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TELKOMNIKA Telecommunication, Computing, Electronics and Control
Vol. 18, No. 2, April 2020, pp. 928~935
ISSN: 1693-6930, accredited First Grade by Kemenristekdikti, Decree No: 21/E/KPT/2018
DOI: 10.12928/TELKOMNIKA.v18i2.14085  928
Journal homepage: http://journal.uad.ac.id/index.php/TELKOMNIKA
Qualitative assessment of image enhancement algorithms for
mammograms based on minimum EDV
Mazin N. Farhan1
, Mohammed G. Ayoub2
, Hassan M. Qassim3
, Abdulrahman K. Eesee4
1,3,4
Department of Medical Instrumentation Technology Engineering, Northern Technical University, Iraq
2
Department of Computer Technology Engineering, Northern Technical University, Iraq
Article Info ABSTRACT
Article history:
Received Sep 12, 2019
Revised Jan 2, 2020
Accepted Feb 19, 2020
Breast cancer is one of the leading reason of death among women.
Nevertheless, medications for this fatal disease are still away of ambitions.
Patients (thought to have breast cancer) should go through several advanced
medical diagnostic procedures like mammography, biopsy analysis,
ultrasound imaging, etc. Mammography is one of the medical imaging
techniques used for detecting breast cancer. However, its resulted images may
not be clear enough or helpful for physician to diagnose each case correctly.
This fact has pushed researchers towards developing effective ways to enhance
images throughout using various enhancement algorithms. In this paper,
a comparison amongst these applied algorithms was done to evaluate
the optimum enhancement technique. A morphology enhancement, which is
resulted from combining top-hat operation and bottom-hat operation, was used
as a proposed enhancement algorithm. The proposed enhancement algorithm
was compared to three other well-known enhancement algorithms, specifically
histogram equalization, logarithmic transform, and gamma correction with
different gamma values. Twenty-five mammographic images were taken from
the mammography image analysis society (MIAS) database samples.
The minimum entropy difference value (EDV) was used as metric to evaluate
the best enhancement algorithm. Results has approved that the proposed
enhancement algorithm gave the best-enhanced images in comparison to
the aforementioned algorithms.
Keywords:
Entropy difference value (EDV)
Gamma correction
Histogram equalization
Logarithmic transformation
Morphology enhancement
This is an open access article under the CC BY-SA license.
Corresponding Author:
Mohammed G. Ayoub,
Department of Computer Technology Engineering
Technical Engineering College/Mosul,
Northern Technical University,
Al-minasa street, across from Ibn Alatheer hospital, Mosul, Iraq.
Email: mohammed.ghanim@ntu.edu.iq
1. INTRODUCTION
Cancer is an unconfined growth of malignant cells in a certain location of human body [1-3]. It is fatal
disease and those suffering cancers most likely facing death [4]. The World Health Organization (WHO)
reported in 2014 that cancer is the second cause of deaths in the world [5]. Breast cancer is one of the most
health problems in the world. Moreover, it is the main cause of cancer death amongst women especially
in developing countries [6]. According to a study conducted by Rajaraman et al. in 2015, the range of women
with breast cancer in India was around 36 per 100,000 whilst in Europe and North America was 92 to 112 per
100,000 women [7]. This study also found that the mortality of breast cancer in India is relatively high
(12.7 per 100,000 women) which is similar to the rates in developing countries [7]. According to the estimation
TELKOMNIKA Telecommun Comput El Control 
Qualitative assessment of image enhancement algorithms for mammograms … (Mazin N. Farhan)
929
of the American Cancer Society (ACS) in 2016, women deaths resulted from breast cancer was about 40,290
in the United States [8]. A study conducted by Malvia et al. in 2017 declared that 1,797,900 women suffered
from breast cancer in India by 2020 [9]. The last estimation of the American cancer society in 2019 stated that
about 268,600 women will be considered to have breast cancer and 41,760 women will face death due to breast
growth [10, 11]. The prevention of breast cancer is still impossible due to the unidentified cause of it.
Thus, there is no effective way to avoid breast cancer but screening to detect it in early stages [12].
Many organizations in the health sector have raised the awareness to breast cancer by encouraging women to
participate in diagnostic investigations such as tissue sampling, clinical breast examination (CBE) and imaging
for early detection of breast cancer [13]. Imaging is still the most popular way in breast screening. The X-ray
mammography is used for interpreting breast cancer. According to Vikhe and Thool in 2016, mammography
is the most effective way for breast screening. This technique has led to decrease breast cancer deaths by
25% [14]. Mammography is the initial step for breast cancer recognition [15, 16]. Calcium depositions create
calcifications that usually appear as spots in mammographic images indicating a potential abnormality that is
mostly considered as a sign of cancer [1]. In some cases of micro-calcifications in breast tissues, low contrast
affects the radiologist’s ability in diagnosing breast cancer by digital mammographic images [1]. Gray shade
variation in mammograms reduces contrast level due to scattered X-radiation, highly powered X-ray
penetration and the film limited capacity which leads to false positive results [17]. Hence, enhancing these
images will significantly improve the diagnosing capability. The fuzzy nature of mammographic image and its
low differentiability from the background make it too difficult to analyze them. Thus, it is essential to suppress
the noise and enhance the region of interest (ROI) [18, 19]. Image enhancement techniques have been used
widely for diagnosing aspects. Algorithms such as histogram equalization, median filters, gamma correction,
Gaussian filters, logarithmic transformation and morphological filter have been applied to medical images to
enhance the region of interest (ROI) [20]. In this paper, four enhancement techniques have been applied on
digital mammographic images: Histogram Equalization (HE), Logarithmic transformation (Log Transform),
Gamma Correction (GC) and finally Morphology enhancement (the proposed enhancement algorithm).
The rest sections are arranged as follows: next section gives a brief explanation about the used
enhancement algorithms. Materials and methods section discusses the research methodology and how
the research was performed. Results section clarifies the enhanced mammographic images resulted from all
used algorithms. Discussion section explains other aspects that accompany enhancement algorithms. Finally,
conclusion section summarizes the used enhancement algorithms and declares the optimum one.
Digital mammographic images are usually accompanied with high noise and low contrast [19].
