Elicitation and representation of expert knowledge for computer aided diagnosis in mammography

To study how professional radiologists describe, interpret and make decisions about micro-calcifications in mammograms. The purpose was to develop a model of the radiologists' decision making for use in CADMIUM II, a computerized aid for mammogram interpretation that combines symbolic reasoning with image processing

Computer-aided detection and diagnosis of breast cancer in 2D and 3D medical imaging through multifractal analysis

This Thesis describes the research work performed in the scope of a doctoral research program and presents its conclusions and contributions. The research activities were carried on in the industry with Siemens S.A. Healthcare Sector, in integration with a research team. Siemens S.A. Healthcare Sector is one of the world biggest suppliers of products, services and complete solutions in the medical sector. The company offers a wide selection of diagnostic and therapeutic equipment and information systems. Siemens products for medical imaging and in vivo diagnostics include: ultrasound, computer tomography, mammography, digital breast tomosynthesis, magnetic resonance, equipment to angiography and coronary angiography, nuclear imaging, and many others. Siemens has a vast experience in Healthcare and at the beginning of this project it was strategically interested in solutions to improve the detection of Breast Cancer, to increase its competitiveness in the sector. The company owns several patents related with self-similarity analysis, which formed the background of this Thesis. Furthermore, Siemens intended to explore commercially the computer- aided automatic detection and diagnosis eld for portfolio integration. Therefore, with the high knowledge acquired by University of Beira Interior in this area together with this Thesis, will allow Siemens to apply the most recent scienti c progress in the detection of the breast cancer, and it is foreseeable that together we can develop a new technology with high potential. The project resulted in the submission of two invention disclosures for evaluation in Siemens A.G., two articles published in peer-reviewed journals indexed in ISI Science Citation Index, two other articles submitted in peer-reviewed journals, and several international conference papers. This work on computer-aided-diagnosis in breast led to innovative software and novel processes of research and development, for which the project received the Siemens Innovation Award in 2012. It was very rewarding to carry on such technological and innovative project in a socially sensitive area as Breast Cancer.No cancro da mama a deteção precoce e o diagnóstico correto são de extrema importância na prescrição terapêutica e caz e e ciente, que potencie o aumento da taxa de sobrevivência à doença. A teoria multifractal foi inicialmente introduzida no contexto da análise de sinal e a sua utilidade foi demonstrada na descrição de comportamentos siológicos de bio-sinais e até na deteção e predição de patologias. Nesta Tese, três métodos multifractais foram estendidos para imagens bi-dimensionais (2D) e comparados na deteção de microcalci cações em mamogramas. Um destes métodos foi também adaptado para a classi cação de massas da mama, em cortes transversais 2D obtidos por ressonância magnética (RM) de mama, em grupos de massas provavelmente benignas e com suspeição de malignidade. Um novo método de análise multifractal usando a lacunaridade tri-dimensional (3D) foi proposto para classi cação de massas da mama em imagens volumétricas 3D de RM de mama. A análise multifractal revelou diferenças na complexidade subjacente às localizações das microcalci cações em relação aos tecidos normais, permitindo uma boa exatidão da sua deteção em mamogramas. Adicionalmente, foram extraídas por análise multifractal características dos tecidos que permitiram identi car os casos tipicamente recomendados para biópsia em imagens 2D de RM de mama. A análise multifractal 3D foi e caz na classi cação de lesões mamárias benignas e malignas em imagens 3D de RM de mama. Este método foi mais exato para esta classi cação do que o método 2D ou o método padrão de análise de contraste cinético tumoral. Em conclusão, a análise multifractal fornece informação útil para deteção auxiliada por computador em mamogra a e diagnóstico auxiliado por computador em imagens 2D e 3D de RM de mama, tendo o potencial de complementar a interpretação dos radiologistas

Modular Machine Learning Methods for Computer-Aided Diagnosis of Breast Cancer

The purpose of this study was to improve breast cancer diagnosis by reducing the number of benign biopsies performed. To this end, we investigated modular and ensemble systems of machine learning methods for computer-aided diagnosis (CAD) of breast cancer. A modular system partitions the input space into smaller domains, each of which is handled by a local model. An ensemble system uses multiple models for the same cases and combines the models\u27 predictions. Five supervised machine learning techniques (LDA, SVM, BP-ANN, CBR, CART) were trained to predict the biopsy outcome from mammographic findings (BIRADS™) and patient age based on a database of 2258 cases mixed from multiple institutions. The generalization of the models was tested on second set of 2177 cases. Clusters were identified in the database using a priori knowledge and unsupervised learning methods (agglomerative hierarchical clustering followed by K-Means, SOM, AutoClass). The performance of the global models over the clusters was examined and local models were trained for clusters. While some local models were superior to some global models, we were unable to build a modular CAD system that was better than the global BP-ANN model. The ensemble systems based on simplistic combination schemes did not result in significant improvements and more complicated combination schemes were found to be unduly optimistic. One of the most striking results of this dissertation was that CAD systems trained on a mixture of lesion types performed much better on masses than on calcifications. Our study of the institutional effects suggests that models built on cases mixed between institutions may overcome some of the weaknesses of models built on cases from a single institution. It was suggestive that each of the unsupervised methods identified a cluster of younger women with well-circumscribed or obscured, oval-shaped masses that accounted for the majority of the BP-ANN’s recommendations for follow up. From the cluster analysis and the CART models, we determined a simple diagnostic rule that performed comparably to the global BP-ANN. Approximately 98% sensitivity could be maintained while providing approximately 26% specificity. This should be compared to the clinical status quo of 100% sensitivity and 0% specificity on this database of indeterminate cases already referred to biopsy

