A review on automatic detection of kidney abnormalities in ultrasound

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images

Gurjeet Kaur1, Dr. Sukhwinder Singh2, Dr.Sukhdev Singh3

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1
Research Scholar, Punjabi University, Patiala, India
2
Head,Department of computer science, Guru Hargobind Sahib Khalsa Girls college, Karhali Sahib, Patiala, India
3
Assistant professor, Multani Mal Modi College, Patiala,India
Email: gurjeetkaurmangat7@gmail.com

Abstract: In these days people are suffering from various diseases. Kidney diseases are one of the major diseases amongst them which are increasing day
by day like formation of cysts and stones, infection, tumour, change in kidney position and appearance etc. We cannot ignore kidney related problems

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because kidney malfunctioning can put life in risk. Hence, to prevent such kind of kidney abnormalities in patients, early detection and prevention is
required. This paper presents a review on the detection and recognition of kidney abnormalities. The information can be useful to detect and locate the
kidney diseases in the earlier stages to perform the surgical operation to cure them successfully. So, it has a recurring application domain that includes
computer aided diagnosis system which helps to detect kidney abnormalities and provide a diagnosis of potential disease. Moreover B-mode ultrasound
image has many issues like low contrast, speckle noise, gaussian noise, and other artefacts. So, there is a big need of superior image quality to extract

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related features. To overcome this challenge, appropriate image processing techniques as pre-processing and classification techniques have been
described. The research work presents the overview of the various techniques for the detection and recognition of kidney abnormalities. Moreover, the
objectives of these techniques and their performance are explained.ee
Keywords: Kidney abnormalities, ANN, SVM, KNN, Intensity threshold variation, Texture classification.

1. Introduction 1.1. Limitations of ultrasound images

Due to unawareness, people are not familiar with the symptoms of kidney Even though, ultrasound imaging plays an important role to detect and
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locate the position of the kidney stone as primary diagnosis technique.

diseases at their earlier stage that can cause to damage kidney slowly.
Moreover Kidney diseases become common and are increasing day by
day. Hence, to prevent such kind of kidney abnormalities in patients,
early detection and prevention is required. In modern era due to the
advancement of science and technology different diagnostic techniques
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Apart from that, it is widely used because of its low cost as well as it is
radiation free, safe and manageable diagnosis assistance. Moreover, it is
also necessary to identify the exact and precise location of kidney stone
during surgical processes. So, there is need of superior image quality to
extract related features. But entry of noise into these images as well as

are available in the medical science such as Ultrasound, MRI, and CT
scan etc. These all techniques have their own merits and demerits with
reference to diagnose the particular disease. Moreover, ultrasound
imaging is the primary choice of physician because it is radiation free and
economical cheaper than other techniques. Furthermore, it can be used to
estimate kidney size, its position, and presence of cysts, stones and
diagnosing other structural abnormalities. We cannot ignore kidney
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having low contrast and other artifacts generate various problems.
Moreover, there are three types of noises as (a) Impulsive noise, also
called salt and paper noise, which is caused by error in data transmission,
memory location problem or error in timing for digitization, (b) Additive
Noise (Gaussian noise) is arising from electronic noise in the image
acquisition system and (c) Multiplicative noise (Speckle) is unsystematic
in nature and it is main issue in ultrasound images. The proper balance
between noise reduction and image quality enhancement should be made

related problems as kidney malfunctioning can put life in risk. So, it is so that essential features are not affected.
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necessity to detect and locate the kidney disease as stone, cyst, tumor in
the earlier stages to perform the surgical operation to remove such 1.2. Speckle Noise
abnormalities successfully. It is too necessary to identify the exact and
precise location of kidney abnormality during surgical processes. Even Speckle noise is an unsystematic and multiplicative in nature as well as it
though, ultrasound imaging is used to diagnose kidney disease but it is is a signal dependent noise which degrades the original image. To degrade
the image, this noise changes some pixels of the original image with new
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highly challenging task due to having low contrast and speckle noise. This
challenge can be overcome by using appropriate image processing
techniques as well as automatic system is required to analyses ultrasound
kidney images [1].
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pixels. These new pixels contain luminance values which are almost equal
to the minimum or maximum of the allowable dynamic luminance range.
Speckle noise removes significant information from image as edge, shape,
intensity value and may lead to the identification problem for the doctors.
Moreover, speckle noise can reduce the human interpretation of

ultrasound images and create problem for segmentation [2].

