See discussions, stats, and author profiles for this publication at: https://www.researchgate.net/publication/335857756 Segmentation and Detection of Acute Leukemia Using Image Processing and Machine Learning Techniques: A Review Article in AUS · September 2019 DOI: 10.4206/aus.2019.n26.2.60 CITATIONS READS 0 648 3 authors: Saif S Aljaboriy Nilam Nur Amir Sjarif Universiti Teknologi Malaysia Universiti Teknologi Malaysia 1 PUBLICATION 0 CITATIONS 18 PUBLICATIONS 42 CITATIONS SEE PROFILE SEE PROFILE Suriayati Chuprat Universiti Teknologi Malaysia 78 PUBLICATIONS 374 CITATIONS SEE PROFILE Some of the authors of this publication are also working on these related projects: Real time ETL system View project Segmentation and Detection of Acute Leukemia Using Image Processing and Machine Learning Techniques: A Review View project All content following this page was uploaded by Saif S Aljaboriy on 17 September 2019. The user has requested enhancement of the downloaded file. REVISTA AUS 26-2 / Saif S Al-jaboriy et al.,/ DOI:10.4206/aus.2019.n26.2.60/ www.ausrevista.com/ editor@ausrevista.com ๏จ ๏จ Recepción/ 27 junio 2019 Aceptación/ 25 agosto 2019 Segmentation and Detection of Acute Leukemia Using Image Processing and Machine Learning Techniques: A Review Segmentación y detección de leucemia aguda mediante técnicas de procesamiento de imágenes y aprendizaje automático: una revisión Saif S Al-jaboriy1,2, Nilam Nur Amir Sjarif1, Suriayati Chuprat1 Razak Faculty of Technology and Informatics, Universiti Teknologi Malaysia, Malaysia. 1,2 Razak Faculty of Technology and Informatics, Universiti Teknologi Malaysia, Malaysia; and also with Al-Musiab Technical College, Al-Furat Al-awsat Technical University, Babylon, Iraq. (e-mail: Ssaiff198@yahoo.com ; com.syf4@atu.edu.iq) ABSTRACT/ Leukemia is a blood cancer that affects the white blood cells in the bone marrow. The detection of acute leukemia is dependent on counting the white blood cells percentages in the peripheral blood. This kind of cancer can be a fatal disease if left without early detection. In practice, the manual microscopic examination methods are used for detection of acute leukemia. But these manual methods are inaccurate, prone to errors, and time-consuming due to human factors such as fatigue, stress, and lack of experience. Therefore, several of image processing techniques have been proposed to replace with the manual methods. The results of this study: various computer-aided systems for acute leukemia diagnoses are reviewed; these systems are including image acquisition, pre-processing, segmentation, extraction of feature, and classification. Also this paper provides the pros and cons of existing computer-aided methods with their accuracy. Key Words: Leukemia, image Acquisition, pre-processing, segmentation techniques, feature extraction Classification. ARTÍCULO RESUMEN / La leucemia es un cáncer de sangre que afecta los glóbulos blancos en la médula ósea. La detección de leucemia aguda depende de contar los porcentajes de glóbulos blancos en la sangre periférica. Este tipo de cáncer puede ser una enfermedad mortal si se deja sin detección temprana. En la práctica, los métodos de examen microscópico manual se utilizan para la detección de leucemia aguda. Pero estos métodos manuales son inexactos, propensos a errores y requieren mucho tiempo debido a factores humanos como la fatiga, el estrés y la falta de experiencia. Por lo tanto, se han propuesto varias técnicas de procesamiento de imágenes para reemplazar con los métodos manuales. Los resultados de este estudio: se revisan varios sistemas asistidos por computadora para el diagnóstico de leucemia aguda; Estos sistemas incluyen adquisición de imágenes, preprocesamiento, segmentación, extracción de características y clasificación. Además, este documento proporciona las ventajas y desventajas de los métodos asistidos por computadora existentes con su precisión. Palabras clave: leucemia, adquisición de imágenes, preprocesamiento, técnicas de segmentación, extracción de características Clasificación 511 1. Introduction The human body contains several parts that complement each other in the performance of life functions. Blood is one of the most critical parts of the human body that helps to pass minerals and oxygen to all parts of the body. It also maintains body temperature; as well as protects the body through antibody production. There are three essential components in blood, namely white blood cells (WBC), red blood cells (RBC), and platelets [1]. Blood can be infected with various diseases that lead to body dysfunction and thus affect the life and health of humans. Some of these diseases are not very serious and are treatable such as anemia, and others are very serious and not easy to treat such as leukemia. Leukemia is a type of blood cancer that attacks the bone marrow, which is characterized by an increase in the number of REVISTA AUS 26-2 / Saif S Al-jaboriy et al.,/ DOI:10.4206/aus.2019.n26.2.60/ www.ausrevista.com/ editor@ausrevista.com widely used for diagnosing the existence of acute leukemia. Essentially, the microscope images involve both normal and abnormal blood cells images. Despite extensive research, the accurate detection and classification of acute leukemia by using image-processing techniques remains challenging. The reasons are due to the variation of size, shapes, locations, and image intensities for various kinds of acute leukemia [19,20]. The detecting of leukemia using image processing and computer vision techniques consists of five stages, which include image acquisition, pre-processing image, WBCs segmentation, feature extraction, and classification of leukemia cells. Fig 1 shows the stages of detection of leukemia [21]. Fig1. Illustrate the stages of detection leukemia This aim of this study is to presents a detailed review of computer systems that used to detect and diagnosis acute leukemia (AL). This paper is organized as follows: describes the related work that is divided into five steps with description each method followed by the literature survey about leukemia. Then, the techniques used for segmenting and detecting acute leukemia will also be discussed. 2. Related research Various researchers have proposed many techniques in the field of medical image processing. The majority of the researchers' work is to find an optimal technique to help the hematologists to detect acute leukemia early. The major steps for diagnosis of acute leukemia using image processing and machine learning techniques involves pre-processing of the medical images, segmentation (extract the blast cells from the rest of image), feature extraction, and then classification. These steps are interrelated to each other, and the success of the step will reflect on other steps. In this section, we provide a survey of various methods that have proposed for develop an automatic system that used to detection of acute leukemia cell by image processing. 