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Chapter from the book ‘Medical Image Processing and Health Care Services’,
First Edition, 2018. Editor (s): P.S.Jagadeesh Kumar, Yang Yung
Cite this chapter as:

P.S.Jagadeesh Kumar et al. ‘Promise and Risks Tangled in Hybrid Wavelet
Medical Image Fusion Using Firefly Optimization in the Diagnosis of
Alzheimer’s Disease’, Medical Image Processing and Health Care Services’,
First Edition, pp.1-43, 2018, Published by INTECH.
Downloaded from: http://www.intechopen.com/books/
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1
Promise and Risks Tangled in Hybrid

Wavelet Medical Image Fusion Using
Firefly Optimization Algorithm in the
Diagnosis of Alzheimer’s Disease
P.S.Jagadeesh Kumar, Yang Yung, Mingmin Pan and Wenli Hu
Biomedical Engineering Research Centre
Nanyang Technological University, Singapore
1. Introduction
Medical image fusion syndicates the harmonizing images from diverse imaging modalities
and improves the quality of fused output image that affords supplementary anatomical and
functional information. In this chapter, a hybrid wavelet approach is recycled to combine the
computed tomography and magnetic resonance images employing lifting wavelet transform
and wavelet decomposition to discrete wavelet transform superseding firefly optimization to
advance the sovereignty of the fused images in the diagnosis of Alzheimer’s disease. The
optimized hybrid image fusion method is tested with other traditional methods such as
discrete wavelet transforms, haar wavelet transforms, discrete ridgelet transforms, discrete
curvelet transforms, and dual-tree complex wavelet transforms for its effectiveness. The
applied results display the promise and risks tangled in proposed hybrid wavelet method
over traditional wavelet transforms in refining the quality of the fused images in the diagnosis
of Alzheimer’s disease.
1.1 Defining Image/Data fusion
With the progression of numerous kinds of biosensors, and remote sensors onboard satellites,
an ever-increasing number of data has turned out to be accessible for logical investigations.
As the volume of information develops, so does the need to join information accumulated
from diverse sources to remove the most helpful data. Distinctive terms, for example, data
interpretation, combined analysis, picture combination have been utilized. Since mid-1980's,
"Image Fusion" has been embraced and broadly utilized. The meaning of Image Fusion/Data
Fusion changes. For instance:
- Image fusion is a procedure of consolidating pictures, got by sensors of various wavelengths at the
same time survey of a similar scene, to frame a composite picture. The composite picture is shaped
to enhance picture content and to make it simpler for the client to distinguish, perceive, and
recognize targets and increment the situational mindfulness.
- Image fusion is the way toward consolidating data from at least two pictures of a scene into a
solitary composite picture that is more useful and is more appropriate for visual recognition.
- Image fusion is the mix of at least two unique pictures to shape another picture by utilizing a
specific algorithm.
- Data fusion is a procedure managing information and data from numerous sources to accomplish
refined/enhanced data for decision making.
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2 Medical Image Processing and Health Care Services
1.2 What is Optimized Medical Image fusion?

In medical image fusion, the data of an organ or other human parts gained by at least two
restorative imaging modalities in the meantime or separate circumstances is joined to create
an understanding of the picture not realistic from a solitary methodology. Optimized image
fusion is a part of image fusion got through advancement calculations or algorithms when the
picture information is strict to reliable and more applicable data in breaking down and
diagnosing the illness (Fig. 1). Optimized image fusion is a viable path for ideal use of huge
volumes of information from numerous modalities. Hybrid image fusion tries to consolidate
data from diverse sources to accomplish derivations that are not plausible from a solitary
picture combination technique. It is the point of upgraded medicinal picture combination to
incorporate diverse information all together acquire more important data than can be gotten
from each of the single therapeutic imaging methodology.
Fig. 1. Illustration of relationship amid image fusion and optimized image fusion
1.3 Advances in Medical Image Fusion

Among the most recent couple of years, medical image fusion has increased much worry
because of the significance of capable guide for the specialists in the medicine area. Numerous
medical modalities can go about as a contribution to the fusion steps to deliver a last
enlightening yield picture. The part of these procedures emerges from their capacity to help
the specialists in the conclusion, following up the infections' development, and choosing the
vital treatments with respect to the patient's condition. The present focal point of medical
image fusion particularly accentuation in creating insightful picture combination and machine
learning based image fusion advances. One such upgraded medical image fusion can lessen
the weight of information replication and aides in exhibiting just the significant data in view
of the ailment and the sort of streamlining estimation or algorithm is engaged with the
combination strategy. Image fusion optimization is the most recent pattern developing in the
present days and with the assistance of machine learning based advancement, more precise
data can be recovered considering the investigation and conclusion of a specific sort of
sickness say Alzheimer's disease.
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Promise and Risks Tangled in Hybrid Wavelet Medical Image Fusion Using Firefly Optimization
Algorithm in the Diagnosis of Alzheimer’s Disease 3
2. Medical Image Fusion

Medical image processing is a quickly developing region of research throughout the previous
four decades. X-Ray, Ultrasound, MRI (Magnetic Resonance Imaging) and CT (Computed
Tomography) are a couple of cases of therapeutic imaging sensors which are utilized for
separating clinical data. These sensors give correlative data about patient's pathology, life
systems, and physiology. For instance, CT is generally utilized for tumor and anatomical
recognition, though data about delicate tissues is acquired by MRI. Also, other therapeutic
imaging methods like fMRI (functional Magnetic Resonance Imaging), PET (Positron Emission
Tomography), SPECT (Single Positron Emission Computed Tomography) give practical and
metabolic data. Further, T1-MRI picture gives insights about anatomical structure of tissues,
though T2-MRI picture gives data about typical and strange tissues. Thus, it can undoubtedly
have presumed that none of these modalities can convey all pertinent data in a solitary picture.
In this manner, multimodal medical image fusion is required to acquire all conceivable
pertinent data in a solitary composite picture for better analysis and treatment. Spatial and
transform domain approaches have been generally utilized for medicinal picture combination.
These systems incorporate PCA (Principal Component Analysis), straight combination and so
forth., and multiresolution combination plot utilizing wavelet and pyramid transforms.
Subjective and objective valuations are the two conceivable approaches to survey combination
calculations. Subjective assessment can be performed by therapeutic specialists, while for
objective assessment, reference and non-reference measurements have been utilized. For
medical image fusion, non-reference measurements are more appropriate as there don’t exist
any reference therapeutic picture for examination of intertwined picture. In any case,
consolidated subjective and objective assessment of combination calculations has been
discovered advantageous for better investigation of combination comes about.
The contemporary expertise has made a solid effect in patient care by lessening the time amid
investigation and treatment. Even though image fusion can have incongruent judgments, the
prime goal of fusion is spatial determination change or picture honing. Likewise distinguished
as integrated imaging, it admits a computerized affiliation that licenses for the fusion of
multimodal medical images into a lone picture with more far reaching and exact clarification
of a similar element. The preferences are significantly more insightful in blending auxiliary
imaging properties with practical properties. Around, PET-CT in lung disease, MRI-PET in
mind tumors, SPECT-CT in stomach modifications and ultrasound pictures MRI for vascular
blood stream. Consequences of MRI-CT picture combination has been uncovered to help in
getting ready for surgical strategy. Essentially, medical image fusion endeavors to clarify the
subject of where there is no lone methodology manages both basic and practical confirmation.
Correspondingly, confirm gave by divergent modalities may settle or in orchestrating nature.
There are a few medicinal imaging approaches with divergent imaging stuff, by which unique
therapeutic pictures are formed. The pictures caused from MRI, PET, CT are utilized as a part
of the clinical activities. The picture information recuperated by differing sensors have limit
and disparity in the geometry, band, period and space resolutions, so it is difficult to custom
only one sort of picture data. To have promote far reaching and exact comprehension, associate
of the objective, one must find a down to earth strategy to make utilization of the different
sorts of picture data. In this way, it is huge to syndicate unmistakable sorts of picture data.
Fusion of medicinal pictures has turned out to be helpful for propelling the clinical
dependability of utilizing therapeutic imaging for restorative diagnostics and investigation
and is a logical teach that can possibly develop in future.
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2.1 Medical Imaging Modalities

Medicinal imaging embraces a few checking systems to foresee the human body for indicative
and treatment purposes. Likewise, medicinal imaging is tremendously valuable for tolerant
development, with respect to the advance of the ailment state, which has just been analyzed,
or potentially is experiencing a treatment design. Most of therapeutic imaging depends on the
utilization of X-rays and Ultrasound (US). These therapeutic imaging modalities are engaged
with all levels of healing facility mind. What's more, they are instrumental in the general
wellbeing and preventive drug settings and in the corrective and further reaching out to
palliative care. The principle objective is to set up the right findings. Medical imaging is
currently used widely in clinical trials for qualification, viability, and wellbeing assessments.
The employments of imaging range from a subjective evaluation of sickness discoveries to
quantitative appraisals, each laying on determination of the condition or change in the
seriousness of the condition. This section is intended for the beginner with a restricted or no
foundation in radiological strategies and plans to quickly audit the diverse imaging
procedures, innovation, phrasing, and ideal imaging employments.
2.1.1 Computed Tomography
Computed Tomography (CT), ordinarily alluded to as a CAT filter, is a therapeutic imaging
technique that consolidates numerous X-ray projections taken from various points to create
itemized cross-sectional pictures of regions inside the body. Not at all like a traditional x-ray,
which utilizes a settled x-ray tube, a CT scanner utilizes a mechanized x-ray source that turns
around the roundabout opening of a doughnut formed structure called a gantry. Amid a CT
check, the patient lies on a bed that gradually travels through the gantry while the x-ray tube
turns around the patient, shooting tight light emissions beams through the body (Fig.2). Rather
than film, CT scanners use unique advanced x-ray locators, which are found straightforwardly
inverse the x-ray source. As the x-rays leave the patient, they are grabbed by the indicators and
transmitted to a PC. Each time the x-ray source finishes one full turn, the CT PC utilizes
modern numerical procedures to develop a 2D image slice of the patient. The thickness of the
tissue spoke to in each image slice can change contingent upon the CT machine utilized,
however ordinarily runs from 1-12 millimeters. At the point when a complete slice is finished,
the picture is put away, and the mechanized bed is pushed ahead incrementally into the
gantry. The x-ray filtering process is then rehashed to create another image slice. This
procedure proceeds until the point that the coveted number of slices is gathered. Image slices
can either be shown exclusively or stacked together by the PC to create a 3D picture of the
patient that demonstrates the skeleton, organs, and tissues and in addition any variations from
the norm the physician is attempting to distinguish. This strategy has numerous points of
interest including the capacity to pivot the 3D image in space or to see slices in progression,
making it less demanding to locate the correct place where an issue might be found. CT images
permits to get extremely exact, 3-D perspectives of specific parts of the body, for example,
delicate tissues, the pelvis, veins, the lungs, the cerebrum, the heart, belly and bones. CT is
regularly the favored technique for diagnosing numerous growths, for example, liver, lung
and pancreatic tumors. CT is frequently used to assess:
- Presence, size and location of tumors
- Organs in the pelvis, chest and abdomen
- Colon health (CT colonography)
- Vascular condition/blood flow, Cardiovascular diseases
- Pulmonary embolism (CT angiography)
- Abdominal aortic aneurysms (CT angiography)
- Bone injuries, Cardiac tissues, Traumatic injuries,
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Promise and Risks Tangled in Hybrid Wavelet Medical Image Fusion Using Firefly
Optimization Algorithm in the Diagnosis of Alzheimer’s Disease 5
Fig. 2. Computed Tomography Steered Therapeutic Medical Imaging
2.1.2 Magnetic Resonance Imaging

