size of the gROI depends on the spread of MCC spots within the cluster.
Function bandXtrct(clst, gROI, Bj, αj) further crops a band Bj at angle αj from gROi. The center of the cropped band is at the geometric center of the spots within the cluster clst. In practice, the shape of a band is a square so that two, not one, ensemble average curves of two sets of lines (with respect to αj and αj+π/2) can be computed (see Equation 2) with one band.
Function profileFeatureXtrct(∀sj, Ψ, ) collects the ensemble averages and computes features (or measures) Ψ and
according to Equations 3 and 4.
Function apply ProfileRules(clst, Ψ, ) evaluates Ψ and
with pre-determined boundaries (thresholds) then tags the cluster clst with a number indicating the status as ‘LS (associated with linear structure)’, ‘non-LS (not associated with linear structure)’, or ‘uncertain’. The evaluation criteria will be detailed later.
If a cluster is labeled as ‘uncertain’, that cluster will be further evaluated by first applying a Hough Transform bandHoughTrnsfm(B, H, Θ) to the band and generates a Hough peak array H and an angle array Θ. The band B used in function bandHoughTrnsfm( ) could be the one (denoted by BΨ) that generates the maximum relative magnitude of the ensemble average curve in Equation 3. Or it could be a band having a different (usually larger) size but with the same orientation and center position as BΨ.
Function HoughFeatureXtrct(H, Θ, δθ, φh) executes Equations 5 and 6. Function applyHoughRules(clst, δθ, φh) evaluates δθ and φh with pre-defined thresholds and tags the cluster clst with a number indicating the status as ‘LS’, or ‘non-LS’.
If, after evaluating the features of the rotatable bands, a cluster is labeled as LS (associated with linear structure), function rightHitChk(clst, gROI, ξt) computes ξt (see Equation 7) that is evaluated in function applyRingHitRules(clst, ξt). It basically checks the number of hits that each of the spots has in a cluster and changes the status from LS to non-LS if the maximum number of hits that any one of the spots has exceeds a threshold. The purpose of employing function rightHitChk(clst, gROI, ξt) is to analyze the band and the use function applyRingHitRules(clst, ξt) to remove the tag LS that is attached incorrectly.
The algorithm developed in the present invention has been applied to clinical mammograms for assessment.
The distribution 1402 of features Ψ and is obtained from a number of training mammograms and shown in
provide a statistically satisfactory separation for the clusters that have linear structures (LS) and the clusters that are true-positives (non-LS). Although sophisticated algorithms such as Support Vector Machine, a conventional pattern recognition technology popular in the field of computer vision, as will be understood by the person skilled in the art, could be used to find the feature separation boundaries, the distribution in
). Exemplary predefined thresholding values for Ψ are 700 and 300. Exemplary predefined thresholding value for
is 0.6.
=90. Intuitively, the angle spread δθ for the elements hi,js having values above
percent of the highest peak value is very small. While for the lesion band 904 in
The distribution 1602 of features r and θ in
To demonstrate statistical significance of the FP reduction, the present algorithm has been applied to over 5000 normal mammographic images. The upper curve in graph 1802 in
As discussed previously with regard to in the cascade rule based verification algorithm.
Referring again to . Operator 168 commands the system to select the constant parameters through the steps of human intervention 162 and parameter selection 158. A feedback path 164 from the verification step 160 provides useful information to the human intervention step 162 (e.g., by displaying of an intermediate result) for seeking either staying on the current course or calling for a change of the operation. If the latter is true, the operator can halt the operation through human intervention step 162 and adjust corresponding parameters δθ, φh, Ψ and
(this action is represented by the step of using the controllable parameter generator 152). Then operator 168 commands the system to select the controllable parameters through the steps of human intervention 152 and parameter selection 158.