2.1 Image acquisition The detection of acute leukemia disease through microscopic medical blood image begins with the peripheral blood images acquisition phase. At this stage, the medical ARTÍCULO immature WBCs named ‘blasts cells’. Leukemia can be classified into two types which are acute leukemia and chronic leukemia [2]. This research focuses on the acute type of leukemia. In acute leukemia, the abnormal WBCs called immature blasts cells malfunction, where it grows very quickly, and the condition of the patient becomes very dangerous if it not controlled quickly. Acute leukemia infects the bone marrow and progresses very fast. This kind of cancer can infect children and adults too; as this disease can develop many abnormal WBCs in their body [3,4]. Acute leukemia can be classified into two types that include acute lymphoblastic leukemia (ALL) and acute myeloid leukemia (AML) based on a French– American–British model. ALL is one of the acute leukemia types that negatively affect the lymphocytes (WBCs that fight infection). The bone marrow produces a number of blasts cells that develop quickly to be lymphocytes [5]. This condition is fatal if left untreated because it quickly spreads; the early diagnosis of ALL is essential for saving patients’ life and for recovery [6-8]. ALL occurs when the white blood cells have yet to completely mature. While in the case of AML, the immature white blood cells are unable to fight infections [11,12]. The detection of acute leukemia in different types is essential for early diagnosis and drug discovery [13,14]. The diagnosis of acute leukemia is dependent on counting the percentages of blasts cells in the blood. Manual microscopic examination of the blood smear is less accurate and time-consuming [9,15,16]. Acute leukemia diagnosis requires tools and automated solutions, and the ability for early detection [17]. Therefore, the image processing and computer vision systems can play an important role in diagnosis of such types of these medical problems. In this case, the system uses to examine the blood sample automatically in order to overcome the limitations of manual examination. Can be built these type of systems with use the microscopic images to recognize types of acute leukemia cells. Using these types of systems will reduce the time and effort and increase the accuracy of the diagnosis [10]. The detection and classification of leukemia depend on color, texture, size, and shape of WBCs image [18]. Medical images provide useful information about normal and abnormal blood cells. Presently, the microscope images are most 512 ARTÍCULO REVISTA AUS 26-2 / Saif S Al-jaboriy et al.,/ DOI:10.4206/aus.2019.n26.2.60/ www.ausrevista.com/ editor@ausrevista.com 513 blood images samples are captured from the bone marrow by a camera to obtain digital data that is used to test a proposed technique. The light is one of the factors that has an effect on the blood images, where the light determines the quality and clarity of the images. Thus, the pre-processing of the images consists of the variety of techniques that are used to change the domain of images to another domain (this will be described in detail in the next section) to be more easily handled by the proposed systems [18,19]. Many researchers tested and evaluated their systems with a few samples of blood images, which are not available publicly. Therefore, they could not compare their findings with other researchers’ results. Hence, many researchers used a public dataset that is available online such as ALL-IDB1 (These kind of samples were captured and collected by experts at the M. Tettamanti Research Centre in Monza, Italy).This is an example of section. 2.2 Pre-processing image Enhancing medical images is an important and complex step in computer vision, machine learning and image processing techniques because it used to improve the quality of an image. Many medical images types (e.g. MRI, microscope image, ultrasound Image, Nuclear medicine, and others) are used to develop diagnostic systems [20]. Many authors have enhanced the blood image by converting to another domain such as convert RGB to HSV or to HSL domain to highlight the features of objects for efficiently detecting an interesting area [21]. Many factors can affect the quality of images such as low contrast, false background, and pepper noise. These kinds of noises may occur because of the camera and light condition during the capture of the images. Currently, various techniques have been proposed and suggested by Authors to detect and enhance these kinds of factors in order to make the blood images suitable for segmenting region of interest (ROI) [22]. Histogram equalization is one of the techniques that used for adjust the images contrast. This technique is suitable to improve and enhance the dark background and blood image contrast [6,73]. Another technique is linear contrast that also used to improve and enhance the quality of the blood images by increasing the contrast; this technique also known as normalization of an image [7, 8]. In addition, many proposed techniques are used the minimum filter to highlight the lighter object, which can easily recognize during the segmentation process [10,72]. All the technique that have been mentioned contain disadvantages such as vulnerable to noise, useful with image has low contrast, cannot perform with blood images that having high percentage of noise, i.e. led to remove some detail from the image, and so forth. Therefore, researchers need to find and propose new techniques for enhancing image quality. 