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 Medical Image Processing,
Reconstruction and Analysis
Taylor a nd F ra ncis Seri es in S ignal Pro cessin g an d Co mmu ni cation s

Series Editor
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Menoufia University, Egypt

Digital Signal Processing for Multimedia Systems

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Modulated Coding for Intersymbol Interference Channels

Xiang-Gen Xia

Digital Speech Processing

Synthesis and Recognition, Second Edition
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King N. Ngan, Chi W. Yap, Keng T. Tan

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Design of Digital Video Coding Systems

A Complete Compressed Domain Approach
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 Medical Image Processing,
Reconstruction and Analysis
Concepts and Methods
Second Edition

Jiří Jan
CRC Press
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Library of Congress Cataloging-in-Publication Data

Names: Jan, Jiří, author.

Title: Medical image processing reconstruction and analysis: concepts and methods/Jiri Jan.
Other titles: Medical image processing, reconstruction, and restoration
Description: Second edition. | Boca Raton: CRC Press, 2019. | Preceded by Medical image processing,
reconstruction, and restoration/Jiří Jan.2006.
Identifiers: LCCN 2019012187 | ISBN 9781138310285 (hardback: alk. paper)
Subjects: | MESH: Image Processing, Computer-Assisted–methods | Diagnostic Imaging–methods |
Signal Processing, Computer-Assisted
Classification: LCC RC78.7.D53 | NLM WN 26.5 | DDC 616.07/54–dc23
LC record available at https://lccn.loc.gov/2019012187

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Contents
Preface ................................................................................................................................ xvii
Acknowledgments................................................................................................................ xxi
Author Biography .............................................................................................................. xxiii

PART I Images as Multidimensional Signals

Chapter 1 Analogue (Continuous-Space) Image Representation ..........................................3
1.1 Multidimensional Signals as Image Representation ..................................... 3
1.1.1 General Notion of Multidimensional Signals ...................................3
1.1.2 Some Important Two-Dimensional Signals ......................................5
1.2 Two-Dimensional Fourier Transform .......................................................... 8
1.2.1 Forward Two-Dimensional Fourier Transform.................................8
1.2.2 Inverse Two-Dimensional Fourier Transform ................................. 10
1.2.3 Physical Interpretation of the Two-Dimensional Fourier
Transform ....................................................................................... 11
1.2.4 Properties of the Two-Dimensional Fourier Transform .................. 13
1.3 Two-Dimensional Continuous-Space Systems ............................................15
1.3.1 The Notion of Multidimensional Systems ...................................... 15
1.3.2 Linear Two-Dimensional Systems:
Original-Domain Characterization ................................................. 17
1.3.3 Linear Two-Dimensional Systems:
Frequency-Domain Characterization ............................................. 19
1.3.4 Nonlinear Two-Dimensional Continuous-Space Systems ............... 21
1.3.4.1 Point Operators................................................................. 21
1.3.4.2 Homomorphic Systems ..................................................... 22
1.4 Concept of Stochastic Images .....................................................................25
1.4.1 Stochastic Fields as Generators of Stochastic Images ..................... 26
1.4.2 Correlation and Covariance Functions ........................................... 29
1.4.3 Homogeneous and Ergodic Fields .................................................. 31
1.4.4 Two-Dimensional Spectra of Stochastic Images ............................. 34
1.4.4.1 Power Spectra ................................................................... 34
1.4.4.2 Cross-Spectra .................................................................... 35
1.4.5 Transfer of Stochastic Images via Two-Dimensional
Linear Systems................................................................................ 36
1.4.6 Linear Estimation of Stochastic Variables—Principle
of Orthogonality ............................................................................. 38

Chapter 2 Digital Image Representation .............................................................................41

2.1 Digital Image Representation .....................................................................41
2.1.1 Sampling and Digitizing Images ..................................................... 41

v
vi Contents

2.1.1.1 Sampling ........................................................................... 41

2.1.1.2 Digitization ....................................................................... 45
2.1.2 Image Interpolation from Samples.................................................. 48
2.2 Discrete Two-Dimensional Operators .........................................................49
2.2.1 Discrete Linear Two-Dimensional Operators.................................. 50
2.2.1.1 Generic Operators............................................................. 50
2.2.1.2 Separable Operators.......................................................... 51
2.2.1.3 Local Operators ................................................................ 52
2.2.1.4 Convolutional Operators .................................................. 54
2.2.2 Nonlinear Two-Dimensional Discrete Operators ............................ 56
2.2.2.1 Point Operators................................................................. 56
2.2.2.2 Homomorphic Operators.................................................. 57
2.2.2.3 Order Statistics Operators................................................. 58
2.2.2.4 Neuronal Operators .......................................................... 58
2.3 Discrete Two-Dimensional Linear Transforms ...........................................65
2.3.1 Two-Dimensional Unitary Transforms Generally ........................... 66
2.3.2 Two-Dimensional Discrete Fourier and Related Transforms .......... 68
2.3.2.1 Two-Dimensional DFT Definition .................................... 68
2.3.2.2 Physical Interpretation of Two-Dimensional DFT ............ 69
2.3.2.3 Relation of Two-Dimensional DFT to
Two-Dimensional Integral FT and Its Applications
in Spectral Analysis........................................................... 71
2.3.2.4 Properties of the Two-Dimensional DFT .......................... 75
2.3.2.5 Frequency Domain Convolution....................................... 76
2.3.2.6 Two-Dimensional Cosine, Sine, and
Hartley Transforms ........................................................... 77
2.3.3 Two-Dimensional Hadamard-Walsh and Haar Transforms............ 80
2.3.3.1 Two-Dimensional Hadamard-Walsh Transform ............... 80
2.3.3.2 Two-Dimensional Haar Transform ................................... 81
2.3.4 Two-Dimensional Discrete Wavelet Transforms.............................. 84
2.3.4.1 Two-Dimensional Continuous Wavelet
Transforms........................................................................ 84
2.3.4.2 Two-Dimensional Dyadic Wavelet Transforms ................. 87
2.3.5 Two-Dimensional Discrete Karhunen-Loeve Transform ................ 89
2.4 Discrete Stochastic Images..........................................................................91
2.4.1 Discrete Stochastic Fields as Generators of Stochastic
Images ............................................................................................ 91
2.4.2 Discrete Correlation and Covariance Functions ............................. 92
2.4.3 Discrete Homogeneous and Ergodic Fields .................................... 93
2.4.4 Two-Dimensional Spectra of Stochastic Images ............................. 94
2.4.4.1 Power Spectra ................................................................... 94
2.4.4.2 Discrete Cross-Spectra ...................................................... 95
2.4.5 Transfer of Stochastic Images via Discrete
Two-Dimensional Systems .............................................................. 95
Part I References.................................................................................................96
Contents vii