Magnetic Resonance Imaging (MRI) is a medicinal imaging innovation that utilizes radio
waves and a magnetic field to make point by point pictures of organs and tissues. MRI apply
capable magnets which deliver a solid magnetic field that powers protons in the body to line
up with that field. When a radiofrequency current is then beat through the patient, the protons
are empowered, and turn out of harmony, stressing against the draw of the magnetic field. At
the point when the radiofrequency field is turned off, the MRI sensors can identify the vitality
discharged as the protons realign with the magnetic field (Fig. 3). The time it takes for the
protons to realign with the magnetic field, and the measure of vitality discharged, changes
relying upon the environment and the substance idea of the atoms. Physicians can differentiate
between a few kinds of tissues considering these magnetic properties. To acquire a MRI
picture, a patient is put inside a substantial magnet and must stay yet amid the imaging
procedure all together not to obscure the picture. Contrast agents, habitually comprising the
component Gadolinium might be given to a patient intravenously or amid the MRI to build
the speed at which protons realign with the magnetic field. The speedier the protons realign,
the brighter the picture. Even though MRI does not transmit the harming ionizing radiation
that is found in x-ray and CT imaging, it employs a solid magnetic field. The magnetic field
stretches out past the machine and applies capable powers on objects of iron, a few steels, and
other magnetizable articles; it is sufficiently solid to excursion a wheelchair over the room.
Patients ought to inform their physicians of any type of restorative or embed preceding a MRI
examine.
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MRI has turned out to be very viable in diagnosing a few conditions by demonstrating the
distinction amongst typical and ailing delicate tissues of the body. MRI is regularly used to
assess:
- Blood vessels
- Abnormal tissue
- Breasts
- Bones and joints
- Organs in the pelvis, chest and abdomen (heart, liver, kidney, spleen)
- Spinal injuries, Tendon and ligament tears
Fig. 3. MRI Steered Therapeutic Medical Imaging
2.1.3 Positron Emission Tomography

Positron Emission Tomography (PET) is an atomic imaging system that gives physicians, data
about the working of tissues and organs. A PET output utilizes a radioactive medication
(tracer) to demonstrate those exercises. This scan can now and then identify diseases before it
appears on other imaging tests. The tracer might be infused, gulped or breathed in, contingent
upon which organ or tissue is being considered. The tracer gathers in regions of the body that
have more elevated amounts of concoction movement, which regularly compare to territories
of ailment. On a PET scan, these zones appear as brilliant spots. A PET output is valuable in
uncovering or assessing a few conditions, including numerous tumors, coronary illness and
mind issue. Frequently, PET pictures are joined with CT or MRI scans to make extraordinary
perspectives. A PET output is a viable method to look at the synthetic action in various parts
of your body. It might help distinguish an assortment of conditions, including numerous
growths, coronary illness and cerebrum issue. The photos from a PET output give data not
quite the same as that revealed by various kinds of scans, for example, CT or MRI. A PET
output or a consolidated CT-PET scan empowers to better analyze sickness and evaluate
wellbeing condition. Malignancy cells appear as splendid spots on PET sweeps since they have
a higher metabolic rate than do typical cells.
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PET scans can uncover areas of diminished blood stream in the heart. This data can help in
dissecting whether to decide on an open clogged heart arteries (angioplasty) or coronary artery
bypass surgery. PET scans can be utilized to assess certain cerebrum issue, for example,
tumors, Alzheimer's illness and seizures. PET scan images don't appear as much detail as
computed tomography (CT) examines or magnetic resonance imaging (MRI) because the
photos demonstrate just the area of the tracer. The PET picture might be coordinated with
those from a CT scan to get more point by point data about where the tracer is found. Today,
all PET scans are performed on instruments that are joined PET and CT scanners (Fig. 4). The
consolidated PET/CT examines give pictures that pinpoint the anatomic area of irregular
metabolic action inside the body. The consolidated scans have been appeared to give more
precise findings than the two outputs performed independently. PET is regularly used to
assess:
- Neurological diseases such as Alzheimer’s
- Multiple Sclerosis
- Cancer
- Effectiveness of treatments
- Heart conditions
Fig. 4. PET and CT Steered Therapeutic Medical Imaging
2.1.4 Single-Photon Emission Computed Tomography

Single Photon Emission Computed Tomography (SPECT) scan is a sort of atomic imaging test
that shows how blood streams to tissues and organs. SPECT imaging offers the exceptional
chance to envision cerebrum chemicals including locales of medication activity and in addition
unmistakable useful conditions of the living human mind utilizing radioactive medications.
During the most recent three decades, huge advances have been made both in the innovation
and in the improvement of novel radiopharmaceuticals for imaging of neural receptors and
transporters in the living human cerebrum utilizing SPECT. Perfusion SPECT is routinely
utilized for the clinical analysis and evaluation of a few neurological issue.
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Neuroreceptor SPECT imaging has been valuable in research to start to distinguish the
substance condition of various neuropsychiatric issue that outcome from a lopsidedness of
chemicals in the cerebrum, for example, liquor addiction, Alzheimer's sickness, bipolar
confusion, cocaine reliance, real misery, Parkinson's illness, schizophrenia, and tobacco
reliance. While in its childhood, neuroreceptor SPECT imaging holds colossal potential in the
clinical setting for the determination of a bunch of mental issue for which right now there is
no organic or concoction indicative instrument. With proceeded advance in the development
of radiopharmaceuticals and in the innovation for the procurement and image processing of
SPECT information, SPECT imaging can possibly change how neuropsychiatric clutters are
analyzed and treated. SPECT check screens level of natural movement at each place in the 3-D
locale dissected. Outflows from the radionuclide demonstrate measures of blood stream in the
vessels of the imaged areas. SPECT imaging is performed by utilizing a gamma camera to
secure different 2-D images likewise called projections, from various edges. A PC is then used
to apply a tomographic reconstructing calculation to the numerous projections, yielding a 3D
dataset (Fig. 5). This dataset may then be controlled to demonstrate thin slices along any picked
hub of the body, like those got from other tomographic systems, for example, magnetic
resonance imaging (MRI), X-ray computed tomography (X-beam CT), and positron emission
tomography (PET). SPECT resembles PET in its utilization of radioactive tracer material and
location of gamma beams.
Fig. 5. SPECT Steered Therapeutic Medical Imaging
Interestingly with PET, nonetheless, the tracers utilized as a part of SPECT emanate gamma
radiation that is estimated specifically, while PET tracers transmit positrons that obliterate
with electrons up to a couple of millimeters away, making two gamma photons be produced
in inverse ways. A PET scanner recognizes these emanations "correspondent" in time, which
gives more radiation occasion limitation data and, along these lines, higher spatial
determination pictures than SPECT, which has around 1 cm resolution. SPECT scans, in any
case, are fundamentally more affordable than PET scans, to some degree since they can utilize
longer-lived more effectively got radioisotopes than PET. SPECT is regularly used to assess:
- Stress fractures in the spine (Spondylolysis)
- Blood deprivation (Ischemic)
- Stroke, Tumors, Infection imaging (Leukocyte)
- Thyroid imaging, Bone scintigraphy
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2.1.5 Ultrasound Imaging

Diagnostic ultrasound, otherwise called medical sonography or ultrasonography, utilizes high
recurrence sound waves to make pictures of within the body. The ultrasound machine sends
sound waves into the body and can change over the returning sound echoes into an image.
Ultrasound innovation can likewise create capable of being heard hints of blood stream,
enabling medicinal experts to utilize the two sounds and visuals to survey a patient's
wellbeing. Medicinal ultrasound falls into two classes: indicative and restorative. Analytic
ultrasound is a non-obtrusive symptomatic method used to picture inside the body (Fig. 6).
Ultrasound tests, called transducers, create sound waves that have frequencies over the limit
of human hearing of over 20KHz, however most transducers in current utilize work at
substantially higher frequencies in the megahertz. Most indicative ultrasound tests are put on
the skin. Nonetheless, to improve picture quality, tests might be put inside the body through
the gastrointestinal tract, vagina, or veins. Furthermore, ultrasound is some of the time utilized
amid surgery by putting a clean test into the area being worked on. Analytic ultrasound can
be further sub-isolated into anatomical and useful ultrasound. Anatomical ultrasound
produces pictures of interior organs or different structures. Utilitarian ultrasound joins data,
for example, the development and speed of tissue or blood, delicate quality or hardness of
tissue, and other physical attributes, with anatomical images to make "data maps." These maps
enable specialists to imagine changes/contrasts in work inside a structure or organ. Helpful
ultrasound likewise utilizes sound waves over the scope of human hearing however does not
create pictures. Its motivation is to associate with tissues in the body to such an extent that they
are either adjusted or wrecked. Among the adjustments conceivable are: moving or pushing
tissue, warming tissue, dissolving blood clusters, or conveying medications to specific areas in
the body. These dangerous, or ablative, capacities are made conceivable by utilization of high-
power pillars that can wreck ailing or unusual tissues, for example, tumors. The benefit of
utilizing ultrasound treatments is that, much of the time, they are non-obtrusive. No entry
points or slices should be made to the skin, leaving no injuries or scars. Ultrasound waves are
created by a transducer, which can both discharge ultrasound waves, and recognize the
ultrasound echoes reflected. Much of the time, the dynamic components in ultrasound
transducers are made of exceptional clay precious stone materials called piezoelectric. These
materials can create sound waves when an electric field is connected to them, yet can likewise
work backward, delivering an electric field when a sound wave hits them.
At the point when utilized as a part of an ultrasound scanner, the transducer conveys a light
emission waves into the body. The sound waves are reflected to the transducer by limits
between tissues in the way of the shaft (e.g. the limit amongst fluid and delicate tissue or bone).
At the point when these echoes hit the transducer, they create electrical signs that are sent to
the ultrasound scanner. Utilizing the speed of sound and time of each echo’s arrival, the
scanner ascertains the separation from the transducer to the tissue limit. These separations are
then used to produce two-dimensional pictures of tissues and organs. Amid an ultrasound
exam, the specialist will apply a gel to the skin. This keeps air pockets from framing between
the transducer and the skin, which can square ultrasound waves from going into the body.
Ultrasound imaging is frequently used to assess:
- Pregnancy
- Abnormalities in the heart and blood vessels
- Organs in the pelvis and abdomen
- Symptoms of pain, swelling and infection
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Fig. 6. Ultrasound Steered Therapeutic Medical Imaging
2.1.6 X-Ray Imaging

X-ray innovation is the most seasoned and most regularly utilized type of medicinal imaging.
X-rays utilize ionizing radiation to deliver pictures of a man's inward structure by sending X-
ray beams through the body, which are invested in various sums relying upon the thickness
of the material. What's more, included as "x-ray type" gadgets are likewise mammography,
interventional radiology, computed radiography, and digital radiography. Radiation Therapy
is a sort of gadget which likewise uses either x-rays, gamma rays, electron beams or protons to
treat disease. When imaging with X-rays, an X-ray beam delivered by a supposed X-ray tube
goes through the body. On its way through the body, parts of the vitality of the X-ray beam
are ingested. This procedure is portrayed as attenuation of the X-ray beam (Fig. 7). On the
contrary side of the body, identifiers or a film catch the constricted X-rays, bringing about a
clinical picture. In customary radiography, one 2D image is created. In computed tomography,
the tube and the locator are both turning around the body amid the examination so various
pictures can be obtained, bringing about a 3D representation. Distinctive organs and tissues
have an alternate affectability to radiation. Along these lines, the genuine hazard to the body
from X-ray methods fluctuates relying upon the piece of the body being X-rayed. "Effective
dosage" is a parameter of the measurements consumed by the whole body that assesses these
varying sensitivities. Physicians and manufacturers know about the dangers and do
everything conceivable to limit radiation dosage. Guided by specialized benchmarks that are
set and constantly refreshed by national and global radiology security chambers, they take
extraordinary care amid X-ray examinations to utilize the least radiation dosage conceivable
while creating the pictures. Propelled X-ray frameworks contain one of a kind highlights that
assistance diminish the radiation measurements. For instance, there are advancements created
to guarantee that those parts of a patient's body not being imaged get no or just insignificant
radiation introduction. X-ray pictures are commonly used to assess:
- Broken bones
- Cavities, Swallowed objects
- Lungs, Blood vessels
- Breast (mammography)
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Fig. 7. X-Ray Steered Therapeutic Medical Imaging
2.2 Needs and Difficulties of Medical Image Fusion