2.3 Segmentation image Understanding the digital images or extracting the information from some regions in the image is one of the most crucial tasks in image processing techniques. The first step in detecting an object in the digital image is image segmentation. In practice, image segmentation is one of the important bases for the recognition of the region of interest in the image, and it is considered a hotspot in the image processing, computer vision and machine learning techniques [5,20,71]. Fig 2: WBCs segmentation methods. The segmentation stage has divided an image into a number of objects that have the same features based on certain criteria in order to extract the area of interest. Many authors have been proposed different techniques to segment blast cells (AML and ALL) from the rest of the blood image as depicted in Figure 2; but the results of these techniques could not produce ideal segmentation for the complex blood cell images. In addition, many factors made the segmentation of WBCs from the rest of image a challenging process (e.g., the light, contrast, and quality of medical images) [22,70]. Generally, different features in the medical blood image can be used at segmentation stage such as color, shape, and texture and level intensity. REVISTA AUS 26-2 / Saif S Al-jaboriy et al.,/ DOI:10.4206/aus.2019.n26.2.60/ www.ausrevista.com/ editor@ausrevista.com ………… (1) Where the ๐ผ is the original image in grey mode and the ๐ is the image pixel value. And the ๐ผ' is conceder as binary image. The advantage of this method is the operation speed is faster, and the calculation is simple; especially, when the target objects have high contrast. Nevertheless, the disadvantage of this method is it is difficult getting the accurate results; especially when there is a large overlap of the gray-scale or no significant gray-scale difference in the image. It is also sensitive to gray-scale unevenness and noise in the image. Therefore, it needed to be combined with other methods to get better performance [26]. 2.3.2 Regional growth The regional growth method is one of the conventional region segmentation algorithms that segment an image based on the similar properties of the pixels in order to get the target objects [27]. This method requires two main steps that include selecting a seed pixel and merging all the pixels that have similar properties, and they are located around the seed pixel. Its basic formula is as follows: ๐ a) ๐๐=1 ๐ ๐ = ๐ . b) ๐ ๐ is a connected region, i = 1, 2, 3, . . . , n c) ๐ ๐ ∩ ๐ ๐ = ๐ for all ๐ = 1, 2, . . . , ๐. d) (๐ ๐) = TRUE for ๐ = 1, 2, . . . , ๐. e) (๐ ๐ ∪๐ ๐) = FALSE for regions of ๐ ๐ and ๐ ๐. (a) Every pixel is part of the same region in the image. While in (b) all the pixels should be connected to each other in the region; (c) all the region disjoint each other. The (d) are the properties that are true or false with some criteria. While in (e) all regions different with predicate ๐ 2.3.3 Clustering In clustering method, there is a difference between the pixel and the cluster center in the blood image that depends on the density, location, or other factors such as the K-means clustering algorithm that is used to divide a digital image according to the distance. The process of implementing the K-means clustering technique is expressed as follows: (1) Randomly select the initial K clustering centers value, (2) Calculate the distance from each cluster center to each sample to return the sample to the nearest center, (3) For each cluster, the mean of the samples is connecting with the new clustering centers [28]. The advantage of this method is the algorithm is simple and fast, and it is effective when used with large datasets. In addition, it is close to linear with the time, and thus it is suitable for large-scale data sets. Mathematically it can be defined as: Where each of the ๐ฅ๐ will be assigned to one (๐ก).While the centroid of the calculate the new mean in the cluster. It can be defined as following: The disadvantage of the clustering method is it is difficult to estimate the K clustering number; where there is has no explicit selection criteria [28]. Secondly, this method is currently very expensive because of the iteration. Finally, the clustering algorithm is a partitioning method that depends on the distance [29]. 2.3.4 Watershed Segmentation Watershed segmentation technique that starts from the initial pixel (marker) and then deluges all the neighboring pixels of that marker, which known as basins. These basins ARTÍCULO 2.3.1 Thresholding Threshold segmentation is one of the simplest and most common segmentation algorithms that divide an image based on the gray-scale value to get the target objects. It can be classified this methods into two techniques that include the local threshold and global threshold techniques such as Otsu's method, maximum entropy method, and others. The local threshold technique divides an image into multiple objects and background by implementing multiple thresholds. While in the global threshold technique, an image can be divided into two target regions and the background by implementing a single threshold [23,24]. This technique works with a threshold value; if the image intensity values are less than the threshold values, the all values will be zero (black color). While if the intensity level values are greater, then the intensity values will be one (white color). Thus, these operations will generate the image in binary mode and will help to get a better image understanding [25]. Mathematically, the technique can be written as follows: 514 REVISTA AUS 26-2 / Saif S Al-jaboriy et al.,/ DOI:10.4206/aus.2019.n26.2.60/ www.ausrevista.com/ editor@ausrevista.com are partition the markers into di๏ฌerent regions using the watershed technique [30]. Watershed technique used in the medical image because of the objects (e.g. WBCs) in the images are overlapping; therefore, Authors need this kind of algorithms to separate the overlapping objects and get more accurate classi๏ฌcation results. Although the watershed segmentation technique is suitable for parallel processing, it can produce oversegmentation. Nevertheless, many studies have been used the marker-controlled watershed for segmenting the acute leukemia cells [31]. In marker-controlled watershed segmentation technique, the boundaries can be de๏ฌned between external that manually de๏ฌned according to ROI and internal markers that automatically obtained. This method will help to solve the over-segmentation problem [41]. Mathematically it can be written as Where the LS (๐ฅ) is lower slope of image ๐ผ in ๐ฅ pixel and the (๐ฅ) are neighbor pixels. While the (๐ฅ, ๐ฆ) is the watershed distance. If ๐ = ๐, then the LS will be zero. 2.3.5 Morphology Morphology is a technique used to extract components (ROI) from the medical image for better description of the regions details [32]. It is deals with the shape of the objects in an image using specific operations. The basic idea of morphology technique is move a small shape that known as the structuring element over the medical image so that can get the desired result [33]. The morphological include four operators, which are the dilation ⊕, erosion โ, opening, and closing. Can define erosion โ and dilation ⊕ of a binary image as the following: ARTÍCULO Where the E is binary image and S is the structuring element. 