PART II Imaging Systems as Data Sources

Chapter 3 Planar X-Ray Imaging........................................................................................99
3.1 X-Ray Projection Radiography ...................................................................99
3.1.1 Basic Imaging Geometry................................................................. 99
3.1.2 Source of Radiation ...................................................................... 100
3.1.3 Interaction of X-Rays with Imaged Objects .................................. 103
3.1.4 Image Detection............................................................................ 104
3.1.5 Post-measurement Data Processing in Projection Radiography .... 107
3.2 Subtractive Angiography ..........................................................................109

Chapter 4 X-Ray Computed Tomography ........................................................................ 111

4.1 Imaging Principle and Geometry ..............................................................111
4.1.1 Principle of a Slice Projection Measurement................................. 111
4.1.2 Variants of Measurement Arrangement........................................ 113
4.2 Measuring Considerations ........................................................................117
4.2.1 Technical Equipment .................................................................... 117
4.2.2 Attenuation Scale.......................................................................... 118
4.3 Imaging Properties....................................................................................119
4.3.1 Spatial Two-Dimensional and Three-Dimensional
Resolution and Contrast Resolution............................................. 119
4.3.2 Imaging Artifacts.......................................................................... 120
4.4 Postmeasurement Data Processing in Computed Tomography .................123
4.5 Spectral Computed Tomography ..............................................................125
4.5.1 Double-Energy CT ....................................................................... 126
4.5.2 Multi-Band (Spectral) CT............................................................. 128

Chapter 5 Magnetic Resonance Imaging........................................................................... 131

5.1 Magnetic Resonance Phenomena..............................................................131
5.1.1 Magnetization of Nuclei ............................................................... 131
5.1.2 Stimulated NMR Response and Free Induction Decay ................ 133
5.1.3 Relaxation..................................................................................... 135
5.1.3.1 Chemical Shift and Flow Influence ................................. 137
5.2 Response Measurement and Interpretation ..............................................138
5.2.1 Saturation Recovery (SR) Techniques........................................... 139
5.2.2 Spin-Echo Techniques................................................................... 140
5.2.3 Gradient-Echo Techniques ........................................................... 144
5.3 Basic MRI Arrangement...........................................................................146
5.4 Localization and Reconstruction of Image Data ......................................148
5.4.1 Gradient Fields............................................................................. 148
5.4.2 Spatially Selective Excitation ........................................................ 149
5.4.3 RF Signal Model and General Background for Localization ....... 151
5.4.4 One-Dimensional Frequency Encoding: Two-Dimensional
Reconstruction from Projections................................................... 155
viii Contents

5.4.5 Two-Dimensional Reconstruction via Frequency and

Phase Encoding ............................................................................ 159
5.4.6 Three-Dimensional Reconstruction via Frequency and
Double Phase Encoding................................................................ 163
5.4.7 Fast MRI ...................................................................................... 164
5.4.7.1 Multiple-Slice Imaging.................................................... 165
5.4.7.2 Low Flip-Angle Excitation.............................................. 165
5.4.7.3 Multiple-Echo Acquisition.............................................. 166
5.4.7.4 Echo-Planar Imaging ...................................................... 167
5.5 Image Quality and Artifacts......................................................................170
5.5.1 Noise Properties............................................................................ 170
5.5.2 Image Parameters ......................................................................... 171
5.5.3 Point-Spread Function.................................................................. 173
5.5.4 Resolving Power ........................................................................... 173
5.5.5 Imaging Artifacts.......................................................................... 174
5.6 Post-measurement Data Processing in MRI..............................................175
5.7 Functional Magnetic Resonance Imaging (fMRI) ....................................177

Chapter 6 Nuclear Imaging............................................................................................... 183

6.1 Planar Gamma Imaging............................................................................184
6.1.1 Gamma Detectors and Gamma Camera....................................... 185
6.1.2 Inherent Data Processing and Imaging Properties ........................ 189
6.1.2.1 Data Localization and System Resolution ...................... 189
6.1.2.2 Total Response Evaluation and Scatter Rejection ........... 191
6.1.2.3 Data Post-processing....................................................... 191
6.2 Single-Photon Emission Tomography .......................................................192
6.2.1 Principle........................................................................................ 192
6.2.2 Deficiencies of SPECT Principle and Possibilities of Cure ............ 193
6.3 Positron Emission Tomography ................................................................197
6.3.1 Principles of Measurement............................................................ 197
6.3.2 Imaging Arrangements ................................................................. 200
6.3.3 Post-processing of Raw Data and Imaging Properties................... 202
6.3.3.1 Attenuation Correction ................................................... 203
6.3.3.2 Random Coincidences .................................................... 204
6.3.3.3 Scattered Coincidences.................................................... 205
6.3.3.4 Dead-Time Influence....................................................... 205
6.3.3.5 Resolution Issues ............................................................ 206
6.3.3.6 Ray Normalization ......................................................... 207
6.3.3.7 Comparison of PET and SPECT Modalities................... 208

Chapter 7 Ultrasonography .............................................................................................. 209

7.1 Two-Dimensional Echo Imaging...............................................................210
7.1.1 Echo Measurement ....................................................................... 210
7.1.1.1 Principle of Echo Measurement ...................................... 210
7.1.1.2 Ultrasonic Transducers ................................................... 211
Contents ix

7.1.1.3 Ultrasound Propagation and Interaction with Tissue ..... 216

7.1.1.4 Echo Signal Features and Processing .............................. 218
7.1.2 B-Mode Imaging........................................................................... 221
7.1.2.1 Two-Dimensional Scanning Methods and Transducers... 221
7.1.2.2 Format Conversion ......................................................... 224
7.1.2.3 Two-Dimensional Image Properties and Processing ........ 225
7.1.2.4 Contrast Imaging and Harmonic Imaging ...................... 227
7.2 Flow Imaging............................................................................................229
7.2.1 Principles of Flow Measurement .................................................. 229
7.2.1.1 Doppler Blood Velocity Measurement (Narrowband
Approach) ....................................................................... 229
7.2.1.2 Cross-Correlation Blood Velocity Measurement
(Wideband Approach)..................................................... 233
7.2.2 Color Flow Imaging ..................................................................... 234
7.2.2.1 Autocorrelation-Based Doppler Imaging ........................ 234
7.2.2.2 Movement Estimation Imaging....................................... 237
7.2.2.3 Contrast-Based Flow Imaging ........................................ 237
7.2.2.4 Post-processing of Flow Images ...................................... 237
7.3 Three-Dimensional Ultrasonography........................................................238
7.3.1 Three-Dimensional Data Acquisition ........................................... 238
7.3.1.1 Two-Dimensional Scan-Based Data Acquisition............. 238
7.3.1.2 Three-Dimensional Transducer Principles....................... 240
7.3.2 Three-Dimensional and Four-Dimensional Data
Post-Processing and Display ......................................................... 241
7.3.2.1 Data Block Compilation ................................................. 241
7.3.2.2 Display of Three-Dimensional Data ............................... 242
7.4 Plane Wave (Ultra-Fast) Ultrasonic Imaging ............................................243
7.4.1 Principle of Plane-Wave Imaging .................................................. 244
7.4.1.1 Individual Frame Data Acquisition ................................ 244
7.4.1.2 Individual Image Reconstruction .................................... 247
7.4.2 Image Compounding .................................................................... 248
7.4.3 Shear Wave Visualization and Elastography ................................. 250