Several enhancement techniques can be applied to these images to improve their clarity. Thus, enhancing
contrast, removing noise, suppressing background and enhancing edges are examples of common image
enhancements [20]. In digital images, histogram gives a graphical representation of gray levels distribution in
the image. Hence, the frequency of any individual gray level in the image can be estimated and analyzed easily
by observing the image histogram. Histogram equalization is a common method used for enhancing image
contrast by spreading out the intensity values along the entire range of values. Histogram equalization technique
is efficient in contrast enhancement wherever the represented image has closed contrast values. Intensity
transformation is another way of image enhancement, it has been considered as the simplest technique used in
the field of image processing [21]. Intensity transformations include image negative, logarithmic
transformation, gamma correction and piecewise linear stretching. Logarithmic transformation maps the values
of low intensity pixels in the input into wider output values and vice versa. This technique is used to expand
dark pixels values in the input images and compress the values of bright ones. Similarly, gamma correction
maps dark pixels in the input images into brighter ones and vice versa depending on (γ) value.
The morphology enhancement (the proposed Enhancement algorithm) depends on top-hat operation
and bottom-hat operation to enhance mammographic image in terms of accentuating high-intensity and
low-intensity morphological structures. Opening and closing operations are built from erosion and dilation as
follows [22, 23].
Opening operation:
𝑂𝐼 ○ 𝑆𝐼 = (𝑂𝐼 ⊖ 𝑆𝐼) ⊕ 𝑆𝐼 (1)
Closing operation:
𝑂𝐼 • 𝑆𝐼 = (𝑂𝐼 ⊕ 𝑆𝐼) ⊖ 𝑆𝐼 (2)
where, OI is the original image
SI is the structural element
⊖ Refers to erosion operation
⊕ Refers to dilation operation.
 ISSN: 1693-6930
TELKOMNIKA Telecommun Comput El Control, Vol. 18, No. 2, April 2020: 928 - 935
930
Then, top-hat (TH) and bottom-hat (BH) filtering are respectively expressed as shown in (3) and (4).
𝑇𝐻 = 𝑂𝐼 − 𝑂𝐼 ○ 𝑆𝐼 (3)
𝐵𝐻 = 𝑂𝐼 • 𝑆𝐼 − 𝑂𝐼 (4)
Finally, morphology enhancement algorithm is obtaind by adding the top-hat operation to the original image,
then the bottom-hat operation is subtracted from the result as shown in the following (5).
𝐸𝑛ℎ𝑎𝑛𝑐𝑒𝑑 𝐼𝑚𝑎𝑔𝑒 = 𝑂𝐼 + 𝑇𝐻 − 𝐵𝐻 (5)
Proposed enhancement algorithm will reduces the noise in addition to enhancing the low and high intensity
regions.
2. MATERIALS AND METHOD
MATLAB version R2015b was used to perform all the enhancement algorithms. The mammographic
images were taken from the Mammography Image Analysis Society (MIAS) Database samples. MIAS’s
samples are characterized by 8-bits of grayscale level and size of 1024x1024. The MIAS’s samples provide an
information about the specific location of the abnormal tissue throughout the mammography [24].
Consequently, MIAS’s are considered the most suitable database and has been chosen as the sources of images
for testing various images enhancing methods and identifying the optimum one thereafter.
MIAS’s mammography samples were labeled by numbers and letters to be different from other
samples. Furthermore, MIAS’s images have two regions, firstly the background, which forms the whole image
except the breast part, secondly the foreground, which represents the breast tissue. Trying to enhance
the mammography with their labels and backgrounds has led to distract the effects of the enhancement
algorithms on the entire image. Therefore, region of the interest (Breast tissue) was firstly extracted as shown
in Figure 1 using algorithm designed for that purpose, then all the enhancement algorithms were applied to
region of interest (RoI). In this paper, the qualitative assessment process is done through the following stages:
- Image acquisition.
- Preprocessing (RoI extraction).
- Applying the enhancement algorithms.
- Doing Entropy analysis to the results.
- Declaring the optimum algorithm.
Four enhancement algorithms were applied on 25 mammographic images taken from MIAS’s
database. The applied enhancement algorithms were histogram equalization, logarithm transformation, and
gamma correction for different values specifically (0.3, 0.45, 0.6, 0.75 and 0.9) and morphology enhancement
(the proposed one). The optimum enhancement algorithm was chosen depending on the minimum entropy
difference value (EDV) [25], looking for entropy near or similar to the original entropy.
Figure 1. Two original samples from MIAS’s
database (on the left) were preprocessed
to extract the region of interest (RoI) on the right
Figure 2. The block diagram of assessment process
TELKOMNIKA Telecommun Comput El Control 
Qualitative assessment of image enhancement algorithms for mammograms … (Mazin N. Farhan)
931
3. RESULTS AND DISCUSSION
The entropy of the enhanced images is depending on the used algorithms as shown in Table 1.
Table 1 shows that different algorithms modify the original entropy in different ways. Histogram equalization
algorithm significantly decreased the original entropy, while the proposed enhancement algorithm have almost
the same entropy as the original. The Logarithmic transformation algorithm has slightly modified the original
entropy. Whereas the Gamma correction algorithm modified the original entropy according to the used factor,
this algorithm (i.e GC) showed that the lowest factor being used gives the highest change in entropy and vice
versa (refer to Figure 3 and Figure 4). The differences between the original entropy and the modified entropies
that resulted from the used enhancement algorithms have been examined to identify the minimum EDV and
eventually the optimum enhancement algorithm is chosen. It is clearly seen that the minimum EDV is obtained
when using the proposed enhancement algorithm (morphology enahancement). Gamma correction of 0.9,
however, was ranked secondly in producing minimum EDV. Figures (3 and 4) show how the mammography
image is enhanced according to used algorithms.