515 The opening of an image is erosion followed by dilation of a binary image as the following: The closing of an image is dilation followed by erosion of a binary image as the following: In acute leukemia detection, many researchers have been used the morphological operation for segmenting the blast cells. Where it used to enhances the blast cells by filling gaps and removing the pepper noise from the cells [34]. 2.4 Feature Extraction Feature extraction (FE) is one of the most important and critical stages of the image processing techniques. This stage used to extract and identify the features derived from the objects that were segmented from parts of the image or from the whole image. In other words, transforming the data that is obtained from the image into the set of features for pattern recognition is called feature extraction. One of the important issues related to pattern recognition is choosing the relevant set of features extraction in order to extract the relevant information to perform the task and get accurate information. The features extraction have been used in many applications such as leukemia detection, character recognition, reading bank deposit slips, applications for credit cards, tax forms, data entry, check sorting and others [35]. Many features can be extracted from the objects in the image, such as the shape features (e.g. area, perimeter, solidity and others), Texture Features (e.g. homogeneity, energy, angular second, entropy contrast, and others), Statistical Features (e.g. mean, skewness and, variance), Geometrical features (e.g. perimeter, area, compactnes and symmetry), color features and so forth [36]. In acute leukemia detection, the features extraction stage plays an important role in determining the leukemia type because blast cells (ROI) have a lot of information that included characteristics of nucleus and cytoplasm [53]. There are different features have been extracted in the current studies as shown in Figure 3. The results of feature extraction stage will be useful for the classification stage (next stage). Fig 3: Features extraction techniques. Feature extraction and feature selection are crucial steps for image processing and machine learning techniques. How to extract and select the ideal features is still a challenging problem in image processing. Hence, in this paper, we survey image feature representation techniques that are used to extract and select the features from the blast cell image and then determine whether the blast cells are cancerous or otherwise. 2.4.1 Color feature Color feature is one of the most important relevant information that fetching from the objects in the image. It is defined based on a particular model or color space. There are a number of color spaces such as LUV, HSV, RGB and others that have been used to make extracting the features easier. Therefore, Color features are useful for extraction the information from the blood cells image for better classification. [37,38]. 2.4.2 Texture feature Texture feature is a useful characterization for an image, where pixel properties are used to measure the color in the image while the group of pixels is used to measure a texture. Two techniques are used to extract the texture features based on the domain, which include the spectral texture feature extraction and spatial texture feature extraction. In the spectral texture feature extraction approach, an input image is transformed into the frequency domain, and the texture feature from the transformed image is then calculated. While in the spatial approach, the extracting features have been accomplished by computing the statistics of a pixel in the original image domain[39,40]. In the blood smear images, the texture is an important feature that used to identify the blast cells by analyzing that features to get the ROI, which can help to obtain better classification. 2.4.3 Shape features Shape feature extraction technique is one of the key methods in feature extraction field. It can be classified into two groups, which include the region-based and contour-based methods. In the contour-based method, the shape features are calculating from the boundary of the shape only, while in the region-based method, the features are extracting from the whole region in the image. Shape features play an important role in acute leukemia cell detection [41,42]. 2.5 Feature Selection Features selection (FS) is one of most important technique used to selecting the more relevant features from the objects in the image processing. In this case, the algorithms will select a subset of relevant features, which will help to increase the accuracy and thus this process will reduce the cost of computational [43,44].Therefore, feature selections algorithms will compare all features that are extracted from the blood smear images and then selecting the most relevant features. Different techniques are used for leukemia cells detection such as PCA (Principal Component Analysis), GA (Genetic Algorithm), and PPCA (Probabilistic Principal Component Analysis) techniques [45]. 2.6 Classification The stage of classification is one of the most important stages in image processing and machine learning techniques, and it is an indemand field in this area. Classification is used to assign and classify a set of unclassified data. There are two types of classifiers that are known as supervised and unsupervised classifications. In the supervised classification, the set of possible results or classes are known in advanced. While in the unsupervised classification, the set of classes are unknown in advance. Many methods can be used to form a classification of data that are known as the classifiers. These classifiers can be used to classify objects types, such as support vector machine (SVM), Artificial Neural Network (ANN), Random forest (RF), KNN (๐พ-Nearest Neighbor), Naive Bayes (NB), Multilayer Perceptron (MLP),Hybrid and others, as summarized in Figure 4 [49]. Once the features are selected and extracted from the segmented image, the object's type is recognized and determined through this stage. ARTÍCULO REVISTA AUS 26-2 / Saif S Al-jaboriy et al.,/ DOI:10.4206/aus.2019.n26.2.60/ www.ausrevista.com/ editor@ausrevista.com 516 REVISTA AUS 26-2 / Saif S Al-jaboriy et al.,/ DOI:10.4206/aus.2019.n26.2.60/ www.ausrevista.com/ editor@ausrevista.com ARTÍCULO 2.6.1 Support vector machine (SVM) In machine learning and image processing techniques, the support vector machine (SVM) also known as the support vector network [46,47]. It is a supervised learning model that analyzes the data to use for both classification and regression tasks. The main objective of the SVM algorithm is to find a hyper-plane in N number of features that classify the data points. The SVM classifier separates the classes based on the labeled training data. The main objective of the separate classes is to find the maximum margin, i.e., find the maximum distance between the classes. The maximizing distance provides a capability that can classify future data points with more confidence. The SVM classifier is seeking to find the compromise between the complexities models according to the training data (limited sample information). This type of classifier is suitable for small samples of circumstances. The SVM classifier algorithm provides four types of the kernel that include: (1) Sigmoid, (2) Radial Basis Function, (3) Polynomial and (4) Linear [50]. The main reason for selecting SVM for detection of leukemia cell is the efficiently classify between the normal and abnormal cells [74]. 