Chapter 8 Other Modalities .............................................................................................. 253

8.1 Optical and Infrared Imaging ...................................................................253
8.1.1 Three-Dimensional Confocal Microscopy .................................... 254
8.1.2 Optical Coherence Tomography (OCT) ........................................ 256
8.1.3 Body Surface Infrared Imaging..................................................... 257
8.2 Electron Microscopy.................................................................................258
8.2.1 Scattering Phenomena in the Specimen Volume............................ 259
8.2.2 Transmission Electron Microscopy ............................................... 259
8.2.3 Scanning Electron Microscopy ..................................................... 262
8.2.4 Post-processing of EM Images ...................................................... 264
8.3 Electrical Impedance Tomography............................................................265
Part II References .............................................................................................268
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x Contents

PART III Image Processing and Analysis

Chapter 9 Reconstructing Tomographic Images ............................................................... 273
9.1 Reconstruction from Near-Ideal Projections.............................................273
9.1.1 Representation of Images by Projections ...................................... 273
9.1.2 Algebraic Methods of Reconstruction .......................................... 277
9.1.2.1 Discrete Formulation of the Reconstruction Problem ..... 277
9.1.2.2 Iterative Solution ............................................................ 279
9.1.2.3 Reprojection Interpretation of the Iteration.................... 281
9.1.2.4 Simplified Reprojection Iteration .................................... 283
9.1.2.5 Other Iterative Reprojection Approaches........................ 284
9.1.3 Reconstruction via Frequency Domain......................................... 284
9.1.3.1 Projection Slice Theorem ................................................ 284
9.1.3.2 Frequency-Domain Reconstruction ................................ 285
9.1.4 Reconstruction from Parallel Projections by
Filtered Back-Projection ............................................................... 286
9.1.4.1 Underlying Theory.......................................................... 286
9.1.4.2 Practical Aspects ............................................................. 289
9.1.5 Reconstruction from Fan Projections ........................................... 292
9.1.5.1 Rebinning and Interpolation ........................................... 293
9.1.5.2 Weighted Filtered Back-Projection.................................. 293
9.1.5.3 Algebraic Methods of Reconstruction ............................ 296
9.2 Reconstruction from Non-ideal Projections..............................................297
9.2.1 Reconstruction under Nonzero Attenuation ................................. 297
9.2.1.1 SPECT Type Imaging ..................................................... 297
9.2.1.2 PET Type Imaging .......................................................... 299
9.2.2 Reconstruction from Stochastic Projections ................................. 300
9.2.2.1 Stochastic Models of Projections .................................... 300
9.2.2.2 Principle of Maximum-Likelihood Reconstruction ......... 302
9.3 Other Approaches to Tomographic Reconstruction..................................304
9.3.1 Image Reconstruction in Magnetic Resonance Imaging ............... 304
9.3.1.1 Projection-Based Reconstruction .................................... 304
9.3.1.2 Frequency-Domain (Fourier) Reconstruction ................. 305
9.3.2 Image Reconstruction in Ultrasonography ................................... 306
9.3.2.1 Reflective (Echo) Ultrasonography ................................. 306
9.3.2.2 Transmission Ultrasonography ....................................... 307
9.3.2.3 Plane Wave Ultrasonography and Elastography.............. 308

Chapter 10 Image Fusion ................................................................................................... 309

10.1 Ways to Consistency ...............................................................................310
10.1.1 Geometrical Image Transformations........................................... 312
10.1.1.1 Rigid Transformations .................................................. 312
10.1.1.2 Flexible Transformations .............................................. 314
10.1.1.3 Piece-Wise Transformations .......................................... 318
10.1.2 Image Interpolation .................................................................... 320
Contents xi

10.1.2.1 Interpolation in the Spatial Domain ............................. 321

10.1.2.2 Spatial Interpolation via Frequency Domain ................ 326
10.1.3 Image Similarity Criteria............................................................. 327
10.1.3.1 Direct Intensity-Based Criteria...................................... 328
10.1.3.2 Information-Based Criteria ........................................... 332
10.2 Disparity Analysis...................................................................................339
10.2.1 Disparity Evaluation................................................................... 339
10.2.1.1 Disparity Definition and Evaluation Approaches ......... 339
10.2.1.2 Nonlinear Matched Filters as Sources of Similarity
Maps ............................................................................. 341
10.2.2 Computation and Representation of Disparity Maps ................. 344
10.2.2.1 Organization of the Disparity Map Computation ......... 344
10.2.2.2 Display and Interpretation of Disparity Maps .............. 344
10.3 Image Registration ..................................................................................345
10.3.1 Global Similarity ........................................................................ 346
10.3.1.1 Intensity-Based Global Criteria .................................... 347
10.3.1.2 Point-Based Global Criteria .......................................... 348
10.3.1.3 Surface-Based Global Criteria....................................... 349
10.3.2 Transform Identification and Registration Procedure ................. 349
10.3.2.1 Direct Computation ...................................................... 350
10.3.2.2 Optimization Approaches ............................................. 350
10.3.3 Registration Evaluation and Approval........................................ 351
10.4 Image Fusion ..........................................................................................353
10.4.1 Image Subtraction and Addition ................................................ 353
10.4.2 Vector-Valued Images ................................................................. 354
10.4.2.1 Presentation of Vector-Valued Images........................... 355
10.4.3 Three-Dimensional Data from Two-Dimensional Slices ............. 356
10.4.4 Panorama Fusion........................................................................ 356
10.4.5 Stereo Surface Reconstruction .................................................... 357
10.4.6 Time Development Analysis ....................................................... 359
10.4.6.1 Time Development via Disparity Analysis .................... 359
10.4.6.2 Time Development via Optical Flow............................. 360
10.4.7 Fusion-Based Image Restoration ................................................ 362

Chapter 11 Image Enhancement ......................................................................................... 363

