European Journal of Scientific Research ISSN 1450-216X Vol.23 No.1 (2008), pp.6-12 EuroJournals Publishing, Inc. 2008 http://www.eurojournals.com/ejsr.

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The Effect of Image Data Compression on the Clinical Information Quality of Compressed Computed Tomography Images for Teleradiology Applications
S. E. Ghrare Faculty of Engineering Universiti Kebangsaan Malaysia (UKM) E-mail: seddeq@vlsi.eng.ukm.my M. A. M. Ali Faculty of Engineering Universiti Kebangsaan Malaysia (UKM) E-mail: mama@vlsi.eng.ukm.my M. Ismail Faculty of Engineering Universiti Kebangsaan Malaysia (UKM) K. Jumari Faculty of Engineering Universiti Kebangsaan Malaysia (UKM) Abstract Image communication systems for medical images have bandwidth and image size constraints that result in time-consuming transmission of uncompressed raw image data. Thus image compression plays vital role to reduce the bit rate for transmission or storage while maintaining an acceptable reproduction quality, but it is natural to rise the question of how much an image can be compressed and still preserve sufficient information for a given clinical application. Evaluation of the quality of medical image compression still remains an important issue. Image quality has two implications: fidelity and intelligibility. Fidelity describes how the reconstructed image differs from the original one. Intelligibility shows the ability through which the image can offer information to people with classification accuracy. Many techniques for achieving data compression have been introduced. Wavelet transform techniques currently provide the most promising approach to high-quality image compression, which is essential for teleradiology. In this study, three different Computed Tomography images which are adrenal, chest and liver have been compressed and reconstructed using wavelet transform. Subjective and objective evaluation has been done to investigate the clinical information quality of the compressed images. For the objective evaluation, the results show that the PSNR which indicates the quality of the reconstructed image is ranging from (27.6dB to 36.7dB, 23.8dB to 31.8dB, and 23.9dB to 31.0dB) for adrenal, chest, and liver respectively. For the subjective evaluation test, the results show that the compression ratio of 30:1 was acceptable for chest and liver images, whereas for adrenal image 40:1 was acceptable.

The Effect of Image Data Compression on the Clinical Information Quality of Compressed Computed Tomography Images for Teleradiology Applications

Keywords: Medical Image, Computed Tomography, Wavelet Transform, Teleradiology.

1. Introduction
Teleradiology is an application in which dynamic fluoroscopy images during a radiological interventional procedure are transmitted in real time or near real time to another location, where the physician can advice regarding the diagnostic and therapeutic strategies [1]. The average size of medical images generated is around 250-300MB/patient/visit. Each individual image can be easily transmitted but the special problem in teleradiology is how to handle the total volume of images which requires a high speed and high bandwidth communication system [2]. Image compression plays an important role in the archiving and transmission of medical images. Image data compression can be classified into two broad categories: lossy and lossless (information preserving) [3]. Lossy compression schemes have not been widely used for both clinical and legal reasons. However standard and newer lossless compression algorithms such as JPEG2000 and wavelet-based compression can yield images statistically identical diagnostic results compared with using the original images without any loss [4,5]. Therefore lossless image coding is important for medical image compression because any information loss or error caused by the image compression process could affect clinical diagnostic decision [6]. The aim of this paper is to evaluate a set of compressed computed tomography medical images using wavelet transform technique for an acceptable degree of the reconstructed adrenal, chest and liver images for different compression levels. Both objective and subjective methods are applied to carry out this evaluation.

2. Materials and Methods

In this study, three different CT images have been used and tested. These images were lossy compressed using wavelet transforms. Two different methods for reconstructed images quality evaluation have been used. These are objective and subjective methods. By objective measures method some statistical indices are calculated to indicate the reconstructed image quality and by subjective measure method a group of viewers were involved to see and investigate the reconstructed images directly to determine their quality. 2.1. Objective Evaluation Method A widely used measure of reconstructed image for an N x M size image is the maximum absolute error (MAE) and mean square error (MSE) as given by [7]. 2 1 N 1 M 1 (1) MSE = f (i, j ) f * (i, j ) NM 1=0 j =0 The root mean square error is calculated as: RMSE = MSE Whereas the maximum absolute error is calculated as: MAE = max f (i, j ) f * (i, j )
*

(2)

(3)

