Global Transitions Proceedings 3 (2022) 13–19

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Global Transitions Proceedings

journal homepage: http://www.keaipublishing.com/en/journals/global-transitions-proceedings/

Processing of echocardiographic images using segmentation, feature

extraction and classification for detection of heart abnormality
Ayesha Heena a,∗, Nagashettappa Biradar a, Najmuddin M Maroof b, Vishwanath P c
a
Department of Electronics and Communication, BKIT Bhalki Karnataka/VTU Belagavi, Karnataka, India
b
Department of Computer Science Engineering, VTURC PG cente Kalaburagi Karnataka/VTU Belagavi, Karnataka India
c
Department of ECE, H.K.E Society’s SLN College of Engineering, Raichur, Karnataka India

a r t i c l e i n f o a b s t r a c t

Keywords: This article is mainly focused to accurately detecting any abnormality of heart if present using echocardiographic
Artificial neural network image of the patient. Heart abnormalities are now a days very common not only in India but all over the globe
Classification irrespective of age and gender. The detection of abnormality is achieved by using Artificial neural network (ANN)
Discrete Wavelet transform filters
Classifier. However, processing of the image is achieved through preprocessing, segmentation, feature extraction
Feature extraction
and then achieving classification. Processing of image for removal of noise and enhancement is carried out as
Level set segmentation
Preprocessing Preprocessing of image followed by segmentation. The most significant processing task is segmentation which is
Segmentation discussed in detail and preferable algorithm which overcomes the drawbacks and limitations of previous algo-
rithms is proposed. This algorithm is a solution to all problems faced in previous algorithms. carried out using
different techniques, three different segmentation techniques are discussed where algorithm proposed Reaction
Diffusion Level Set Segmentation (RDLSS) is better than other three methods also overcome the problems faced in
previous algorithms, then feature extraction is done to extract energy features where the novelty of the research
is use of symlet, Debauches and Bio orthogonal filters for feature extraction and these features are used to classify
the images as normal or abnormal using ANN classifier. The ANN classifier is effective and efficient resulting in
accuracies of greater than 98%. The results are also clinically validated by doctors.

1. Introduction
Processing of Echocardiographic images is very essential for disease
detection and diagnosis. Various processing techniques have been dis-
cussed in the previously published papers like Preprocessing [1], seg-
mentation [2], feature extraction and classification [3]. Each processing
approach used in research for optimization is discussed in methodology
section.
The main aim of the paper is as follows: Preprocessing: The in-
put echocardiographic image is preprocessed [4–6] so as to remove
inherent noise using appropriate filters the filters used for preprocess-
ing in the research are fractional order filters. Segmentation of the de-
noised/enhanced image is carried out using level set segmentation (LSS)
[7] techniques which is considered as preferable and popular method of
segmentation. Four different LSS techniques discussed in methodology
section i.e. (Conventional Level set segmentation (LSS), Re- Initializa-
tion LSS [8], Distance Regularized level set evolution (DRLSE), DRLSE1,
DRLSE2, and DRLSE3 [9] respectively for three different rates and lastly
proposed method of segmentation Reaction diffusion LSS) [10]. Feature
extraction is done so as to extract energy features which are the best
choice of features for biomedical applications. The three filters used in
proposed methodology are Symlet filters, Debauches filter and Bio or-
thogonal filters. The use of this combination of three different filters is
novel approach in the research. Lastly ANN classifier is used for classi-
fication of given input images into normal or abnormal.
The remaining paper is organized in the following sections: Section
2 specifies the related work. Preprocessing, segmentation, feature ex-
traction and classification are discussed in Section 3 in Methodology
section. Section 4 discusses results and Section 5 is conclusion.
2. Related work
In [1] authors discussed denoising algorithm for noise removal in
echocardiographic images again the filter used for denoising is a frac-
tional order integral filter. In [2] authors have discussed 10 different
segmentation techniques used in last one decade in Comparative Anal-
ysis of various image segmentation techniques. Earlier many researches
have proposed classification techniques for heart abnormalities [3, 11].
Medical image resolution enhancement is done in [4] where authors fo-
cus on wavelet transform which is dual tree complex wavelet transform
and singular value decomposition (SVD) is used as basis algorithm. In

∗
Corresponding author. Tel.: +0-805-040-1459
E-mail address: ayeshaheena31@gmail.com (A. Heena).