This research has passed through several stages; starting from choosing the right database as a source
of the images until the final stage of producing enhanced images. As mentioned in the previous sections, four
enhancing algorithms have been used. The proposed enhancement algorithm (morphology enhancement), HE,
Log Transform and GC with different values (0.3, 0.45, 0.6, 0.75, 0.9). The reason for using these algorithms
in accompanying with the proposed one is to compare their outputs. MIAS was chosen as a source of
the mammography images due to the good images’ resolution, in addition to the diagnosing information
supplied with them. The goal of the proposed enhancement algorithm is to reach the best possible enhancement
of the interested area. The labels and the background of the breast are considered as lower importance than
the breast itself. Therefore, the region of interest (Breast area) was identified and cropped before applying any
of the enhancing algorithms. Approving the best enhancing algorithm has basically based on the statistical
factor minimum EDV. The EDV has been used to compare the entropy resulted from each applied algorithm
with that of the original images. Thus, the closer resulted entropy to the original one was identified as the best
enhancing algorithm. Table (1) showed the entropies resulted from used enhancements algoritms. It is clearly
seen that the proposed algorithm has provided the nearest entropy value to the original entropy. The quality of
images enhanced by the GC is basically depending on the value of (γ). In this paper, five values of (γ) were
used, the maximum used value was (0.9). Exceeding (γ = 0.9) to (γ = 1) will produce an identical image to
the original one. In addition, multiplying Log Transform and GC by a factor will modify the brightness of
the enhanced image, depending on the value of that factor. Using factor less than one decrease the brightness
and vice versa.
Table 1. Comparison amongst the applied enhancement algorithm on mammograms for Entropy analysis
Images sequences
Original
Entropy
Proposed
Enhancement
Entropy
HE
Entropy
Log.
Transform
Entropy
GC 0.3
Entropy
GC 0.45
Entropy
GC 0.6
Entropy
GC 0.75
Entropy
GC 0.9
Entropy
1 6.8974 6.9177 5.3222 6.4244 6.1989 6.4721 6.6368 6.7503 6.846
2 6.9393 6.9688 5.318 6.4318 6.1691 6.4694 6.6497 6.7763 6.881
3 6.607 6.6775 5.4783 6.0771 5.807 6.0958 6.2891 6.4416 6.5594
4 6.529 6.5814 5.1717 6.0034 5.7121 6.0118 6.1972 6.339 6.4601
5 5.6535 5.7205 4.5656 5.2023 4.9535 5.2111 5.3692 5.4912 5.5947
6 6.4031 6.4322 5.1507 5.9051 5.6415 5.9216 6.1044 6.2359 6.3463
7 6.4192 6.4398 5.0577 5.8848 5.5707 5.8837 6.0675 6.2172 6.3468
8 5.4226 5.4507 4.3588 4.9726 4.7036 4.9639 5.1273 5.2535 5.3598
9 6.1838 6.1987 4.8155 5.679 5.3886 5.6813 5.8511 5.9933 6.1117
10 6.7011 6.7298 5.3856 6.1186 5.7722 6.1085 6.3201 6.4835 6.6185
11 6.874 6.91 5.3906 6.3177 6.0029 6.3262 6.5194 6.6675 6.7949
12 6.1148 6.1507 4.9428 5.591 5.2726 5.5831 5.7603 5.9131 6.0407
13 6.9124 6.9429 5.456 6.4246 6.203 6.4756 6.6501 6.774 6.8652
14 7.0354 7.0564 5.6098 6.5593 6.3579 6.6344 6.8056 6.9135 6.9935
15 6.6299 6.6591 5.4398 5.9932 5.5986 5.9751 6.1874 6.3675 6.5279
16 6.6299 6.6591 5.4398 5.9932 5.5986 5.9751 6.1874 6.3675 6.5279
17 6.3156 6.3584 5.1258 5.7748 5.4529 5.7668 5.9625 6.115 6.2387
18 7.0258 7.0407 5.4752 6.4713 6.168 6.4888 6.6809 6.8312 6.9542
19 6.7645 6.7884 5.3806 6.3053 6.1011 6.3615 6.5275 6.6403 6.722
20 6.6236 6.6449 5.0616 6.1413 5.8861 6.1644 6.33 6.4567 6.5651
21 6.0842 6.1467 4.9165 5.5847 5.2929 5.581 5.7632 5.9073 6.0221
22 6.7434 6.7774 5.4621 6.1796 5.8593 6.183 6.3867 6.5374 6.6723
23 6.8611 6.8811 5.3794 6.3376 6.062 6.3556 6.5461 6.6899 6.8002
24 6.7768 6.8079 5.4936 6.1964 5.8702 6.2013 6.4133 6.5697 6.7018
25 6.8256 6.8473 5.3021 6.2644 5.9314 6.2601 6.4543 6.6104 6.7444
 ISSN: 1693-6930
TELKOMNIKA Telecommun Comput El Control, Vol. 18, No. 2, April 2020: 928 - 935
932
Original Image
HE Log Transform GC 0.3 GC 0.45
GC 0.6 GC 0.75 GC 0.9 Proposed Algorithm
(a)
Original Image
HE Log. Transform GC 0.3 GC 0.45
GC 0.6 GC 0.75 GC 0.9 Proposed Algorithm
(b)
Figure 3. (a) Histograms of the original mammogram with the output of different enhancement algorithms,
(b) The effect of applied enhancement algorithms on mammograms
TELKOMNIKA Telecommun Comput El Control 
Qualitative assessment of image enhancement algorithms for mammograms … (Mazin N. Farhan)
933
Original Image
HE Log Transform GC 0.3 GC 0.45
GC 0.6 GC 0.75 GC 0.9 Proposed Algorithm
(a)
Original Image
HE Log. Transform GC 0.3 GC 0.45
GC 0.6 GC 0.75 GC 0.9 Proposed Algorithm
(b)
Figure 4. (a) Histograms of the original mammogram with the output of different enhancement algorithms,
(b) The effect of applied enhancement algorithms on mammograms
 ISSN: 1693-6930
TELKOMNIKA Telecommun Comput El Control, Vol. 18, No. 2, April 2020: 928 - 935
934
4. CONCLUSION
Several popular enhancement techniques including the proposed enhancement algorithm have been
applied to the selected mammographic images. Minimum (EDV) was used as a metric to evaluate the efficiency
of proposed enhancement algorithm in comparison with other enhancement algorithms. For every selected
image, the entropy has been calculated before and after applying the aforementioned algorithms. Then, a brief
comparison was done amongst these algorithms according to the resulted entropy differences. Thus, our study
declared that the best enhancement was done by the mathematical morphology enhancement (the proposed
enhancement algorithm) in comparison with other enhancement algorithms.
