Pre and Post-hoc Diagnosis and Interpretation of Malignancy from Breast DCE-MRI

We propose a new method for breast cancer screening from DCE-MRI based on a post-hoc approach that is trained using weakly annotated data (i.e., labels are available only at the image level without any lesion delineation). Our proposed post-hoc method automatically diagnosis the whole volume and, for positive cases, it localizes the malignant lesions that led to such diagnosis. Conversely, traditional approaches follow a pre-hoc approach that initially localises suspicious areas that are subsequently classified to establish the breast malignancy -- this approach is trained using strongly annotated data (i.e., it needs a delineation and classification of all lesions in an image). Another goal of this paper is to establish the advantages and disadvantages of both approaches when applied to breast screening from DCE-MRI. Relying on experiments on a breast DCE-MRI dataset that contains scans of 117 patients, our results show that the post-hoc method is more accurate for diagnosing the whole volume per patient, achieving an AUC of 0.91, while the pre-hoc method achieves an AUC of 0.81. However, the performance for localising the malignant lesions remains challenging for the post-hoc method due to the weakly labelled dataset employed during training.Comment: Submitted to Medical Image Analysi

Deep Learning in Breast Cancer Imaging: A Decade of Progress and Future Directions

Breast cancer has reached the highest incidence rate worldwide among all malignancies since 2020. Breast imaging plays a significant role in early diagnosis and intervention to improve the outcome of breast cancer patients. In the past decade, deep learning has shown remarkable progress in breast cancer imaging analysis, holding great promise in interpreting the rich information and complex context of breast imaging modalities. Considering the rapid improvement in the deep learning technology and the increasing severity of breast cancer, it is critical to summarize past progress and identify future challenges to be addressed. In this paper, we provide an extensive survey of deep learning-based breast cancer imaging research, covering studies on mammogram, ultrasound, magnetic resonance imaging, and digital pathology images over the past decade. The major deep learning methods, publicly available datasets, and applications on imaging-based screening, diagnosis, treatment response prediction, and prognosis are described in detail. Drawn from the findings of this survey, we present a comprehensive discussion of the challenges and potential avenues for future research in deep learning-based breast cancer imaging.Comment: Survey, 41 page

AI-enhanced diagnosis of challenging lesions in breast MRI: a methodology and application primer

Computer-aided diagnosis (CAD) systems have become an important tool in the assessment of breast tumors with magnetic resonance imaging (MRI). CAD systems can be used for the detection and diagnosis of breast tumors as a “second opinion” review complementing the radiologist’s review. CAD systems have many common parts such as image pre-processing, tumor feature extraction and data classification that are mostly based on machine learning (ML) techniques. In this review paper, we describe the application of ML-based CAD systems in MRI of the breast covering the detection of diagnostically challenging lesions such as non-mass enhancing (NME) lesions, multiparametric MRI, neo-adjuvant chemotherapy (NAC) and radiomics all applied to NME. Since ML has been widely used in the medical imaging community, we provide an overview about the state-ofthe-art and novel techniques applied as classifiers to CAD systems. The differences in the CAD systems in MRI of the breast for several standard and novel applications for NME are explained in detail to provide important examples illustrating: (i) CAD for the detection and diagnosis, (ii) CAD in multi-parametric imaging (iii) CAD in NAC and (iv) breast cancer radiomics. We aim to provide a comparison between these CAD applications and to illustrate a global view on intelligent CAD systems based on ANN in MRI of the breast

Seeing Beyond Cancer: Multi-Institutional Validation of Object Localization and 3D Semantic Segmentation using Deep Learning for Breast MRI

The clinical management of breast cancer depends on an accurate understanding of the tumor and its anatomical context to adjacent tissues and landmark structures. This context may be provided by semantic segmentation methods; however, previous works have been largely limited to a singular focus on the tumor alone and rarely other tissue types. In contrast, we present a method that exploits tissue-tissue interactions to accurately segment every major tissue type in the breast including: chest wall, skin, adipose tissue, fibroglandular tissue, vasculature and tumor via standard-of-care Dynamic Contrast Enhanced MRI. Comparing our method to prior state-of-the-art, we achieved a superior Dice score on tumor segmentation while maintaining competitive performance on other studied tissues across multiple institutions. Briefly, our method proceeds by localizing the tumor using 2D object detectors, then segmenting the tumor and surrounding tissues independently using two 3D U-nets, and finally integrating these results while mitigating false positives by checking for anatomically plausible tissue-tissue contacts. The object detection models were pre-trained on ImageNet and COCO, and operated on MIP (maximum intensity projection) images in the axial and sagittal planes, establishing a 3D tumor bounding box. By integrating multiple relevant peri-tumoral tissues, our work enables clinical applications in breast cancer staging, prognosis and surgical planning.Comment: 9 pages, 2 figures, to appear in SPIE: Medical Imaging 202

Modified fuzzy rough set technique with stacked autoencoder model for magnetic resonance imaging based breast cancer detection

Breast cancer is the common cancer in women, where early detection reduces the mortality rate. The magnetic resonance imaging (MRI) images are efficient in analyzing breast cancer, but it is hard to identify the abnormalities. The manual breast cancer detection in MRI images is inefficient; therefore, a deep learning-based system is implemented in this manuscript. Initially, the visual quality improvement is done using region growing and adaptive histogram equalization (AHE), and then, the breast lesion is segmented by Otsu thresholding with morphological transform. Next, the features are extracted from the segmented lesion, and a modified fuzzy rough set technique is proposed to reduce the dimensions of the extracted features that decreases the system complexity and computational time. The active features are fed to the stacked autoencoder for classifying the benign and malignant classes. The results demonstrated that the proposed model attained 99% and 99.22% of classification accuracy on the benchmark datasets, which are higher related to the comparative classifiers: decision tree, naïve Bayes, random forest and k-nearest neighbor (KNN). The obtained results state that the proposed model superiorly screens and detects the breast lesions that assists clinicians in effective therapeutic intervention and timely treatment