AUTHOR 1

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2. Literature Review
This section discussed about the existing literature of kidney
abnormalities diagnose.
K. Kumar, and B. Abhishek have introduced a study which defines the
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comparison among three neural network algorithms namely Radial basis
function, Learning vector quantization and Multilayer perception with
back propagation algorithm to recognize kidney stone disease [3].
M. D. Sorensen and J.D. Harper have proposed comparison study
between color Doppler twinkling artifact and B-mode ultrasonography to
detect kidney stone. According to this study color Doppler twinkling
artefact technique improved the sensitivity and specificity of ultrasound.
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Since B-mode was more sensitive but another side twinkling artifact was
more specific in order to detect kidney stone [4].
T. Rahman and M. S. Uddin have developed and implemented a
system which could segment the kidney from ultrasound image and helps
the doctor during surgical operations. They have used Gabor filter to
reduce the speckle noise and Histogram equalization to enhance the
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quality of image. Moreover two segmentations methods region based
segmentation and cell segmentation were described and compared. They
used region based segmentation method to get better result and MATLAB
to implement the system [5].
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K. Kalyan and S. Jain have developed a scheme for classification of
normal and abnormal kidney from the ultrasound images of kidney by
using feature extraction methods and ANNs. This system was developed
in MATLAB and image processing toolbox was used to implement image
pre-processing techniques as rotation, cropping, background subtraction
and edge detection. Moreover, imageJ software was used to perform edge
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detection techniques. After this, feature extraction methods were used to
extract four types features namely grey level run matrix, Invariant
moments, Intensity histogram features and Grey level co-occurrence
matrix. Moreover, by using these four features and combination of these
features, 48 features were extracted for the purpose of better classification
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result. In order to best feature selection, Waikato environment for
knowledge analysis software have used. Finally, ANN with Back
Propagation algorithm was used to classify optimum features set among
the extracted features. Moreover resultant figure has cleared that
combined features were more effective then single type features for
classification of abnormal kidney [6].
M. Marsousi and K. N. Plataniotis introduced a three-dimensional
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ultrasound system for automatically detection and segmentation of
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kidneys in 3-D abdominal ultrasound images. The proposed system was
based on the probabilistic kidney shape model for detection and
segmentation approaches. In this paper, 3-D Morison’s pouch ultrasound
images were used to propose automatic kidney detection method.
Moreover, shape based method used for segmentation of detected kidney.
Furthermore to solve the problem of speckle noise and inhomogeneous
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intensity Finite Impulse Response filter and Hamming window were used
respectively [7].
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AUTHOR
This preprint research paper has not been peer reviewed. Electronic copy available at: https://ssrn.com/abstract=3565030
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P. T. Akkasalgar and S. S. Karakalmani have developed a method to