https://doi.org/10.1016/j.gltp.2022.04.003

Available online 2 April 2022

2666-285X/© 2022 The Authors. Publishing Services by Elsevier B.V. on behalf of KeAi Communications Co. Ltd. This is an open access article under the CC
BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/)
A. Heena, N. Biradar, N.M. Maroof et al.
Fig. 1. Diagram of proposed processing Techniques.
[5] A technique which is stated as versatile is used for filtering noise
in medical images and uses wavelet domain. Fuzzy logic is used for
speckle noise reduction adaptively. This method based on coefficient of
variation used for ultrasound images in [6]. Level set algorithm is used
for segmentation of anatomical structures in 3D images by C. Baillard
et al in [7]. In [8] K Zhang et al discusses how level set segmentation
is achieved using reaction diffusion algorithm. [9] is also proposed for
segmentation where the authors have come up with level set method for
surface detection of 3D images automatically. Machine Learning based
Detection and Classification of Heart Abnormalities is proposed in [10].
In [11] variational model for selective image segmentation is discussed
which is based on local information in the images. Another method
of segmentation with multiple resolution for ultrasound images called
Bayesian segmentation is carried out by E.A. Ashton et al in [12]. Again
in [13] another segmentation technique of segmentation for the left ven-
tricle using active shape models used for echocardiographic images are
discussed. In [14, 15]authors have proposed Combinative image seg-
mentation of echocardiographic images using a framework of multi-
scale level set algorithm. In [16] the authors proposed model based
on random field used for Segmentation of images especially 3D ultra-
sonic images. F. Gaudreault et al [17] also Proposed segmentation tech-
nique for intravascular ultrasound images with Modelization. Authors
proposed segmentation algorithm for ultrasound images based on Max-
imum likelihood with Rayleigh distribution in [18–20]. Next as in [7,
21] authors proposed segmentation technique for 3D based on level set
algorithm for segmenting of anatomical structures [22]. Also [23] dis-
cusses both 2D and 3D segmentation [24]. Where the algorithm essen-
tially based on both global and local statistics serves for segmentation
of ultrasound images both 2D and 3D in multiresolution. In [25] au-
thors have proposed intuitionistic fuzzy set theory for edge detection
application measure [26]. An algorithm based on discrete topological
derivative used for segmentation of images is nicely discussed in [27].
A novel approach to review various image segmentation techniques [28,
29] discusses various segmentation techniques where none is said to be
perfect for all images however some are suitable for some types of im-
ages while others are best for some other [30]. Still no algorithm is
developed which can be claimed to be perfect for all types of images.
[31] is a paper based on how fractional order calculus finds applica-
tions in various fields of image processing with a comparative analysis
is discussed in detail.
3. Methodology
The methodology proposed can be explained as follows Fig. 1 gives
complete details of processing techniques.
3.1. Image data description
The dataset used comprises of 43 echocardiographic images captured
in different views such as A2C, A3C, A4C, A5C, Parasternal views, apical
views etc. All the processing is carried out on each individual image
results of all 43 images are tabulated in tables.
14
Global Transitions Proceedings 3 (2022) 13–19
3.2. Preprocessing
This step is a fundamental step in image processing as all medical
images are affected with inherent noise which reduces the quality and
makes difficult for further processing. The filters used for preprocessing
are fractional order filters [22].
3.3. Segmentation
Segmentation technique used in the article is LSS such other segmen-
tation techniques are discussed below sequentially as a consequence of
problem in one and getting solution in next consecutive technique.
Background Illustrations
LSS Segmentation
Image segmentation plays significant role to identify the desired
portion from the Ultrasound (US) Biomedical image. Level set based
segmentation is widely preferred in the medical field for diagnosis of
Biomedical images. The proposed Reaction Diffusion Level Set Segmen-
tation (RDLSS) is very good identification of the Biomedical portion of
US image because it is free from the varying functions involved: diffi-
culty to handle topological changes, serious numerical errors, time con-
sumption and capability of anti-leaking for boundaries that are weak
and sensitive to noise. RDLSS algorithm is designed by adding a differ-
𝑑
entiation of the diffusion term " 𝑑𝑡 𝜀Δ𝜑" into the conventional Level Set
Evolution (LSE) which makes LSE stable without re-initialization and
the integration of reaction term “∫ 1𝜀 𝐿(𝜑)” for final steady state.
RDLSS segments an image into sets of desired and unwanted regions.
It is very important, especially in the methods concerned with Biomed-
ical volume calculation which are based on the surface or area recon-
struction. Accurate and high-speed segmentation technique are required
to ensure getting results with the least operator interaction which is
usual manual and very fast, especially when dealing with poor signal-
to-noise ratio and PSNR. Many approaches exist for improving the seg-
mentation of US images. These can be categorized as texture based, ac-
tive contour based, region growing based and level-set based. Among all
these segmentation techniques, the level set based approach is widely
preferred by experts for better segmentation of Biomedical images.
Basic level set motion is applied first to separate desired portion of
the area from ultrasound scanned image and to this desired segmented
biomedical area level set segmentation is applied again for segment-
ing to ensure reduction in the processing time and memory utilization
for image storage. The level set motion equation basically comprises of
two methods. Where, one modified gradient method refers to momen-
tum and other modified gradient method is resilient propagation (Rprop )
term. The reason for this kind of partitioning is to overcome difficulties
in energy function. The properties of the image on which energy func-
tion depends are gradient, curvature, intensity and regularization term.
Level set segmentation implementation is directly compatible with sim-
ple and effective modifications of basic methods in all types of LSS. The
modifications proposed in the paper starts with first method wherein a
momentum is added to the motion in the solution space. As a result, the
physical properties of the momentum are stimulated which frequently
allows for searching to disregard local optima with larger steps taken in
positive directions. The use of adaptive individual step sizes and posi-
tive or negative signs of the gradient components helps to avoid gradient
descent search problems by use of Rprop . Spinning adopts machine learn-
ing algorithms to choose search vector as given by Eq. (1) for gradient
descent with momentum.
𝑎𝑙 = −𝜂(1 − 𝑤)∇𝑓𝑙 + 𝑤𝑎𝑙 − 1 (1)
Where 𝜂 is the learning rate and 𝜔 ∈ [0, 1] is the momentum. Note that
𝑤= 0 gives standard gradient descent al = −𝜂fl , while 𝑤= 1 gives “infi-
nite momentum” al = al -1 . The problem of Standard Gradient Descent
(SGD) is resolved by use of adaptive step-sizes ∇l which are referred
as update values. Each dimension will have one update value i.e., dim
(∇l ) = dim (xl ), thus Rprop never uses the gradient size. Only the sign
A. Heena, N. Biradar, N.M. Maroof et al. Global Transitions Proceedings 3 (2022) 13–19