11.1 Contrast Enhancement ...........................................................................363
11.1.1 Piece-Wise Linear Contrast Adjustments.................................... 365
11.1.2 Nonlinear Contrast Transforms .................................................. 367
11.1.3 Histogram Equalization .............................................................. 369
11.1.4 Pseudocoloring ........................................................................... 372
11.2 Sharpening and Edge Enhancement........................................................373
11.2.1 Discrete Difference Operators ..................................................... 374
11.2.2 Local Sharpening Operators ....................................................... 378
11.2.3 Sharpening via Frequency Domain............................................. 381
11.2.4 Adaptive Sharpening................................................................... 383
xii Contents

11.3 Noise Suppression...................................................................................385

11.3.1 Narrowband Noise Suppression.................................................. 386
11.3.2 Wideband “Gray” Noise Suppression......................................... 387
11.3.2.1 Adaptive Wideband Noise Smoothing .......................... 389
11.3.3 Impulse Noise Suppression ......................................................... 391
11.4 Geometrical Distortion Correction .........................................................394

Chapter 12 Image Restoration ............................................................................................ 395

12.1 Correction of Intensity Distortions .........................................................396
12.1.1 Global Corrections ..................................................................... 397
12.1.2 Field Homogenization ................................................................ 397
12.1.2.1 Homomorphic Illumination Correction ........................ 399
12.2 Geometrical Restitution ..........................................................................399
12.3 Inverse Filtering ......................................................................................400
12.3.1 Blur Estimation........................................................................... 400
12.3.1.1 Analytical Derivation of PSF ........................................ 400
12.3.1.2 Experimental PSF Identification ................................... 401
12.3.2 Identification of Noise Properties ............................................... 405
12.3.3 Actual Inverse Filtering .............................................................. 406
12.3.3.1 Plain Inverse Filtering ................................................... 406
12.3.3.2 Modified Inverse Filtering............................................. 408
12.4 Restoration Methods Based on Optimization .........................................409
12.4.1 Image Restoration as Constrained Optimization ........................ 409
12.4.2 Least Mean Square Error Restoration ........................................ 411
12.4.2.1 Formalized Concept of LMS Image Estimation............ 411
12.4.2.2 Classical Formulation of Wiener Filtering for
Continuous-Space Images ............................................. 412
12.4.2.3 Discrete Formulation of the Wiener Filter .................... 418
12.4.2.4 Generalized LMS Filtering ........................................... 420
12.4.3 Methods Based on Constrained Deconvolution.......................... 422
12.4.3.1 Classical Constrained Deconvolution............................ 422
12.4.3.2 Maximum Entropy Restoration .................................... 425
12.4.4 Constrained Optimization of Resulting PSF ............................... 427
12.4.5 Bayesian Approaches .................................................................. 428
12.4.5.1 Maximum a Posteriori Probability Restoration............. 429
12.4.5.2 Maximum-Likelihood Restoration................................ 430
12.5 Homomorphic Filtering and Deconvolution...........................................430
12.5.1 Restoration of Speckled Images .................................................. 431
12.6 Fusion Based Blind Restoration..............................................................432
12.6.1 Blind Deconvolution and Registration of Fused Images ............. 432

Chapter 13 Lower-Level Image Analysis ............................................................................ 435

13.1 Local Feature Analysis............................................................................435
13.1.1 Local Features ............................................................................ 436
13.1.1.1 Parameters Provided by Local Operators ...................... 436
Contents xiii

13.1.1.2 Parameters of Local Statistics ....................................... 436

13.1.1.3 Local Histogram Evaluation ......................................... 437
13.1.1.4 Frequency-Domain Features......................................... 437
13.1.2 Edge Detection ........................................................................... 438
13.1.2.1 Gradient-Based Detectors ............................................. 439
13.1.2.2 Laplacian-Based Zero-Crossing Detectors .................... 441
13.1.2.3 Laplacian-of-Gaussian-Based Detectors ....................... 442
13.1.2.4 Combined Approaches to Edge and
Corner Detection .......................................................... 443
13.1.2.5 Line Detectors............................................................... 444
13.1.3 Texture Analysis.......................................................................... 445
13.1.3.1 Local Features as Texture Descriptors .......................... 447
13.1.3.2 Co-Occurrence Matrices................................................ 447
13.1.3.3 Run-Length Matrices .................................................... 448
13.1.3.4 Autocorrelation Evaluators ........................................... 448
13.1.3.5 Texture Models ............................................................. 448
13.1.3.6 Syntactic Texture Analysis ............................................ 449
13.1.3.7 Textural Parametric Images and Textural Gradient ...... 450
13.2 Image Segmentation................................................................................450
13.2.1 Parametric Image-Based Segmentation....................................... 451
13.2.1.1 Intensity-Based Segmentation ....................................... 451
13.2.1.2 Binary (Black and White) Segmentation ....................... 454
13.2.1.3 Segmentation of Vector-Valued Parametric, Color,
or Multimodal Images................................................... 455
13.2.1.4 Texture-Based Segmentation ......................................... 456
13.2.2 Region-Based Segmentation ....................................................... 456
13.2.2.1 Segmentation via Region Growing ................................ 456
13.2.2.2 Segmentation via Region Merging................................. 457
13.2.2.3 Segmentation via Region Splitting and Merging ........... 458
13.2.2.4 Watershed-Based Segmentation .................................... 460
13.2.3 Edge-Based Segmentation........................................................... 463
13.2.3.1 Borders via Modified Edge Representation ................... 463
13.2.3.2 Borders via Hough Transform ...................................... 466
13.2.3.3 Boundary Tracking ....................................................... 470
13.2.3.4 Graph Searching Methods ............................................ 471
13.2.4 Segmentation by Pattern Comparison ........................................ 471
13.2.5 Segmentation via Flexible Contour Optimization ....................... 471
13.2.5.1 Parametric Flexible Contours ....................................... 472
13.2.5.2 Geometric Flexible Contours – Level Sets..................... 474
13.2.5.3 Active Shape Contours.................................................. 476
13.3 Generalized Morphological Transforms..................................................478
13.3.1 Basic Notions.............................................................................. 478
13.3.1.1 Image Sets and Threshold Decomposition .................... 478
13.3.1.2 Generalized Set Operators and Relations ...................... 479
13.3.1.3 Distance Function......................................................... 480
13.3.2 Morphological Operators ........................................................... 481
xiv Contents

13.3.2.1 Erosion.......................................................................... 483

13.3.2.2 Dilation ......................................................................... 485
13.3.2.3 Opening and Closing..................................................... 486
13.3.2.4 Fit-and-Miss Operator .................................................. 488
13.3.2.5 Derived Operators......................................................... 488
13.3.2.6 Geodesic Operators....................................................... 490
13.3.3 Some Applications ...................................................................... 491

