Automatic Segmentation of Different-Sized Leukoaraiosis Regions in Brain MR Images

Cerebrovascular diseases are the third leading cause of death in Japan. Therefore, a screening system for the early detection of asymptomatic brain diseases is widely used. In this screening system, leukoaraiosis is often detected in magnetic resonance (MR) images. The quantitative analysis of leukoaraiosis is important because its presence and extension is associated with an increased risk of severe stroke. However, thus far, the diagnosis of leukoaraiosis has generally been limited to subjective judgments by radiologists. Therefore, the purpose of this study was to develop a computerized method for the segmentation of leukoaraiosis, and provide an objective measurement of the lesion volume. Our database comprised of T1- and T2-weighted images obtained from 73 patients. The locations of leukoaraiosis regions were determined by an experienced neuroradiologist. We first segment cerebral parenchymal regions in T1-weighted images by using a region growing technique. For determining the initial candidate regions for leukoaraiosis, the k-means clustering of pixel values in the T1- and T2-weighted images was applied to the segmented cerebral region. For the elimination of false positives (FPs), we determined features such as the location, size, and circularity from each of the initial candidates. Finally, rule-based schemes and a quadratic discriminant analysis with these features were employed for distinguishing between the leukoaraiosis regions and the FPs. The results indicated that the sensitivity for the detection of leukoaraiosis was 100% with 5.84 FPs per image. Our computerized scheme can be useful in assisting radiologists for the quantitative analysis of leukoaraiosis in T1- and T2-weighted images.