Fig. 2. Proposed Reaction Diffusion LSS procedure.

of the partial derivative is considered for update. This should be con-
sidered in the context of Rprop which has great utility in practice and
constitutes the stoutness of its parameters. Rprop is applied in many ap-
plications wherein only standard values of its parameters are used. A
brief description of Rprop is now attempted for which a search value is
chosen, represented by Eq. (2)
𝑠𝑙 = −𝑠𝑖𝑔𝑛(∇𝑓𝑙 ) ∗ ∇𝑙 (2)
i.e., Eq. (5) gives the familiar level set equation:
𝜕𝜙
= −𝑔(𝑥, 𝑦)|∇𝜙| (5)
𝜕𝑡
In Level Set Segmentation (LSS) process, altogether three LSS meth-
ods are discussed and analysed. Finally, a novel reaction-diffusion level
set segmentation is proposed which can estimate the problems of the
conventional level set segmentation methods.

where ∇l is a vector containing the current update values and sign (•) 3.3.1. Conventional LSS
is the element wise sign function. Approach to segmentation problem In the conventional LSS, consider a closed parameterized planar
is possible through application of calculation of the variations wherein curve or surface which is denoted by C (y, t): [0,1]x R+ to Rn , where
the energy functions is defined using the Euler language equation. This n=2 for planar curve and n=3 for surface and t is the artificial time gen-
finds use in the derivation of motion equation and the corresponding erated by the movement of the initial curve or surface, C0 (y) and its
energy gradients for the contour. Use of these gradients in segmentation inward normal direction is 𝑁̄ . The curve or surface evolution equation
applications are performed in contour space for gradient descent search. is as follows as given in Eq. (6).
The following function in Eq. (3) describes derivation of the weighted {
𝐶(𝑦, 𝑡 = 0) = 𝐶0 (𝑦)
region. (6)
𝐶𝑡 = 𝐹 𝑁
𝑓 (𝑝) = 𝑔(𝑥, 𝑦)𝑑 𝑥𝑑 𝑦 (3) where F is the force function
∫ ∫
Ω𝑝 In the above equation, the intrinsic drawback of interactively solving
Eq. (6) consists difficulty in handling splitting and merging because of
Where p represents 1D curve embedded in a 2D space, Ωp is the region
the topological changes of the moving front. This problem is resolved in
inside of p, and g (x, y) is a scalar function. These function finds use in
level set method (LSM) by modification of above equation and Eq. (7) is
maximizing quantity given by g (x, y) inside p. The area is maximum
obtained by taking the derivative of above equation w.r.t time t on the
when g (x, y) = 1. Calculating the first variation of above equation i.e.,
both sides, yielding the following equation.
Eq. (4) yields the evolution equation: {
𝜑𝑡 + ∇𝜑 .𝐶𝑡 = 𝜑𝑡 + Δ𝜑 .𝐹 𝑁 = 0
𝜕𝑝 (7)
= −𝑔(𝑥, 𝑦)𝜂 (4) 𝜑(𝑥, 𝑡 = 0) = 𝜑0 (𝑥)
𝜕𝑡
𝜕(.) 𝜕(.)
where 𝜂 is the curve normal using g (x, y) = 1 and it is the constant where gradient operator ∇(.) = ,
𝜕 𝑥1 𝜕 𝑥2
, ..... 𝜕𝜕(𝑥.) and 𝜑0 (𝑥)𝑖𝑠the initial
𝑛
flow in the negative normal direction. Implicit representation of the con- LSF𝐶0 (𝑦) = {𝑥|𝜑0 (𝑥) = 0}, but problem with Eq. (7) is it doesn’t work
tour is often done by level set function which is in turn defined as the for very flat or very steep near the zero-level set. The Re initialization
zero level of a time dependent signed distance function. A contour p is is so introduced to address this issue.
formally described by p = {x: 𝜑 (x, t) = 0}. The contour p is evolved
in time using a set of partial differential equations (PDEs). Generally 3.3.2. Re-initialization LSS
speaking, translation of a motion equation for a parameterized curve In the above-mentioned process of evolution serious numerical errors
𝜕𝑝
𝜕𝑡
= 𝛾𝜂 is done into the level set equation 𝜕𝜙
𝜕𝑡
= 𝛾|∇𝜙| below equation occur. As a solution to the problem, a procedure called re-initialization