517 Fig 3: Classification methods for acute leukemia. 2.6.2 Artificial neural networks Artificial neural network (ANN) is a type of artificial intelligence inspired by imitating the functions from the human brains. In other words, ANN is an interconnected set of virtual neurons that created as the computer systems that work similar to a biological neuron (electronic probes designed to emulate neurons). Generally, it consists of a set of communication nodes that are known as neurons, which are connected to form a network of neurons. Each contact between these neurons has a set of values called weights that can contribute to determining the values that are produced by each node of the network based on the values of this node [48]. The ANN is a framework that has a different machine learning algorithm that works together to process complex data. These types of algorithms depend on the learning to perform different tasks by using examples that being programmed for a similar task, i.e., working based on the learning. For example, in the recognition pattern, the systems learn by analyzing example images to identify other images such as to identify the image that contains flowers by analyzing some of the flowers images that are manually labeled as "flower" or "no flower”. The systems automatically generate some of the characteristics from the learning material to identify those objects [49,50]. 2.6.3 K-Nearest Neighbor K-Nearest Neighbor (KNN) is a classifier technique that widely used, where it uses the nonparametric to classify data. In this algorithm, the data are classified by voting from the nearest neighbors. Based on this voting, the objects in the image will be assigned to relevant classes. For acute leukemia cell classification, the KNN algorithm is used to get better classification result to determine if the cells are normal or abnormal [75]. 2.6.4 Random Forest Random forest (RF) is a classifier that uses an ensemble learning to classify an object from the vector. It contains different tree combinations, which perform voting for the class, and then selection will be the class who has a maximum vote [76]. The RF preferred by the researcher because it corrects the overfitting problem. For acute leukemia detection, the RF classifier has been found to be suitable for detection of normal and abnormal cells [77]. 2.6.5 Naive Bayes Naive Bayes (NB) is a classifier that is used to classify data based on the features values in the image that are independent of the other values [51]; also, the Naive Bayes can be called as simple Bayes. For acute leukemia detection, the NB has utilized in current studies, where it used to classify the WBCs and determine if the cells are normal or abnormal [52]. 3. Leukemia literature survey The literature discusses the methods that are used to segment and detect acute leukemia using machine learning and image processing techniques. In this case, the methods detect acute leukemia using the microscope blood sample, whereby the process of detection of acute leukemia cells can be divided into four stages that include: ๏ท Pre-processing blood image ๏ท Blast cells Segmentation ๏ท Feature Extraction of the blast cell ๏ท Detect and Classify the blast Cell The steps of pre-processing, segmentation, feature extraction, and classification techniques are presented in this paper. All of these steps are important in detecting leukemia by using machine learning and image processing techniques. The success of each step in the detection of acute leukemia depends on the previous step. The work by [23] has proposed several phases to diagnosis and detect acute lymphoblastic leukemia from the rest of blood images. This technique has included blood image acquisition using public dataset (ALL-IDB), the segmentation of the WBCs is accomplished by a marker-based segmentation, and the features are extracted from the segmented WBCs using gray level co-occurrence matrix (GLCM) with using Probabilistic Principal Component Analysis (PPCA) to reduce and obtain the relevant features. This study proposed the RF classifier to determine if the cells are normal or abnormal. While the work by [53] introduced a new approach for detection of acute leukemia, which includes: firstly, preprocessing stage by converting RGB to a gray-scale image and then performs a histogram equalization to improve and enhance the image quality to highlights the contrast of nucleus; secondly, using morphological contour segmentation by edges detection of WBCs, and using HSV conversion with erosion to segmenting the blast cell; thirdly, extracting the features of the blast cell such as geometry, color and texture features; Finally, classify the acute leukemia cells using Fuzzy C-means clustering technique. The work by [54] has proposed the Barebones Particle Swarm Optimization (BBPSO) technique to diagnosis acute leukemia. This technique has consists of the following steps: 1) Segmenting the WBCs from the rest of blood image background using the watershed technique, 2) Nucleus-cytoplasm separation phase using a stimulating discriminant measure (SDM)-based clustering, (3) Extracting the features such as the statistics, texture and shape features, 4) Classification phase using three techniques: 1-Nearest Neighbour (NN), Radial Basis Function (RBF) and Support Vector Machine (SVM). The work by [55] has presented a new technique used for detection of acute leukemia using image processing. The proposed technique is performed by using several phases. Firstly, the pre-processing by removing the noise from the images using median filtering technique followed by unsharp masking technique and then converting the blood images from RGB to HSV color space mode. Secondly, segmenting the RIO using the thresholding technique (i.e. Otsuโs method). After that, the features (shape and texture features) are extracted from the RIO that has been segmented