Display for computer-aided evaluation of medical images and for establishing clinical recommendation therefrom

• US 7,418,119 B2
• Filed: 01/12/2004
• Issued: 08/26/2008
• Est. Priority Date: 10/31/2002
• Status: Expired due to Term

• Current Assignee: Siemens Computer Aided Diagnosis Ltd. (Siemens AG)
• Original Assignee: Siemens Computer Aided Diagnosis Ltd. (Siemens AG)
• Inventors: Bamberger, Philippe, Leichter, Isaac, Lederman, Richard
• Primary Examiner(s): Le; Brian Q
• Application Number:
  US10/754,622
• Publication Number:
  US 20040184644A1
• Time in Patent Office: 1,688 Days
• Field of Search: 382/131, 382/128, 382/132, 382/133, 424/9.3, 424/9.4, 378/4, 378 21- 33, 378/901, 128/922
• US Class Current: 382/128
• CPC Class Codes: G06T 2207/30068 Mammography; Breast
• CPC Class Codes: G06T 7/0012 Biomedical image inspection
• CPC Class Codes: G06V 10/987 with the intervention of an operator
• CPC Class Codes: G06V 2201/03 Recognition of patterns in medical or anatomical images
• CPC Class Codes: G16H 30/40 for processing medical images, e.g. editing
• CPC Class Codes: G16H 50/20 for computer-aided diagnosis, e.g. based on medical expert systems

Abstract

A method for displaying a computer-generated determination of the overall likelihood of malignancy in a mammogram lesion. The method requires providing a digitized image of a mammogram, displaying the digitized image, and selecting a region of interest directly on the displayed digitized image. The digitized image is then processed so that classifier data of the lesion in the user-selected region of interest are generated and displayed. The overall likelihood of malignancy is generated from the classifier data and also displayed. A clinical recommendation for further assessing the lesion is derived from the overall evaluation of malignancy and presented to the user. A system for displaying a determination of the overall likelihood of malignancy in a mammogram lesion and for presenting a clinical recommendation to the user is also provided. A method for integrating the overall likelihood of malignancy with a physician'"'"'s independent score for the lesion is discussed.

Claims

1. A method for providing to a user a clinical recommendation for assessing the pathological nature of a lesion in living tissue, said method including the steps of:

providing a digital image of the living tissue for display, the digital image devoid of a computer selected region of interest;

prior to computer evaluation of the image, user-selecting on the displayed image a region of interest consisting of a portion of the tissue encompassing a single lesion;

subsequent to said step of selecting, processing the digital image and computing an overall evaluation of the likelihood of disease for the lesion in the user-selected region of interest;

based on the overall evaluation of the likelihood of disease and correlated therewith, generating a processor-computed explicit clinical recommendation for a further clinical course of action for assessing the lesion, the clinical recommendation usable for patient management; and

presenting to the user, as separate items of information, both the overall evaluation of likelihood of disease and the explicit clinical recommendation for a further clinical course of action usable for patient management, wherein

when said tissue is breast tissue said clinical recommendations are chosen from a group of recommendations including biopsy, short term follow-up, specific short term follow-up suggestion, examining the patient using other modalities, and comparing to one or more previous mammograms;

when said tissue is lung tissue said clinical recommendations are chosen from a group of recommendations including biopsy surgical intervention, medical treatment, short term follow-up, and comparing to one or more previous examinations;

when said tissue is intestinal tissue said clinical recommendations are chosen from a group of recommendations including biopsy, surgical excision, and colonoscopy;

when said tissue is coronary artery tissue said clinical recommendations are chosen from a group of recommendations including use of a stent, performing balloon angioplasty, performing a bypass graft, and examining the patient using other modalities; and

when said tissue is bone tissue said clinical recommendations are chosen from a group of recommendations including surgical intervention, medical treatment, short term follow-up, comparing to one or more previous examinations, radiation therapy and cement injection.

2. A method according to claim 1, wherein the tissue being evaluated is breast tissue.

3. A method according to claim 2 wherein said step of providing includes the step of directly providing a digital image of the breast and wherein said method further includes the following additional steps:

inputting into a processor a score corresponding to a user evaluated overall likelihood of disease and a user evaluated clinical recommendation relating to the lesion found in the digital image; and

following the inputting of the score in said step of inputting, modifying the score in accordance with a processor generated clinical recommendation so as to produce a final clinical recommendation,

and wherein said step of presenting includes displaying the final clinical recommendation to the user.

4. A method according to claim 2, wherein said step of providing includes the step of scanning an analogue film mammogram so as to produce a digital image and wherein said method further includes the step of reading the film mammogram on a light box and wherein said method further includes the following additional steps:

inputting into a processor a score corresponding to a user evaluated overall likelihood of disease and a user evaluated clinical recommendation relating to the lesion found in the film mammogram; and

following the inputting of the score in said step of inputting, modifying the score in accordance with a processor generated clinical recommendation so as to produce a final clinical recommendation,

and wherein said step of presenting includes displaying the final clinical recommendation to the user.