15
A. Heena, N. Biradar, N.M. Maroof et al. Global Transitions Proceedings 3 (2022) 13–19

Table 1 Eq. (10) is a diffusion equation with rates

Classification output for complete dataset.
1
𝑟1 (𝜑) = 1 −
Database No Condition of the image |∇𝜑|
1 Abnormal However, r1 (𝜑) →−∞ when |∇𝜑|→0, which may cause oscillation in
2 Abnormal the final LSF 𝜑. This problem is solved by applying a new diffusion rate
3 Normal
as given below in Eq. (11).
4 Normal
5 Abnormal ⎧ sin(2 ∏ |∇𝜑|)
6 Abnormal ⎪ ∏ 𝜑| , 𝑖𝑓 |∇𝜑| ≤ 1
7 Abnormal 𝑟2 (𝜑) = ⎨ 2 |∇ 1 (11)
8 Abnormal ⎪1 − |∇𝜑| , 𝑖𝑓 |∇𝜑| ≥ 1
⎩
9 Abnormal
10 Abnormal and a constrained level set diffusion rate as in Eq.12
11 Abnormal
12 Abnormal 𝑟3 (𝜑) = 𝐻𝑝 (|∇𝜑| − 1) (12)
13 Normal
14 Normal where 𝐻𝑝 (𝑧) = ( 21 )[1 + 2
∏ arctan( 𝜌𝑧 )] and 𝜌 is a fixed parameter. The
15 Normal DRLSE methods using r1 (𝜑), r2 (𝜑), and r3 (𝜑) are called as generalized
16 Abnormal
DRLSE such as GDRLSE1, GDRLSE2, and GDRLSE3, respectively.
17 Normal
18 Normal
Eq. (11) needs iteration several times for the re-initialization meth-
19 Normal ods, with a new to make LSF a SDF while keeping the zero-level set
20 Abnormal stationary. But this is a highly time-consuming technique. The GDRLSE
21 Normal methods are known for their computational efficiency compared to the
22 Abnormal
re-initialization method. In Eq. (11) there are two components in each
23 Abnormal
24 Normal iteration for the computation of GDRLSE. The first term is regularization
25 Abnormal term and second term is LSE term it is driven by force F. The major dif-
26 Abnormal ference is dividing of the process of computation into two steps: In first
27 Abnormal
step compute the LSE term, and then in second step compute the signed
28 Abnormal
29 Abnormal
term. Therefore, the computation complexity of GDLSE has a close re-
30 Normal semblance to GDRLSE1 and GDRLSE2 methods
31 Abnormal
32 Abnormal 3.3.4. Proposed Reaction Diffusion LSS (RDLSS)
33 Normal
To overcome problems faced in previous method, viz segmentation
34 Normal
35 Normal fails, use for two flat abrupt changes near zero level set, expensive com-
36 Normal putational cost and being highly time consuming the above method can
37 Abnormal be modified by a novel method known as RDLSS. This RDLSS proposed
38 Abnormal in the research results in equation designed by addition of term called
39 Normal
diffusion term into equation of conventional LSE. This will help in sta-
40 Normal
41 Normal bilization without Re initialization.
{
42 Abnormal 𝑑
𝜑𝑡 = 𝑑𝑡 𝜀Δ𝜑 − ∫ 1𝜀 𝐿(𝜑), 𝑥𝜀Ω ⊂ 𝑅𝑛
43 Normal (13)
𝑆𝑢𝑏𝑗𝑒𝑐𝑡 → 𝜑(𝑥, 𝑡 = 0, 𝜀) = 𝜑0 (𝑥)