Image fusion has turned into a typical term utilized within therapeutic diagnostics and
treatment. The term is utilized when various pictures of a patient are enrolled and overlaid or
converged to give extra data. Fused images might be made from numerous pictures from a
similar imaging methodology, or by joining data from different modalities, for example,
magnetic resonance image, computed tomography, positron emission tomography, and single
photon emission computed tomography. In radiology and radiation oncology, these pictures
fill distinctive needs. For instance, CT pictures are utilized more regularly to find out contrasts
in tissue thickness while MRI pictures are commonly used to analyze cerebrum tumors. For
precise conclusions, radiologists must coordinate data from different picture groups. Melded,
anatomically steady pictures are particularly helpful in diagnosing and treating malignancy.
With the appearance of these advances, radiation oncologists can take full favorable position
of intensity modulated radiation therapy (IMRT). Having the capacity to overlay analytic
pictures into radiation arranging pictures brings about more exact IMRT target tumor
volumes. Relative investigation of image fusion tactics shows that distinctive measurements
bolster diverse client needs, delicate to various image fusion methods, and should be adapted
to the application. Classes of image fusion evaluation depend on data hypothesis, highlights,
basic likeness, or human recognition. Another, purpose of intrigue is that while tending to the
therapeutic image fusion issues, the accentuation has been toward creating calculations that
endeavor to enhance the imaging quality and area of interest inside pictures. The requirement
for enhancing the picture quality emerges from the signal noise and the physical confinements
of the imaging methodology. The estimation of signal noise and compensation is considered
as an imperative issue in therapeutic imaging, and the progressions in improvements to
picture quality can positively affect the image fusion process. Another territory of intrigue is
to enhance the speed of preparing chiefly in the instances of volumetric picture combination.
An algorithmic approach is to create calculations that are advanced for rapid preparing. These
are rising zones of considerations and would require generous advance in image fusion
frameworks investigation.
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2.3 Role of Medical Image Fusion in Alzheimer’s Disease

Alzheimer's disease (AD) is a gradually dynamic malady of the cerebrum that is portrayed by
impedance of memory and inevitably by aggravations in thinking, dialect, and observation.
Numerous researchers trust that Alzheimer's disease comes about because of an expansion in
the creation or gathering of beta-amyloid protein in the cerebrum that prompts nerve cell
demise. The probability of having Alzheimer's disease increments generously after the age of
70 and may influence around half of people beyond 85 years old. In any case, Alzheimer's
disease isn't an ordinary piece of maturing and isn't something that unavoidably occurs in
later life. For instance, numerous individuals live to more than 100 years and never build up
Alzheimer's disease. While, Dementia is a disorder portrayed by impedance in memory,
hindrance in another area of reasoning, for example, the capacity to compose musings and
reason, the capacity to utilize dialect, or the capacity to see precisely the visual world other
than eye sickness, and these debilitations are sufficiently serious to cause a decrease in the
patient's typical level of working. Albeit a few sorts of memory misfortune are typical parts of
maturing, the progressions because of maturing are not sufficiently serious to meddle with the
level of capacity. Albeit a wide range of maladies can cause dementia, Alzheimer's disease is
the most well-known reason for dementia in most nations on the planet. Mild cognitive
impairment (MCI) causes psychological changes that are not kidding enough to be seen by the
people encountering them or to other individuals, however the progressions are not
sufficiently extreme to meddle with day by day life or free capacity. Individuals with MCI,
particularly MCI including memory issues, will probably build up Alzheimer's illness or
different dementias than individuals without MCI. Nonetheless, MCI does not generally
prompt dementia. In a few people, MCI returns to typical perception or stays stable. In
different cases, for example, when a pharmaceutical causes psychological hindrance, MCI is
erroneously analyzed. That is the reason it's essential that intellectual impedance look for help
as quickly as time permits for conclusion and conceivable treatment. MCI is a middle of the
road arrange between the normal subjective decrease of ordinary maturing and the more-
genuine decay of dementia. It can include issues with memory, dialect, considering and
judgment that are more prominent than ordinary age-related changes. From this time forward,
a few kinds of mind ailments may have similar manifestations however requires diverse
clinical treatment. Along these lines, the effective human services and patients' checking
critically depends in ordering and assessing the different neurodegenerative disorders and
their related sickness.
Diagnosis and treatment of afflictions require that exact data be acquired through different
modalities of medicinal imaging, for example, Computed Tomography, Positron Emission
Tomography, and Magnetic Resonance Imaging, and so on. Regularly these systems give some
data with respect to the sickness which is inadequate and vague. In this situation, image fusion
increases most extreme significance as the general nature of outputs can be made strides. In
this manner, combining diverse multimodal medical images into an unmistakable intertwined
picture with more definite anatomical data and high phantom data is profoundly wanted in
clinical analysis. For example, PET produces pictures with reasonable shading and low spatial
determination, while MRI provides fitting spatial determination with no shading data content.
The combined picture appeared around 90-95% more precise results with diminished shading
contortion and without losing any anatomical data as far as execution records including
Average Gradient and Spectral Discrepancy, when substantiated for normal axial, normal
coronal and Alzheimer's brain disease images. Restorative picture combination assumes a
critical part in arranging and assessing different neurodegenerative disorders and their related
sickness like dementia, mild cognitive impairment and Alzheimer's disease. Further, image
fusion has set another technique in segregating unmistakable phases of Alzheimer's illness like
mild, moderate and severe Alzheimer’s disease.
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2.4 What is Hybrid Medical Image Fusion?

Image fusion is a helpful strategy for blending single sensor and multi-sensor pictures to
upgrade the data. The target of image fusion is to consolidate data from various pictures to
create a picture that convey just the valuable data. Medicinal image fusion is having a few
imaging modalities which can be utilized as essential contributions to break down and
conclude the sickness. Be that as it may, the most troublesome part is the determination of
image modality and combination strategy for the focused on clinical examination. Also,
having one image modality would not guarantee any exactness, vigor and dependability for
the examination and coming about determination. In this manner, to enhance the exactness
and power of the examination and coming about determination more picture modalities were
considered. Besides, the specialists were additionally persuaded that taking a gander at
pictures from various modalities can offer them better outcomes regarding lessening
arbitrariness, excess and enhancing exactness, strength and dependability. Accordingly, the
subsequent appraisal data is more solid and exact. In cross breed medicinal picture
combination, the upsides of different combination methods and guidelines were incorporated
to acquire single melded yield picture with better quality outcomes by limiting mean square
value and maximizing signal to noise ratio in helping to proficient determination of maladies
say Alzheimer's sickness.
Hybrid imaging alludes to the combination of at least two imaging modalities to shape another
strategy. By joining the intrinsic preferences of the intertwined imaging abilities
synergistically, for the most part another and more effective methodology appears. Around
hybrid imaging modalities are synergistic only in anatomical points of interest, while others
consolidate basic and atomic imaging. This possibility to uncover sub-atomic procedures in
vivo while demonstrating their anatomic area has been a groundbreaker as far back as
PET/CT was voted in the "Restorative Invention of the Year" in 2000. As a coin has two sides,
every combination strategy has its own arrangement of focal points and constraints. The mix
of a few diverse combination plans has been endorsed to be the helpful system which may
accomplish better nature of results. As a for example, many specialists have concentrated on
coordinating the customary IHS technique into wavelet changes, since the IHS combination
strategy performs well spatially while the wavelet strategies perform well frightfully. In any
case, choice and game plan of those applicant combination plans are very self-assertive and
frequently relies on the client's understanding. Ideal consolidating procedure for various
combination calculations, in another word, Hybrid Medical Image Fusion' methodology, is
hence pressing required. However, there have been excessively numerous image fusion
strategies accessible to upgrade the highlights of a subsequent intertwined picture, there still
exist a designing need to grow more productive hybrid techniques that could bring about
enhanced precision and dependability. Hybrid imaging technique can be effectively stretched
out to larger amounts of combination where the root mean square (RMS) error between the
first and melded pictures can in any case decrease in this manner containing more data in the
intertwined picture. This hybrid procedure acquaints a predominant execution contrasted and
the various conventional methods. It gives significantly more picture points of interest, higher
picture quality, the briefest preparing time and a superior visual review. Every one of these
advantages settle on it as an attractive decision for a few applications, for example, therapeutic
analysis for an exact treatment. All in all, Hybrid medical image fusion is executed to enhance
the picture content by melding pictures taken from imaging devices. Further examinations are
fundamental for the additional viewpoints on combination of diverse fusion methods.
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2.5 Benefits of Fusing CT and MRI in Diagnosing Alzheimer’s Disease

Latest advances in imaging stratagems have made therapeutic image fusion more successful
in recognizing Alzheimer's disease. The practical downside of single methodology medicinal
imaging is its poor anatomical and spatial separation. Combination imaging utilizing high-
determination CT and MRI pictures has all the earmarks of being a promising procedure for
both the examination and finding of Alzheimer's disease. It gives helpful data to examination
and analysis in brain imaging method. Computerized tomography scan joins extraordinary X-
ray gear with modern PCs to create numerous pictures of within the body. Physicians utilize
a CT of the brain to search for and markdown distinct reasons for dementia and Alzheimer's
disease. Magnetic resonance imaging utilizes an intense magnetic field, radio frequency pulses
and a PC to create itemized pictures of organs, delicate tissues, bone and for all intents as well
as purposes of all other inner body structures. X-ray can distinguish brain irregularities related
with gentle subjective weakness and can be utilized to anticipate those patients with MCI may
in the end build up Alzheimer's disease. In the underlying phases of Alzheimer's disease, a
MRI scan of the cerebrum might be ordinary. In later stages, MRI may demonstrate a decline
in the extent of various zones of the brain for the most part influencing the temporal and
parietal lobes. Existing hybrid imaging modalities include PET/CT, SPECT/CT, MRI/PET,
MRI/SPECT, ultrasound and MRI, ultrasound and CT, MRI and CT. The general advantages
of combining CT and MRI incorporates;
- Increased diagnostic accuracy.
- Further step towards individualized medicine.
- Precise monitoring of interventional procedures.
- Reduced radiation exposure.
- Reduced cost.
- Highly volumetric.
- High availability.
3. Wavelet Transforms
The wavelet transforms resemble the Fourier transform with totally extraordinary legitimacy
function. The principle contrast is that Fourier transform disintegrates the signal into sines and
cosines, i.e. the functions confined in Fourier space; in opposite the wavelet transform utilizes
functions that are restricted in both the real and Fourier space. By and large, the wavelet
transform can be communicated by accompanying the below equation;
∗
( , )= ( ) ( , )( )
where * is the complex conjugate and ψ is an arbitrary function which can be chosen arbitrarily
if it follows confident rules.
Wavelet transform is in certainty a boundless arrangement of different changes, contingent
upon the legitimacy function utilized for its calculation. This is the principle reason, why the
expression "wavelet transform" in altogether different circumstances and applications. There
are additionally numerous developments how to sort the kinds of the wavelet transforms. The
image fusion calculation in view of Wavelet Transform which speedier created was a multi-
resolution examination image fusion technique in late decade. Wavelet Transform has great
time-frequency attribute. Wavelet transform is an instrument that cuts up data or functions or
operators into various frequency components, and after that reviews every component with a
resolution coherent to its scale. Orthogonal wavelets for discrete wavelet transform progress
and non-orthogonal wavelets for consistent wavelet transform advance may be used.
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These two transforms have the subsequent possessions;