Chapter 14 Selected Higher-Level Image Analysis Methods............................................... 495

14.1 Image Decomposition Using Principal and Independent
Component Analyses ..............................................................................496
14.1.1 Principal Component Analysis.................................................... 496
14.1.2 Independent Component Analysis .............................................. 503
14.1.2.1 ICA Based on Minimization of Mutual Information .... 505
14.1.2.2 ICA Based on Maximization of Non-Gaussianity ........ 506
14.2 Deep Learning-Based Image Analysis.....................................................507
14.2.1 Introduction to Deep Learning ................................................... 507
14.2.2 Deep Feed-Forward (Back-Propagation) Neural Networks ........ 508
14.2.3 Convolutional Neural Networks ................................................. 513
14.2.3.1 Generic Structure .......................................................... 514
14.2.3.2 Convolutional Layers .................................................... 515
14.2.3.3 Nonlinear Layers .......................................................... 516
14.2.3.4 Pooling Layers .............................................................. 517
14.2.4 Modifications of Convolutional Neural Networks...................... 517
14.2.4.1 Neuron Nonlinearities................................................... 518
14.2.4.2 Tendencies in CNN Architectures ................................. 518
14.2.4.3 Inception Concept......................................................... 519
14.2.4.4 Residual Concept .......................................................... 520
14.2.5 Matrix-Output Type Convolutional Neural Networks................ 521
14.2.6 Applications of Convolutional Neural Networks........................ 524
14.2.6.1 Supervised Learning from Limited Databases............... 525
14.2.6.2 Unsupervised Learning ................................................. 526
14.2.6.3 Image Classification ...................................................... 526
14.2.6.4 Semantic Segmentation ................................................. 527
14.2.6.5 Blind Learning Based Restoration ................................ 529
14.2.7 Recurrent Neural Networks ........................................................ 530

Chapter 15 Medical Image Processing Environment........................................................... 533

15.1 Hardware and Software Features ............................................................533
15.1.1 Hardware Features...................................................................... 533
15.1.2 Software Features ....................................................................... 536
15.2 Principles of Image Compression for Archiving and Communication.....539
15.2.1 Philosophy of Image Compression.............................................. 539
15.2.2 Generic Still-Image Compression System ................................... 540
15.2.3 Principles of Lossless Compression............................................. 541
Contents xv

15.2.3.1 Predictive Coding .......................................................... 542

15.2.4 Principles of Lossy Compression ................................................ 543
15.2.4.1 Pixel-Oriented Methods ................................................ 544
15.2.4.2 Block-Oriented Methods............................................... 545
15.2.4.3 Global Compression Methods ...................................... 548
15.3 Present Trends in Medical Image Processing...........................................550
Part III References............................................................................................552

Index.................................................................................................................................... 557
Preface
Beginning with modest initial attempts in, roughly, the 1960s, digital image processing has
become a recognized field of science, as well as a broadly accepted methodology, to solve
practical problems in many different kinds of human activities. The applications encompass
an enormous range, starting perhaps with astronomy, geology, and physics, via medical, bio-
logical, and ecological imaging and technological exploitation, up to the initially unexpected
use in humane sciences (e.g., archaeology or art history). The results obtained in the area of
digital image acquisition, synthesis, processing, and analysis are impressive, though it is
often not generally known that digital methods have been applied. The basic concepts and
theory are, of course, common to the spectrum of applications, but some aspects are more
emphasized and some less in each particular application field. This book, besides introdu-
cing general principles and methods, concentrates on applications in the field of medical
imaging, which is specific for at least two features: biomedical imaging often concerns
internal structures of living organisms inaccessible to standard imaging methods, and the
resulting images are observed, evaluated, and classified mostly by non-technically oriented
staff.
The first feature means that rather specific imaging methods had to be developed,
namely, tomographic modalities that are entirely dependent on digital processing of meas-
ured pre-image data and utilize rather sophisticated theoretical backgrounds stemming from
the advanced signal theory. Therefore, development of new or innovated image processing
approaches, as well as the interpretation of more complicated or unexpected results, requires
a deep understanding of the underlying theory and methods.
Excellent theoretical books on general image processing methods are available, some of
them mentioned in the references of this book. In the area of medical imaging, many books
oriented toward individual clinical branches have been published, mostly with medically
interpreted case studies. Technical publications on modality-oriented specialized methods
are frequent, either original journal papers and conference proceedings or edited books,
contributed to by numerous specialized authors summarizing recent contributions to
a particular field of medical image processing. However, there may be a niche for books
that respect the particularities of biomedical orientation while providing a consistent, theor-
etically reasonably exact, and yet comprehensible explanation of the underlying theoretical
concepts and principles of methods of image processing as applied in the broad medical field
and other application fields.
This book is intended as an attempt in this direction. It is the author’s persuasion that
a good understanding of concepts and principles forms a necessary basis to any valid meth-
odology and solid application. It is relatively easy to continue studying and even designing
specialized advanced approaches with such a background; on the other hand, it is extremely
difficult to grasp a sophisticated method without understanding the underlying concepts.
Investigating a well-defined theory from the background makes the study enjoyable; this
aspect was part of the foundation of the concept for the book.
This book is primarily for a technically oriented audience (e.g., staff members in the med-
ical environment, interdisciplinary experts of different (not necessarily only biomedical)
orientations, and graduate and postgraduate engineering students. The purpose of the book
is to provide insight; this determines the way the material is treated: the rigorous mathemat-
ical treatment—definition, lemma, proof—has been abandoned in favor of continuous
explanation, in which most results and conclusions are consistently derived, though the der-
ivation is contained (and sometimes perhaps even hidden) in the text. The aim is for the