where 𝜀 is a small positive constant, L (𝜑) for PDE-based LSM or L (𝜑) = -

is periodically employed for reshaping a signed distance function (SDF).
In re-initialization ∅(𝑥) = 1 ± 𝑑𝑖𝑠𝑡2 (𝑥) where dist. (.) is a distance func-
tion and ± denotes the signs inside and outside the contour. But due
to many problems involved, such as cost of computations is high, new
emerging contours are blocked, failure due to deviation of LSF from an
SDF and inconsistency between theory and implementation. Variational
LSF is regularized to eliminate the re-initialization and computational
cost some formulations have been proposed. The re-initialization equa-
tion is given by Eq. (8).
𝜑𝑡 + 𝑆(𝜑0 )(|∇𝜑|) = 0
𝜑0
where 𝑆(𝜑0 )= 𝜑0 = √ , 𝜙0 is the initial LSF and Δ𝑥 is the spatial
𝜑20 +Δ𝑥2
step.
3.3.3. Distance regularized level set evolution (DRLSE)
Li et al have proposed a signed distance penalizing energy function
which is given by Eq. (9)
1 √
𝑃 (𝜑) (|∇𝜑| − 1)2 𝑑𝑥
2∫
Ω
Eq. (9) is a measure of closeness between an LSF∅ and an SDF in
the domain Ω⊂Rn , n=2 or 3. The gradient flow of P (∅) is obtained by
calculation of variation is as given in Eq. (10).
𝜑𝑡 = −𝑃𝜑 (𝜑) = 𝑑𝑖𝑣(𝑟1 (𝜑)∇𝜑)
F 𝛿( 𝜑) for variational level set method, Δ is the Laplacian operator
defined by Eq.(14).
𝑛
∑ 𝜕 2 (.)
Δ(.) = (14)
𝑖=1 𝜕𝑥2𝑖
and 𝜑0 (𝑥) is the initial LSF. Eq. (13) has two dynamic processes, the
𝑑
diffusion term 𝑑𝑡 𝜀Δ𝜑 gradually regularizes the level set function to be
constant in each segment domain Ωi and the reaction term “ ∫ −𝜀−1 L
(𝜑)” marines the final steady solution of Eq. (13) to L (𝜑) =0, which
(8) determinesΩi. The analysis in RD shows the equilibrium of solution of
Equation and is seen t as 𝜀→0+ , which is the characteristic of phase tran-
sition, the said equation with the intrinsic problem of phase transition,
i.e., the stiff parameter 𝜀–1 makes Eq. (13) difficult to implement and this
is shown in Fig. 2. The implementation of Eq. (13) reduces the side effect
of stiff parameter 𝜀–1 . Regularization of an image on 𝜙 consisting of the
minimization of the total variation |∇𝜑| of the reaction-diffusion level
set function. The modified boundary regularization given as Eq. (15).
(9) |𝑅| = |∇𝜑2 | + 𝜀2 𝑑𝑥 (15)
∫Ω
𝜀 is very small for the highest accuracy and more stability and |∇𝜑|=0
to
√ avoid a singular gradient in the Euler equation. The total variation
|∇𝜑2 | + 𝜀2 𝑑𝑥 is the curvature motion to minimize the curve length of
the RD level set function. The splitting of reaction and diffusion terms
(10) can produce a curve dependent motion. The first requirement in the

16
A. Heena, N. Biradar, N.M. Maroof et al. Global Transitions Proceedings 3 (2022) 13–19

Table 2
Sub band type and energy values for dataset of 43 images.

