Abstract

Background: Current naked-eye examination of the ultrasound images for inflamed appendix has limitations due to its intrinsic operator subjectivity problem.

Objective: In this paper, we propose a fully automatic intelligent method for extracting inflamed appendix from ultrasound images. Accurate and automatic extraction of inflamed appendix from ultrasonography is a major decision making resource of the diagnosis and management of suspected appendicitis.

Methods: The proposed method uses Fuzzy C-means learning algorithm in pixel clustering with semi-dynamic control of initializing the number of clusters based on the intensity contrast dispersion of the input image. Thirty percent of the prepared ultrasonography samples are classified into four different groups based on their intensity contrast distribution and then different number of clusters are assigned to the images in accordance with such groups in Fuzzy C-means learning process.

Results: In the experiment, the proposed system successfully extracts the target without human intervention in 82 of 85 cases (96.47% accuracy). The proposed method also shows that it can cover the false negative cases occurred previously that used self-organizing map as the learning engine.

Conclusion: Such high level reliable correct extraction of inflamed appendix encourages to use the automatic extraction software in the diagnosis procedure of suspected acute appendicitis.

Keywords: Appendicitis, inflamed appendix, fuzzy C-means, ultrasonography, automatic extraction software, diagnosis.

Graphical Abstract