5. A system for providing to a user a clinical recommendation for assessing a lesion in imaged living tissue, said system including:

an image provider for providing a digital image of the living tissue, the digital image devoid of a computer selected region of interest;

a display for displaying the digital image of the tissue;

a user operated input device in communication with said display for selectably indicating on the displayed digital image a user-selected region of interest, the user-selected region of interest being a portion of the breast encompassing a single lesion of interest;

a processor operative to receive the digital image from said image provider, said processor computing an overall evaluation of the likelihood of disease of the lesion in the user-selected region of interest on the digital image and said processor also deriving an explicit clinical recommendation for a further clinical course of action usable for patient management correlated with the computed overall evaluation for the lesion in the user-selected region of interest; and

providing means arranged in data communication with said processor for receiving therefrom the overall evaluation of the likelihood of disease of the lesion and the clinical recommendation and for presenting to the user, as two separate pieces of information both the overall evaluation of the likelihood of disease of the lesion and the explicit clinical recommendation suggesting a clinical course of action for assessing the lesion in the user-selected region of interest, the clinical recommendation usable for patient management,

wherein said processor initiates processing after the region of interest is selected by the user, and

wherein when said tissue is breast tissue said clinical recommendations are chosen from a group of recommendations including biopsy, short term follow-up, specific short term follow-up suggestion, screening using other modalities, examining the patient using other modalities, and comparing to one or more previous mammograms;

when said tissue is lung tissue said clinical recommendations are chosen from a group of recommendations including biopsy, surgical intervention, medical treatment, short term follow-up, and comparing to one or more previous examinations;

when said tissue is intestinal tissue said clinical recommendations are chosen from a group of recommendations including biopsy, surgical excision, and colonoscopy;

when said tissue is coronary artery tissue said clinical recommendations are chosen from a group of recommendations including use of a stent, performing balloon angioplasty, performing a bypass graft and examining the patient using other modalities; and

when said tissue is bone tissue said clinical recommendations are chosen from a group of recommendations including surgical intervention, medical treatment, short term follow-up, comparing to one or more previous examinations, radiation therapy, and cement injection.

6. A system according to claim 5, said system further including a means for entering a score determined by the user, the score indicating the user'"'"'s evaluation of the level of suspicion of the lesion according to a predetermined scoring system, the score correlated with a specific clinical recommendation for a further clinical course of action for assessing the lesion, wherein the user-determined clinical recommendation is modified by the overall evaluation of the likelihood of disease generated by said processor, the modified clinical recommendation being displayed to the user by said providing means.

7. A method for providing to a user a clinical recommendation for assessing the pathological nature of a lesion in living tissue, said method including the steps of:

providing a digital image of the living tissue for display, the digital image devoid of a computer selected region of interest;

prior to computer evaluation of the image, user-selecting on the displayed image a region of interest consisting of a portion of the tissue encompassing a single lesion;

subsequent to said step of selecting, processing the digital image and computing an overall evaluation of the likelihood of disease for the lesion in the user-selected region of interest;

based on the overall evaluation of the likelihood of disease and correlated therewith, generating a processor-computed explicit clinical recommendation for a further clinical course of action for assessing the lesion, the clinical recommendation usable for patient management; and

presenting to the user the explicit clinical recommendation for a further clinical course of action usable for patient management, wherein

when said tissue is breast tissue said clinical recommendations are chose from a group of recommendations including biopsy, short term follow-up, specific short term follow-up suggestion, examining the patient using other modalities, and comparing to one or more previous mammograms;

when said tissue is lung tissue said clinical recommendations are chosen from a group of recommendations including biopsy, surgical intervention, medical treatment, short term follow-up, and comparing to one or more previous examinations;

when said tissue is intestinal tissue said clinical recommendations are chosen from a group of recommendations including biopsy, surgical excision, and colonoscopy;

when said tissue is coronary artery tissue said clinical recommendations are chosen from a group of recommendations including use of a stent, performing balloon angioplasty, performing a bypass graft, and examining the patient using other modalities; and

when said tissue is bone tissue said clinical recommendations are chosen from a group of recommendations including surgical intervention, medical treatment, short term follow-up, comparing to one or more previous examinations, radiation therapy, and cement injection.

8. A system for providing to a user a clinical recommendation for assessing a lesion in imaged living tissue, said system including:

an image provider for providing a digital image of the living tissue, the digital image devoid of a computer selected region of interest;

a display for displaying the digital image of the tissue;

a user operated input device in communication with said display for selectably indicating on the displayed digital image a user-selected region of interest, the user-selected region of interest being a portion of the breast encompassing a single lesion of interest;

a processor operative to receive the digital image from said image provider, said processor computing an overall evaluation of the likelihood of disease of the lesion in the user-selected region of interest on the digital image and said processor also deriving an explicit clinical recommendation for a further clinical course of action usable for patient management correlated with the computed overall evaluation for the lesion in the user-selected region of interest; and

providing means arranged in data communication with said processor for receiving therefrom the overall evaluation of the likelihood of disease of the lesion and the clinical recommendation and for presenting to the user the explicit clinical recommendation suggesting a clinical course of action for assessing the lesion in the user-selected region of interest, the clinical recommendation usable for patient management,

wherein said processor initiates processing after the region of interest is selected by the user, and wherein

when said tissue is breast tissue said clinical recommendations are chosen from a group of recommendations including biopsy, short term follow-up, specific short term follow-up suggestion, screening using other modalities, examining the patient using other modalities, and comparing to one or more previous mammograms;

when said tissue is lung tissue said clinical recommendations are chosen from a group of recommendations including biopsy, surgical intervention, medical treatment, short term follow-up and comparing to one or more previous examinations;

when said tissue is intestinal tissue said clinical recommendations are chosen from a group of recommendations including biopsy, surgical excision, and colonoscopy;

when said tissue is coronary artery tissue said clinical recommendations are chosen from a group of recommendations including use of a stent, performing balloon angioplasty, performing a bypass graft, and examining the patient using other modalities; and

when said tissue is bone tissue said clinical recommendations are chosen from a group of recommendations including surgical intervention, medical treatment, short term follow-up, comparing to one or more previous examinations, radiation therapy, and cement injection.