Database Images Db3:cH1 Db3:cV1 Sym3:cH2 Sym3:cV2 Rbio3.3: cH3 Rbio3.3: cD3

1 0.0082 5.3946e-04 0.0082 5.3946e-04 0.0138 0.0012

2 0.0088 5.6111e-04 0.0088 5.6111e-04 0.0177 0.0012
3 0.0090 5.7367e-04 0.0090 5.7367e-04 0.0180 0.0012
4 0.0080 6.4810e-04 0.0080 6.4810e-04 0.0127 0.0013
5 0.0083 5.4083e-04 0.0083 5.4083e-04 0.0136 0.0011
6 0.0083 5.3246e-04 0.0083 5.3246e-04 0.0162 0.0010
7 0.0083 5.8607e-04 0.0083 5.8607e-04 0.0136 0.0013
8 0.0083 5.8755e-04 0.0083 5.8755e-04 0.0136 0.0012
9 0.0080 5.7212e-04 0.0080 5.7212e-04 0.0134 0.0011
10 0.0080 5.7212e-04 0.0080 5.7212e-04 0.0134 0.0011
11 0.0080 5.7041e-04 0.0080 5.7041e-04 0.0133 0.0010
12 0.0080 5.7041e-04 0.0080 5.7041e-04 0.0133 0.0010
13 0.0045 3.5275e-04 0.0045 3.5275e-04 0.0088 7.2543e-04
14 0.0049 3.1961e-04 0.0049 3.1961e-04 0.0087 6.6540e-04
15 0.0044 2.2519e-04 0.0044 2.2519e-04 0.0083 6.8374e-04
16 0.0050 2.4023e-04 0.0050 2.4023e-04 0.0093 6.8415e-04
17 0.0041 2.9803e-04 0.0041 2.9803e-04 0.0079 5.2464e-04
18 0.0084 2.5530e-04 0.0084 2.5530e-04 0.0081 5.1555e-04
19 0.0079 2.2078e-04 0.0079 2.2078e-04 0.0150 5.8399e-04
20 0.0041 2.6636e-04 0.0041 2.6636e-04 0.0090 6.3808e-04
21 0.0038 3.2910e-04 0.0038 3.2910e-04 0.0070 4.3924e-04
22 0.0052 2.0395e-04 0.0052 2.0395e-04 0.0096 3.6302e-04
23 0.0077 2.6696e-04 0.0077 2.6696e-04 0.0118 5.1406e-04
24 0.0043 1.9934e-04 0.0043 1.9934e-04 0.0076 4.6728e-04
25 0.0065 1.9683e-04 0.0065 1.9683e-04 0.0119 4.7833e-04
26 0.0103 2.7611e-04 0.0103 2.7611e-04 0.0133 5.2616e-04
27 0.0103 2.7611e-04 0.0103 2.7611e-04 0.0133 5.2616e-04
28 0.0073 2.0877e-04 0.0073 2.0877e-04 0.0115 6.1133e-04
29 0.0076 2.0346e-04 0.0076 2.0346e-04 0.0115 4.3781e-04
30 0.0044 1.6529e-04 0.0044 1.6529e-04 0.0095 4.6725e-04
31 0.0054 1.2371e-04 0.0054 1.2371e-04 0.0093 4.7303e-04
32 0.0057 1.6816e-04 0.0057 1.6816e-04 0.0098 4.6562e-04
33 0.0054 2.0869e-05 0.0054 2.0869e-05 0.0137 5.9212e-06
34 0.0027 3.4688e-05 0.0027 3.4688e-05 0.0080 8.2729e-06
35 0.0045 1.3383e-05 0.0045 1.3383e-05 0.0110 4.6131e-06
36 0.0123 0.0010 0.0123 0.0010 0.0214 0.0016
37 0.0080 6.8185e-04 0.0080 6.8185e-04 0.0142 6.8128e-04
38 0.0063 3.4345e-05 0.0063 3.4345e-05 0.0150 7.1797e-06
39 0.0020 1.2301e-05 0.0020 1.2301e-05 0.0035 5.3023e-06
40 0.0106 0.0010 0.0106 0.0010 0.0146 0.0010
41 0.0038 2.9359e-04 0.0038 2.9359e-04 0.0072 3.7424e-04
42 0.0045 3.3312e-04 0.0045 3.3312e-04 0.0099 3.3669e-04
43 0.0045 1.3383e-05 0.0045 1.3383e-05 0.0110 4.6131e-06

reaction function must produce a binary valued function with values
0 and 1. The diffusion function then becomes pragmatic to the binary
function for producing a curvature dependent motion, which is not the
same as used for curvature reliant motion. The Level set evolution (LSE)
is drawn by the reaction function using the LSE equation.
3.4. Feature Extraction
Discrete wavelet transform (DWT) filters are used in the proposed
methodology for feature extraction. Three DWT filters are applied for
feature extraction. The novelty is all these are applied to extract fea-
tures corresponding to four different directions at 0-degree, 90-degree,
180 degree and 360 degrees. The filters are 1. Symlet filter, 2. Debauches
filter and 3. Bio orthogonal filter. All these three filters are applied on
each image in the dataset in four different directions one by one so that,
maximum image area is covered and there is no loss of information
content in the image. All these filters extract energy features. The clas-
sification results are shown in Table 1. Tables 2 and 3 gives overview
of filtering and its application. The energy values extracted using Sym-
let filter is Esym, sym values are obtained for both horizontal and ver-
tical directions SymcH and SymcV as shown in Table 3. Similarly, Db
denotes values corresponding to Debauches filter Db values are also ob-
tained in both horizontal and vertical direction as DbcH and DbcV then
Bio orthogonal filter further has three sub functions corresponding to
three vanishing moments at 3.3, 3.5 and 3.7 accordingly given in the
Table 2 as Rbio values these values in addition to horizontal and verti-
cal direction also has diagonal values for all three vanishing moments
as shown in Table 2.
3.5. Classification
The energy feature values extracted from above step are given as in-
put to ANN. Classification requires reference data for training. The train-
ing of ANN is achieved by two set of values called reference data/values
in terms of energy. One set of values are for normal classification and
other set for abnormal classification of images. This reference values
are compared with input values to detect whether given values match
the trained reference for normal or abnormal and accordingly output
of ANN is either normal or abnormal. Table 1 gives the classification
output for all 43 images in the dataset.
4. Results
The experimental setup used for implanting the proposed work was
successfully analysed using a dataset of 43 echocardiographic images
out of 43 many images were abnormal and few were normal as given
in Table 1. The accuracy of classification was almost 99%. Accuracy be-
ing most significant performance metric frequently used for analysing
classification task which is measured as ratio of accurate predictions

