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Image interpolation techniques often are required in medical imaging for image generation (e.g., discrete back projection for inverse Radon transform) and processing such as compression or resampling. Since the ideal interpolation function spatially is unlimited, several interpolation kernels of finite size have been introduced. This paper compares 1) truncated and windowed sine; 2) nearest neighbor; 3) linear; 4) quadratic; 5) cubic B-spline; 6) cubic; g) Lagrange; and 7) Gaussian interpolation and approximation techniques with kernel sizes from 1/spl times/1 up to 8/spl times/8. The comparison is done by: 1) spatial and Fourier analyses; 2) computational complexity as well as runtime evaluations; and 3) qualitative and quantitative interpolation error determinations for particular interpolation tasks which were taken from common situations in medical image processing. For local and Fourier analyses, a standardized notation is introduced and fundamental properties of interpolators are derived. Successful methods should be direct current (DC)-constant and interpolators rather than DC-inconstant or approximators. Each method's parameters are tuned with respect to those properties. This results in three novel kernels, which are introduced in this paper and proven to be within the best choices for medical image interpolation: the 6/spl times/6 Blackman-Harris windowed sinc interpolator, and the C2-continuous cubic kernels with N=6 and N=8 supporting points. For quantitative error evaluations, a set of 50 direct digital X-rays was used. They have been selected arbitrarily from clinical routine. In general, large kernel sizes were found to be superior to small interpolation masks. Except for truncated sine interpolators, all kernels with N=6 or larger sizes perform significantly better than N=2 or N=3 point methods (p/spl Lt/0.005). However, the differences within the group of large-sized kernels were not significant. Summarizing the results, the cubic 6/spl times/6 int- - erpolator with continuous second derivatives, as defined in (24), can be recommended for most common interpolation tasks. It appears to be the fastest six-point kernel to implement computationally. It provides eminent local and Fourier properties, is easy to implement, and has only small errors. The same characteristics apply to B-spline interpolation, but the 6/spl times/6 cubic avoids the intrinsic border effects produced by the B-spline technique. However, the goal of this study was not to determine an overall best method, but to present a comprehensive catalogue of methods in a uniform terminology, to define general properties and requirements of local techniques, and to enable the reader to select that method which is optimal for his specific application in medical imaging.