xvii
xviii Preface

reader to become familiar with the explained concepts and principles and acquire the idea
of not only believing the conclusions, but also checking and interpreting every result him-
or herself, though perhaps with informal reasoning. It is also important that all the results
be interpreted in terms of their “physical” meaning. This does not mean that they be related
to a concrete physical parameter, but rather that they are reasonably interpreted with the
purpose of the applied processing in mind (e.g., in terms of information or spectral con-
tent). The selection of the material in the book was based on the idea of including the
established background without becoming mathematically or theoretically superficial, while
possibly eliminating unnecessary details or overly specialized information that, moreover,
may have a time-limited validity.
Though the book was primarily conceived with the engineering community of readers in
mind, it should be readable also to technically inclined biomedical experts. It is, of course,
possible to successfully exploit image-processing methods in clinical practice or scientific
research without becoming involved in the processing principles. The implementation of
imaging modalities must be adapted to this standard situation through an environment in
which the nontechnical expert would not feel image processing to be a strange or hostile
element. However, the interpretation of the image results, in more complicated cases, as well
as the indication of suitable image-processing procedures, under more complex circum-
stances, may be supported by the user’s understanding of the processing concepts. It is
therefore a side ambition of this book to be comprehensible enough to enable appreciation
of the principles, perhaps without derivations, even by a differently oriented expert.
It should also be stated what the book is not intended to be. It does not discuss the med-
ical interpretation of the image results; no casuistic analysis is included. Concerning the
technical contents, it is not a theoretical in-depth monograph on a highly specialized theme,
which would not be understandable to a technically or mathematically educated user of the
imaging methods or a similarly oriented graduate student. Such specialized publications
may be found among the references. Finally, while the book may be helpful even as a daily
reference to concepts and methods, it is not a manual on application details and does not
refer to any particular program, system, or implementation.
The content of the book has been divided into three parts. The first part, “Images as
Multidimensional Signals,” provides the introductory chapters on the basic image-
processing theory. The second part, “Imaging Systems as Data Sources,” is intended as an
alternative view on the imaging modalities. While the physical principles are limited to the
extent necessary to explain the imaging properties, the emphasis is on analyzing internal
signals and (pre)image data that are to be consequently processed. With respect to this
goal, the technological solutions and details of the imaging systems are also omitted. The
third part, “Image Processing and Analysis,” starts with tomographic image reconstruction,
which is of fundamental importance in medical imaging. Another topical theme of medical
imaging is image fusion, including multimodal image registration. Methods of image
enhancement and restoration are treated in individual chapters. The next chapter is devoted
to image analysis, including segmentation, as a preparation for diagnostics. The originally
concluding chapter, on the image-processing environment, briefly comments on hardware
and software exploited in medical imaging and on processing aspects of image archiving
and communication, including principles of image data compression.
With respect to the broad spectrum of potential readers, the book was designed to be as
self-contained as possible. Although a background in signal theory would be advantageous,
it is not necessary, as basic terms are briefly explained where needed. Each part of the book
has a list of references, containing literature used as sources or recommended for further
study. The citation of numerous original works, although their influence on and
Preface xix

contribution to the medical imaging field are highly appreciated, was mostly avoided, unless
they served as immediate sources or examples.
The author hopes that (in spite of some ever-present oversights and omissions) the reader
will find the book’s content to be consistent and interesting, and studying it intellectually
rewarding. If the basic knowledge contained within becomes a key to solving practical
application problems and to informed interpretation of results, or a starting point to inves-
tigating more advanced approaches and methods, the book’s intentions will have been
fulfilled.
Jiří Jan
Brno, Czech Republic

COMMENTS TO THE SECOND EDITION:

In 2017, the publishing house (CRC Press—Taylor and Francis) contacted me with
a suggestion to issue the second edition of my 2006 book. When the following independent
expert reviews concerning the second-edition intention, organized by the publishing house,
were positive, among others pointing to the predominantly timeless content of the book
that would not require great modifications, I decided to accept the invitation.
In the second edition, besides naturally correcting some misprints or oversights and
partly modifying or complementing some explanations, also new material was included. It
consisted of, on the one hand, introducing novel imaging principles (namely planar ultra-
sound imaging, spectral CT, functional MRI, and optical coherent tomography) and on the
other hand new or newly used image analysis methodologies—a new chapter was added on
selected methods of higher-level analysis (primarily deep-learning based methods, namely
convolutional neural networks and some other learning approaches) and on principal and
independent component analysis (PCA, ICA). A subchapter has been added on principles
of fusion-based image restoration, and some chapters have been somewhat modified or
complemented.
The author hopes that the second edition of the book will fulfill readers’ expectations,
when providing the insight and explaining the principles of image processing and analysis,
using the transparent and straightforward explanation approach of the first edition that
seems to have already proved its merit.
Brno, 2019
Jiří Jan
Visit https://textbookfull.com
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Acknowledgments
This book is partly based on courses on basic and advanced digital-image processing
methods, offered for over 30 years to graduate and Ph.D. students of electronics and
informatics at Brno University of Technology. Part of these courses has always been
oriented toward biomedical applications. Here, I express thanks to all colleagues and stu-
dents, with whom discussions often led to a better view of individual problems. In this
respect, the comments of the book reviewer, Dr. S.M. Krishnan, Nanyang Technological
University Singapore, have also been highly appreciated.
Most medical images presented as illustrations or used as material in the derived figures
have been kindly provided by cooperating hospitals and their staffs: the Faculty Hospital of
St. Anne Brno (Assoc. Prof. P. Krupa, M.D., Ph.D.), the Faculty Hospital Brno-Bohunice
(Assoc. Prof. J. Prasek, M.D., Ph.D.; Assoc. Prof. V Chaloupka, M.D., Ph.D., Assist. Prof.
R. Gerychova, M.D.), Masaryk Memorial Cancer Institute Brno (Karel Bolcak, M.D.),
Institute of Scientific Instruments, Academy of Sciences of the Czech Republic (Prof.
M. Kasal, Ph.D.), and Brno University of Technology (Assoc. Prof. A. Drastich, PhD.,
D. Janova, M.Sc.). Their courtesy is highly appreciated. Recognition notices are only placed
with figures that contain original medical images; they are not repeated with figures where
these images serve as material to be processed or analyzed. Thanks also go to former doc-
toral students V. Jan, Ph.D., and R. Jirik, Ph.D., who provided most of the drawn and
derived-image figures in the first edition. Concerning the second edition, sincere thanks for
support providing photos or other supporting material, as well as for useful discussions, go
also to my former or present doctoral students, M. Malínský, PhD, R. Peter,
PhD, M. Lamoš, PhD., P. Walek, PhD., J. Chmelík and R. Jakubíč ek; the last two contrib-
uted also to the final manuscript preparation.
The book utilizes as illustrations of the described methods, among others, some results of
research conducted by the group headed by the author. Support of related projects by the
grant no. 102/02/0890 of the Grant Agency of the Czech Republic, grants no. CEZ MSM
262200011 and CEZ MS 0021630513 of the Ministry of Education of the Czech Republic,
and the grant 1M6798555601 supporting the national research center, which our group was
a part of, is acknowledged. In the second edition, some figures illustrating specific methods
developed by this group in frame of a long-term cooperation with the firm Philips Medical
Systems Nederland B.V. were included; the possibility of this inclusion is also
acknowledged.

