Automation in Sputum Microscopy: A Hybrid Intelligent Technique in Diagnostic Device Automation

Automation in Sputum Microscopy: A Hybrid Intelligent Technique in Diagnostic Device Automation

Pramit Ghosh (RCC Institute of Information Technology, India), Debotosh Bhattacharjee (Jadavpur University, India) and Mita Nasipuri (Jadavpur University, India)
DOI: 10.4018/978-1-4666-9474-3.ch014
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This chapter describes an automatic intelligent diagnostic system for Tuberculosis. Sputum microscopy is the most common diagnostic technique to diagnose Tuberculosis. In Sputum microscopy, Sputum are examined using a microscope for Mycobacterium tuberculosis. This manual process is being automated by image processing, where classification is performed by using a hybrid approach (color based and shape based). This hybrid approach reduces the false positive and false negative rate. Final classification decision is taken by a fuzzy system. Image processing, soft-computing, mechanics, and control system plays a significant role in this system. Slides are given as input to the system. System finds for Mycobacterium tuberculosis bacteria and generates reports. From designing point of view ARM11 based, 32 bit RISC processor is used to control the mechanical units. The main mathematical calculation (including image processing and soft computing) is distributed between ARM11 based group and Personal Computer (Intel i3). This system has better sensitivity than manual sputum microscopy.
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Tuberculosis (TB) is an infectious disease that is caused by a bacterium called Mycobacterium tuberculosis (Centers for Disease Control and Prevention [CDC], 2014). TB primarily affects the lungs called Pulmonary TB, but it can also affect organs in the central nervous system, lymphatic system, and circulatory system among others. TB is spread from person to person through the air. The TB bacteria are put into the air when a person with TB disease of the lungs or throat coughs, sneezes, speaks, or sings. People nearby may breathe in these bacteria and become infected. If TB is not treated properly, it can be fatal. However, TB is not spread by shaking someone's hand, sharing food or drink, sharing toilet seats, etc. People, who have TB disease, do feel sick, have symptoms, and may spread TB bacteria to others. The active TB disease symptoms are:

  • Overall sensation of feeling unwell;

  • Cough, possibly with bloody saliva;

  • Fatigue;

  • Shortness of breath;

  • Slight fever;

  • Weight loss;

  • Pain in the chest;

  • Night sweats.

The occurrence of additional symptoms depends on where the disease has spread beyond the chest and lungs. For example, if TB spreads to the lymph nodes, it can cause swollen glands on the sides of the neck or under the arms. When TB spreads to the bones and joints, it can cause pain and swelling in the knee or hip. About one-third of the world's population has latent TB, which means people have been infected by TB bacteria, but they are not yet sick with disease, do not have symptoms and cannot transmit the disease. Persons infected with TB bacteria have a lifetime risk of falling ill due to TB with a certainty of 10%. However individuals with compromised immune systems, such as persons living with HIV, malnutrition or diabetes, or people who use tobacco, have a much higher risk of falling ill. When a person develops active TB disease, the symptoms of cough, fever, night sweats, weight loss, etc. may be mild for many months. This can lead to delay in seeking care and results in transmission of the bacteria to others. People sick with TB can infect up to 10-15 other persons through close contact over the course of a year. Without proper treatment, up to two-third of people, who are ill with TB, will die (World Health Organization [WHO], 2015). The following factors may play a role in promoting active disease in someone who has an inactive TB infection:

  • Diabetes;

  • Cancer;

  • Illnesses that suppress the immune system, such as HIV or AIDS;

  • Kidney disease;

  • Long-term steroid use;

  • Malnutrition;

  • Medications that suppress the immune system, such as anticancer medications (e.g., cyclosporine);

  • Pregnancy;

  • Radiotherapy.

The Relation between Diabetes and TB

Most of the people from a weak immune system are suffering from chronic disease like diabetes. They are at a higher risk of moving ahead from latent to active tuberculosis. Diabetes affected people have 2-3 times higher risk of TB compared to the persons without diabetes. The risk of death and TB relapse rate after treatment completion are much higher for the people with diabetes. WHO-recommended treatments should be thoroughly implemented for people with TB or diabetes (WHO, 2008).

Key Terms in this Chapter

CCD: A charge-coupled device (CCD) is a device for the movement of electrical charge, usually from within the device to an area where the charge can be manipulated CCDs move charge between capacitive bins in the device, with the shift allowing for the transfer of charge between bins. In a CCD sensor, points are represented by p-doped MOS capacitors.

Thinning: Thinning is a morphological operation that is used to remove selected foreground pixels from binary images, somewhat like erosion or opening. It can be used for several applications, but is particularly useful for skeletonization. The thinning operation is related to the hit-and-miss transform.

ARM11 Processor Family: The ARM11 is a 32-bit RISC processor cores. The ARM11 micro architecture (announced 29 April 2002) introduced the ARMv6 architectural. This micro architecture includes SIMD media instructions, multiprocessor support and a new cache architecture.

Pulse Width Modulation: Pulse Width Modulation, or PWM, is a technique for getting analog results with digital means. Digital control is used to create a square wave, a signal switched between on and off. This on-off pattern can simulate voltages in between full on (5 Volts) and off (0 Volts) by changing the portion of the time the signal spends on versus the time that the signal spends off. The duration of “on time” is called the pulse width.

HSI Color Space: The HSI color model represents every color with three components: hue (H), saturation (S), intensity (I). The Hue component describes the color in the form of an angle between [0,360] degrees. The Saturation component describes how much the color is diluted with white light. The range of the S varies between [0,1]. The Intensity range is between [0,1] and 0 means black, 1 means white.

CCD Camera: A CCD camera is a camera whose imaging system uses three separate charge-coupled devices (CCDs), each one taking a separate measurement of the primary colors, red, green, or blue light. Light coming through the lens is split by a trichroic prism assembly, which directs the appropriate wavelength ranges of light to their respective CCDs. The system is employed by still cameras, telecine systems, professional video cameras etc.

Closing: It is a morphological operators, the exact operation is determined by a structuring element. The effect of the operator is to preserve foreground regions that have a similar shape to this structuring element, or that can completely contain the structuring element, while eliminating all other regions of foreground pixels.

Erosion: It is typically applied to binary images, but there are versions that work on grayscale images. The basic effect of the operator on a binary image is to erode away the boundaries of regions of foreground pixels (i.e. white pixels, typically). Thus areas of foreground pixels shrink in size, and holes within those areas become larger.

Stepper Motor: A stepper motor (or step motor) is a brushless DC electric motor that divides a full rotation into a number of equal steps. The motor's position can be commanded to move and hold on one of steps without any feedback sensor (an open-loop controller).

Image Segmentation: In computer vision, image segmentation is the process of partitioning a digital image into multiple segments.

Opening: Opening is normally applied to binary images. The basic effect of an opening is somewhat like erosion in that it tends to remove some of the foreground (bright) pixels from the edges of regions of foreground pixels.

Dilation: The basic effect of the operator on a binary image is to gradually enlarge the boundaries of regions of foreground pixels (i.e. white pixels, typically). Thus areas of foreground pixels grow in size while holes within those regions become smaller.

H Bridge: An H bridge is an electronic circuit that enables a voltage to be applied across a load in either direction. These circuits are often used in robotics and other applications to allow DC motors to run forwards and backwards.

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