ACKNOWLEDGEMENTS
We take this opportunity to express our profound gratitude and deep regards to the presidency of
the Northern Technical University for their constant scientific encouragement.
REFERENCES
[1] Vikhe, P. S., Thool, V. R., “Contrast enhancement in mammograms using homomorphic filter technique,” 2016
International Conference on Signal and Information Processing, pp. 1-5, 2016.
[2] American Cancer Society, “Cancer facts & figures 2011,” Atlanta: American Cancer Society, 2011.
[3] Cancer Institute at the National Institutes of Health. [Online]. Available: www.cancer.gov.
[4] Tabár L., et al, “The incidence of fatal breast cancer measures the increased effectiveness of therapy in women
participating in mammography screening,” Cancer, vol. 125, no. 4, pp. 515-523, 2019.
[5] DeSantis C., Ma J., Bryan L., & Jemal, A., “Breast cancer statistics, 2013,” CA: A Cancer Journal for Clinicians,
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[7] Rajaraman P., Anderson B. O., Basu P., Belinson J. L., Cruz A. D., Dhillon P. K., “Recommendations for screening
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[8] American Cancer Society. “Cancer facts & figures 2015,” Atlanta: American Cancer Society; 2015
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[11] Smith R. A., et al., “Cancer screening in the United States, 2019: A review of current American Cancer Society
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May 2019.
[12] J. Tang, R. M. Rangayyan, J. Xu, I. El Naqa, Y. Yang., “Computer-aided detection and diagnosis of breast cancer
with mammography: recent advances,” IEEE Transactions on Information Technology in Biomedicine, vol. 13,
no. 2, pp. 236–251, 2009.
[13] Gadgil A, Sauvaget C, Roy N., et al., “Cancer early detection program based on awareness and clinical breast
examination: Interim results from an urban community in Mumbai, India,” The Breast, vol. 31, pp. 85–89, 2016.
[14] P. S. Vikhe, V. R. Thool, “Mass detection in mammographic images using wavelet processing and adaptive threshold
technique,” Journal of Medical Systems, vol. 40, no. 4, pp. 1–16, 2016.
[15] Seely J. M., Alhassan T., “Screening for breast cancer in 2018-what should we be doing today?,” Current Oncology,
vol. 25, no. 1, pp. s115-s124, 2018.
[16] Elmore J. G., “Screening for Breast Cancer,” JAMA, vol. 293, no. 10, pp. 1245-1256, 2005.
[17] Bhateja V., Misra M., Urooj S., “Human visual system based unsharp masking for enhancement of mammographic
images,” Journal of Computational Science, vol. 21, pp. 387-393, July 2017.
[18] W. Peng, R. Mayorga, E. Hussein, “An automated confirmatory system for analysis of mammograms,” Computer
Methods and Programs in Biomedicine, vol. 125, pp. 134-144, 2016.
[19] Vijaya K.G., Ambalika S., “Contrast enhancement of mammographic images using wavelet transform,” 2010
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International Conference on Computer Science and Information Technology, pp. 323–327, 2010.
[20] Qassim H., Basheer N., Farhan M., “Brightness preserving enhancement for dental digital X-ray images based on
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[21] Gonzalez R. C., R. E. Woods, S. L. Eddins, “Digital Image Processing Using MATLAB, Second Edition,” Gatesmark
Publishing, 2009.
[22] McAndrew A., “A computational introduction to digital image processing,” Tylor and Francis Group, 2015.
[23] Al-Nima R. R. O., Dlay S. S., Chambers J. A., Woo W. L., “Human authentication with finger textures based
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[24] J. Suckling, “The Min-MAIS database of mammograms,” [Online], Available: http://peipa.essex.ac.uk/info/
mias.html, 2013.
[25] Menon H. P., Rajeshwari B., “Enhancement of Dental Digital X-Ray Images based On the Image Quality,” Intelligent
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BIOGRAPHIES OF AUTHORS
Mazin N. Farhan is academic lecturer works at the Northern Technical University (NTU).
He received his Bachelor’s degree in Medical Instrumentation Technology Engineering from
the Northern Technical University in 2007 and a Master’s degree in Medical Devices from
the University of Strathclyde, Glasgow, UK in 2014. He have studied and worked with
medical Instrumentation and have had the chance to get an in depth understanding of medical
devices and their environment. He is looking to use his engineering skills in improving the
current state of medical devices. His top research interest topics are medical image processing,
biosignal processing and medical sensors. Please email mazin.nadheer@ntu.edu.iq or go to
https://www.linkedin.com/in/mazin-n-farhan-2a1367a7/ to contact Mazin.
Mohammed Ghanim Ayoub is a Lecturer at the Technical Engineering College of
Mosul-Northern Technical University (NTU) since 2015. Mohammed completed his Bachelor
of Engineering in Computer Technology from Northern Technical University, in 2006,
and completed his MSc in Electronic Communications and Computer Engineering at
University of Nottingham in 2015. His primary research interests revolve around
the application of signal processing and sensor data techniques to solve or understand
biomedical engineering problems.
Hassan Messar Qassim is a lecturer at Northern Technical University (NTU) with two
certificates in Medical Engineering, BEng and MSc. He obtained his master degree from
University of Strathclyde in 2013. His research field is the medical image processing and
medical sensors.
Abdulrahman K. Eesee is a Lecturer in the Technical Engineering College of
Mosul/Northern Technical University, Iraq. Holding Master degree MSc in the Biomedical
Engineering from the University of Strathclyde/United Kingdom in 2015 through a fully
funded scholarship from the Iraqi government, and holding Bachelor of Engineering B.Eng
in the Medical Instrumentation Technology Engineering. The main researching field is
the Bio-signal processing, medical sensors and image processing.