Where f (i, j ) the original is image data and f (i, j ) is the compressed image data. Signal-to-Noise Ratio (SNR) is widely used in the signal processing literature (since it is related to the signal power and noise power), and is perhaps more meaningful because it gives 0 dB for equal signal and noise power. SNR is used more commonly in the image-coding field. So, the SNR that is used corresponding to the above error is defined as:

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N 1 M 1 2 0 f (i, j ) i=0 j = SNR = 10 log N 1 M 1 f (i , j ) f * (i , j )2 i =0 j =0

S. E. Ghrare, M. A. M. Ali, M. Ismail and K. Jumari

dB

(4)

Another quantitative measure is the peak signal-to-noise ratio (PSNR), based on the mean square error of the reconstructed image. The formula for PSNR is given by: 2B 1 PSNR = 20 log MSE dB (5) Where B is the bit depth of the image. For an 8-bit image, the PSNR is computed by: (255)2 (6) PSNR = 10 log MSE dB
2.2. Subjective Evaluation Method

Subjective evaluation by viewers is still a method commonly used in measuring image quality. The subjective test emphatically examines fidelity and at the same time considers image intelligibility. When taking subjective test, viewer's focus on the difference between reconstructed image and the original image, they notice such details where information loss cannot be accepted. The representative subjective method is Mean Opinion Score (MOS) [8, 9 and 10]. It has two kinds of scores: one is absolute and another is relative. Two examples are shown below in table 1. In our experiment, we use absolute score in order to seek the consistency between subjective and objective measures. Each viewer compares the reconstructed image with the original one to decide which level it belongs to and gives the score.

3. Results and Discussion

In this study, we have applied two dimensional wavelet decomposition, quantization and reconstruction using several families of filter banks. Discrete Wavelet Transform (DWT), which provides efficient framework of multi-resolution frequency, was used to decorrelate the image data, quantizing the resulting transform coefficients (this is where the actual lossy compression takes place) and coding the quantized.values taking into account the high inter-subband correlations A MATLAB program is designed using the wavelet and image processing toolbox of MATLAB version 7 [7]. This program has been used to calculate the statistical indices such as MAE, MSE, RMSE, SNR and PSNR using the above equations. Three different CT scan medical images which are CT Adrenal,, CT Chest, and CT Liver have been used in our simulation. The test results obtained by both objective and subjective measures are shown in figures 1-5. Tables 2, 3, and 4 summarize the statistical (objective) results for these images. For the subjective evaluation results, table 5 represents the average score of 20 observers involved in this study. A score of 5 is no distortion (Excellent), score of 4 represents a little distortion which can be ignored (Good), score of 3 shows distortion which can be seen evidently but it can be accepted (Fair), score 2 shows a lot of distortion, which can not be accepted (Bad), and finally score of 1 shows too much distortion, therefore can not be tolerated (Very Bad). These results have been illustrated in figure 5 and a comparison between the original and reconstructed images is illustrated in figure 1-3. Figure (4) illustrates the PSNR values versus compression ratio.

The Effect of Image Data Compression on the Clinical Information Quality of Compressed Computed Tomography Images for Teleradiology Applications
Table 1: Mean Opinion Score (MOS) method used for subjective evaluation
Absolute Score Excellent Good Fair Bad Very Bad Relative Score The best in the group Better than the average The average of the group Worst than the average The worst in the group

5 4 3 2 1

5 4 3 2 1

Table 2:
CR 10 :1 20 :1 30 :1 40 :1 50 :1

The MAE, MSE, RMSE, SNR, and PSNR results of CT Adrenal image
Image Size (Byte) 15448 7724 5148 3860 3088 MAE 2.632 4.080 4.940 6.241 7.139 MSE 13.760 36.007 58.708 86.153 113.609 RMSE 3.710 6.000 7.662 9.282 10.659 SNR (dB) 31.010 26.830 25.264 23.041 21.840 PSNR (dB) 36.745 32.567 30.444 28.780 27.577

Table 3:
CR 10 :1 20 :1 30 :1 40 :1 50 :1

The MAE, MSE, RMSE, SNR, and PSNR results of CT Chest image
Image Size (Byte) 13800 6900 4600 3448 2760 MAE 4.612 7.050 8.828 10.120 11.257 MSE 43.065 107.439 161.459 223.176 267.952 RMSE 6.562 10.365 12.707 14.939 16.369 SNR (dB) 25.454 21.483 19.714 18.309 17.515 PSNR (dB) 31.790 27.819 26.050 24.644 23.850