xxi
Author Biography
Jiří Jan is a full professor of signal and image processing within the Department of Biomed-
ical Engineering at Brno University of Technology. As the Head of the Department (1990 –
2010) he constituted novel concepts of MSc and PhD study in Biomedical and Ecological
Engineering, and in Biocybernetics. During his professional life, he served here and abroad
(The Netherlands, Denmark, United Kingdom, Belgium, Estonia, etc.) as a university
teacher and researcher.
Since 1980-th he concentrated his scientific interest in the area of biomedical image ana-
lysis. His publication record lists over 280 research papers in scientific journals and confer-
ence proceedings besides several books on digital signal and image processing (VUTIUM,
IEE Press, CRC Taylor&Francis). His activities encompass memberships in editorial boards
of international journals (Springer, IEEE, EURASIP, Hindawi) and in conference boards
(IEEE-EMBC, IEEE-ICASSP, IEEE-ISBI, EURASIP-EUSIPCO, IFMBE, WOC and
others); he was also organizing and chairing the series of 20 biennial international confer-
ences BIOSIGNAL (1978-2012) under the patronage of IEEE-EMBS and EURASIP asso-
ciations. Several teams of his doctoral students were working in the image processing area
under his guidance, namely the Brno section of the national research centre DAR (2005-
2011) and presently the team cooperating with the firm Philips HealthCare Nederland since
2008. His present research interests in medical image data processing concern namely multi-
modal image fusion and diagnostic feature analysis.

xxiii
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 ERICA margaritacea.

CHARACTER SPECIFICUS.

Erica, antheris cristatis, inclusis; stylo exserto; corollis globoso

campanulatis; floribus terminalibus, sub-umbellatis; foliis quaternis, lineari-
trigonis, glabris, erectis.

DESCRIPTIO.

Caulis erectus, ramosus; ramuli frequentissimi, erecti, glabri.

Folia quaterna, lineari-trigona, erecta, subtus sulcata, glabra; petiolis
brevissimis, adpressis.
Flores terminales, nutantes, sub-umbellati; pedunculi filiformes, bracteis
tribus, linearibus instructi.
Calyx. Perianthium tetraphyllum, foliolis subulatis, carinatis, sulcatis,
lævibus, adpressis.
Corolla urceolata, alba, calyce paulo longior; laciniæ limbi obtusæ,
erecto-patulæ.
Stamina. Filamenta octo capillaria, apice inflexa. Antheræ ovatæ,
brunneæ, cristatæ, inclusæ.
Pistillum. Germen globosum, sulcatum. Stylus filiformis, exsertus.
Stigma tetragonum.
Habitat ad Caput Bonæ Spei.
Floret a mensi Junii, in Septembrem.

REFERENTIA.

1. Calyx, et Corolla.
2. Calyx, lente auctus.
3. Stamina, et Pistillum.
 4. Stamen unum, lente auctum.
5. Pistillum, lente auctum.

SPECIFIC CHARACTER.

Heath, with crested tips, within the blossom; shaft without; blossoms
globularly bell-shaped; flowers terminate the branches in small bunches;
leaves grow by fours, linearly three-sided, smooth and upright.

DESCRIPTION.

Stem upright, and branching; the small branches are numerous, upright,
and smooth.
Leaves grow by fours, linearly three-sided, upright, furrowed on the
under part and smooth; with very short foot-stalks, pressed to the branches.
Flowers terminate the branches, are a little bent downwards, and grow in
small bunches; the foot-stalks are thread-shaped, with three linear floral
leaves on them.
Empalement. Cup four-leaved, the little leaves are awl-shaped, keeled,
furrowed, smooth, and pressed to the blossom.
Blossom pitcher-shaped, white, and a little longer than the cup; the
segments of the border are blunt, upright and spreading.
Chives. Eight hair-like threads, bent inwards at the ends. Tips egg-
shaped, brown, crested and within the blossom.
Pointal. Seed-bud globular, and furrowed. Shaft thread-shaped and
without the blossom. Summit four-cornered.
Native of the Cape of Good Hope.
Flowers from June, till September.

REFERENCE.

1. The Empalement, and Blossom.

2. The Empalement, magnified.
3. The Chives, and Pointal.
4. A Chive, magnified.
5. The Pointal, magnified.
 ERICA Massonia.

CHARACTER SPECIFICUS.

Erica, antheris muticis, inclusis; corollis sub-cylindricis, viscosis,

speciosissimis, tricoloratis; foliis subquaternis, pilis longis vestitis.

DESCRIPTIO.

Caulis fruticosus, erectus, bipedalis, basi simplicissimus, dein ramosus,

rami suberecti, foliis toti tecti.
Folia subquaterna, oblonga, serrata, pilis longis vestita, supra plana,
subtus sulcata, petiolis brevissimis adpressis.
Flores subterminales, plures, simplice verticillati, cernuo-patenti,
pedunculi pilosi, foliolis tribus subtus instructi.
Calyx. Perianthium tetraphyllum, foliolis lanciolatis, hirsutis, adpressis,
apicibus revolutis.
Corolla subcylindracea, micans, viscosa, rubra, lutea et viridia
speciosissime colorata, ore arctato, quadrisido.
Stamina. Filamenta octo capillaria, longitudine tubi, receptaculo inserta.
Antheræ muticæ.
Pistillum. Germen clavatum, sulcatum. Stylus filiformis, subexsertus.
Stigma tetragonum.
Habitat ad Caput Bonæ Spei.
Floret a mensi Augusti ad Decembrem.

REFERENTIA.

1. Calyx et Corolla.
2. Calyx lente auctus.
3. Stamina et Pistillum.
 4. Stamina a Pistillo diducta, anthera una lente aucta.
5. Stylus et Stigma lente aucta.

SPECIFIC CHARACTER.

Heath, with beardless tips, within the blossom, which are nearly cylindrical,
clammy, most beautiful, and three-coloured; the leaves grow mostly by
fours, and are entirely covered with long hairs.

DESCRIPTION.

Stem shrubby, upright, grows two feet high, simple at the base, then
branching, the branches nearly upright, and quite covered by the leaves.
Leaves grow mostly by fours, oblong, sawed, clothed with long hairs,
smooth on the upper, and furrowed on the under part, having very short leaf-
stems pressed to the branches.
Flowers are numerous, in single whorls, near the summit of the
branches, bending downward, and spreading, the foot-stalks hairy, with three
small leaves fixed on their under part.
Empalement. Cup four-leaved, which are lance-shaped, hairy, pressed to
the blossom, and rolled back at the point.
Blossom nearly cylindrical, shining, clammy, and most beautifully
coloured with red, yellow, and green, narrow at the mouth, which is divided
into four segments.
Chives. Eight hair-like threads, the length of the blossom, fixed into the
receptacle. Tips beardless.
Pointal. Seed-vessel club-shaped, and furrowed. Shaft thread-shaped,
rather without the blossom. Summit four-cornered.
Native of the Cape of Good Hope.
Flowers from August till December.