- The discrete wavelet transform yields a data vector of the similar length as the input.
Generally, even in this vector several data are nearly zero. This resembles to the statistic
that it festers into a set of wavelets functions that are orthogonal to its transformations
and scaling. Thus, it decomposes such a signal to a similar or inferior number of the
wavelet coefficient band as is the quantity of signal data facts. Such a wavelet band is very
decent for signal processing and compression, perhaps, no redundant data is constructed
at this point.
- The continuous wavelet transforms in divergent yields an array of one dimension higher
than the source data. For a 1D data, an image of the time-frequency plane is obtained. It
can be easily observed that the signal frequencies developed through this period of the
signal are related with other signals bands. Since, Non-orthogonal set of wavelets are
being used, data are extremely interrelated, thus immense redundancy is observed here.
This aids to understand the consequences in a further humane form.
Wavelet transform could be castoff as a multi resolution image fusion and for medical image
fusion at pixel level fusion arrangements. Wavelets are fruitful in place of point discontinuities
in one dimension, nevertheless, less fruitful in two dimensions. By means of wavelet transform
fusion method, the merged images are very adjacent to output images. The algorithm of image
fusion using DWT is described in the following steps;
1. Size of inputs images: Given the two-dimensional images (example, image I1, image I2) it is
essential to translate it into the equivalent size a power of two square forms (Fig. 8).
2. Computation of two dimensions DWT: In this phase, the two-dimensional Discrete Wavelet
Transform must be pragmatic to the resized two-dimensional images.
3. Fusion rule: The usually castoff image fusion rule consuming wavelet transform is maximum
selection, relate the two coefficients of DWT of the source images and chose the maximum
amongst. Though the lowpass sub-band approximates the source image, the three detail sub-
bands transport data about the aspect portions in horizontal, vertical and diagonal directions.
Dissimilar merging trials will be practical to guesstimate and feature sub-bands. Lowpass sub-
band will be combined by means of simple averaging procedures since they both comprise
projections of the input images.
4. Inverse discrete wavelet transforms: Subsequently, after selecting the merged low frequency
and high frequency spectrums, fused coefficient is rebuilt by means of the Inverse fast discrete
wavelet transform to obtain the fused image which signifies the later images.
Fig. 8. Wavelet Transform Based Image Fusion
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3.1 Types of Wavelet Transform

Wavelet transform (WT) is a comparatively topical fusion technique, which is a mathematical
implement originally intended for signal processing. Since it delivers multiresolution and
multiscale analysis function, image fusion can be applied in the wavelet transform domain.
This aspect cannot be substituted by supplementary traditional fusion methods. Unswerving
to the dissimilar wavelets, five kinds of wavelet approaches were deliberated and applied to
assess their fusion fallouts in medical image fusion.
3.1.1 Discrete Wavelet Transform

In numerical examination and functional investigation, a discrete wavelet transforms (DWT)
is any wavelet transform for which the wavelets are discretely tested. Likewise, with other
wavelet transforms, a key preferred standpoint it has more than Fourier transforms been
transient determination: it catches both frequency and location information i.e. area in time.
Fourier transforms can acquire time data about a signal if a windowing strategy is utilized to
make a Short Time Fourier transform (STFT). The window is a square wave which truncates
the sine or cosine capacity to fit a window of a width. Since a similar window is utilized for
all frequencies, the resolution is the same at all situations in the time-frequency plane. The
discrete wavelet transforms, then again, has a window measure that differs frequency scale
(Fig. 9). This is beneficial for the investigation of signs containing the two discontinuities and
smooth parts. To put it plainly, high frequency premise capacities are required for the
discontinuities, while in the meantime, low frequency ones are required for the smooth parts.
This is precisely the sort of time-frequency tiling from wavelet transforms.
Fig. 9. Discrete Wavelet Transform Vs Short Time Fourier transform

The Discrete Wavelet Transform will decay the source pictures to acquire the decomposed
coefficients. The decomposed coefficients are joined in the wavelet domain considering the
fusion rule. The intertwined picture is accomplished by taking the inverse DWT on combined
coefficients. The resultant intertwined picture outwardly shows a mix of picture highlights
from the joined picture dataset. DWT based medical image fusion technique is given below;
1. Load the pictures to be combined.
2. Apply DWT, break down the pictures into four sub pictures (LL, LH, HL, HH).
3. Apply Lagranges interpolation on every one of the four sub pictures.
4. Discover the distinction picture between interpolated LL-sub picture and info picture.
5. Include the distinction picture with sub-groups HL, LH, HH.
6. Apply maximum frequency fusion rule and take inverse DWT on intertwined coefficients
to get melded picture.
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3.1.2 Haar Wavelet Transform

Haar wavelet is a succession of rescaled "square-molded" functions which together shape a
wavelet family or premise. Wavelet investigation resembles Fourier examination permits an
objective capacity over an interim to be spoken as an orthonormal premise. The Haar wavelet
transform (HWT) is likewise the least complex conceivable wavelet. The specific detriment of
the Haar wavelet is that it isn't ceaseless, and hence not differentiable. This property can, in
any case, be preference for the examination of signs with sudden advances, for example,
observing of hardware disappointment in machines. Haar wavelet premise can be utilized to
speak to a picture by figuring a wavelet transform. The pixel is averaged together pair-wise
and is computed to get the new determination picture with pixel esteems. Some data might
be lost in the averaging procedure. The Haar wavelet transform is utilized to break down
pictures successfully and proficiently at different resolutions. It is utilized to get the guess
coefficients and detail coefficients at distinct levels. The Haar transform functions like a low-
pass filter and a high-pass filter at the same time. Utilizing Haar wavelet, the combination
technique is accepted as the most productive regarding calculation time.
Fig. 10. Haar Wavelet Transform and Medical Image Fusion
HWT based medical image fusion technique is given below;

1. Each source image is resampled i.e. preprocessing is performed. The pixel dimensions of
the image are changed by resampling. This process does not alter the gray level value.
2. A nearest neighbor interpolation is preferred if variations in the gray levels need to be
maintained.
3. HWT is applied on each source image to obtain the decimated coefficients.
4. Source images are subjected to decomposition and the resulting coefficients are evaluated.
5. The fusion is performed by applying maximum frequency fusion rule.
6. The fused image is reconstructed using inverse transform (Fig. 10).
7. Quality metrics are calculated and analyzed.
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3.1.3 Discrete Ridgelet Transform

Discrete ridgelet transform (DRT) has a place with the group of discrete transforms utilizing
premise capacities. To encourage its scientific portrayal, it is a wavelet examination in the
Radon space. The Radon transform itself is an apparatus for shape recognition. Along these
lines, the Ridgelet Transform is essentially a device of edge recognition or shape discovery of
the items in a picture. Ridgelet Transform is the use of the 1D-Wavelet Transform to the cuts
of the Radon transform where the rakish variable is steady, and it is fluctuating. To make the
Ridgelet Transform discrete, both the Radon transform, and the Wavelet Transform must be
discrete. The discrete ridgelet transform is outlined by first utilizing a discrete Radon
transform considering the nonequispaced Fast Fourier transform. To start with the 2D Fast
Fourier Transform (FFT) of the given picture is registered. At that point the subsequent
capacity in the recurrence area is to be utilized to assess the recurrence esteems in a polar
matrix of beams going through the inception and spread consistently in edge. While applying
1D-FFT for the beams, a variation of the Radon transform is acquired, where the projection
points are not separated consistently. A side-effect of this development is the way that the
transform is sorted out as a 2D cluster with lines containing the projections as a component
of the point. In this way, preparing the Radon transform in one hub is effortlessly connected.
To finish the ridgelet transform, a one-dimensional wavelet transforms along the outspread
variable in Radon space must be taken. Collecting every above fixing together gives the
flowchart of the discrete ridgelet transform (Fig. 11).
Fig. 11. First Generation Curvelet Transform
DRT based medical image fusion technique is given below;

1. Two images, MR and CT are registered.
2. Ridgelet Transform is applied on both the images.
3. Ridgelet coefficients are fused using maximum frequency fusion rule which selects the
coefficients that have the maximum absolute values.
4. Inverse DRT is applied on the fused ridgelet coefficients to obtain the fused image.
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3.1.4 Discrete Curvelet Transform

The discrete curvelet transform (DCVT) is a higher dimensional speculation of the wavelet
transform intended to represent pictures at various scales and distinctive points. Curvelets
appreciate two kinds of scientific property, to be specific: curved singularities can be all
approximated with not very many coefficients and curvelets stay cognizant waveforms under
the activity of the wave condition in a smooth medium. Curvelets are a non-versatile strategy
for multi-scale question portrayal. Being an expansion of the wavelet idea, they are getting to
be well known in comparative fields, in picture handling and logical registering. Wavelets
sum up the Fourier transform by utilizing a premise that represents to both location and
spatial frequency. A curvelet transform contrasts from different transforms in the level of
limitation in introduction that shifts with scale. The essential confinement in the wavelet
transform is in the combination of curved items. In this way, the use of the curvelet transform
for curved object image fusion would bring about better combination productivity. A couple
of endeavors for curvelet combination have been made in the field of satellite picture
combination yet no endeavors in medicinal picture combination have been made utilizing the
curvelet transform. In medicinal picture handling, edges are bended as opposed to straight
lines and ridgelets are not ready to productively represent such pictures. Nonetheless, one
can even now send the ridgelet hardware localized, at fine scales, where bended edges are
straight lines. This is the thought fundamental of the original curvelets (Fig. 12).
Fig. 12. First Generation Curvelet Transform
Notwithstanding these intriguing properties, the original curvelet development introduces a

few drawbacks. To start with, the development includes a confused seven-record structure
among which have parameters for scale and area. Indeed, original curvelet expect a wide
variety of standpoint proportions. These realities make numerical and quantitative scrutiny
particularly fragile. Second, the spatial apportioning of the original curvelet transform utilizes
covering windows to abstain from blocking effects. The computational cost of the calculation
may similarly be a restraint for wide scale information. Interestingly, the second generation
curvelets display a much less complex and normal ordering structure with three parameters:
scale, edge and area, thus disentangling scientific investigation. Dissimilar to the original
curvelet, second generation curvelet won't utilize ridgelets yielding a speedier calculation.
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Fig. 13. Discrete Curvelet Transform and Medical Image Fusion
DCVT based medical image fusion technique is given below;

1. The input images are initially registered.
2. Apply 2D Wavelet Transform to each input image to generate 8x8 block based sub-bands
in the first iteration.
3. Decompose the 8x8 sub-bands of each input image of the first iteration to 4x4 sub-bands
using wavelet decomposition to reduce redundancy in the second iteration.
4. Apply 2D Fast Fourier Transform to each sub-bands of the input images in the second
iteration (Fig. 13).
5. Apply First Generation DCVT using ridgelet transform to the input images yield after FFT.
6. Maximum frequency fusion rules are applied to perform the fusion of CT and MRI images.
7. Finally, the inverse curvelet transform (ICVT) step is performed to obtain the fused image.
3.1.5 Dual-Tree Complex Wavelet Transform

