Classification of breast masses in ultrasonic b-mode images using a compounding technique in the nakagami distribution domain

Classification of masses in ultrasonic B-mode images of the breast tissue using "normalized" parameters of the Nakagami distribution was recently investigated. The technique, however, did not yield performances that were comparable to those of an experienced radiologist, and utilized only a single image for tissue characterization. Because radiologists commonly use two to four images of a mass for characterization, a similar procedure is developed here. A simple summation of the normalized Nakagami parameters from two different images of a mass is utilized for classification as benign or malignant. The performance of the normalized Nakagami parameters before and after the summation has been carried out through a receiver operating characteristic (ROC) study. The bootstrap procedure has been utilized to compute the mean and SD of the ROC area, A_z, obtained for each parameter. It has been observed that combining normalized Nakagami parameters from two images of the mass may help to improve classification performance over that from utilizing the parameters of just a single image. The performance of this automated parameter-based approach appears to match that of a trained radiologist.