Table 4:
CR 10 :1 20 :1 30 :1 40 :1 50 :1

The MAE, MSE, RMSE, SNR, and PSNR results of CT Liver image
Image Size (Byte) 14088 7275 4851 3639 2908 MAE 5.092 7.243 8.867 10.157 11.124 MSE 51.230 106.981 164.778 216.298 263.544 RMSE 7.158 10.343 12.837 14.707 16.234 SNR (dB) 25.525 22.327 20.451 19.270 18.412 PSNR (dB) 31.036 27.838 25.962 24.780 23.922

Table 5:

Subjective evaluation results for Adrenal, Chest, and Liver CT test images
The average score of all readers CT Chest 5 5 4 3 2 2

Compression Ratio Original Image 10:1 20:1 30:1 40:1 50:1

CT Adrenal 5 5 5 4 3 2

CT Liver 5 4 4 3 2 1

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S. E. Ghrare, M. A. M. Ali, M. Ismail and K. Jumari

Figure1: Comparison between original and compressed CT Adrenal image.
Original Image 10:1 20:1

30:1

40:1

50:1

Figure2: Comparison between original and compressed CT Chest image.

Original Image 10:1 20:1

30:1

40:1

50:1

Figure3: Comparison between original and compressed CT Liver image.

Original Image

30:1

40:1

50:1

The Effect of Image Data Compression on the Clinical Information Quality of Compressed Computed Tomography Images for Teleradiology Applications
Figure 4: PSNR and Compression ratio for CT test images
PSNRv ersus Com pression Ratio 38 36 34 32 PSNR 30 28 26 24 22 10 15 20 25 30 CR 35 40 45 50 CT Adrenal Im age CT C hest Image CT Liv Image er

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Figure 5: Subjective score comparison between CT test images

Compression Ratio versus MOS 6 Adrenal Chest Liver

MOS

Original Image 10:1

20:1 30:1 Compression Ratio

40:1

50:1

4. Conclusion
In this study; three different computed tomography medical images which are Adrenal, Chest, and Liver have been compressed and reconstructed using wavelet transform. The visual quality of the resulting compressed images is evaluated using widely accepted objective and subjective criteria. Under objective criteria some statistical measures are calculated using the equations in section 2.1. Subjectively, a group of 20 reviewers were asked to rate a set of 6 images from each CT (adrenal, chest, and liver). Each set contains on original image and the compressed images from 1050:1 compression ratios. The images were displayed in random as well as in increasing compression ratio order.

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S. E. Ghrare, M. A. M. Ali, M. Ismail and K. Jumari B. R. Sanders, J. H. Shanon, " Telemedicine: Theory and Practice", Springfield, Illionis, 1997. James H. Thrall, Giles Boland, Telemedicine in Practice", Seminars in Nuclear Medicine, volume xxvii, no. 2 1998, pp 145-157 Rafael C. Gonzalez, Richard E. Woods "Digital Image Processing" 2nd edition, Pearson Prentice Hall, 2002 Persons K., Pallison P., Patrice M., Manduca A., Willian J., Charboneau. "Ultrasound grayscale image compression with JPEG and Wavelet techniques ", Journal of Digital Imaging, 13: 25-32, 2000. Bradley J. and Erickson M.D, "Irreversible Compression of Medical Images", Department of Radiology Mayo Foundation, Journal of Digital Imaging, vol.15, No.1, pp.5-14, 2002. Sayre J., Aberle D., and Boechat I., "The Effect of Data Compression on Diagnostic Accuracy in Digital Hand and Chest Radiography", Proceedings of SPIE, 1653: 232-240, 1992. Rafael C. Gonzalez, Richard E. Woods and Steven L. Eddins "Digital Image Processing using MATLAB", Pearson Prentice Hall, 2004. Ahmet M., Paul S., "Image quality measures and their performance", IEEE Transactions on communications, 43: 2959-2965, 1995. Lee H., Haynor D., and Kim Y. "Subjective evaluation of compressed image quality" Proceedings of SPIE, Image Capture, Formatting and Display, 1653: 241-245, 1992. Pamela, C., Robert, M., Richard, A. "Evaluating quality of compressed medical images: SNR, Subjective Rating, and Diagnostic Accuracy", Proceedings of the IEEE, 82: 919-932, 1994

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