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Qualitative assessment of image enhancement algorithms for mammograms based on minimum EDV

  • 1. TELKOMNIKA Telecommunication, Computing, Electronics and Control Vol. 18, No. 2, April 2020, pp. 928~935 ISSN: 1693-6930, accredited First Grade by Kemenristekdikti, Decree No: 21/E/KPT/2018 DOI: 10.12928/TELKOMNIKA.v18i2.14085  928 Journal homepage: http://journal.uad.ac.id/index.php/TELKOMNIKA Qualitative assessment of image enhancement algorithms for mammograms based on minimum EDV Mazin N. Farhan1 , Mohammed G. Ayoub2 , Hassan M. Qassim3 , Abdulrahman K. Eesee4 1,3,4 Department of Medical Instrumentation Technology Engineering, Northern Technical University, Iraq 2 Department of Computer Technology Engineering, Northern Technical University, Iraq Article Info ABSTRACT Article history: Received Sep 12, 2019 Revised Jan 2, 2020 Accepted Feb 19, 2020 Breast cancer is one of the leading reason of death among women. Nevertheless, medications for this fatal disease are still away of ambitions. Patients (thought to have breast cancer) should go through several advanced medical diagnostic procedures like mammography, biopsy analysis, ultrasound imaging, etc. Mammography is one of the medical imaging techniques used for detecting breast cancer. However, its resulted images may not be clear enough or helpful for physician to diagnose each case correctly. This fact has pushed researchers towards developing effective ways to enhance images throughout using various enhancement algorithms. In this paper, a comparison amongst these applied algorithms was done to evaluate the optimum enhancement technique. A morphology enhancement, which is resulted from combining top-hat operation and bottom-hat operation, was used as a proposed enhancement algorithm. The proposed enhancement algorithm was compared to three other well-known enhancement algorithms, specifically histogram equalization, logarithmic transform, and gamma correction with different gamma values. Twenty-five mammographic images were taken from the mammography image analysis society (MIAS) database samples. The minimum entropy difference value (EDV) was used as metric to evaluate the best enhancement algorithm. Results has approved that the proposed enhancement algorithm gave the best-enhanced images in comparison to the aforementioned algorithms. Keywords: Entropy difference value (EDV) Gamma correction Histogram equalization Logarithmic transformation Morphology enhancement This is an open access article under the CC BY-SA license. Corresponding Author: Mohammed G. Ayoub, Department of Computer Technology Engineering Technical Engineering College/Mosul, Northern Technical University, Al-minasa street, across from Ibn Alatheer hospital, Mosul, Iraq. Email: mohammed.ghanim@ntu.edu.iq 1. INTRODUCTION Cancer is an unconfined growth of malignant cells in a certain location of human body [1-3]. It is fatal disease and those suffering cancers most likely facing death [4]. The World Health Organization (WHO) reported in 2014 that cancer is the second cause of deaths in the world [5]. Breast cancer is one of the most health problems in the world. Moreover, it is the main cause of cancer death amongst women especially in developing countries [6]. According to a study conducted by Rajaraman et al. in 2015, the range of women with breast cancer in India was around 36 per 100,000 whilst in Europe and North America was 92 to 112 per 100,000 women [7]. This study also found that the mortality of breast cancer in India is relatively high (12.7 per 100,000 women) which is similar to the rates in developing countries [7]. According to the estimation
  • 2. TELKOMNIKA Telecommun Comput El Control  Qualitative assessment of image enhancement algorithms for mammograms … (Mazin N. Farhan) 929 of the American Cancer Society (ACS) in 2016, women deaths resulted from breast cancer was about 40,290 in the United States [8]. A study conducted by Malvia et al. in 2017 declared that 1,797,900 women suffered from breast cancer in India by 2020 [9]. The last estimation of the American cancer society in 2019 stated that about 268,600 women will be considered to have breast cancer and 41,760 women will face death due to breast growth [10, 11]. The prevention of breast cancer is still impossible due to the unidentified cause of it. Thus, there is no effective way to avoid breast cancer but screening to detect it in early stages [12]. Many organizations in the health sector have raised the awareness to breast cancer by encouraging women to participate in diagnostic investigations such as tissue sampling, clinical breast examination (CBE) and imaging for early detection of breast cancer [13]. Imaging is still the most popular way in breast screening. The X-ray mammography is used for interpreting breast cancer. According to Vikhe and Thool in 2016, mammography is the most effective way for breast screening. This technique has led to decrease breast cancer deaths by 25% [14]. Mammography is the initial step for breast cancer recognition [15, 16]. Calcium depositions create calcifications that usually appear as spots in mammographic images indicating a potential abnormality that is mostly considered as a sign of cancer [1]. In some cases of micro-calcifications in breast tissues, low contrast affects the radiologist’s ability in diagnosing breast cancer by digital mammographic images [1]. Gray shade variation in mammograms reduces contrast level due to scattered X-radiation, highly powered X-ray penetration and the film limited capacity which leads to false positive results [17]. Hence, enhancing these images will significantly improve the diagnosing capability. The fuzzy nature of mammographic image and its low differentiability from the background make it too difficult to analyze them. Thus, it is essential to suppress the noise and enhance the region of interest (ROI) [18, 19]. Image enhancement techniques have been used widely for diagnosing aspects. Algorithms such as histogram equalization, median filters, gamma correction, Gaussian filters, logarithmic transformation and morphological filter have been applied to medical images to enhance the region of interest (ROI) [20]. In this paper, four enhancement techniques have been applied on digital mammographic images: Histogram Equalization (HE), Logarithmic transformation (Log Transform), Gamma Correction (GC) and finally Morphology enhancement (the proposed enhancement algorithm). The rest sections are arranged as follows: next section gives a brief explanation about the used enhancement algorithms. Materials and methods section discusses the research methodology and how the research was performed. Results section clarifies the enhanced mammographic images resulted from all used algorithms. Discussion section explains other aspects that accompany enhancement algorithms. Finally, conclusion section summarizes the used enhancement algorithms and declares the optimum one. Digital mammographic images are usually accompanied with high noise and low contrast [19]. Several enhancement techniques can be applied to these images to improve their clarity. Thus, enhancing contrast, removing noise, suppressing background and enhancing edges are examples of common image enhancements [20]. In digital images, histogram gives a graphical representation of gray levels distribution in the image. Hence, the frequency of any individual gray level in the image can be estimated and analyzed easily by observing the image histogram. Histogram equalization is a common method used for enhancing image contrast by spreading out the intensity values along the entire range of values. Histogram equalization technique is efficient in contrast enhancement wherever the represented image has closed contrast values. Intensity transformation is another way of image enhancement, it has been considered as the simplest technique used in the field of image processing [21]. Intensity transformations include image negative, logarithmic transformation, gamma correction and piecewise linear stretching. Logarithmic transformation maps the values of low intensity pixels in the input into wider output values and vice versa. This technique is used to expand dark pixels values in the input images and compress the values of bright ones. Similarly, gamma correction maps dark pixels in the input images into brighter ones and vice versa depending on (γ) value. The morphology enhancement (the proposed Enhancement algorithm) depends on top-hat operation and bottom-hat operation to enhance mammographic image in terms of accentuating high-intensity and low-intensity morphological structures. Opening and closing operations are built from erosion and dilation as follows [22, 23]. Opening operation: 𝑂𝐼 ○ 𝑆𝐼 = (𝑂𝐼 ⊖ 𝑆𝐼) ⊕ 𝑆𝐼 (1) Closing operation: 𝑂𝐼 • 𝑆𝐼 = (𝑂𝐼 ⊕ 𝑆𝐼) ⊖ 𝑆𝐼 (2) where, OI is the original image SI is the structural element ⊖ Refers to erosion operation ⊕ Refers to dilation operation.