segment and identify area of kidney stone from the ultrasound image of
kidney. The main focus of the proposed method was to identify the
presence of renal calculi in the ultrasound image. Apart from that it also
helped to measuring the size of stone in millimeters and provides
information regarding number of stones in kidney. Initially median filter
and wavelet filter were used to pre-process the US image which reduce
speckle noise and reflection etc [8].
Soumya and Narayanan have proposed a computer aided system to
detect kidney disease automatically in ultrasound image. Initially, they
were obtained region of interest manually by the help of physician to limit
the possibilities of error. Secondly, ultrasound image were pre-processed
by using wiener filter, median filter and histogram equalization while
median filter has provided best performance as comparison to other filters.
Thirdly, statistic based and multi-scale based features were extracted and
best features were selected using principal component analysis technique.
In the last, for classification a multilayer feed forward neural network with
back propagation algorithm was used [9].
Ranjitha has developed a system for detection of kidney stone from
ultrasound image. The key motive of this system was to detect the
exclusive features of a ROI. Fourteen features were extracted and these
features were reduced to five critical features through Principle
Component Analysis technique. Gray Level Co Occurrence Matrix was
used for extraction of features from segmented ROI (Renal
Calculi/Artifact) which aids as a statistical tool to pull out the second
order textural features. Clustering based feature discretization using k-
means was performed on these different classes of attributes which were
extracted from the system. The amount of computation may increases due
to rises the number of features. In this paper author has stated, a good
quality feature depends on the statistical measures such as feature
variance, Inter class variation and Intra class variation. Principal
Component Analysis was used as a Feature reduction technique in RCD-
AD(Renal Calculi Detection-Artifact Differentiation), medical images.
Moreover level set segmentation method and ANN classification were
used [10].
P. Vaish and R. Bharath have developed an android application for
B-mode ultrasound images to detect automatically abnormality of kidney.
The main abnormalities were stones and cysts which detected using Viola
Jones algorithm. Moreover to detect these abnormalities in kidney, texture
feature were extracted as system was used gray level co-occurrence
matrix, Intensity histogram features and gray level run length matrix
features. Furthermore, classification was done by SVM classifier [11].
M. Pathak and H. Sadawarti have developed a semiautomatic system
aimed to identify the stone region in the kidney ultrasound image. The
system consists of feature extraction and classification. The feature
extraction was applied on cropped regions, which may contain stone. The
various features such as contrast, angular second moment, entropy and
Correlation were used. The KNN classifier was used to analyses the
features for detection of stone in the images. The confusion matrix was
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prepared to analyse the complexity and accuracy of the proposed system classification. Gabor filter technique and histogram equalization method
[12]. were used to sort the problem of speckle noise and low contrast of image.
M. P. Pawar and A. N. Mulla have focused on the abnormalities of The pre-processed image was segmented using Level Set Segmentation.
the kidney. Mainly this research was based on normal kidney or cystic one Three Artificial Neural Network algorithms, namely Multilayer
kidney classification from the kidney ultrasound image as well as it Perceptron, Radial Basis Function, and Linear Vector Quantization were