to classify the cells whether is cancerous or healthy by the Support Vector Machine (SVM). The work by [18] has presented the segmentation of WBCs using Fuzzy C-Means clustering for diagnosis acute leukemia. In this method, the authors are collected the images from the net, and then the noises are removed using median filtering technique. In addition, enhanced the contrast image using the histogram equalization techniques. In this work, the blast cell is segmented using Fuzzy C-means, and then the features (statistical, texture, and color) are extracted from the ROI to classify the cells using the SVM. The work by [57] has proposed the hybrid hierarchical techniques to detect acute leukemia. In this technique, the segmentation of the blast cell by applying the global thresholding with a Morphological opening on the image. In the next step, the features (e.g., shape and texture) are extracted from the segmented blast cell, and then these features are reduced using Principal Component Analysis (PCA). Finally, the probabilistic neural network, SVM, K-NN, adaptive neuron-fuzzy inference system for the classification of the WBCs on the features that have been extracted. Table 1 shows the summary and comparisons between the four steps algorithms that are used to detection acute leukemia. ARTÍCULO REVISTA AUS 26-2 / Saif S Al-jaboriy et al.,/ DOI:10.4206/aus.2019.n26.2.60/ www.ausrevista.com/ editor@ausrevista.com 518 REVISTA AUS 26-2 / Saif S Al-jaboriy et al.,/ DOI:10.4206/aus.2019.n26.2.60/ www.ausrevista.com/ editor@ausrevista.com Table 1. Shows the Summarizes of current methods Performance Author, Year Methods - Preprocessing J. Su , et al 2017 [7] Segmentation This technique used k-means cluster, and builds cell images to represent-ing model by HMRF (Hidden-Markov Random Field) Feature Extraction Classification - Preprocessing Histogram green color of RGB component that has most contrast information Segmentation Using K-means clustering technique S. Negm, et al 2017 [58] Geometry features, statistics features, textures features and size ratio from regions selection (Nucleus, cytoplasm, and whole cell). Feature Extraction Preprocessing Segmentation Feature Extraction classification Preprocessing Segmentation ARTÍCULO W. Srisukkham, et al 2017 [54] 519 Feature Extraction classification S. Mishra, et al 2017 [23] Preprocessing STRENGTHS: this method has improved the segmentation results in both of the whole and cropped images WEAKNESS: K values are difficult to estimate and not suitable for non-convex clusters. STRENGTHS: This technique got good accuracy by detect ALL cells and separate overlapping cells. Accuracy This technique achieved a segmentation accuracy 96% (average) and it is compared with a manual segmentation that per implemented by an expert and other existing methods The technique achieved the following accuracies: The accuracy technique is 99.517%. The sensitivity accuracy is 99.348%. WEAKNESS: K values are difficult to estimate and it not suitable for non-convex clusters. The specificity accuracy is 99.529%. Artificial Neural Network (ANN) classification J. Rawat. , et al, 2017 [8] STRENGTHS And WEAKNESS Convert RGB image into gray scale image. Then enhance the blood image quality using histogram equalization STRENGTHS: This method used GAGaussian with radial basis kernel (RBF) for classify acute leukemia Divide the image to sub-images and used Thresholding using Otsu’s technique WEAKNESS: - need high contrast between the objects and background - It is very sensitive to gray-scale unevenness and noise in the image This method used the statistical, texture , and geometrical features This method got accuracy for the classification of leukemia cells 99.5% . The accuracy for the FAB subtypes of ALL is 97.1%. The accuracy for the FAB subtypes of AML is 98.5% genetic algorithm GA-Gaussian radial basis kernel converted the image to Sub-images Using marker-controlled watershed to getting the blast cells Particle Swarm Optimization (PSO), Dragonfly Algorithm (DA)and Cuckoo Search (CS) STRENGTHS: this method has good performance by using marker-controlled watershed with Particle Swarm Optimization SVM WEAKNESS: - over segmentation - sensitivity to noise using histogram equalization and weiner filtering to enhance blood images STRENGTHS: marker-based watershed segmentation algorithm This technique achieved the performances of 94.94% and 96.25% as accuracy The presented method achieved results as following : The segmentation accuracy , 96.29% REVISTA AUS 26-2 / Saif S Al-jaboriy et al.,/ DOI:10.4206/aus.2019.n26.2.60/ www.ausrevista.com/ editor@ausrevista.com Segmentation By using marker-based watershed segmentation scheme to separate the overlapping cells Feature Extraction gray level co-occurrence matrix (GLCM) and the probabilistic principal component analysis (PPCA) is used to extract the relevant Feature reduction Preprocessing T. Karthikeyan, et al 2017 [18] Feature Extraction Gabor Texture Extraction method is used to extract color Features Segmentation A. Gajul, et al 2016 [56] Feature Extraction classification Preprocessing Segmentation M. Sukanya, et al 2016 [60] Feature Extraction classification K. ElDahshan, et al 2015 [59] -Image acquisition -Noise removal using Adaptive median filter -Contrast enhancement using histogram equalization Fuzzy c- means clustering Preprocessing Preprocessing Segmentation WEAKNESS: - over segmentation - sensitivity to noise Random Forest (RF) technique Segmentation classification The classification accuracy is 99.004% STRENGTHS: this technique got high accuracy by used Fuzzy c-mean with SVM WEAKNESS: - determination of fuzzy membership is complex. - Sensitive to the noises in images. - Computationally expensive due to long time. The Fuzzy c-means method gives 90% as accuracy Support Vector Machine (SVM) Convert RGB image to CIELAB L*a*b* color space. k-means clustering -Hausdorff Dimension (HD - Local Binary Pattern (LBP) -Shape Features: -GLCM Features: -Color Feature: Cell Energy STRENGTHS: This good technique to detect AML and separate the overlapping cell by using K-mean clustering with SVM WEAKNESSES: - K values are difficult to estimate - time consuming - it is not suitable for non-convex sclusters. This technique achieved result as following : -Sensitivity 71.43 % -Specificity 100 % -Precision 100 % -overall classification performance of 83.33 % support vector machines (SVM) Convert RGB image to CIEL*a*b color space K-Means Clustering. This technique used the edgetexture feature, Discriminative Robust Local Binary Pattern (DRLBP) and Discriminative Robust Local ternary Pattern (DRLTP) STRENGTHS This technique used K-Means