The present invention comprises a method and a configurable linear structure verification system that provides a configurable linear structure verifier in mammography CAD system. The verifier parameters for the linear structure verifier are from a plurality of different parameter generating sources, at least one of which is controllable by human input. The present invention also comprises a methodology of MCC cluster driven linear structure verification for MCC false-positive reduction in mammography CAD system. Different from linear structure detection algorithms that are popular in image processing literature, the method of linear structure verification in the present invention requires no actual structural lines to be generated and no re-sampling of images. This results in searching for identifiable information in a target area that is a tiny fraction of a size already limited region of interest. This cluster driven linear structure verification methodology also employs an efficient cascade rule based algorithm that is mostly in linear operation (ensemble averaging). The efficiency and efficacy of the proposed method are demonstrated with the results obtained by applying the LS verification method to over thousand normal cases.
In general, algorithms such as the one in the present invention do not distinguish between concave and convex objects in images. The linear structures to be verified in mammograms usually appear brighter than other background contents. An exemplary ROI 502 is shown in
Graph 602 in
Referring again to
Where xm and xn signify two orthogonal axes of image I, and element hm,n is a partial derivative. Solve the following matrix equation to obtain eigenvalues λ1 and λ2 for every pixel pl
where e1 and e2 are 2 by 1 column vectors (eigen vectors). The sign of the eigenvalues indicates the surface orientation, either concave or convex. In the present invention, to evaluate the surface orientation, a metric, S, is defined as eigenvalue band integral profile to verify object surface property (convexity and concavity). The element of the eigenvalue band integral profile, S, is computed as
and W is the number of lines within the band.
The present invention is described as a method. However, in another preferred embodiment, the present invention comprises a computer program product for image linear structure verification in medical applications in accordance with the method described. In describing the present invention, it should be apparent that the computer program of the present invention can be utilized by any well-known computer system, such as the personal computer. However, many other types of computer systems can be used to execute the computer program of the present invention. Consequently, the computer system will not be discussed in further detail herein.
It will be understood that the computer program product of the present invention may make use of image manipulation algorithms and processes that are well known. Accordingly, the present description will be directed in particular to those algorithms and processes forming part of, or cooperating more directly with, the method of the present invention. Thus, it will be understood that the computer program product embodiment of the present invention may embody algorithms and processes not specifically shown or described herein that are useful for implementation. Such algorithms and processes are conventional and within the ordinary skill in such arts.
Additional aspects of such algorithms and systems, and hardware and/or software for producing and otherwise processing the images or co-operating with the computer program product of the present invention, are not specifically shown or described herein and may be selected from such algorithms, systems, hardware, components and elements known in the art.
The computer program for performing the method of the present invention may be stored in a computer readable storage medium. This medium may comprise, for example; magnetic storage media such as a magnetic disk (such as a hard drive or a floppy disk) or magnetic tape; optical storage media such as an optical disc, optical tape, or machine readable bar code; solid state electronic storage devices such as random access memory (RAM), or read only memory (ROM); or any other physical device or medium employed to store a computer program. The computer program for performing the method of the present invention may also be stored on computer readable storage medium that is connected to the image processor by way of the internet or other communication medium. Those skilled in the art will readily recognize that the equivalent of such a computer program product may also be constructed in hardware.
It will be appreciated that variations and modifications can be effected by a person of ordinary skill in the art without departing from the scope of the invention. The subject matter of the present invention relates to digital image processing and computer vision technologies, which is understood to mean technologies that digitally process a digital image to recognize and thereby assign useful meaning to human understandable objects, attributes or conditions, and then to utilize the results obtained in the further processing of the digital image.
The invention has been described in detail with particular reference to presently preferred embodiments, but it will be understood that variations and modifications can be effected within the scope of the invention. The presently disclosed embodiments are therefore considered in all respects to be illustrative and not restrictive. The scope of the invention is indicated by the appended claims, and all changes that come within the meaning and range of equivalents thereof are intended to be embraced therein.
Priority is claimed from related to U.S. Provisional Patent Application Ser. No. 60/954,153 filed Aug. 6, 2007 by Shoupu Chen and Lawrence Ray, entitled LINEAR STRUCTURE VERIFICATION IN MEDICAL APPLICATIONS.
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