17
A. Heena, N. Biradar, N.M. Maroof et al. Global Transitions Proceedings 3 (2022) 13–19

Table 3
Sub band type with energy values.

Database Images Rbio3.3: cV3 Rbio3.5: cH4 Rbio3.5: cD4 Rbio3.5: cV4 Rbio3.7: cH5 Rbio3.7: cV5 Rbio3.7: cD5 Rbio3.7: cV5

1 0.0011 0.0131 0.0010 0.0010 0.0139 9.0890e-04 0.0010 0.0011

2 0.0012 0.0168 0.0011 0.0011 0.0164 0.0012 0.0010 0.0011
3 0.0013 0.0171 0.0010 0.0011 0.0167 0.0011 0.0010 0.0011
4 0.0014 0.0121 0.0011 0.0013 0.0129 9.2960e-04 0.0011 0.0013
5 0.0012 0.0130 9.9194e-04 0.0011 0.0138 8.8844e-04 9.9249e-04 0.0011
6 0.0012 0.0154 9.3876e-04 0.0011 0.0150 0.0011 9.4674e-04 0.0011
7 0.0013 0.0129 0.0011 0.0012 0.0135 9.7772e-04 0.0011 0.0012
8 0.0013 0.0129 0.0011 0.0012 0.0135 9.9175e-04 0.0011 0.0012
9 0.0012 0.0126 9.5066e-04 0.0011 0.0134 8.3582e-04 9.4558e-04 0.0011
10 0.0012 0.0126 9.5066e-04 0.0011 0.0134 8.3582e-04 9.4558e-04 0.0011
11 0.0012 0.0126 9.0542e-04 0.0011 0.0134 8.8482e-04 9.0627e-04 0.0011
12 0.0012 0.0126 9.0542e-04 0.0011 0.0134 8.8482e-04 9.0627e-04 0.0011
13 0.0011 0.0082 5.3926e-04 7.2250e-04 0.0080 4.5723e-04 4.7126e-04 6.1417e-04
14 9.5958e-04 0.0081 5.0011e-04 6.7486e-04 0.0084 4.9517e-04 4.4881e-04 5.7920e-04
15 6.1228e-04 0.0085 5.0844e-04 4.3702e-04 0.0091 4.7595e-04 4.4518e-04 4.0154e-04
16 6.6347e-04 0.0090 5.1621e-04 5.1621e-04 0.0100 5.8034e-04 4.5429e-04 4.8647e-04
17 9.2008e-04 0.0066 3.7798e-04 5.3765e-04 0.0066 3.9457e-04 3.3138e-04 4.3057e-04
18 8.0797e-04 0.0084 3.9044e-04 4.6268e-04 0.0088 4.0940e-04 3.4338e-04 3.7483e-04
19 8.0253e-04 0.0153 4.4456e-04 7.3629e-04 0.0208 8.2505e-04 3.8999e-04 6.8279e-04
20 9.3595e-04 0.0086 4.9174e-04 9.0866e-04 0.0086 5.5229e-04 4.4176e-04 8.9925e-04
21 0.0010 0.0056 3.2527e-04 6.2454e-04 0.0052 3.4766e-04 2.9065e-04 6.2452e-04
22 6.6665e-04 0.0086 2.6508e-04 3.8738e-04 0.0087 3.9214e-04 2.3431e-04 3.2124e-04
23 7.7905e-04 0.0111 4.3253e-04 5.9801e-04 0.0112 5.2370e-04 4.3716e-04 5.6047e-04
24 4.8580e-04 0.0068 3.5178e-04 4.1166e-04 0.0065 4.4145e-04 3.1757e-04 4.3111e-04
25 7.2746e-04 0.0131 3.4887e-04 5.6545e-04 0.0129 6.0750e-04 3.0733e-04 5.1551e-04
26 7.7359e-04 0.0122 3.9710e-04 5.0563e-04 0.0123 6.3384e-04 3.5732e-04 5.3150e-04
27 7.7359e-04 0.0122 3.9710e-04 5.0563e-04 0.0123 6.3384e-04 3.5732e-04 5.3150e-04
28 4.5038e-04 0.0101 4.4582e-04 3.1711e-04 0.0099 6.0693e-04 3.8666e-04 2.9727e-04
29 6.5808e-04 0.0110 3.2954e-04 4.2217e-04 0.0112 4.7591e-04 2.9267e-04 3.5056e-04
30 4.9690e-04 0.0076 3.4919e-04 3.2102e-04 0.0069 3.8979e-04 3.1175e-04 2.8326e-04
31 3.1977e-04 0.0092 3.4048e-04 2.2369e-04 0.0095 5.2667e-04 2.9493e-04 1.9754e-04
32 4.1434e-04 0.0097 3.4365e-04 3.2669e-04 0.0108 5.9186e-04 3.0608e-04 3.3410e-04
33 9.9650e-05 0.0086 2.4474e-06 4.5103e-05 0.0067 6.6598e-05 1.8072e-06 3.0350e-05
34 1.7097e-04 0.0050 3.2647e-06 8.7741e-05 0.0046 4.3562e-05 2.3002e-06 6.8903e-05
35 6.0140e-05 0.0086 1.9434e-06 2.4720e-05 0.0073 9.1787e-05 1.4844e-06 1.7019e-05
36 0.0023 0.0203 0.0012 0.0022 0.0206 0.0015 0.0011 0.0023
37 0.0014 0.0124 5.4844e-04 0.0014 0.0119 8.2454e-04 5.1325e-04 0.0015
38 1.8098e-04 0.0155 2.7895e-06 7.5159e-05 0.0146 2.3787e-04 2.0164e-06 4.8413e-05
39 6.0248e-05 0.0024 2.3654e-06 2.4157e-05 0.0020 2.2272e-05 1.7622e-06 1.6665e-05
40 0.0016 0.0110 8.4170e-04 0.0017 0.0119 7.6992e-04 7.9247e-04 0.0018
41 7.1674e-04 0.0069 2.8537e-04 5.8433e-04 0.0071 3.7472e-04 2.6262e-04 5.5445e-04
42 7.2733e-04 0.0088 2.4257e-04 6.4014e-04 0.0083 4.3246e-04 2.1425e-04 6.2244e-04
43 6.0140e-05 0.0086 1.943e-06 2.4720e-05 0.0073 9,1787e-05 1.4844e-06 1.7019e-05

