Rationale and objectives. The objective of this work is to evaluate the imp
ortance of image preprocessing, using multiresolution and multiorientation
wavelet transforms (WTs), on the performance of a previously reported compu
ter assisted diagnostic (CAD) method for breast cancer screening, using dig
ital mammography. Method: An analysis of the influence of WTs on image feat
ure extraction for mass detection is achieved by comparing the discriminant
ability of features extracted with and without the wavelet-based image pre
processing using computed ROC. Thr ee indexes are proposed to assess the se
gmentation of the mass area with comparison to the ground truth. Data was a
nalyzed on the region-of-interest (ROI) database that included mass and nor
mal regions from digitized mammograms with the ground truth. Results: The m
etrics for the measurement of segmentation of the mass clearly demonstrated
the importance of image preprocessing methods. Similarly, the relative imp
rovement in performance was observed in feature extraction based on the eva
luation of the ROC curves, where the Az values are increased, for example,
from 0.71 to 0.75 for a pixel intensity feature and from 0.72 to 0.85 for a
morphological feature of the Normalized Deviation of Radial Length. The im
provement, therefore, depends on the feature characteristics, being large f
or boundary-related features while small for intensity-related features. Co
nclusion: The use of image preprocessing modules using wavelet transforms r
esults in a significant improvement in feature extraction for the previousl
y proposed CAD detection method. We are therefore exploring additional impr
ovement in wavelet-based image preprocessing methods, including adaptive me
thods, to achieve a further improvement in performance and an evaluation on
lar ger image databases. (C) 1999 American Association of Physicists in Me
dicine. [S0094-2405(99)01603-X].