Cervical cancer rates have dramatically declined in the United States due to widespread Pap smear screening and the ability to treat precancerous lesions before they develop into cancer. The introduction of the Pap test in the 1940s allowed early detection and helped reduce cervical cancer incidence and mortality rates by over 60% between 1955 and 1992. New automated screening systems using digital imaging and computational analysis now further aid in screening and may help expand screening to rural areas through remote image analysis.

1. Translational Health Research
Cervical cancer

3. http://www.thelancet.com/

4. YESTERDAY
In 1940s, cervical cancer was a major cause of death among women of childbearing age
in the United States.
TODAY
Cervical cancer – once one of the most common cancers affecting U.S. women – now
ranks 14th in frequency. Because precancerous lesions found by Pap smears can be
treated and cured before they develop into cancer, and because cervical cancer is often
detected before it becomes advanced, the incidence and death rates for this disease are
relatively low.
HOW?
Better visualization:- Introduction Papanicolaou (Pap) smear test in which a sample of
cervical cells is examined under a microscope to detect cellular abnormalities. The
incidence of invasive cervical cancer declined dramatically. Between 1955 and 1992,
U.S. cervical cancer incidence and death rates declined by more than 60%. and
automation
Automation:- Introduction of ThinPrep®, FocalPoint® (FDA approved) systems which
screens and suggest potential cases to cytopathologists
http://report.nih.gov/NIHfactsheets/ViewFactSheet.aspx?csid=76
http://report.nih.gov/NIHfactsheets/ViewFactSheet.aspx?csid=76

5. ‘’Cancer Facts and Figures 2012’’ America cancer society

6. Why cant I just mimic
the existing technology?

7. Experinced Cytopathologists
COST
Accuracy (False neg.)
Massive screening OUR CONCERN
Automated imaging
Computational Facility
Extension to rural areas
Business Model
Awareness
.
.

9. Monolayer Preparation
Collection of cervical smears from transformation zone and endo
cervix by Ayer’s spatula and endo-cervical brush respectively into
polysol solution.
Centrifugation at 2000-4000 rpm for 5 mins, supernatant
discarded and re-suspension of pallet in fresh polysol solution
Preparation of cervical monolayer smear using cyto-centrifuge
with appropriate funnel and filter cards.
Fixation of the smear with 95% ethanol for 10 mins.
Pap staining of the monolayer cervical smear using hematoxylin
(stains nucleus blue), orange G (stains cytoplasm of superficial
cells pink) and eosine-azure (stains cytoplasm of intermediate
cells blue to green)
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10. Feature Identification &
Significance
No. Nuclear Feature Significance
1 Brightness of Nucleus Most Significant
2 Area of Nucleus Significant
3 Irregularity of the Nuclear Significant
Membrane
4 Nucleus Roundness Significant
5 Size of Chromatin Granule Significant
Table shows the importance of feature significance in 40 X
magnification
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11. Presence of Variations in
Normal Nuclei
A set of normal nuclei cropped from images of size 2048 x 1536.
Magnification 40X.
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12. Presence of Variations in
Abnormal Nuclei
A set of abnormal nuclei. Image size 404 x 270. Courtesy by International
Agency for Research on Cancer cervical cells image database.
Magnification 40X
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13. Ambiguity in Nuclear
Features
a b c d
a.Malignant Intermediate Cell Nucleus.
b.Normal Parabasal Cell Nucleus
c.Malignant Superficial Cell Nucleus.
d.Normal Parabasal Cell Nucleus
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14. Implementating out of box
Features and Classification
Classification
Classification
Feature
Feature
Quantification
Quantification
Feature
Feature
Identification
Identification
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15. Nucleus Localization &
Segmentation
A three phase technique is adopted for segmentation of
nucleus.
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16. Color Imbalance
• As we are intend to implement color image
processing , there should be no disruptions
in color cue
• Sources of description
a) Light source (temperature dependent)
b) Digital camera (biasing of any one channel of
R,G,B)
CIE standard Color gamut
provided and limitation of
screen display
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17. White Balancing Cont.
Pap stained image of a Normal Pap stained image of a Abnormal
smear under microscope at 40x smear under microscope at 40x
White Balancing Step
White Balanced Images
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18. Image Enhancement
Top two images are white balanced. Bottom two are enhanced with CLAHE
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19. Haematoxyline Probability
Plane
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20. Segmentaion performance
Level set
Method
Morphological
filtering
Bilateral Initial Color Original L Plane Saturation
Filtered Mask Deconv image of Lab +
Color Intensity
image output
space 22
https://www.dropbox.com/sh/p2kt9e181mdx9eh/NfHrVzhrTC

21. Results of Active
Contour(Level Sets)
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22. 24
Segmented results

23. 25
Segmented results

24. Target Features of the nucleus for
computer assisted diagnosis
1. Area 1. Mean value of Blue color value on
2. Perimeter
nucleus
2. Entropy of red color values of nucleus
3. ConvexArea
3. Entropy of Green color values of
4. Filled area nucleus
5. Eccentricity 4. Entropy of Blue color values of
6. MajorAxisLength nucleus
7. MinorAxisLength 5. contrast of gray values of nucleus
8. EquivDiameter 6. correlation of gray values of nucleus
9. MinorAxisLength 7. energy homogeneity of gray values of
nucleus
10. Standard deviation of Red color values on
nucleus
8. standard deviation of Laws mask
response
11. Mean value of Red color value on nucleus 9. mean of Laws mask response
12. Standard deviation of Green color values 10. standard deviation of LBP(local
on nucleus binary pattern) response
13. Mean value of Green color value on 11. mean of LBP response
nucleus
14. Standard deviation of Blue color values on
nucleus 26

25. SVM based classification for 25 nuclear features
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