Table 4 5. Conclusion
Comparative table of state-of-the-art-methods.

Method Accuracy Sensitivity Specificity Precision The proposed method of processing implemented for detection and
classification of echocardiographic images into normal and abnormal
K. Zhang et al (2013) 0.84 0.89 0.91 0.48
involves four processes: Pre-processing, Segmentation, feature extrac-
T. Chiara et al (2008) 0.87 0.85 0.89 0.82
J.P. Zhang et al (2014) 0.63 0.91 0.92 0.85 tion and Classification. It is concluded that all processing is carried out
Proposed method 0.93 0.91 0.95 0.90 efficiently and resulted in very good accuracy of detection and classifi-
cation. The ANN classifier was trained with set of two references cor-
responding to normal and abnormal energy values, tested successfully.
Detection of heart abnormality is very important if this is possible, can
to total observations. Other performance parameters include sensitiv- save lives by initiating early and proper treatment. This could also be
ity, specificity and precision. All other performance parameters are also an aid to doctors for early and accurate diagnosis which is need of the
giving good results. The results of detection and classification are val- hour. As it is known fact precaution is better than cure if diagnosis and
idated by doctor, are able to accurately detect abnormality if present prognosis is done accurately it leads to correct treatment and hence con-
from the echo images and classify them as abnormal images and oth- sequently reducing risk of death due to critical conditions.
ers as normal images. The practical implications of the proposed paper
are it can assess doctors in diagnosis and early detection of abnormality Declaration of Competing Interest
can result in early treatment. Moreover, it can reduce the time taken
by doctors for diagnosis as result of detection and classification is quite The Authors declare that they have no Conflicts of Interest.
fast. Also, since echocardiography is non-invasive there are no side ef-
fects. Thus, it helps reduce mortality rate due to heart abnormalities in Acknowledgments
patients.
Table 4 give comparative table in terms of performance metric which The authors would like to Acknowledge BKIT Bhalki, KBNCE,
includes accuracy, sensitivity, specificity and precision and it reveals Visveswaraya Technological University, Belagavi, Karnataka INDIA. The
proposed method exhibits better performance than others. Authors declare that they have no Conflicts of Interest.

18
A. Heena, N. Biradar, N.M. Maroof et al.
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