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determined more accurate classification method. Gaussian low pass filter
technique and histogram equalization method were used to sort the
problem of speckle noise and low contrast of image. Gradient Vector
Flow was used for segmentation and region of interest was identified on
pre-processed image. 22 features were extracted and trained by feed
forward ANN to identify the class of kidney as normal or cyst one [13].
N. A. Shaharuddin and W. Mahani have developed a CAD system to
automatically identify kidney and non- kidney ultrasound images.
considered to diagnose the kidney stones disease. [17].
The threat in patients about receiving more kidney stones can be
decreased by knowing the type of stone because it helps to detect the
reason for formation of the stones So, P. M. Arabi and G. Joshi have
developed a novel approach to identify three types of stones namely
calcium stones, stag horn stones. Moreover, stone type identification task
was based on Euler number as well as contrast calculated by pixel
intensity matrix [18].

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MATLAB R2013 setup was used to develop a system. To analyse an
image, firstly specific image uploaded in the system by the user. Since Table 1 - The brief of various techniques of pre-processing,
the size and position of every image was different, thus user manually segmentation and classification by various authors are shown.
crops the image in the size 400x200 pixels. Moreover, the image was Methods Research Dataset/ Result
automatically improved by histogram equalization and filtered by Wiener purpose

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filtering. After that image manually segmented by user and classified by Pre-processing: Finite impulse Kidney detection 28 3-D ultrasound
ANN technique [14]. response (FIR) filter , Hamming and segmentation images used and
J. Verma and M. Nath have developed a system for kidney stone window automatically in 3-
92.86% detection
analysis and identification. Gaussian filter, Median filter and un-sharp Segmentation: Manually D US image.
accuracy was
Classification : Probabilistic kidney
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masking were used in enhancement of US image. Whereas Median filter
shape model[7] attained.
and Gaussian filter actually used to remove noise and filtering the image
as well as Un-sharp masking for sharpening the image. Moreover,
Pre-processing: Median filter and Segmentation and 40 images and
Principal Component Analysis method was used for feature reduction to
wavelet filter identification of accuracy was 95%
get more accurate features as well as morphological operations like
Segmentation: Seed region growing kidney stone as for normal images
dilation and erosion were performed. After this, study used entropy based algorithm well as measure it’s and 90% for calculi
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segmentation methods and SVM and KNN classification techniques to Classification : Identification is based size. images.
analysis the ultrasound image of kidney. The proposed system was on segmentation[8]
developed in MATLAB. To evaluate the result of this system, publically
Pre-processing: Median filter, wiener Classification of Accuracy is 92% on
available datasets of kidney ultrasound images were used. The research
filter, histogram equalization filter kidney disease 66 images.
presented two types of classification techniques KNN and SVM and Segmentation: Manually automatically
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displayed the analysis comparison between them [15]. Classification : Multilayer feed
R. Vasanthselvakumar and M. Balasubramanian have proposed a forward neural network and back
framework to diagnose kidney diseases by using feature extraction and propagation algorithm[9]
modelling techniques. The system carried out by three methods. Firstly,
detection of kidney diseases was done by using Viola Jones incorporated Pre-processing: Gaussian low pass Classification of Accuracy was
with HOG, Haar, and LBP features whereas HOG features provided better filter and histogram equalization ultrasound kidney 87.5% on 26 US
performance than others. Secondly, SIFT used for feature extraction Segmentation: Gradient Vector Flow image as normal images.
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which provided the unique pattern of features such as blobs, edges, and Classification : Feed forward kidney or cystic
Artificial Neural Network[13] one
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corners intensity of an image at specific interest point. Moreover, SURF

was the vision based feature vector that was computed from the local
elements of an image. The last method was the classification of several Pre-processing: Histogram Computer-aided 232 ultrasound
kidney diseases using SVM. The classification performance measured equalization and Wiener filter diagnosis system to images. Accuracy
with two featuring techniques with SVM such that SIFT and SURF. Segmentation: Manually automatically for non-kidney
SURF had produced better performance than SIFT [16]. Classification : ANN[14] identify kidney or images and kidney
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Manjunath and S.Pande have focused on recognition of different non-kidney US images was 92.2%
image and 94.3%
forms of stones. Author defined five modules of this system as input
ultrasound image, pre-processing, segmentation, feature extraction and Pre-processing: Median filter, un- Kidney stone the accuracy of
sharp masking and Gaussian filter Analysis and KNN as 89% and
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AUTHOR 3

This preprint research paper has not been peer reviewed. Electronic copy available at: https://ssrn.com/abstract=3565030
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Segmentation: Morphological identificatin SVM as well as feature extraction using SIFT, classification the = 50,
operation like erosion, dilation and 84%.(dataset size SURF kidney diseases
Accuracy = 96.67%
entropy not defined) Classification : SVM[16] using Viola Jones
for HOG, 93.3%
Classification : KNN and SVM [15] algorithm
for Haar, 90.0%
for LBP, 89.3%
Pre-processing: Gabor filter Recognition of 98% accuracy on
using SURF.