The double tree complex wavelet transforms (DTCWT) is a moderately late upgradation to
the discrete wavelet transform (DWT), with essential superfluous properties: it is almost shift
invariant and directionally specific in two and higher measurements. The multidimensional
double tree CWT depends on a computationally productive, detachable filter bank. DTCWT
verges on reflecting the appealing properties of the Fourier transform, including a smooth,
nonoscillating magnitude; a nearly shift-invariant magnitude with a linear phase encoding of
signal shifts; greatly diminished aliasing; and directional wavelets in higher measurements.
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The design of complex analytical wavelets raises a few astounding and nontrivial challenges
that don't emerge with the genuine DWT. For a few uses of the discrete wavelet transform,
consummations can be acquired by utilizing an extensive wavelet transform. An extensive
transform is one that transforms over a N-point motion into M coefficients with M>N. There
are a few sorts of extensive DWTs; the double tree complex discrete wavelet transform is the
best case of its kind. DTCWT of a signal x is actualized utilizing two fundamentally inspected
DWT in parallel on similar information (Fig.14).
Fig. 14. Dual-Tree Complex Wavelet Transform
In a critically sampled transform, it is hard to accomplish the close shift invariance of the
double tree CWT. The double tree CWT is a profitable upgrade of the customary genuine
wavelet transform that is about shift invariant and, in higher measurements, directionally
particular. Since the genuine and nonexistent parts of the double tree CWT are, truth be told,
ordinary genuine wavelet transforms, the CWT helps from the huge hypothetical, reasonable,
and computational assets that have been produced for the standard DWT. For instance,
programming and equipment produced for usage of the genuine DWT can be utilized
straightforwardly for the CWT. Be that as it may, furthermore, the size and period of CWT
coefficients can be misused to grow new powerful wavelet-based transforms, especially for
applications where DWT is unsuited or fails to meet expectations. Inexact shift invariance
property and accessibility of stage data in DTCWT are valuable in the image fusion process.
The inexact shift invariance property of DTCWT is essential in robust sub-band combination
and makes it to keep away from loss of critical picture content at distinct levels. Then again,
the accessibility of stage data in complex coefficients of DTCWT is valuable in encoding more
sound structures of the melded pictures. DTCWT based medical image fusion technique is
given below;
1. Re-slicing and co-registration of 3D volumes of input images by means of the statistical
parametric mapping tool (Fig. 15).
2. Apply maximum frequency fusion rules.
3. Fusion of co-registered sliced images using DTCWT.
4. Applying inverse DTCWT to wavelet coefficients to obtain fused image.
5. Quality metrics are calculated and analyzed for the fused image.
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Fig. 15. Dual-Tree Complex Wavelet Transform Based Medical Image Fusion
3.2 Wavelet Transform and Medical Image Fusion

In medical imaging, CT and MRI picture both are topographic scanning pictures and have
special highlights. In CT picture, brightness is identified with tissue thickness. In this way,
the splendor of bone is higher and some of delicate tissue can't be found in CT pictures. In
MRI picture brightness is identified with measure of hydrogen molecule in tissues, therefore
brightness of delicate tissue is higher, and bones can't be seen. By utilizing fusion method, it
is conceivable to get both data in the single yield picture. The genuine combination process
can occur at distinct levels of data delineation; a nonspecific order is to consider the levels as
pixel level fusion, feature level fusion, decision level fusion. The productive combination of
pictures procured from assorted modalities is critical in numerous applications, for example,
medicinal imaging, microscopic imaging, remote detecting, computer vision. The aftereffects
of picture combination in regions, for example, remote detecting and medicinal imaging are
basically expected for introduction to a human onlooker for less demanding and upgraded
elucidation. Thus, the understanding of the intertwined picture is of foremost significance
while assessing diverse combination plans. Pixel level combination calculations may shift
from exceptionally basic picture averaging to extremely perplexing wavelet transforms. A
few ways to deal with pixel level combination can be recognized relying upon whether the
pictures are intertwined in the spatial domain or in transform domain. After the melded
picture is created it might be handled further and a few highlights of intrigue might be
separated. Wavelet transform based medical image fusion schemes offer several advantages
over other fusion schemes;
- Wavelet transform provides directional information while the pyramid representation
doesn’t introduce any spatial orientation in the decomposition process.
- In major image fusion schemes, the fused images often contain blocking effects in the
regions where the input images are vigilantly different. No such artefacts are observed
in wavelet-based fusion.
- Fused images generated by wavelet image fusion have better signal-to-noise ratios (SNR)
than images caused by other image fusion schemes when the same fusion rules are used.
- When subject to human analysis wavelet fusion results are better perceived.
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3.3 Why Hybrid Wavelet Transform?

The standard image fusion techniques, such as Intensity-Hue-Saturation (IHS) based method,
principal component analysis (PCA) based method and Brovey transform method operate under
spatial domain. Nonetheless, the spatial space combinations may deliver spectral degradation. It
has been discovered that wavelet-based combination methods beat the standard combination
procedures in spatial and spectral quality, particularly in minimizing color distortion. Orthogonal
transforms are utilized to explore global properties. Each transform has its own attributes. In
wavelet transform, some orthogonal transform centers around global properties of information
while some exhibit local properties in better way. Hybrid wavelet joins properties of two diverse
orthogonal transforms giving qualities of both transforms. The results of the hybrid wavelet
transform are compared with other traditional wavelet transform techniques in medical image
fusion using quantitative metrics such as, Standard Deviation (SD), Entropy (E), Cross Entropy
(CE), Spatial Frequency (SF), Fusion Image Mutual Information (FIMI), Fusion Image Quality Index
(FIQI), Fusion Image Similarity Metrics (FISI), Weighted Fusion Quality Index (WFIQI), Edge
Dependent Fusion Quality Index (EDFQI), Degree of Distortion (DD) for performance evaluation.
Schemes that combine different wavelet transform produce superior results than either standard
methods or simple wavelet-based methods alone. Yet, the trade-off is higher complexity and cost.
3.4 Lifting Wavelet Transform

First generation wavelets have demonstrated to be valuable in numerous applications in
designing and software engineering. Be that as it may, they can't be utilized with non-linear,
data-adaptive decompositions and non-equispaced data. Second generation wavelets and the
lifting transform that can be utilized to apply the customary advantages of wavelets into an
extensive variety of new zones in signal processing, data processing and computer graphics.
Lifting scheme is a basic development of second generation wavelets; these are wavelets that
are not necessarily translates and dilates of one fixed function. Such wavelets can be adjusted
to interims, spaces, surfaces, weights, and unpredictable examples. Lifting scheme prompts a
quicker, set up count of the wavelet transform. The lifting scheme is a method for both scheme
wavelets and playing out the discrete wavelet transform. In a usage, it is regularly beneficial
to blend these means and scheme the wavelet channels while playing out the wavelet
transform. The lifting scheme factorizes any discrete wavelet transform with limited channels
into an advancement of rudimentary convolution operators, lifting steps, which decreases the
quantity of number juggling activities by almost a factor two. Treatment of signal boundaries
is additionally disentangled. The DWT applies a few channels autonomously to a similar
signal. As opposed to that, for the lifting scheme, the signal is isolated like a zipper. A solitary
lifting step can be depicted by the accompanying three fundamental tasks:
- Split: Splitting the signal into disjoint components. A typical method to do this is to
remove the even and odd polyphase parts as broadcasted in Fig. 17. This split task is
otherwise called the lazy wavelet.
- Predict: The odd polyphase component based on a linear combination of samples of the
even polyphase component got from the split step. The samples of the odd polyphase
components are supplanted by the distinction between the odd polyphase component
and the predicted value. The predict operation is additionally alluded to as the dual
lifting step.
- Update: The even polyphase component based on a linear combination of difference
samples obtained from the predict step. The update step is also referred to as the primal
lifting step.
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Fig. 16. One Lifting Step of Lifting Wavelet Transform
(a) (b)
Fig. 17. (a) Design of Split Step and (b) Design of Update Step Using Lifting Scheme
(a) (b)
Fig. 18. (a) Lifting Wavelet Transform and (b) Inverse Lifting Wavelet Transform
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Lately, the medical imaging technology is generally utilized as a part of clinical conclusion.
Distinctive gadgets have diverse imaging rule, so the body tissues reflected is unique. For
instance, CT is a sort of medicinal hardware which has high spatial resolution, bones can be
obviously imaged, and the sore can be found precisely, yet the delicate tissue can't show up
unmistakably. The spatial resolution of MRI is lower than CT's, yet its imaging of delicate
tissue is clear, so it can precisely characterize the extent of the injury, its downside is only that
MRI isn't touchy to calcification, MRI isn't conductive to infection finding. Accordingly, it is
essential that multi-modular therapeutic picture ought to be incorporated to give more exact
pictures to medicinal analysis. The lifting wavelet is utilized to break down and reproduce
the picture. The technique received defeats the confinement of the first wavelet translate and
expanse constantly, diminishes the computational multifaceted nature of wavelet transform
process, enhances the impact of combined picture clearly. The outline system of split and
update step utilizing lifting wavelet transform is appeared in Fig. 17. The scheme of lifting
wavelet transforms, and inverse lifting wavelet transform is appeared in Fig. 18. Lifting
wavelet transform based medical image fusion technique is given below;
1. Apply two-dimensional lifting wavelet decomposition to the source images.
2. Adopt the rules of selection and weighted average low-frequency fusion for the low-
frequency decomposition coefficient; the corresponding low frequency fused images.
3. For vertical, horizontal and diagonal three orientations of high-frequency decomposition
coefficient, go for high frequency component.
4. Determine the scale coefficients and the coefficients for each wavelet.
5. By applying inverse lifting wavelet transform, the ultimate fusion image is obtained.
The mathematical representation for the design of lifting wavelet transform and inverse
lifting wavelet transform in given below;
Lifting Wavelet Transform

{ ( )} = { ( )} − ({ ( )} )
{ ( )} = { ( )} + ({ ( )} )
{ ( )} = ({ ( )} , { ( )} )
Inverse Lifting Wavelet Transform

{ ( )} , { ( )} = ({ ( )}
{ ( )} = { ( )} − ({ ( )} )
{ ( )} = { ( )} + ({ ( )} )
The lifting wavelet transform espouse the following important properties;

1. Perfect reconstruction - Every transform by the lifting scheme can be reversed. Every perfect-
reconstruction filter bank can be decayed into lifting steps.
2. Speedup - Speedup is by a factor of two. This is conceivable because lifting is constrained to
perfect-reconstruction filter banks.
3. Non-linearities - The convolution operations can be substituted by any other operation. For
perfect reconstruction only the invertibility of the addition operation is pertinent.
4. Increasing vanishing moment, stability and regularity - A lifting changes biorthogonal filters to
increase the number of vanishing moments of the subsequent biorthogonal wavelets, and
expectantly their stability and regularity.
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4. Nature Inspired Algorithms

