Shape characterization of mediastinum in tuberculosis chest radiographs using level set segmentation

Abstract

Mediastinum is considered as one of the substantial anatomical regions for the gross diagnosis of several chest related pathologies. The geometric variations of the mediastinum in Chest Radiographs (CXRs) could be utilised as potential image markers in the early detection of Tuberculosis (TB). This study attempts to segment mediastinum in CXRs using level sets for the shape characterization of TB conditions. The CXR images for this study are considered from a public database. An edge-based distance regularized level set evolution is employed to segment the lungs followed by a region-based Chan-Vese model that extracts mediastinum region. Features such as mediastinum area and lungs area are extracted from the segmented images. Further, mediastinum to lungs area ratio is calculated. Statistical analysis is performed on the features to differentiate normal and TB images. Results show that the proposed segmentation approach is able to segment the lungs and extract the mediastinum in CXRs. It is found that features namely mediastinum area and mediastinum to lungs area ratio are statistically significant in the differentiation of TB. Larger mediastinum area is observed in TB images as compared to normal. The performance of lung field segmentation is also observed to be in line with the literature. The mediastinum segmentation approach in CXRs obtains to be a novel method as compared to the existing methods. As the proposed approach based on mediastinum image analysis provides better shape characterization, the study could be clinically useful in the differentiation of TB conditions.