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technique and histogram equalization different forms of 160 X-ray
Segmentation: Level Set stones images.
Segmentation
3. Proposed system to diagnose kidney abnormalities
Classification : Multilayer Perceptron,
Linear Vector Quantization and
Radial Basis Function[17] Automatic detection of kidney abnormalities in kidney ultrasound image
is a system to classify the abnormal kidney image and normal kidney
Pre-processing: Median filter, wiener Quantification of On more than 200 image. Following diagram shows general model of proposed system to
filter, Gaussian low – pass filter. kidney stone and images, accuracy

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diagnose kidney abnormalities. The procedure of this system automatic
Segmentation: Threshold selection, calculate the area was 99.74%,
detection of stone in kidney ultrasound images involves six basic phases
morphological operations, objects of stone. sensitivity was
windowing. 94.60% and to diagnose abnormal kidney and normal kidney ultrasound image.
Classification: Texture classification. specificity was
[22] 99.48%.
Input US Image

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Table 2 - The brief of various feature extraction methods and Pre-Processing
classification methods by various authors are shown.
ee Segmentation
Methods Research Dataset/ Result
purpose
Feature Extraction
Feature extraction : Gray level To classify normal 40 images and
run length matrix, intensity and abnormal 87.5% accuracy
histogram, gray-level co-occurrence kidney Classification
rate.
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matrix and invariant moments
Classification : ANN utilizing a
back-propagation algorithm[6] Results and Analysis

Feature extraction : Statistical Automatic Accuracy is 92 %

based features, multi scale wavelet classification of on 66 images.
no

Figure-1: General model for kidney stone detection

based features and PCA approach
Classification : A multilayer feed
forward neural network using back-
propagation algorithm[9]
Feature extraction : Intensity
histogram, GLRLM and GLCM
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Kidney diseases
Input US image: This phase of the system is to input and ultrasound
image which can be kidney or non- kidney image as well as normal or
abnormal kidney ultrasound image. Next, the quality of ultrasound image
Android 900 images/ enhanced and reduced speckle noise in pre-processing phase. Pre-
application to accuracy = 90.91 Processing: Pre-processing is essential to improve the quality of the

Classification : SVM [11] detect kidney ultrasound image which include Noise suppression, Contrast
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abnormalities enhancement, Image restoration and Smoothing and sharpening. De-

using Viola jones
speckling filters use to enhance the difference of the region of interest as
algorithm
well as reduce background speckle. It may include Gaussian noise,
Speckle noise etc. After enhance the quality of image, region of interest is
Feature extraction : Principal Kidney stone Accuracy of KNN found. Segmentation: in this phase region of interest of particular disease
component analysis analysis and as 89% and SVM
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is finding on the behalf of relevant characteristics of object or area. Some

Classification : KNN, SVM[15] identification. as 84%.
of the segmentation techniques used by various researchers are Seed
region growing algorithm, Gradient vector Flow, Morphological
Feature extraction : HOG, Haar as Detection and Ultrasound images operations, Threshold selection, Level set segmentation, objects
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AUTHOR 4

This preprint research paper has not been peer reviewed. Electronic copy available at: https://ssrn.com/abstract=3565030

