Cytology Imaging Segmentation Using the

Locally Constrained Watershed Transform

N. Béliz-Osorio1, J. Crespo1 , M. Garcı́a-Rojo2, A. Muñoz3 , and J. Azpiazu1

1
Biomedical Informatics Group - LIA, DIA & DLSIIS
Facultad de Informática, Universidad Politécnica de Madrid
28660 Boadilla del Monte (Madrid), Spain
nbeliz@infomed.dia.fi.upm.es
2
Department of Pathology, General Hospital of Ciudad Real
C/ Tomelloso s/n, 13005 Ciudad Real, Spain
3
Department of Radiology, Facultad de Medicina
Ciudad Universitaria, 28040, Madrid, Spain

Abstract. The segmentation of medical images poses a great challenge

in the area of image processing and analysis due mainly to noise, com-
plex background, fuzzy and overlapping objects, and non-homogeneous
gradients. This work uses the so-called locally constrained watershed
transform introduced by Beare [1] to address these problems. The shape
constraints introduced by this type of flexible watershed transformation
permit to successfully segment and separate regions of interest. This type
of watershed offers an alternative to other methods (such as distance
function flooding) for particle extraction in medical imaging segmenta-
tion applications, where particle overlapping is quite common. Cytology
images have been used for the experimental results.

Keywords: Image segmentation, image analysis, watershed, locally con-

strained watershed transform, medical images, cytology.

1 Introduction
In this paper, we are concerned with the segmentation of medical images. At
present the semi-automatic or automatic analysis of medical images has be-
come a fundamental tool in medicine[2]. For example: high resolution images
of cancer cells can be used to determine the progression of cancer cells mi-
gration, indicating the invasion of cancer cells and cancer metastases [3], and
the count of cells can help to diagnosis diseases [4]. As shown in [5,6,7,8], with
the advancement of the new technologies is more common that hospitals have
new technologies for testing and other assessments. This need for medical tools
has generated a new line of research that include multiple disciplines (doctors,
computer scientists, physicists, etc.) with the objective of effective analysis and
management of biomedical data. The watershed transform is a well-known tool
for segmentation of medical imaging [9,10,11]. The locally constrained watershed
introduced by Beare [1] provides a great flexibility to control how shapes are ex-
tracted. Shape criteria can be added so that the gradient flooding that occurs

P. Soille, M. Pesaresi, and G.K. Ouzounis (Eds.): ISMM 2011, LNCS 6671, pp. 429–438, 2011.

c Springer-Verlag Berlin Heidelberg 2011
430 N. Béliz-Osorio et al.

in watershed methods is controlled. The technique possesses some characteris-

tics found in other region based segmentation approaches, like geodesic active
contours [12] and classical Partial Differential Equations (PDEs) [13,14]. As will
be shown, the locally constrained watershed can successfully segment particles
in some particularly difficult situations. This is especially relevant in medical
image analysis, where precision is of high importance. We apply in this work
the locally constrained watershed transform to biomedical images, particularly
cytology images. These types of images often show fuzzy and overlapping ob-
jects, as well as non-homogeneous gradients. There are other methods that can
also solve the problems caused by overlapping objects [15,16] and by touching
edges are [17,18]. However, the aim of this work is to study the properties and
capabilities of the locally constrained watershed transform in cytology imaging,
especially in cases where the input image is directly segmented without prior pre-
processing. The rest of this paper is structured as follows: Section 2 comments
cytology imaging and its relevance. Section 3 treats the main points regarding
the locally constrained watershed transform. Section 4 shows the application of
the locally constrained watershed transform to cytology images and discusses
some experimental results. Finally, Section 5 concludes the paper.

2 Cytology Imaging
2.1 Pleural Fluid Imaging
A cytology examination of pleural fluid (pleural fluid cytology) is a laboratory
test that detects cancerous cells in the pleural space, the area that surrounds
the lungs [19]. The test is performed by inserting a needle into the pleural space
to draw off a sample of pleural fluid (the procedure is called thoracentesis). The
sample of fluid is examined under the microscope for the presence of abnormal
cells. About 75% of malignant pleural effusions are secondary to lung cancer,
breast cancer and lymphoma. It is estimated that about 50% of patients with
bronchial cancer and 40 to 50% of patients with disseminated breast cancer
have a pleural effusion in the course of its evolution. Pleural metastases can also
cause other primary tumors, such as ovarian carcinomas, sarcomas, melanomas,
cervical cancer, cancers of the digestive tract, bladder, etc.

2.2 Papanicolau Smear Imaging

Papanicolau Smear (pap smear) is a medical test that uses five degrees to classify
the cells of a cervix-vaginal cytology according to its degree of malignancy. In
the test of Papanicolau, samples of cells of the vagina and the neck of the uterus
are observed under the microscope. It allows to see cellular variations based
on the hormonal cycle, if infections exist, and most important, the detection of
malignant cells before tumors are pronounced. This test is able occasionally to
detect the 95% of the cancers of the vaginal neck of the uterus, as well as others
such as ovarian and endometrial cancers (although the reliability is smaller here).
This test has radically changed the prognosis of women with cervical cancer.