Clustering with DRLBP and DRLTP to gives a perfect decision about the disease. This technique presented system performs well WEAKNESS: - K values are difficult to estimate - time consuming - it is not suitable for non-convex sclusters. support vector machines (SVM) Convert RGB to HSV color space STRENGTHS: This technique used the FPGA with Xilinx for segmentation - ARTÍCULO classification is used to segmentation and separation overlapping cells and it is achieved good accuracy 520 REVISTA AUS 26-2 / Saif S Al-jaboriy et al.,/ DOI:10.4206/aus.2019.n26.2.60/ www.ausrevista.com/ editor@ausrevista.com -FPGA pre-processing -Xilinx models for FPGA segmentation -FPGA post-processing Feature Extraction - classification Preprocessing G. Patil, et al 2015 [55] Segmentation Feature Extraction Shape features and Densitom-etric features: Energy, GLCM, Correlation Preprocessing .T. Madhloom, et al 2012 [61] convert the image from RGB color space to HSV domain and perform the median filtering This method have used the Thresholding is done by Otsu’s method with bounding box technique to getting sub-image classification Segmentation This technique used CIELAB Color Space, Transform to HSV Color Space and extract (H) Channel Marker- Controlled Watershed and SRG algorithm - classification Segmentation L. Putzu, et al 2014 [21] Feature Extraction ARTÍCULO classification 521 M. MoradiAmin , et al 2015 [12] Preprocessing Segmentation STRENGTHS: Its fast ,simple and got good result WEAKNESS: - need high contrast between the objects and background -it is very sensitive to gray-scale unevenness and noise in the image Support Vector Machine(SVM) Feature Extraction Preprocessing WEAKNESS: - over segmentation - sensitivity to noise Convert the images from RGB to CMYK colour model, then perform the Histogram equalization to improve the image quality threshold with Zack algorithm, and then separation of overlapping cells by watershed segmentation technique with Solidity to remove the nois -shape features -color features -texture features STRENGTHS this method give good accuracy for segmentation by using Marker-Controlled Watershed and SRG algorithm This technique presented segmentation results of 96% accuracy WEAKNESS: - over segmentation - sensitivity to noise STRENGTHS: this technique achieved good accuracy by using the Zack algorithm with SVM . Using this technique achieved the results as following : WEAKNESS: - over segmentation - sensitivity to noise - need high contrast image as accuracy from 33images is 92% identification of ALL, with an accuracy 93% and sensitivity 98% support vector machine (SVM) Convert RGB to HSV Color space, and then Histogram equalization on V band By using fuzzy c-means clustering and then using watershed algorithm to separate overlapping objects STRENGTHS: This technique achieved a good accuracy by used fuzzy c-mean with SVM .Also its success to find the sub-type of ALL. The presented method achieved results as following : The sensitivity , 98% The specificity 95 % The classification accuracy is 97% REVISTA AUS 26-2 / Saif S Al-jaboriy et al.,/ DOI:10.4206/aus.2019.n26.2.60/ www.ausrevista.com/ editor@ausrevista.com classification support vector machine (SVM) 4. Analysis and Discussion A survey of image processing techniques that are used for segmentation and classification of acute leukemia cells have presented in this paper. Moreover, we have discussed the techniques and methods that have used in previous works. To check how the previous works were implemented and compared these methods to the manual methods for leukemia cells detection. These studies focused on the results of each following steps: preprocessing, segmenting, features extracting, and then the detection of acute leukemia. The computerized methods are more reliable, accurate, and efficient compared to the manual techniques that were time-consuming and less efficient. In the segmentation stage, many techniques have been proposed by previous studies to obtain the ideal results for segmenting and detecting of acute leukemia cells. The higher results of this phase were achieved using a marker-based watershed technique to segment and separate the overlapping cells with 96.29% of accuracy. In addition, the researchers also use some of the segmentation techniques such as Fuzzy CMeans and K-Means, thresholding, watershed, HSV color based and others to segment the blast cell accurately. Most of these methods have difficulties in segmenting complex blood images due to some major shortcomings, such as lack of contrast between objects and background and sensitivity to noise in images. Therefore, it is indispensable to develop an effective technique for segmenting blast cells from peripheral blood smears. In addition, the scientists are still seeking for a more accurate technique to segment the blast cells. In the phase of feature extraction, various features used include the color, geometrical and texture features. The numbers of the features are numerous; therefore, it is better to make the feature selection by using T-SNE, LDA or PCA. Fisher's Discrimination Ratio (FDR) can also be used followed by Exhaustive Search (ES) to obtain the best extraction features. WEAKNESS: - determination of fuzzy membership is complex. - Sensitive to the noises in images. - Computationally expensive due to long time. The work by W. Srisukkham, et al [54] have divided the image to Sub-images for preprocessing of blood smear images and then marker-controlled watershed was used to detect and segment the blast cells and after extracting features using Particle Swarm Optimization (PSO), Dragonfly Algorithm (DA) and Cuckoo Search (CS); the SVM was used for detection and classification of blasted cells. This method able to achieve 94.94% as accuracy result. While the work by S. Negm, et al [58] have improved the accuracy to 99.517% using Histogram green color of RGB component for preprocessing of blood smear images and then Using K-means clustering technique was used to segment the blast cells and after extracting features using Geometry features, statistics features, and textures features; the Artificial Neural Network (ANN) was used for detection and classification of blasted cells. In the classification phase, different techniques were carried out by researchers to obtain the accurate results, where the ANN and SVM techniques were the most accurate. Moreover, the detection phase was dependent on the previous stages (segmentation and feature extraction). The studies that used Support Vector Machine (SVM) have presented higher accuracy compared to other classifiers. Moreover, other studies also found the Fuzzy logic-based classifier was greater