windowing etc. After that, Feature extraction: The relevant features are
extracted from the images and the system is trained with these features.
Various feature extraction methods are available which can be used or
improved to extract the features from segmented image. Some of the
features extracted by various researchers are Intensity histogram features,
iew
Gray level run length matrix features, Gray level co-occurrence matrix
features, HOG features, LBP features, Speeded- up Robust Feature
(SURF), statistical-based features, Haar features, the multi-scale wavelet-
based features etc. After feature extraction, abnormal and normal kidney
images are classified. Classification: The ultrasound image of kidney can
be classified as kidney is normal or abnormal on the basis of features
extracted from the ultrasound image. Some of the classification techniques
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that are used in the literature are SVM (Support Vector Machine)
[11][15][16][19][23], intensity threshold variation[20],Texture
classification [22]and neural networks includes Radial basis function
(RBF), Learning vector quantization(LVQ) and Multilayer perception
with back propagation algorithm (MLP) [6][13][14][21].
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Results and Analysis: The analysis is carried out to identify the
abnormality recognition performance of the system. In this phase, results
are evaluated for the system with the help of various statistical tools.
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3.1. Pre-processing
Ultrasound image has problems of low contrast and speckle noise but to
enhance the quality of image and performance of the system some steps
are described as.
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1. Image restoration
2. Smoothing and sharpening
3. Contrast enhancement.
1. Image Restoration
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The aim of image restoration is to remove or reduce the
degradations that have occurred during ultrasound image obtaining
process. Basically a level set function is used for proper orientation.
2. Smoothing and Sharpening
Smoothing and sharpening is used to get optimal resolution in both spatial
and frequency domains as well as highlights edges and fine details of
object. For this purpose many filters like Gabor filter, Gaussian function
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etc. are used.
3. Contrast Enhancement
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Contrast enhancement is useful to make the features of ultrasound image
clear. Histogram equalization is used to improve contrast and obtain
uniform intensity by changing the range of values in image. [2] [17]
3.2. Classification
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3.2.1. Artificial Neural Network
ANNs are non-parametric classifiers and its structure idea is inspired from
human nervous system. Where, every circular node denotes an artificial
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AUTHOR
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neuron and an arrow shows a connection from the output of one artificial
neuron to the input of another. There are two stages of each neuron-
training and using phase. Training phase used to learn the neuron for
performing specific operation whereas testing phase is used to train the
information to predict the output.
The key advantages of ANN are:
• It has high a rate computation.
• It can deal efficiently with noisy inputs.
• It learns from the training data because of data driven technique.
Disadvantages of ANN are:
• There is prior training required which is time-consuming.
• There can be problem of overfitting.
Three architectures are used in ANN Classification as Multilayer
Perceptron, Radial Basis Function and Learning Vector Quantization
[17] [24].
3.2.2. Support Vector Machine
A Support Vector Machine is a supervised machine learning algorithm
which is used for classification purpose and formally defined by a
separating hyperplane. In other words, SVM is a binary classifier used to
separate the classes by linear boundary. This algorithm optimizes the
training data use and boost the speed of the classifier to great extent.
Commonly used kernel functions of SVM are Linear Kernel, Gaussian
Kernel and Polynomial Kernel.
The key advantages of SVM are:
• Generalization capacity is excellent.
• There is no problem of overfitting.
• It is very useful to non-linear transformation.
Disadvantages of SVM are:
• It is difficult to understand this concept due to complex structure of an
algorithm.
• Not possible to defines optimal parameters easily [17] [24].
3.2.3. KNN Classifier
KNN (K-nearest neighbors) is an algorithm that stores all accessible cases
and classifies new cases supported a similar measure. This is used for
pattern recognition and statistical estimation. Moreover, KNN
classifies associate object where the majority of the neighbor belongs to
[15].
3.2.4. Intensity threshold variation
Intensity threshold variation is related to the texture features of image
which is used for the characterization of region from images [20].
3.2.5. Texture classification
Texture classification is related to intensity or color of the object.
Moreover, this is a set of metrics of an image which calculated in image
processing designed to measure the perceived texture of an image. Apart
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from that it also provides information about the spatial arrangement of
intensities in selected region of an image [22].
4. Conclusion
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In this paper commonly used techniques to diagnose kidney
abnormalities in B-mode ultrasound images have discussed. Even though,
ultrasound imaging is the primary choice of physician because it is
radiation free and economical cheaper than other techniques but it is
highly challenging task, because entry of noise into these images
generates various problems. Moreover, ultrasound imaging has a problem
of low contrast, speckle noise, gaussian noise, and other artifacts. So,
ev
there is need of superior image quality to extract related features. The
proper balance between noise reduction and image quality enhancement
should be made. To overcome this challenge, appropriate image
processing techniques as pre-processing and classification techniques
have described. Apart from that, we have proposed automatic system for
kidney problem diagnose which will enhance the quality of image as well
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as classify the normal and abnormal kidney ultrasound image.
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This preprint research paper has not been peer reviewed. Electronic copy available at: https://ssrn.com/abstract=3565030