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Accurate segmentation of the breast region of interest (BROI) and breast density (BD) is a significant challenge during the analysis of breast MR images. Most of the existing methods for breast segmentation are semi-automatic and limited in their ability to achieve accurate results. This is because of difficulties in removing landmarks from noisy magnetic resonance images (MRI) due to similar intensity levels and the close connection to BROI. This study proposes an innovative, fully automatic and fast segmentation approach to identify and remove landmarks such as the heart and pectoral muscles. The BROI segmentation is carried out with a framework consisting of three major steps. Firstly, we use adaptive wiener filtering and k-means clustering to minimize the influence of noises, preserve edges and remove unwanted artefacts. The second step systematically excludes the heart area by utilizing active contour based level sets where initial contour points are determined by the maximum entropy thresholding and convolution method. Finally, a pectoral muscle is removed by using morphological operations and local adaptive thresholding on MR images. Prior to the elimination of the pectoral muscle, the MR image is sub divided into three sections: left, right, and central based on the geometrical information. Subsequently, a BD segmentation is achieved with 4 level fuzzy c-means (FCM) thresholding on the denoised BROI segmentation. The proposed method is validated using the 1350 breast images from 15 female subjects. The pixel-based quantitative analysis showed excellent segmentation results when compared with manually drawn BROI and BD. Furthermore, the presented results in terms of evaluation matrices: Acc, Sp, AUC, MR, P, Se and DSC demonstrate the high quality of segmentations using the proposed method. The average computational time for the segmentation of BROI and BD is 1 minute and 50 seconds.

We offer a framework for automatically and accurately segmenting breast lesions from Dynamic Contrast Enhanced (DCE) MRI in this paper. The framework is built using max flow and min cut problems in the continuous domain over phase preserved denoised images. Three stages are required to complete the proposed approach. First, post-contrast and pre-contrast images are subtracted, followed by image registrations that benefit to enhancing lesion areas. Second, a phase preserved denoising and pixel-wise adaptive Wiener filtering technique is used, followed by max flow and min cut problems in a continuous domain. A denoising mechanism clears the noise in the images by preserving useful and detailed features such as edges. Then, lesion detection is performed using continuous max flow. Finally, a morphological operation is used as a post-processing step to further delineate the obtained results. A series of qualitative and quantitative trials employing nine performance metrics on 21 cases with two different MR image resolutions were used to verify the effectiveness of the proposed method. Performance results demonstrate the quality of segmentation obtained from the proposed method.

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The recent report on "tuberculosis and lung cancer" is very interesting. [1] Bhatt et al., [1] concluded that "patients with lung cancer are often misdiagnosed as pulmonary tuberculosis (TB) leading to delay in the correct diagnosis as well as exposure to inappropriate medication." In fact, the problem of missed diagnosis of lung cancer as TB can be a serious problem and can be commonly seen in clinical practice in endemic area of TB. According to the study by Singh et al., [2] several lung cancer patients got anti-TB drug before final diagnosis of lung cancers. Nevertheless, it should also be noted that the concomitant occurrence between TB lung and lung cancer is also possible. [3] To carefully investigate on the possible concurrent disorders is also very important in clinical practice.