Breast tumor classification using fuzzy clustering for breast elastography.

Elastography is a new ultrasound imaging technique to provide the information about relative tissue stiffness. The elasticity information provided by this dynamic imaging method has proven to be helpful in distinguishing benign and malignant breast tumors. In previous studies for computer-aided diagnosis (CAD), the tumor contour was manually segmented and each pixel in the elastogram was classified into hard or soft tissue using the simple thresholding technique. In this paper, the tumor contour was automatically segmented by the level set method to provide more objective and reliable tumor contour for CAD. Moreover, the elasticity of each pixel inside each tumor was classified by the fuzzy c-means clustering technique to obtain a more precise diagnostic result. The test elastography database included 66 benign and 31 malignant biopsy-proven tumors. In the experiments, the accuracy, sensitivity, specificity and the area index Az under the receiver operating characteristic curve for the classification of solid breast masses were 83.5% (81/97), 83.9% (26/31), 83.3% (55/66) and 0.902 for the fuzzy c-means clustering method, respectively, and 59.8% (58/97), 96.8% (30/31), 42.4% (28/66) and 0.818 for the conventional thresholding method, respectively. The differences of accuracy, specificity and Az value were statistically significant (p < 0.05). We conclude that the proposed method has the potential to provide a CAD tool to help physicians to more reliably and objectively diagnose breast tumors using elastography.