A Hybrid Framework for Medical X-ray Image Enhancement and Segmentation Using K-Means, Fuzzy C-Means, and Fuzzy Connectivity

Abstract

Accurate medical image processing is essential for clinical diagnosis, as it helps physicians identify conditions early and provide timely treatment. Among its components, medical image segmentation is a particularly important step. However, many existing clustering-based segmentation methods treat image enhancement, segmentation, and spatial refinement as separate tasks. This fragmented approach often results in suboptimal segmentation and reduced anatomical consistency. This study addresses this limitation by introducing an integrated hybrid framework for X-ray image enhancement and segmentation. The proposed approach combines adaptive preprocessing with multi–color-space analysis, applies K-means clustering for initial segmentation, uses Fuzzy C-Means (FCM) to model soft class memberships, and incorporates fuzzy connectivity to refine spatial relationships while preserving anatomical continuity. Experiments on real clinical X-ray images show that K-means offers high computational efficiency, while FCM provides better boundary delineation in areas with unclear tissue transitions. Incorporating fuzzy connectivity further improves segmentation performance by reducing fragmentation and strengthening spatial coherence. Overall, the results demonstrate that the proposed hybrid approach outperforms standalone clustering methods, producing more consistent and anatomically meaningful segmentation results. The developed Python-based graphical user interface facilitates interactive visualization and analysis, highlighting the practical applicability of the framework for research, education, and potential clinical decision-support systems.

Country : Yemen

1 Khaled Hassan Balhaf2 Manal Abdul Aziz Al-Nahari3 Alwiyah Ahmed Balhaf4 Manal Omar Bawazir5 Adnan Swailem Ba'adil6 Mohammed Fadhl Abdullah

  1. College of Engineering and Computing, University of Science and Technology, Aden, Yemen & College of Applied and Health Sciences, University of Al-Mahra, Mahra, Yemen
  2. College of Applied and Health Sciences, University of Al-Mahra, Mahra, Yemen
  3. College of Applied and Health Sciences, University of Al-Mahra, Mahra, Yemen
  4. College of Applied and Health Sciences, University of Al-Mahra, Mahra, Yemen
  5. College of Applied and Health Sciences, University of Al-Mahra, Mahra, Yemen
  6. College of Engineering and Computing, University of Science and Technology, Aden, Yemen

IRJIET, Volume 10, Issue 2, February 2026 pp. 1-8

doi.org/10.47001/IRJIET/2026.102001

References

  1. I.Galic, M. Habijan, H. Leventic and K. Romic, "Machine learning empowering personalized medicine: A comprehensive review of medical image analysis methods," Electronics, p. 4411, 21 12 2023.
  2. Y. Xu, R. Quan, . W. Xu, Y. Huang, X. Chen and F. Liu, "Advances in medical image segmentation: A comprehensive review of traditional, deep learning and hybrid approaches," Bioengineering, p. 1034, 11 10 2024.
  3. A.A. Mahmoud, E.-S. M. El-Rabaie,. T. E. Taha, A. Elfishawy, O. Zahran and F. E. Abd El-Samie, "Medical image segmentation techniques, a literature review, and some novel trends," Menoufia Journal of Electronic Engineering Research, pp. 23--58, 2 27 2018.
  4. Q. Bani Baker, M. A. Alsmirat, K. Balhaf and M. A. Shehab, "Accelerating white blood cells image segmentation using GPUs," Concurrency and Computation: Practice and Experience, p. e5133, 2 33 2021.
  5. S. K. Dubey, S. Vijay and A. Pratibha, "A review of image segmentation using clustering methods," International Journal of Applied Engineering Research, pp. 2484--2489, 5 13 2018.
  6. A.B. Mimenbayeva, A. A. Aruova, G. K. Bekmagambetova, R. S. Niyazova, R. D. Turebayeva, A. A. Naizagarayeva and. A. F. Tursumbayeva, "Clustering based Medical Image Segmentation: A Study on MRI Scans of Brain Tumors," in 2024, Proceedings of the 2024 8th International Conference on Advances in Artificial Intelligence.
  7. A.Koundal, S. Budhiraja and S. Agrawal, "Medical Image Segmentation using Enhanced Feature Weight Learning Based FCM Clustering," Biomedical & Pharmacology Journal, pp. 2661--2672, 17 2024.
  8. Q. B. Baker and K. Balhaf, "Exploiting GPUs to accelerate white blood cells segmentation in microscopic blood images," in 8th International Conference on Information and Communication Systems (ICICS), 2017.
  9. O. Darvishi, V. Maihami and K. Khamforoosh, "Improvement of the Fuzzy Clustering Algorithm for Medical Image Segmentation and Denoising Using Fast Bilateral Filtering," Contemporary Mathematics, pp. 2816--2852, 2025.
  10. J. B. McQueen, "Some methods of classification and analysis of multivariate observations," in Proc. of 5th Berkeley Symposium on Math. Stat. and Prob., 1967, pp. 281--297.
  11. P. E. Hart, D. G. Stork and R. Duda, Pattern classification, Wiley Hoboken, 2001.
  12. S. Madhukumar and N. Santhiyakumari, "Evaluation of k-Means and fuzzy C-means segmentation on MR images of brain," The Egyptian Journal of Radiology and Nuclear Medicine, pp. 475--479, 2 46 2015.
  13. H. Zhou, G. Schaefer and C. Shi, "Fuzzy c-means techniques for medical image segmentation," Fuzzy systems in bioinfo. and computational biology, pp. 257--271, 2009.
  14. M. Mohammdian-Khoshnoud, A. R. Soltanian, A. Dehghan and M. Farhadian, "Optimization of fuzzy c-means (FCM) clustering in cytology image segmentation using the gray wolf algorithm," BMC Molecular and Cell Biology, 2022.
  15. R. harma and A. Kamra, "Enhancing diagnosis of breast cancer through mammographic image segmentation using Fuzzy C-Means," International Journal of Sustainable Building Technology and Urban Development, pp. 488--499, 4 14 2023.
  16. W. Wiharto and E. Suryani, "The comparison of clustering algorithms K-means and fuzzy C-means for segmentation retinal blood vessels," Acta Informatica Medica, p. 42, 1 28 2020.
  17. A.S. Pednekar and I. A. Kakadiaris, "Image segmentation based on fuzzy connectedness using dynamic weights," IEEE Transactions on Image Processing, pp. 1555--1562, 6 15 2006.
  18. B. Cardone and F. Di Martino, "A novel fuzzy-entropy based online fuzzy C-Means clustering algorithm for massive data," Evolutionary Intelligence, 4 18 2025.
  19. L. Zhang, D. Song, H. Qiu, L. Ye and Z. Xu, "Fuzzy C-means clustering algorithm applied in computed tomography images of patients with intracranial hemorrhage," Frontiers in Neuroinformatics, p. 1440304, 18 2024.
  20. B.A. Mohammed and M. S. Al-Ani, "Digital medical image segmentation using fuzzy C-means clustering," UHD Journal of Science and Technology, pp. 51--58, 1 4 2020.