  • 3.  ISSN: 1693-6930 TELKOMNIKA Telecommun Comput El Control, Vol. 18, No. 2, April 2020: 928 - 935 930 Then, top-hat (TH) and bottom-hat (BH) filtering are respectively expressed as shown in (3) and (4). 𝑇𝐻 = 𝑂𝐼 − 𝑂𝐼 ○ 𝑆𝐼 (3) 𝐵𝐻 = 𝑂𝐼 • 𝑆𝐼 − 𝑂𝐼 (4) Finally, morphology enhancement algorithm is obtaind by adding the top-hat operation to the original image, then the bottom-hat operation is subtracted from the result as shown in the following (5). 𝐸𝑛ℎ𝑎𝑛𝑐𝑒𝑑 𝐼𝑚𝑎𝑔𝑒 = 𝑂𝐼 + 𝑇𝐻 − 𝐵𝐻 (5) Proposed enhancement algorithm will reduces the noise in addition to enhancing the low and high intensity regions. 2. MATERIALS AND METHOD MATLAB version R2015b was used to perform all the enhancement algorithms. The mammographic images were taken from the Mammography Image Analysis Society (MIAS) Database samples. MIAS’s samples are characterized by 8-bits of grayscale level and size of 1024x1024. The MIAS’s samples provide an information about the specific location of the abnormal tissue throughout the mammography [24]. Consequently, MIAS’s are considered the most suitable database and has been chosen as the sources of images for testing various images enhancing methods and identifying the optimum one thereafter. MIAS’s mammography samples were labeled by numbers and letters to be different from other samples. Furthermore, MIAS’s images have two regions, firstly the background, which forms the whole image except the breast part, secondly the foreground, which represents the breast tissue. Trying to enhance the mammography with their labels and backgrounds has led to distract the effects of the enhancement algorithms on the entire image. Therefore, region of the interest (Breast tissue) was firstly extracted as shown in Figure 1 using algorithm designed for that purpose, then all the enhancement algorithms were applied to region of interest (RoI). In this paper, the qualitative assessment process is done through the following stages: - Image acquisition. - Preprocessing (RoI extraction). - Applying the enhancement algorithms. - Doing Entropy analysis to the results. - Declaring the optimum algorithm. Four enhancement algorithms were applied on 25 mammographic images taken from MIAS’s database. The applied enhancement algorithms were histogram equalization, logarithm transformation, and gamma correction for different values specifically (0.3, 0.45, 0.6, 0.75 and 0.9) and morphology enhancement (the proposed one). The optimum enhancement algorithm was chosen depending on the minimum entropy difference value (EDV) [25], looking for entropy near or similar to the original entropy. Figure 1. Two original samples from MIAS’s database (on the left) were preprocessed to extract the region of interest (RoI) on the right Figure 2. The block diagram of assessment process
  • 4. TELKOMNIKA Telecommun Comput El Control  Qualitative assessment of image enhancement algorithms for mammograms … (Mazin N. Farhan) 931 3. RESULTS AND DISCUSSION The entropy of the enhanced images is depending on the used algorithms as shown in Table 1. Table 1 shows that different algorithms modify the original entropy in different ways. Histogram equalization algorithm significantly decreased the original entropy, while the proposed enhancement algorithm have almost the same entropy as the original. The Logarithmic transformation algorithm has slightly modified the original entropy. Whereas the Gamma correction algorithm modified the original entropy according to the used factor, this algorithm (i.e GC) showed that the lowest factor being used gives the highest change in entropy and vice versa (refer to Figure 3 and Figure 4). The differences between the original entropy and the modified entropies that resulted from the used enhancement algorithms have been examined to identify the minimum EDV and eventually the optimum enhancement algorithm is chosen. It is clearly seen that the minimum EDV is obtained when using the proposed enhancement algorithm (morphology enahancement). Gamma correction of 0.9, however, was ranked secondly in producing minimum EDV. Figures (3 and 4) show how the mammography image is enhanced according to used algorithms. This research has passed through several stages; starting from choosing the right database as a source of the images until the final stage of producing enhanced images. As mentioned in the previous sections, four enhancing algorithms have been used. The proposed enhancement algorithm (morphology enhancement), HE, Log Transform and GC with different values (0.3, 0.45, 0.6, 0.75, 0.9). The reason for using these algorithms in accompanying with the proposed one is to compare their outputs. MIAS was chosen as a source of the mammography images due to the good images’ resolution, in addition to the diagnosing information supplied with them. The goal of the proposed enhancement algorithm is to reach the best possible enhancement of the interested area. The labels and the background of the breast are considered as lower importance than the breast itself. Therefore, the region of interest (Breast area) was identified and cropped before applying any of the enhancing algorithms. Approving the best enhancing algorithm has basically based on the statistical factor minimum EDV. The EDV has been used to compare the entropy resulted from each applied algorithm with that of the original images. Thus, the closer resulted entropy to the original one was identified as the best enhancing algorithm. Table (1) showed the entropies resulted from used enhancements algoritms. It is clearly seen that the proposed algorithm has provided the nearest entropy value to the original entropy. The quality of images enhanced by the GC is basically depending on the value of (γ). In this paper, five values of (γ) were used, the maximum used value was (0.9). Exceeding (γ = 0.9) to (γ = 1) will produce an identical image to the original one. In addition, multiplying Log Transform and GC by a factor will modify the brightness of the enhanced image, depending on the value of that factor. Using factor less than one decrease the brightness and vice versa. Table 1. Comparison amongst the applied enhancement algorithm on mammograms for Entropy analysis Images sequences Original Entropy Proposed Enhancement Entropy HE Entropy Log. Transform Entropy GC 0.3 Entropy GC 0.45 Entropy GC 0.6 Entropy GC 0.75 Entropy GC 0.9 Entropy 1 6.8974 6.9177 5.3222 6.4244 6.1989 6.4721 6.6368 6.7503 6.846 2 6.9393 6.9688 5.318 6.4318 6.1691 6.4694 6.6497 6.7763 6.881 3 6.607 6.6775 5.4783 6.0771 5.807 6.0958 6.2891 6.4416 6.5594 4 6.529 6.5814 5.1717 6.0034 5.7121 6.0118 6.1972 6.339 6.4601 5 5.6535 5.7205 4.5656 5.2023 4.9535 5.2111 5.3692 5.4912 5.5947 6 6.4031 6.4322 5.1507 5.9051 5.6415 5.9216 6.1044 6.2359 6.3463 7 6.4192 6.4398 5.0577 5.8848 5.5707 5.8837 6.0675 6.2172 6.3468 8 5.4226 5.4507 4.3588 4.9726 4.7036 4.9639 5.1273 5.2535 5.3598 9 6.1838 6.1987 4.8155 5.679 5.3886 5.6813 5.8511 5.9933 6.1117 10 6.7011 6.7298 5.3856 6.1186 5.7722 6.1085 6.3201 6.4835 6.6185 11 6.874 6.91 5.3906 6.3177 6.0029 6.3262 6.5194 6.6675 6.7949 12 6.1148 6.1507 4.9428 5.591 5.2726 5.5831 5.7603 5.9131 6.0407 13 6.9124 6.9429 5.456 6.4246 6.203 6.4756 6.6501 6.774 6.8652 14 7.0354 7.0564 5.6098 6.5593 6.3579 6.6344 6.8056 6.9135 6.9935 15 6.6299 6.6591 5.4398 5.9932 5.5986 5.9751 6.1874 6.3675 6.5279 16 6.6299 6.6591 5.4398 5.9932 5.5986 5.9751 6.1874 6.3675 6.5279 17 6.3156 6.3584 5.1258 5.7748 5.4529 5.7668 5.9625 6.115 6.2387 18 7.0258 7.0407 5.4752 6.4713 6.168 6.4888 6.6809 6.8312 6.9542 19 6.7645 6.7884 5.3806 6.3053 6.1011 6.3615 6.5275 6.6403 6.722 20 6.6236 6.6449 5.0616 6.1413 5.8861 6.1644 6.33 6.4567 6.5651 21 6.0842 6.1467 4.9165 5.5847 5.2929 5.581 5.7632 5.9073 6.0221 22 6.7434 6.7774 5.4621 6.1796 5.8593 6.183 6.3867 6.5374 6.6723 23 6.8611 6.8811 5.3794 6.3376 6.062 6.3556 6.5461 6.6899 6.8002 24 6.7768 6.8079 5.4936 6.1964 5.8702 6.2013 6.4133 6.5697 6.7018 25 6.8256 6.8473 5.3021 6.2644 5.9314 6.2601 6.4543 6.6104 6.7444
  • 5.  ISSN: 1693-6930 TELKOMNIKA Telecommun Comput El Control, Vol. 18, No. 2, April 2020: 928 - 935 932 Original Image HE Log Transform GC 0.3 GC 0.45 GC 0.6 GC 0.75 GC 0.9 Proposed Algorithm (a) Original Image HE Log. Transform GC 0.3 GC 0.45 GC 0.6 GC 0.75 GC 0.9 Proposed Algorithm (b) Figure 3. (a) Histograms of the original mammogram with the output of different enhancement algorithms, (b) The effect of applied enhancement algorithms on mammograms
  • 6. TELKOMNIKA Telecommun Comput El Control  Qualitative assessment of image enhancement algorithms for mammograms … (Mazin N. Farhan) 933 Original Image HE Log Transform GC 0.3 GC 0.45 GC 0.6 GC 0.75 GC 0.9 Proposed Algorithm (a) Original Image HE Log. Transform GC 0.3 GC 0.45 GC 0.6 GC 0.75 GC 0.9 Proposed Algorithm (b) Figure 4. (a) Histograms of the original mammogram with the output of different enhancement algorithms, (b) The effect of applied enhancement algorithms on mammograms
  • 7.  ISSN: 1693-6930 TELKOMNIKA Telecommun Comput El Control, Vol. 18, No. 2, April 2020: 928 - 935 934 4. CONCLUSION Several popular enhancement techniques including the proposed enhancement algorithm have been applied to the selected mammographic images. Minimum (EDV) was used as a metric to evaluate the efficiency of proposed enhancement algorithm in comparison with other enhancement algorithms. For every selected image, the entropy has been calculated before and after applying the aforementioned algorithms. Then, a brief comparison was done amongst these algorithms according to the resulted entropy differences. Thus, our study declared that the best enhancement was done by the mathematical morphology enhancement (the proposed enhancement algorithm) in comparison with other enhancement algorithms. ACKNOWLEDGEMENTS We take this opportunity to express our profound gratitude and deep regards to the presidency of the Northern Technical University for their constant scientific encouragement. REFERENCES [1] Vikhe, P. S., Thool, V. R., “Contrast enhancement in mammograms using homomorphic filter technique,” 2016 International Conference on Signal and Information Processing, pp. 1-5, 2016. [2] American Cancer Society, “Cancer facts & figures 2011,” Atlanta: American Cancer Society, 2011. [3] Cancer Institute at the National Institutes of Health. [Online]. Available: www.cancer.gov. [4] Tabár L., et al, “The incidence of fatal breast cancer measures the increased effectiveness of therapy in women participating in mammography screening,” Cancer, vol. 125, no. 4, pp. 515-523, 2019. [5] DeSantis C., Ma J., Bryan L., & Jemal, A., “Breast cancer statistics, 2013,” CA: A Cancer Journal for Clinicians, vol. 64, no. 1, pp. 52–62, 2013. [6] Du X. L., Fox E. E., Lai D., “Competing causes of death for women with breast cancer and change over time from 1975 to 2003,” American Journal of Clinical Oncology, vol. 31, no. 2, pp. 105–116, 2008. [7] Rajaraman P., Anderson