Multiple Sclerosis lesions detection by a hybrid Watershed-Clustering algorithm

Research output: Contribution to journalArticlepeer-review


Background: Computer Aided Diagnosis (CAD) systems have been developing in the last years with the aim of helping the diagnosis and monitoring of several diseases. We present a novel CAD system based on a hybrid Watershed-Clustering algorithm for the detection of lesions in Multiple Sclerosis.

Methods: Magnetic Resonance Imaging scans (FLAIR sequences without gadolinium) of 20 patients affected by Multiple Sclerosis with hyperintense lesions were studied. The CAD system consisted of the following automated processing steps: images recording, automated segmentation based on the Watershed algorithm, detection of lesions, extraction of both dynamic and morphological features, and classification of lesions by Cluster Analysis.

Results: The investigation was performed on 316 suspect regions including 255 lesion and 61 non-lesion cases. The Receiver Operating Characteristic analysis revealed a highly significant difference between lesions and non-lesions; the diagnostic accuracy was 87% (95% CI: 0.83-0.90), with an appropriate cut-off of 192.8; the sensitivity was 77% and the specificity was 87%.

Conclusions: In conclusion, we developed a CAD system by using a modified algorithm for automated image segmentation which may discriminate MS lesions from non-lesions. The proposed method generates a detection out-put that may be support the clinical evaluation.

Keywords: CAD system; Image segmentation; Magnetic Resonance Imaging; Multiple Sclerosis; Watershed algorithm.
Original languageEnglish
Pages (from-to)162-167
Number of pages6
JournalClinical Imaging
Publication statusPublished - Nov 5 2020


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