Nature-inspired algorithms are a group of algorithms that mimic the physical or biological
phenomena to take care of computational issues. They are an arrangement of critical thinking
hones that have been pulling in broad consideration for their dependable execution. Many
heuristic calculations for pursuit and improvement draw their motivation from nature. Cases
incorporate simulated annealing and swarm intelligence algorithms, besides developmental
and hereditary algorithms. The interest of these algorithms is that they are in some sense
universally useful and don't require point by point learning of the issue to be illuminated. This
is helpful in functional situations where time, money, and learning limit the improvement of
issue calculation. Nature-inspired algorithms have been increasing much ubiquity lately since
some certifiable advancement issues have turned out to be progressively vast, unpredictable
and dynamic. The size and multifaceted nature of the problems these days need the progress
of techniques and arrangements whose proficiency is estimated by their capacity to discover
adequate outcomes inside a sensible measure of time, as opposed to a capacity to ensure the
ideal arrangement.
Nature inspired algorithms is an extremely dynamic research region. Behind the unmistakable
marvels, there are endless imperceptible causes covered up now and again. Philosophers and
researchers have been watching these marvels in the nature for a considerable length of time
and attempting to comprehend, clarify, adjust and duplicate the counterfeit frameworks. There
are incalculable specialists and powers inside the living and non-living world, the clear
majority of which are obscure, and the hidden many-sided quality is outside human ability to
realize. These agents’ operators in parallel and regularly against each other giving structure
and highlight to nature, and directing the congruity, magnificence and life of life. This is
viewed as the rationalizations of nature which lies in the idea of the development of the regular
world. The advancement of intricacy in nature takes after a request. There is additional data
preparation in nature performed in a conveyed, self-sorted out and ideal way with no focal
control. This entire arrangement of structures, mechanical, physical, synthetic, organic and
social, is conveyed by many-sided quality from lower to higher. This grouping communicates
its common reliance and relationship regarding structure and history. The exercises change
because of changed conditions. Every one of these marvels known or incompletely referred to
so far are rising as new fields of science and innovation and processing that review critical
thinking procedures roused by nature and endeavors to comprehend the basic standards and
instruments of characteristic, physical, concoction and natural life forms that perform complex
assignments in a befitting way with restricted assets and capacity. Science is a discourse
between the researchers and the nature which has developed throughout the hundreds of
years enhancing with innovative ideas and methodologies. Humankind has been attempting
to comprehend nature as far back as by growing new devices and methods. The field of nature-
motivated processing is interdisciplinary in nature joining computing science with learning
from various branches of sciences, for example, calculations, equipment, or wetware for critical
thinking, amalgamation of examples, practices and life forms. All the living and non-living
world, the planetary, galactic, stellar framework and the glorious bodies in the universe have
a place with nature. One basic viewpoint can be seen in nature, be it physical, substance or
organic, that the nature keeps up its balance by any methods known or obscure to us. A
disentangled clarification of the condition of harmony is the possibility of ideal looking for in
nature. There is ideal looking for in all circles of life and nature. This ideal looking for can be
defined as an improvement issue. That is, it is lessened to finding the best procedure estimated
by an execution list frequently known as target work in numerous areas of computing and
engineering which differs from issue to issue.
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4.1 Kinds of Nature Inspired Algorithms

The nature-inspired computing paradigm is vast. Even though science and designing have
developed over numerous hundred years with numerous astute apparatuses and techniques
accessible for their answer, there is yet an assorted scope of issues to be fathomed, marvels to
be blended. At large, natural computing approaches ought to be thought about when;
- The problem is unpredictable, nonlinear and comprises numerous factors or potential
arrangements and has different goals.
- The problem to be fathomed can't be suitably verified utilizing regular methodologies,
for example, complex pattern recognition and classification tasks.
- Finding an ideal arrangement utilizing customary methodologies isn't conceivable, hard
to get or can't be ensured, however a quality measure exists that permits correlation of
different arrangements.
- The problem fits an assorted variety of arrangements is attractive.
Numerous techniques have risen for the arrangement of enhancement issues which can be
separated into two classes in view of the delivered arrangements, specifically deterministic
and nondeterministic algorithms. Deterministic algorithms as a rule take offer more systematic
techniques rehashing as an analogous way every time and giving a similar arrangement in
various runs. Exemplary algorithms are deterministic and in view of scientific programming.
A wide range of scientific programming techniques have been produced in the previous
couple of decades. Cases of deterministic algorithms are quadratic programming, slope based,
direct programming, dynamic programming, and nonlinear programming. These techniques
as a rule give precise answers for issues in a ceaseless space. Most of these strategies,
nonetheless, require the inclination data of the target capacity, imperatives and an appropriate
introductory point. Rather, nondeterministic or stochastic plans display some arbitrariness
and deliver distinctive arrangements in various runs. The preferred standpoint is that these
techniques investigate a few areas of the inquiry space in the meantime and can escape from
nearby optima and achieve the worldwide ideal. In this way, these techniques are more fit for
dealing with NP-problem issues i.e. issues that have no known arrangements in polynomial
time. There is an assortment of subordinate free stochastic advancement calculations which
are of two sorts: heuristic calculations and meta-heuristic calculations. A typical component
shared by all nature-roused meta-heuristic algorithms is that they join tenets and arbitrariness
to mimic some regular marvels. Numerous nature-propelled computing standards have risen
as of late. They can be gathered into three expansive classes: physics-based algorithms,
chemistry-based algorithms and biology-based algorithms. Physics-based algorithms utilize
essential standards of material science, for instance, Newton's laws of attraction, laws of
movement and Coulomb's power law of electrical charge. They are altogether in view of
deterministic physical standards. Biology-based algorithms can be arranged into three
gatherings: Evolutionary Algorithms, Bio-inspired Algorithms and Swarm Intelligence-based
Algorithms. Groups of flying creatures, crowds of quadrupeds and schools of fish are
frequently appeared as interesting cases of self-sorted out coordination. Particle swarm
optimization simulates social behavior of swarms such as birds flocking and fish schooling in
nature. Particles make utilization of the best positions experienced and the best position of
their neighbors to position themselves towards an ideal arrangement. Nature-inspired
processing alludes to a class of meta-heuristic algorithms that copy or propelled by some
normal wonders clarified by characteristic sciences. Firefly algorithm is a metaheuristic
calculation for worldwide advancement, which is roused by blazing conduct of firefly creepy
crawlies. Fireflies utilize the glimmering conduct to pull in different fireflies, typically to send
signs to inverse sex. In any case, in the numerical model, utilized inside Firefly Algorithm,
basically the fireflies are unisex, and any firefly can pull in different fireflies.
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4.2 Firefly Optimization Algorithm

Metaheuristic algorithms shape a key piece of contemporary global optimization algorithms,
computational insight and delicate computing. These algorithms are normally nature-inspired
with various cooperating agents. A subset of metaheuristics is frequently alluded to as swarm
intelligence-based algorithms, and these calculations have been produced by imitating the
purported swarm insight qualities of natural specialists, for example, birds, fish, humans and
others. For instance, particle swarm optimization depended on the swarming conduct of birds
and fish, while the firefly calculation depended on the blazing example of tropical fireflies and
cuckoo look calculation was roused by the brood parasitism of some cuckoo species. Over the
most recent two decades, more than twelve new calculations, for example, particle swarm
optimization, differential development, bat algorithm, firefly algorithm and cuckoo seek have
showed up, and they have demonstrated immense potential in solving tough engineering
optimization problems. Among these new algorithms, it has been demonstrated that firefly
algorithm is exceptionally proficient in managing multimodal, global optimization issues.
Firefly algorithm depends on the glimmering examples and conduct of fireflies. Firefly
calculation utilizes the accompanying three glorified tenets:
1) All fireflies are unisex, so one firefly will be pulled in to different fireflies paying little heed
to their sex;
2) Attractiveness is corresponding to their brightness, in this manner for any two blazing
fireflies, the less bright one will move towards the brighter one. The engaging quality is
corresponding to the brightness and they both abatement as their separation increments. On
the off chance that there is no brighter one than a specific firefly, it will move haphazardly;
3) The brightness of a firefly is influenced or dictated by the scene of the objective function.
For an expansion issue, the brightness can basically be corresponding to the estimation of the
objective function.
In firefly algorithm, there are two basic issues: the variety of light force and definition of the
appeal. For effortlessness, it is constantly accepted that the allure of a firefly is dictated by its
splendor which thusly is related with the encoded objective function. In view of these three
principles, the essential strides of the firefly algorithm can be outlined as the pseudo code
demonstrated as follows;
Begin
Objective function: ( ), = ( , ,…., ) ;
Generate an initial population of fireflies ( = 1,2, . . , );
Formulate light intensity at is determined by ( );
Define light absorption coefficient ;
While (t < MaxGeneration)
for i = 1: n (all n fireflies)
for j = 1: n (all n fireflies)
if ( > ),
Vary attractiveness with respect to distance of light absorption coefficient;
move firefly i towards j;
Evaluate new solutions and update light intensity;
end if
end for j
end for i
Rank fireflies and find the current best;
end while
Post-processing the results and visualization;
End
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4.3 Advantages of Firefly Optimization Algorithm

Firefly algorithm has two noteworthy favorable settings over different algorithms: automatic
subdivision and the capacity of managing multimodality.
1) It is based on attraction and attractiveness decreases with distance. This prompts the way
that the whole populace can naturally subdivide into subgroups, and each gathering can
swarm around every mode or neighborhood ideal. Among every one of these modes, the best
global solution can be found.
2) The subdivision enables the fireflies to have the capacity to discover all optima all the while
if the populace estimate is adequately higher than the quantity of modes. It controls the normal
separation of a gathering of fireflies that can be seen by neighboring gatherings. Accordingly,
a whole populace can subdivide into subgroups with guaranteed, normal separation. In the
outrageous state when γ=0, the whole populace won't subdivide. This automatic subdivision
capacity makes it appropriate for exceptionally nonlinear, multimodal optimization issues.
3) The firefly algorithm parameters can be tuned to control the irregularity as cycles continue,
with the goal that merging can likewise be accelerated by tuning these parameters. These focal
points make it adaptable to manage continuous problems, clustering and classifications, and
combinatorial optimization.
5. Implementation
CT and MRI scanned image of human brain are utilized as info pictures as seemed in Fig. 19.
In MRI image, the delicate tissue like the membranes covering the mind can be unmistakably
watched however the hard tissue like the skull bones can't be plainly observed. In CT scanned
image, hard tissue like the skull bone is plainly observed however the delicate tissue like the
membranes covering the brain are less unmistakable. In this way, to get more data, CT and
MRI examines are combined. By joining both the CT and MRI scanned images of the brain, a
resultant picture in which both hard tissue like skull bones and the delicate tissue like the
membranes covering the mind can be unmistakably noticeable. Wavelet method should be a
standout amongst the most encouraging techniques for image fusion because of its openness
and capacity to save the time and recurrence areas of interest of the picture to be melded.
Wavelet fusion transforms the pictures from spatial area to wavelet space. The wavelet space
signifies to the wavelet coefficient of the images.
Principally, the Discrete Wavelet Transform will decompose the input images to obtain the
decomposed coefficients. Then, firefly optimization algorithm is performed for automatic
subdivision of the decomposed coefficients to obtain the combined optimization of the input
images. Further, the optimized decomposed coefficients of the input images are combined in
the wavelet domain based on the fusion rule. The source images are transformed to the
frequency domain by means of the lifting wavelet transform. Then, the resultant coefficients
of the optimized decomposed coefficients are achieved by comparing the covariance of the
coefficients of the source images. Meanwhile, the resultant coefficients of source images are
calculated according to the matching measure between the directional characteristic of the
coefficients in the same sub-band and thus split, predict, update and merge steps were
performed as explained in the earlier section 3.4. Finally, the optimized fused image is
obtained through the inverse lifting wavelet transform. Several evaluation indexes, such as
Standard Deviation (SD), Entropy (E), Cross Entropy (CE), Spatial Frequency (SF), Fusion
Image Mutual Information (FIMI), Fusion Image Quality Index (FIQI), Fusion Image Similarity
Metrics (FISI), Weighted Fusion Quality Index (WFIQI), Edge Dependent Fusion Quality
Index (EDFQI), Degree of Distortion (DD) are employed to judge the experimental images
with different traditional wavelet fusion methods.
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Fig. 19. Implementation of Proposed Hybrid Wavelet Fusion Using Firefly Optimization
6. Analyzing and Diagnosing Alzheimer’s Disease