than SVM in terms of accuracy. Therefore, it is indispensable to develop an effective classifier to detect blast cells from peripheral blood smears images. After we have analyzed the previous techniques, we have come to the main point: the scientists still need to seek for a more accurate technique to detect acute leukemia cells. Acute leukemia detection is a very sensitive issue and it is related to humans health. Therefore, the Accuracy of diagnosis process should be flawless in order to replace human operators with computerized diagnoses. But the replacement is a very challenging task because the complexities of blood cells are high. 5. Limitations ARTÍCULO Feature Extraction - geometric feature for size and shape of a nucleus - statistical features for gray scale image histogram 522 ARTÍCULO REVISTA AUS 26-2 / Saif S Al-jaboriy et al.,/ DOI:10.4206/aus.2019.n26.2.60/ www.ausrevista.com/ editor@ausrevista.com 523 Although the database of sources that we have used are reliable; but the identification was difficult. Moreover, the timeliness of this study was one of limitations because of the increasing progress in this area. In addition, the response of the researchers to this field is the objective of this review. 6. Conclusion Many studies have been presented in this paper. These studies were conducted for the segmentation and detection of acute leukemia by using image processing and machine learning techniques. Image processing techniques can be easily and rapidly diagnose leukemia, and this increases the chance of patients to be saved and allowing them to be given the appropriate treatment. Image processing and machine learning techniques may replace blood analysis experts in the detection and classification of leukemia in terms of accuracy and time. In future work, researchers could focus on other methods of segmenting acute leukemia cells such as using a combination of two or three segmentation techniques to make full use of the different algorithms advantages to achieve better segmentation for the blast cells. In addition, we can suggest using a machine learning algorithm (e.g., support vector machine, neural network, and others) to improve the segmentation of the blast cell. Moreover, there will be more medical image segmentation techniques widely used; as well as more than one chance to find other suitable features that can detect the type of Acute Leukemia. The features selection techniques and dimensional reduction can be performed to achieve greater efficiency. 6. 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Table 1: Examples State of Tablet's Pill REVISTA AUS 26-2 / Saif S Al-jaboriy et al.,/ DOI:10.4206/aus.2019.n26.2.60/ www.ausrevista.com/ editor@ausrevista.com Max Mean Mean Mean Mean Mean Mean Mean Mean Mean Mean ge Pill 1 Pill 2 Pill 3 Pill 4 pill5 Pill 6 Pill 7 Pill 8 Pill 9 Pill pill . 10 *75 pi .No mean State Ima no % 1 97.11 99.70 92.23 98.87 92.83 96.01 100.0 4 1 8 5 5 9 0 99.62 99.90 100.0 98.50 96.11 99.40 94.13 98.76 0 0 7 9 2 3 2 99.77 100.0 97.75 5 0 98.00 99.40 99.10 88.25 99.10 89.75 99.50 97.31 99.88 99.70 2 4 8 4 12 7 34 75 1 99.71 99.60 98.31 99.30 98.80 98.70 100.0 99.40 98.60 2 1 2 3 5 64 0 29 69 99.88 99.32 98.20 98.50 99.00 99.20 98.60 94.31 98.87 7 2 0 7 4 39 6 1 51 100.0 98.98 99.77 99.77 100.0 98.40 98.60 100.0 99.80 0 7 5 5 0 79 9 0 0 98.61 97.63 99.11 48.35 99.43 98.31 97.91 98.27 99.11 74.57 2 7 7 0 75 2 04 8 7 8 88.44 95.72 92.46 42.29 90.43 92.93 94.93 86.95 90.88 96.06 72.04 4 5 3 4 8 53 8 16 8 2 7 2 2 3 Safety 99.32 98.76 9 0 75.00 75.00 1 0 10 Safety 10 Safety 74.91 Dama 4 75.00 9 74.91 9 ge Dama 5 6 7 8 5 75.00 Dama 9 ge Dama 1 0 ge Dama 1 0 ge Experimental Results In this section, the performance of the implemented system is tested for safety and damage tablet images. The first experiment is tested on fitted tablet images. The second experiment is tested on damage tablet images include broken one of the pills. The third experiment is tested on damage tablet images include missing one of the pills from the tablet. All the experiments are performed Matlab in 32-bit system with 2.40 GHz core i3 processor and 3 GB of RAM, run with the MS Win.7 operating system. The pill image inputted into inspection green circle pill system and pass through all stages as described in the following stages: Stage 1: Input pill image mentioned above as shown in Figure 4, to pass through preprocessing steps. Figure 4: Original green tablet images Stage2: The results of preprocessing step shown in Figure 5. ARTÍCULO 5. 97.07 ge 5 528 REVISTA AUS 26-2 / Saif S Al-jaboriy et al.,/ DOI:10.4206/aus.2019.n26.2.60/ www.ausrevista.com/ editor@ausrevista.com descriptors lead to correct circle detection. The obtained results indicated that this method leading to high speed, high precision, noise resistance and false fault detection. This system is time efficient as it requires just 0.975 seconds on an average for executing the program and predicting the result. The performance of an inspection green pill system is 100% for each database that contain a) 50 image of the tablet fill pill and not broken. b) 50 image of the tablet empty one of the pills. c) 50 image of the tablet broken one of the pills. Noticeable the performance of an inspection green bell system Excellent and nearer from Human vision (The person checking the manual). References [1] Figure 5: preprocessing green tablet images Stage3: The results of Pill Radii for circle detection step shown in Table 2. Table 2: PILL RADII No. [2] 1 2 3 4 5 6 7 8 9 10 18 18 18 16 18 18 18 17 17 19 [3] Pill radii Stage4: analysis circle detection of green pill, table 3 shows the mean of pill detection. [4] Table 3: Mean of Pill Detection no.pill 1 2 3 4 5 6 7 8 9 10 mean 99.9 100 99.4 96.9 98.2 98.6 99.0 99.00 98.4 99.5 pill Stage5: Print number of detected circles & print number of broken circles shown in figure 6 [5] [6] ARTÍCULO Figure 6: Eventual Image of the proposed system 6. Conclusion 529 The experimental results indicated that CHT can be effectively applied to detect the centers and radii of pill circle and color transforms that led to higher enhance the contrast and emphasis of green color for image these [7] Deepti, R. B. (2015). Enhanced Feature Extraction Technique for Detection of Pharmaceutical Drugs. Volume 3, Issue 3. Dhiman, M. K., & Gupta, D. R. (2014). Detection of Broken Blister using Canny and Rc-algorithm International Journal of Scientific Research Engineering & Technology (IJSRET), Vol. 3, Issue 3. Jiang, Y., Ma, S., Gao, H., & Xia, F. (2014). Research on defect detection technology of tablets in aluminum plastic package. 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