B. O., Basu P., Belinson J. L., Cruz A. D., Dhillon P. K., “Recommendations for screening and early detection of common cancers in India,” The Lancet Oncology, vol. 16, no. 7, pp. e352-e361, 2015. [8] American Cancer Society. “Cancer facts & figures 2015,” Atlanta: American Cancer Society; 2015 [9] Malvia S., Bagadi S. A., Dubey U. S., Saxena S., “Epidemiology of breast cancer in Indian women,” Asia-Pacific Journal of Clinical Oncology, vol. 13, no. 4, pp. 289–295, 2017. [10] Siegel R. L., Miller K. D., Jemal A., “Cancer statistics, 2019,” CA: A Cancer Journal for Clinicians, vol. 69, no. 1, pp. 7-34, 2019. [11] Smith R. A., et al., “Cancer screening in the United States, 2019: A review of current American Cancer Society guidelines and current issues in cancer screening,” CA: A Cancer Journal for Clinicians, vol. 69, no. 3, pp. 184-210, May 2019. [12] J. Tang, R. M. Rangayyan, J. Xu, I. El Naqa, Y. Yang., “Computer-aided detection and diagnosis of breast cancer with mammography: recent advances,” IEEE Transactions on Information Technology in Biomedicine, vol. 13, no. 2, pp. 236–251, 2009. [13] Gadgil A, Sauvaget C, Roy N., et al., “Cancer early detection program based on awareness and clinical breast examination: Interim results from an urban community in Mumbai, India,” The Breast, vol. 31, pp. 85–89, 2016. [14] P. S. Vikhe, V. R. Thool, “Mass detection in mammographic images using wavelet processing and adaptive threshold technique,” Journal of Medical Systems, vol. 40, no. 4, pp. 1–16, 2016. [15] Seely J. M., Alhassan T., “Screening for breast cancer in 2018-what should we be doing today?,” Current Oncology, vol. 25, no. 1, pp. s115-s124, 2018. [16] Elmore J. G., “Screening for Breast Cancer,” JAMA, vol. 293, no. 10, pp. 1245-1256, 2005. [17] Bhateja V., Misra M., Urooj S., “Human visual system based unsharp masking for enhancement of mammographic images,” Journal of Computational Science, vol. 21, pp. 387-393, July 2017. [18] W. Peng, R. Mayorga, E. Hussein, “An automated confirmatory system for analysis of mammograms,” Computer Methods and Programs in Biomedicine, vol. 125, pp. 134-144, 2016. [19] Vijaya K.G., Ambalika S., “Contrast enhancement of mammographic images using wavelet transform,” 2010 3rd International Conference on Computer Science and Information Technology, pp. 323–327, 2010. [20] Qassim H., Basheer N., Farhan M., “Brightness preserving enhancement for dental digital X-ray images based on entropy and histogram analysis,” Journal of Applied Sciences and Engineering, vol. 22, no. 1, pp. 187-194. 2019. [21] Gonzalez R. C., R. E. Woods, S. L. Eddins, “Digital Image Processing Using MATLAB, Second Edition,” Gatesmark Publishing, 2009. [22] McAndrew A., “A computational introduction to digital image processing,” Tylor and Francis Group, 2015. [23] Al-Nima R. R. O., Dlay S. S., Chambers J. A., Woo W. L., “Human authentication with finger textures based on image feature enhancement,” 2nd IET International Conference on Intelligent Signal Processing 2015 (ISP), pp. 1-6, 2015. [24] J. Suckling, “The Min-MAIS database of mammograms,” [Online], Available: http://peipa.essex.ac.uk/info/ mias.html, 2013. [25] Menon H. 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  • 8. TELKOMNIKA Telecommun Comput El Control  Qualitative assessment of image enhancement algorithms for mammograms … (Mazin N. Farhan) 935 BIOGRAPHIES OF AUTHORS Mazin N. Farhan is academic lecturer works at the Northern Technical University (NTU). He received his Bachelor’s degree in Medical Instrumentation Technology Engineering from the Northern Technical University in 2007 and a Master’s degree in Medical Devices from the University of Strathclyde, Glasgow, UK in 2014. He have studied and worked with medical Instrumentation and have had the chance to get an in depth understanding of medical devices and their environment. He is looking to use his engineering skills in improving the current state of medical devices. His top research interest topics are medical image processing, biosignal processing and medical sensors. Please email mazin.nadheer@ntu.edu.iq or go to https://www.linkedin.com/in/mazin-n-farhan-2a1367a7/ to contact Mazin. Mohammed Ghanim Ayoub is a Lecturer at the Technical Engineering College of Mosul-Northern Technical University (NTU) since 2015. Mohammed completed his Bachelor of Engineering in Computer Technology from Northern Technical University, in 2006, and completed his MSc in Electronic Communications and Computer Engineering at University of Nottingham in 2015. His primary research interests revolve around the application of signal processing and sensor data techniques to solve or understand biomedical engineering problems. Hassan Messar Qassim is a lecturer at Northern Technical University (NTU) with two certificates in Medical Engineering, BEng and MSc. He obtained his master degree from University of Strathclyde in 2013. His research field is the medical image processing and medical sensors. Abdulrahman K. Eesee is a Lecturer in the Technical Engineering College of Mosul/Northern Technical University, Iraq. Holding Master degree MSc in the Biomedical Engineering from the University of Strathclyde/United Kingdom in 2015 through a fully funded scholarship from the Iraqi government, and holding Bachelor of Engineering B.Eng in the Medical Instrumentation Technology Engineering. The main researching field is the Bio-signal processing, medical sensors and image processing.