With expanded populace of aged people, Alzheimer's Disease (AD) is a foremost problem in
socioeconomic consequences. In this manner, exact investigation of AD is essential, especially,
at its underlying stage. Typically, the study of AD is accomplished by a neuropsychological
assessment in arrangement of basic imaging. It is affirmed that in the underlying phase of AD,
weakening of neurons occurs in the medial temporal lobe, logically upsetting the entorhinal
cortex, the hippocampus, and the limbic framework, and neocortical regions at the later stage.
Therefore, the review of medial temporal lobe atrophy, basically in the hippocampus, the
entorhinal cortex, and the amygdala bears the sign of AD progression. Characteristically, the
medial temporal lobe atrophy is restrained as far as voxel-based, vertex-based, and ROI-based
practices. Be that as it may, as the ailment propels, different zones of the cerebrum are likewise
misrepresented. In those cases, complete brain strategies are picked as opposed to a positive
area-based technique; at that point, the portrayal of cerebrum decay for recognizing AD and
Mild Cognitive Impairment (MCI) patients can be accomplished more capably. Fig. 20 shows
the total methodology for the investigation and analysis of Alzheimer's sickness. Cautious
assessment of people with manifestations of dementia is critical because a few reasons for
subjective weakness are treatable or reversible. Possibly reversible conditions incorporate
wretchedness, antagonistic medication responses, metabolic changes and dietary lacks.
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Fig. 20. Analysis and Diagnosis of Alzheimer’s Disease

There is no single clinical test that can be utilized to recognize Alzheimer's. An exhaustive
assessment incorporates a total wellbeing history, physical examination, neurological and
mental status appraisals, investigation of blood and urine, electrocardiogram, and potentially
an imaging exam, for example, CT or MRI. A patient's parental figure, relative companion may
likewise have the capacity to give valuable data about the patient's psychological status. While
this sort of assessment may give an analysis of conceivable or plausible Alzheimer's with up
to 90 percent precision, supreme affirmation requires examination of brain tissue at dissection.
Amid the Mini-mental state exam (MMSE), a wellbeing proficient solicits a patient the plan
from questions intended to test a scope of ordinary mental abilities. The most extreme MMSE
score is 30 focuses. A score of 20 to 24 proposes gentle dementia, 13 to 20 recommends direct
dementia, and under 12 demonstrates serious dementia. All things considered, the MMSE
score of a man with Alzheimer's decays around two to four focuses every year.
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6.1 Evaluation Metrics

Digital images are liable to a wide hodge-podge of mutilations amid securing, preparing,
compressing, stockpiling, transmission and propagation, any of which may bring about a
corruption of visual quality. For applications in which pictures are at last to be seen by people,
for example, medical image analysis and diagnosis, subjective valuation is usually too badly
arranged, tedious and costly. The objective of research in target picture quality evaluation is
to create quantitative measures that can mechanically foresee apparent picture quality. The
adequacy of the combination strategies and the nature of the resultant intertwined pictures
can be assessed and investigated quantitatively with the picture quality measurements.
Picture quality measurements are characterized into two classes: reference and non-reference
measurements. Reference measurements assesses against the reference picture. Be that as it
may, progressively applications, the accessibility of reference picture isn't conceivable. Thus,
the non-reference picture quality measurements alone considered for assessment of the
proposed hybrid image fusion method. The non-reference picture quality measurements
utilized are Standard Deviation (SD), Entropy (E), Cross Entropy (CE), Spatial Frequency (SF),
Fusion Image Mutual Information (FIMI), Fusion Image Quality Index (FIQI), Fusion Image
Similarity Metrics (FISI), Weighted Fusion Quality Index (WFIQI), Edge Dependent Fusion
Quality Index (EDFQI), Degree of Distortion (DD). Some of these measurements measure the
measure of data exhibit in the combined picture, though alternate measurements measure the
nature of a picture. In restorative applications for better analysis, a picture ought to have both
these characteristics. Thus, rise to importance ought to be given to both the quality
measurements that measure quality and data content. What's more, the estimations of every
one of the quality metric may broadly fluctuate in their range. To get the metric esteems the
uniform range and by giving equivalent significance, the above considered non-reference
picture quality measurements are measurably standardized.
6.1.1 Standard Deviation (SD)
Standard deviation is utilized to gauge the differentiation in the combined picture. At the point
when the estimation of SD is high, it validates the combined picture as sharp differentiation.
Higher the estimation of SD, higher is the nature of the melded picture.
= ( − ) ()
In the above equation, AvF is the pixel grey mean image, PF is the image pixel value
distribution. The standard deviation reflects the image contrast, larger values of SD, the image
contrast is stronger, the visual effect is better.
6.1.2 Entropy (E)
Entropy is utilized to gauge the data substance of a melded picture. The high entropy esteem
demonstrates the combined picture as rich information content.
= − ( ) log ()
In the above equation, PF is to estimate the fused image pixel value distribution. N is the fusion
image of the total grey level. Entropy E represents the amount of information including an
image of the value, larger values of HF, which means the image information is richer, the visual
effect is better.
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6.1.3 Cross Entropy (CE)

Cross entropy is utilized to figure the similitude in data contained between the information
pictures and melded picture. Low estimation of cross entropy demonstrates the information
pictures and intertwined picture containing a similar data.
= log( / )
In the above equation, Pi is the grey level distribution of the source image, Qi is the grey
distribution of fused image, Cross entropy CE is the pixel difference of two images. When the
image difference is small, the more amount of information is extracted, cross entropy CE is the
better evaluation of image fusion.
6.1.4 Spatial Frequency (SF)
Spatial frequency is registered by computing the row frequency and column frequency of
combined picture. Higher estimation of SF shows the info pictures and combined picture are
comparable.
= ( + )
In the above equation, CF is the column frequency of the fused image, RF is the row frequency
of the fused image. Higher value of spatial frequency SF stipulates a superior quality of the
fused image.
6.1.5 Fusion Image Mutual Information (FIMI)
Fusion image mutual information is utilized to register the degree of common data between
the information pictures and intertwined picture. Higher estimation of combination picture
shared data shows a superior nature of the melded picture.
= 1− ( + )
distribution of fused image, MI is the mutual information of the two images. MI is the measure
of the similarity of image intensity between the input images and fused image. Higher the
value of fusion image mutual information FIMI, higher is visual quality (close to 1).
6.1.6 Fusion Image Quality Index (FIQI)
Fusion image quality index is utilized to figure the quality index of the melded picture, the
scope of this metric is 0 to 1. The esteem 1 shows the combined picture contains all the data
from the info pictures.
= 1− ( + )
distribution of fused image, QI is the quality index of the two images. QI is used to model any
distortion as a combination of three several factors: loss of correlation, luminance distortions,
and contrast distortion. The range of QI is –1 to 1. Higher the value of fusion image quality
index FIQI, higher is visual quality (close to 1).
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6.1.7 Fusion Image Similarity Metric (FISI)

Fusion image similarity metric is utilized to compute the spatial likeness between the info and
melded pictures. The scope of this metric is 0 to 1. The esteem 1 shows that the combined picture
contains all the data from the info pictures.
= 1− ( + )
distribution of fused image, SI is the similarity index of the two images. SI is used to compare
the local patterns of pixel intensities between the source images and the fused image. The
range varies between -1 to 1. Higher the value of fusion image similarity metric FISI, higher is
visual quality (close to 1).
6.1.8 Weighted Fusion Image Quality Index (WFIQI)
Weighted fusion image quality index measures the level of striking data of intertwined picture
which is exchanged from the source pictures. Higher estimation of WFIQI shows that the
melded picture as prevalent quality.
= ( + )
distribution of fused image, UIQI is the Universal Image Quality Indicator of the two images
and is given by,
4 ∗ ∗
=
+ +
Where is the covariance between the band of source images and the band of fused image,
µ and SD are the mean and standard deviation of the corresponding images. The higher UIQI
index, the healthier will be spectral quality of the fused image. It is recommended to practice
the moving windows of unusual sizes to evade errors due to index spatial dependence.
6.1.9 Edge Dependent Fusion Quality Index (EDFQI)
Edge dependent fusion quality index measures the edge data of the melded picture. The more
noteworthy the estimation of EDFQI shows that the combined picture as brilliant quality.
= ( + ) ( + )
distribution of fused image, WFIQI is the weighted fusion image quality index as discussed in
the sub-section 6.1.8. Higher value of EDFQI indicates that the fused image as superior quality.
6.1.10 Degree of Distortion (DD)
Degree of Distortion is frequently used to figure the degree of mutilation in intertwined
picture. The lower estimation of DD validates that the intertwined picture as brilliant quality.
1
=
,
+ ,
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6.2 Performance Evaluation of Proposed Hybrid Wavelet Transform

Table 1 illustrates the performance of the proposed optimized hybrid wavelet transform based
on lifting scheme. The comparison results show that the proposed hybrid wavelet based
optimized image fusion built on discrete wavelet transform and lifting wavelet transform has
better fused image quality (Fig. 23).
Hybrid Wavelet
Discrete Lifting Proposed Hybrid
Transform
Fusion Method/ Wavelet Wavelet Wavelet Transform
(DWT+LWT)
Evaluation Metric Transform Transform (DWT+LWT) with
without
(DWT) (LWT) Optimization
Optimization
Standard Deviation
43.111 49.771 56.165 62.043
(SD)
Entropy
17.009 25.673 29.029 36.231
(E)
Cross Entropy
0.6699 0.6214 0.5513 0.4652
(CE)
Spatial Frequency
34.121 46.990 49.123 59.142
(SF)
Fusion Image
Mutual Information 0.5341 0.7986 0.7650 0.8953
(FIMI)
Fusion Image
Quality Index 0.5967 0.8175 0.8423 0.9413
(FIQI)
Fusion Image
Similarity Metrics 0.5341 0.7986 0.7650 0.9261
(FISI)
Weighted Fusion
Image Quality 67.81% 75.04% 86.87% 92.32%
Index (WFIQI)
Edge Dependent
Fusion Quality 39.005 53.893 61.895 75.354
Index (EDFQI)
Degree of
0.6268 0.5595 0.5020 0.3462
Distortion (DD)
Table 1. Fused Image Quality Evaluation Metrics and Proposed Method
The momentous promises of the proposed optimized hybrid wavelet transform built on lifting
scheme is been summarized from the comparison Table 1 as below;
1) Since the proposed method is built on second generation wavelet transform, it leads to a
quicker, in-place calculation of the wavelet transform compared to the first-generation DWT.
2) Fusion image mutual information (FIMI) of proposed method is higher compared to DWT,
proving it more affluent in information content of the source images and has sophisticated
application value in medicinal analysis as well as diagnosis like Alzheimer’s disease.
3) The proposed method is more real in data-adaptive decompositions and non-equispaced
data as built on second generation wavelet transforms reducing arithmetic operations.
4) The firefly optimization benefits in automatic subdivision of wavelet decomposition and
parameter tuning, thus establishing an inclined and information rich optimized fused image
serving higher perception for human vision by reducing redundancy.
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6.3 Performance Evaluation of Traditional Wavelet Transforms and Proposed Method

Table 2 illustrates the performance of the diverse traditional wavelet transforms for various
image quality evaluation metrics. The comparison results show that neither of the single
traditional wavelet transforms were good enough in holding better fused image quality for all
the fused image evaluation metrics apart from the proposed method (Fig. 24).
Haar Discrete Discrete