REFERENCE.
1. The Empalement and Blossom.
2. The Empalement magnified.
3. The Chives and Pointal.
4. The Chives detached from the Pointal; one tip magnified.
5. The Shaft and its Summit magnified.
 ERICA melastoma.

CHARACTER SPECIFICUS.

Erica, antheræ muticæ, exsertæ, attenuata in filamenta plana; corollis

sessilibus, solitariis, luteis, terminalibus; oris laciniis nigris; calyx
duplicatus, heptaphyllus, imbricatus; foliis subulatis, quaternis.

DESCRIPTIO.

Caulis laxus, erectus, bipedalis; rami pauci, simplices; ramuli sparsi,

brevissimi, frequentissimi, foliosi.
Folia quaterna, subulata, apice, recurvata, sub-scabrida, rigida; petiolis
brevissimis, adpressis.
Flores sessiles in apicibus ramulorum, solitarii, dependenti; pedunculi
brevissimi.
Calyx. Perianthium duplex; interius tetraphyllum, foliolis concavis,
ovatis, glabris, imbricatis, integris, luteis; exterius triphyllum, priori
brevioribus, consimilibus.
Corolla conica, lutea, parum curvata, basi quadrifariam sulcata, apice
attenuata; laciniis erectis, obtusis, longissimis, adpressis, nigris.
Stamina. Filamenta octo, plana, linearia. Antheræ muticæ, lineares,
exsertæ, longitudine corollæ, attenuata in filamenta.
Pistillum. Germen ovatum, glabrum, integrum. Stylus exsertus,
filiformis, staminibus paulo longior. Stigma marginatum, virescens.
Habitat ad Caput Bonæ Spei.
Floret a Mensi Februarii, in Julium.

REFERENTIA.

1. Calyx.
2. Corolla, et Stamina.
 3. Stamina, et Pistillum.
4. Stamina a Pistillo diducta.
5. Stamen unum, lente auctum.
6. Pistillum, lente auctum.

SPECIFIC CHARACTER.

Heath, with beardless tips, without the blossom, tapering into the threads
which are flat; blossoms sitting close to the branches singly, are yellow, and
terminate them; the segments of the mouth are black; the cup is doubled, of
seven leaves and tiled; leaves awl-shaped, growing by fours.

DESCRIPTION.

Stem weak, upright, grows two feet high; the branches are few, and
simple; the small branches are scattered, very short, numerous, and covered
with leaves.
Leaves grow by fours, awl-shaped, bent back at the point, roughish and
stiff; foot-stalks very short, and pressed to the stem.
Flowers sitting on the ends of the smaller branches are solitary, and hang
down; the foot-stalks are very short.
Empalement. Cup double; the inner one has four leaves, which are
concave, egg-shaped, smooth, tiled, entire, and yellow; the outer three-
leaved, shorter than the former, and like them.
Blossom conical, yellow, slightly curved, having four furrows at the base,
and tapering at the point; the segments of the border grow upright, are blunt,
very long, pressed to the chives, and black.
Chives. Eight flat, linear, threads. Tips beardless, linear, without the
blossom, and of its length, tapering into the threads.
Pointal. Seed-bud egg-shaped, smooth and entire. Shaft without the
blossom, thread-shaped, a little longer than the chives. Summit bordered,
and greenish.
Native of the Cape of Good Hope.
Flowers from February, till July.
 REFERENCE.

1. The Empalement.
2. The Blossom, and Chives.
3. The Chives, and Pointal.
4. The Chives detached from the Pointal.
5. A Chive magnified.
6. The Pointal magnified.
 ERICA monadelphia.

CHARACTER SPECIFICUS.

Erica, antheris muticis, exsertis, attenuatis in filamenta plana. Corolla

conica, sanguinea, oris laciniis erectis, adpressis. Folia terna.

DESCRIPTIO.

Caulis erectus, sesquipedalis, scaber, ad basin parum ramosus. Ramuli

sparsi.
Folia terna, obtusa, sub-tomentosa, subtus sulcata, petiolis brevissimis
adpressis.
Flores in ramulis, bini vel terni, terminales, cernui, in medio ramorum
racemum formantes speciosissimum; pedunculis brevibus, bracteis nullis.
Calyx. Perianthium duplex, coloratum; exterius triphyllum, foliolis lato-
ovatis, apicibus virescentibus; interius tetraphyllum, foliolis latioribus
majoribus.
Corolla conica, sub-pollicaris, glabra, sanguinea; oris laciniis erectis.
Stamina. Filamenta octo plana, corolla multoties longiora, receptaculo
inserta; antheris muticis, exsertis, attenuatis in filamenta.
Pistillum. Germen ovatum, tenuissime sulcatum. Stylus filiformis.
Stigma tetragonum.
Habitat ad Caput Bonæ Spei.
Floret a mense Augusti in Decembrem.

REFERENTIA.

1. Calyx et Corolla.
2. Calyx lente auctus.
3. Stamina et Pistillum.
 4. Stamina a Pistillo diducta; antherâ unâ lente auctâ.
5. Stylus et Stigma lente aucta.

SPECIFIC CHARACTER.

Heath, with beardless tips without the blossoms, and tapering into filaments,
which are flat. The blossom is conical, of a blood colour, having the
segments of the mouth upright, and pressed to the threads. The leaves grow
by threes.

DESCRIPTION.

Stem upright, a foot and a half high, rough, branching but little at the
base. The smaller branches are scattered.
Leaves grow by threes, blunt-ended, rather downy, channelled
underneath, having very short foot-stalks pressed to the branches.
Flowers grow by twos and threes at the end of the smaller branches,
hanging down, forming a beautiful spike near the middle of the larger
branches. The foot-stalks are short, without floral leaves.
Empalement. Cup double, and coloured; the outer three-leaved, the
leaves of a broad oval-shape, the ends greenish: the inner is four-leaved,
broader and larger than the former.
Blossom cone-shaped, near an inch long, smooth, deep red; the segments
of the mouth upright.
Chives. Eight flat threads, much longer than the blossom, fixed into the
receptacle; the tips beardless, without the blossom, and tapering into the
filaments.
Pointal. Seed-vessel egg-shaped, and slightly furrowed. Shaft thread-
shaped. Summit four-cornered.
Native of the Cape of Good Hope.
Flowers from August till December.

REFERENCE.
1. The Empalement and Blossom.
2. The Empalement magnified.
3. The Chives and Pointal.
4. The Chives detached from the Pointal; one tip magnified.
5. The Shaft and Summit magnified.