Dual-Tree Complex
Fusion Method/ Wavelet Ridgelet Curvelet
Wavelet Transforms
Evaluation Metric Transforms Transforms Transforms
(DTCWT)
(HWT) (DRT) (DCVT)
Standard Deviation
44.874 51.039 59.956 53.867
(SD)
Entropy
18.957 23.475 21.178 19.645
(E)
Cross Entropy
0.7804 0.7236 0.6927 0.6258
(CE)
Spatial Frequency
50.403 45.829 44.756 39.241
(SF)
Fusion Image Mutual
0.5678 0.6744 0.6927 0.6156
Information (FIMI)
Fusion Image Quality
0.6934 0.7297 0.6981 0.7090
Index (FIQI)
Fusion Image
Similarity Metrics 0.4856 0.6827 0.7187 0.7483
(FISI)
Weighted Fusion
Image Quality Index 60.94% 55.63% 59.34% 57.59%
(WFIQI)
Edge Dependent
Fusion Quality Index 41.294 49.920 71.895 63.938
(EDFQI)
Degree of Distortion
0.6392 0.6149 0.6272 0.6794
(DD)
Table 2. Fused Image Quality Evaluation Metrics and Traditional Wavelet Transforms
The substantial promises of the proposed optimized hybrid wavelet transform compared to
other traditional wavelet transforms is been abridged from the comparison Table 2 as below;
1) Edge dependent fusion quality index (EDFQI) of the discrete curvelet transforms (DCVT) is
abstemiously better than the other wavelet transforms though the proposed optimized hybrid
wavelet transforms outperform, proving the edge detection is more precise and robust.
2) Spatial frequency (SF) of the haar wavelet transforms (HWT) is higher relative to other
image fusion methods based on wavelet transforms; however, the proposed method shows
better recital, attesting it easier to implement by reducing the computational complexity.
3) Degree of distortion (DD) is lesser in discrete ridgelet transforms (DRT) in relation to other
wavelet transforms based image fusion, but still the proposed method shows definitive
concert, proving it further distortion free because of the filter banks confined in the split stage.
4) Fusion image similarity metrics (FISI) is better in the case of dual-tree complex wavelet
transforms (DTCWT), yet, the proposed optimized hybrid wavelet transforms display much
better results, proving its perfect reconstruction capability without loss of information content,
which is a vital characteristic for disease analysis and diagnosis like Alzheimer’s disease.
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6.4 Performance Evaluation of Proposed Method in Diagnosing Alzheimer’s Disease

Computerized tomography of the head is a prodigious tool for the fast-preparatory valuation
of cerebral pain, injury or neurological brokenness like dementia, gentle subjective impedance,
and Alzheimer's illness. In any case, the fluctuation of decay in the ordinary maturing process
makes it hard to utilize CT alone as an authoritative indicative procedure. In this manner,
melding CT and MRI pictures are accepted to be a successful strategy for characterizing
neurodegenerative scatters as a minimal effort viable component. For assessing the proposed
hybrid wavelet image fusion strategy in diagnosing Alzheimer's Disease, the quantitative
assessment measurements like Average Gradient and Spectral Discrepancy were utilized.
Average Gradient is a foundation to survey the capacity of the intertwined picture to protect
the spatial nature of source pictures. Average Gradient mirrors the clearness of the combined
image. A bigger normal slope implies a higher spatial resolution. The spatial nature of an AxB
melded picture can act naturally controlled by the normal slope at each band. The average
gradient is figured in percentage as;
⎛ 1− + ⎞
1
=⎜ ⎟ 100
⎜( − 1)( − 1) 2 ⎟
⎝ ⎠
Spectral Discrepancy is a measure for assessing the capacity of melded pictures to hold the
phantom highlights of source pictures. A higher value of percentage spectral discrepancy
represents a higher spectral resolution. The Spectral Discrepancy is figured in percentage;
1
=1− | ( , ) − ( , )| 100
∗
where ( , ) and ( , ) are the pixel values of the fused image at position ( , ) respectively.
Two datasets; Dataset 1 containing the details of 100 patients of normal axial and normal
coronal between age group 25 years to 85 years and Dataset 2 containing the details of 100
patients of Alzheimer’s disease between age group 25 years to 85 years were utilized. Table 3
epitomizes the performance evaluation of the proposed optimized image fusion method in
diagnosing Alzheimer’s disease with other traditional wavelet transform based image fusion
method for two patients with same age of 65 years (Dataset 1 Patient 1, Dataset 2 Patient 1)
when substantiated for normal axial, normal coronal and Alzheimer's brain disease images.
Average gradient and Spectral discrepancy are assessed in percentage to make the comparison
more precise and user-friendly (More than 80% is classified as highly detected, 60%-79% as
moderately detected, 40%-59% as fairly detected and less than 39% as poorly detected).
The extensive promises of the proposed method compared to traditional wavelet transforms
based fusion in the diagnosis of Alzheimer’s disease is been concise from Table 3 as below;
1) Percentage average gradient and percentage spectral discrepancy of the proposed image
fusion method is highly accurate in detecting normal axial, normal coronal and Alzheimer's
brain disease images in comparison to other wavelet transforms based image fusion methods.
2) The proposed method shows better clarity and provides excellent spectral features due to
its progressive nature of stability and regularity.
3) Owing to its ability of invertibility and optimization of non-linear data’s through firefly
optimization, the proposed optimized fusion method shows inevitable efficacy in diagnosing
Alzheimer’s diseases (Fig. 21 and Fig. 22).
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Dataset 1 Patient 1
Dataset 2 Patient 1
(Normal Axial and
Imaging (Alzheimer’s Disease)
Fusion Normal Coronal)
Method Average Spectral Average Spectral
Gradient Discrepancy Gradient Discrepancy
56% 47% 34% 39%
DWT
Fairly detected Poorly detected
74% 71% 56% 59%
LWT
Moderately detected Fairly detected
54% 48% 32% 38%

HWT
Fairly detected Poorly detected
71% 76% 54% 58%

DRT
73% 78% 46% 53%

DCVT
78% 75% 42% 57%

DTCWT
94% 92% 92% 95%

PROPOSED
METHOD Highly detected Highly detected
Table 3. Performance Evaluation of Proposed Optimized Image Fusion Method in Diagnosing

Alzheimer’s Disease with other Traditional Wavelet Transform Based Image Fusion Method
for two patients with same age of 65 years (Dataset 1 Patient 1, Dataset 2 Patient 1).
7. Conclusion
The chapter make available a state-of-art of hybrid wavelet based optimized medical image
fusion. The anticipated optimized hybrid wavelet image fusion method is a cutting-edge for
analyzing and diagnosing diseases like Alzheimer’s disease proficiently. The promises of the
projected method over other traditional wavelet transforms based image fusion method is the
pliable structure by choosing suitable prediction and update factors conferring to the problems
examined. By using firefly optimization method, the connection coefficients on the interlude
are calculated precisely based on the corresponding filters. The numerical outcomes confirm
the competence of the proposed method and validates that the proposed optimized hybrid
wavelet fusion method can be functional to an extensive range of medical conclusion and
engineering glitches capably. However, below are few risks involved in the proposed method;
1) It is not fashionable for high power applications in real time.
2) The error estimation is not constant, varies with respect to the problem declaration and its
application due to predefined nature of optimization.
3) It does not fit for multiple problem analysis.
4) The degree of stiffness cannot be single-minded by means of homogeneous applications, it
diverges dynamically for inhomogeneous applications.
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Fig. 21. Average Gradient and Proposed Method in Diagnosis of Alzheimer’s Disease
Fig. 22. Spectral Discrepancy and Proposed Method in Diagnosis of Alzheimer’s Disease
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Fig. 23. Performance Evaluation of Proposed Fusion Method
Fig. 24. Traditional Wavelet Fusion Methods Versus Proposed Fusion Method
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P.S.Jagadeesh Kumar, Y Yung, M Pan, W Hu. (2018) Classification and Evaluation of Macular
Edema, Glaucoma and Alzheimer’s Disease Using Optical Coherence Tomography.
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Medical Image Processing and Health Care Services
First Edition 2018
Edited by Dr.P.S.Jagadeesh Kumar and Dr.Yang Yung
ISBN 1756-786-51-5021-9
Hard cover, 243 pages
Publisher InTech
Published online 14, February 2018
Published in print edition February 2018
The purpose of this book is to provide an overview of medical image processing and related health care
services in variant diseases like Alzheimer’s disease, glaucoma, mild cognitive impairment, dementia,
and other neurodegenerative syndromes. It is anticipated that it will be useful for research scientists to
capture recent developments and to spark innovative ideas within the medical image processing
domain. With an emphasis on both the basic and advanced applications of medical imaging, this book
covers several unique concepts like optimized image fusion, ophthalmic hashing and linear bootstrap
aggregating that have been graphically represented to improve readability, such as the optimized image
fusion introduced in chapter 1, linear bootstrap aggregating discussed in Chapter 2 and ophthalmic
hashing that is proposed in Chapter 4. The remainder of the book emphases on the area application-
orientated image fusions, which cover the numerous expanses of medical image processing and its
applications.
How to reference
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P.S.Jagadeesh Kumar, Yang Yung (2018). Medical Image Processing and Health Care Services, First Edition
2018, ISBN 1756-786-51-5021-9, Print ISBN 1756-786-51-5020-6, InTech.
Available from: http://www.intechopen.com/books/
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Promise and Risks Tangled in Hybrid

1.2 What is Optimized Medical Image fusion?

1.3 Advances in Medical Image Fusion

2. Medical Image Fusion

2.1 Medical Imaging Modalities

Fig. 2. Computed Tomography Steered Therapeutic Medical Imaging

2.1.2 Magnetic Resonance Imaging

Fig. 3. MRI Steered Therapeutic Medical Imaging

2.1.3 Positron Emission Tomography

Fig. 4. PET and CT Steered Therapeutic Medical Imaging

2.1.4 Single-Photon Emission Computed Tomography

Fig. 5. SPECT Steered Therapeutic Medical Imaging

2.1.5 Ultrasound Imaging

Fig. 6. Ultrasound Steered Therapeutic Medical Imaging

2.1.6 X-Ray Imaging

Fig. 7. X-Ray Steered Therapeutic Medical Imaging

2.2 Needs and Difficulties of Medical Image Fusion

2.3 Role of Medical Image Fusion in Alzheimer’s Disease

2.4 What is Hybrid Medical Image Fusion?

2.5 Benefits of Fusing CT and MRI in Diagnosing Alzheimer’s Disease

These two transforms have the subsequent possessions;

Fig. 8. Wavelet Transform Based Image Fusion

3.1 Types of Wavelet Transform

3.1.1 Discrete Wavelet Transform

Fig. 9. Discrete Wavelet Transform Vs Short Time Fourier transform

3.1.2 Haar Wavelet Transform

Fig. 10. Haar Wavelet Transform and Medical Image Fusion

HWT based medical image fusion technique is given below;

3.1.3 Discrete Ridgelet Transform

Fig. 11. First Generation Curvelet Transform

DRT based medical image fusion technique is given below;

3.1.4 Discrete Curvelet Transform

Fig. 12. First Generation Curvelet Transform

Notwithstanding these intriguing properties, the original curvelet development introduces a

Fig. 13. Discrete Curvelet Transform and Medical Image Fusion

DCVT based medical image fusion technique is given below;

3.1.5 Dual-Tree Complex Wavelet Transform

Fig. 14. Dual-Tree Complex Wavelet Transform

3.2 Wavelet Transform and Medical Image Fusion

3.3 Why Hybrid Wavelet Transform?

3.4 Lifting Wavelet Transform

Fig. 16. One Lifting Step of Lifting Wavelet Transform

Lifting Wavelet Transform

Inverse Lifting Wavelet Transform

The lifting wavelet transform espouse the following important properties;

4. Nature Inspired Algorithms

4.1 Kinds of Nature Inspired Algorithms

4.2 Firefly Optimization Algorithm

4.3 Advantages of Firefly Optimization Algorithm

6. Analyzing and Diagnosing Alzheimer’s Disease

Fig. 20. Analysis and Diagnosis of Alzheimer’s Disease

6.1 Evaluation Metrics

6.1.3 Cross Entropy (CE)

6.1.7 Fusion Image Similarity Metric (FISI)

6.2 Performance Evaluation of Proposed Hybrid Wavelet Transform

Table 1. Fused Image Quality Evaluation Metrics and Proposed Method

6.3 Performance Evaluation of Traditional Wavelet Transforms and Proposed Method

Haar Discrete Discrete