Caracterización de Patrones Anormales en Mamografías

Abstract. Computer-guided image interpretation is an extensive research area whose main purpose is to provide tools to support decision-making, for which a large number of automatic techniques have been proposed, such as, feature extraction, pattern recognition, image processing, machine learning, among others. In breast cancer, the results obtained at this area, they have led to the development of diagnostic support systems, which have even been approved by the FDA (Federal Drug Administration). However, the use of those systems is not widely extended in clinic scenarios, mainly because their performance is unstable and poorly reproducible. This is due to the high variability of the abnormal patterns associated with this neoplasia. This thesis addresses the main problem associated with the characterization and interpretation of breast masses and architectural distortion, mammographic findings directly related to the presence of breast cancer with higher variability in their form, size and location. This document introduces the design, implementation and evaluation of strategies to characterize abnormal patterns and to improve the mammographic interpretation during the diagnosis process. The herein proposed strategies allow to characterize visual patterns of these lesions and the relationship between them to infer their clinical significance according to BI-RADS (Breast Imaging Reporting and Data System), a radiologic tool used for mammographic evaluation and reporting. The obtained results outperform some obtained by methods reported in the literature both tasks classification and interpretation of masses and architectural distortion, respectively, demonstrating the effectiveness and versatility of the proposed strategies.Resumen. La interpretación de imágenes guiada por computador es una área extensa de investigación cuyo objetivo principal es proporcionar herramientas para el soporte a la toma de decisiones, para lo cual se han usado un gran número de técnicas de extracción de características, reconocimiento de patrones, procesamiento de imágenes, aprendizaje de máquina, entre otras. En el cáncer de mama, los resultados obtenidos en esta área han dado lugar al desarrollo de sistemas de apoyo al diagnóstico que han sido incluso aprobados por la FDA (Federal Drug Administration). Sin embargo, el uso de estos sistemas no es ampliamente extendido, debido principalmente, a que su desempeño resulta inestable y poco reproducible frente a la alta variabilidad de los patrones anormales asociados a esta neoplasia. Esta tesis trata el principal problema asociado a la caracterización y análisis de masas y distorsión de la arquitectura debido a que son hallazgos directamente relacionados con la presencia de cáncer y que usualmente presentan mayor variabilidad en su forma, tamaño y localización, lo que altera los resultados diagnósticos. Este documento introduce el diseño, implementación y evaluación de un conjunto de estrategias para caracterizar patrones anormales relacionados con este tipo de hallazgos para mejorar la interpretación y soportar el diagnóstico mediante la imagen mamaria. Los modelos aquí propuestos permiten caracterizar patrones visuales y la relación entre estos para inferir su significado clínico según el estándar BI-RADS (Breast Imaging Reporting and Data System) usado para la evaluación y reporte mamográfico. Los resultados obtenidos han demostrado mejorar a los resultados obtenidos por los métodos reportados en la literatura en tareas como clasificación e interpretación de masas y distorsión arquitectural, demostrando la efectividad y versatilidad de las estrategia propuestas.Doctorad

Computer aided detection in mammography

Tese de mestrado integrado. Engenharia Electrotécnica e de Computadores. Faculdade de Engenharia. Universidade do Porto. 201

A Bottom-Up Review of Image Analysis Methods for Suspicious Region Detection in Mammograms.

Breast cancer is one of the most common death causes amongst women all over the world. Early detection of breast cancer plays a critical role in increasing the survival rate. Various imaging modalities, such as mammography, breast MRI, ultrasound and thermography, are used to detect breast cancer. Though there is a considerable success with mammography in biomedical imaging, detecting suspicious areas remains a challenge because, due to the manual examination and variations in shape, size, other mass morphological features, mammography accuracy changes with the density of the breast. Furthermore, going through the analysis of many mammograms per day can be a tedious task for radiologists and practitioners. One of the main objectives of biomedical imaging is to provide radiologists and practitioners with tools to help them identify all suspicious regions in a given image. Computer-aided mass detection in mammograms can serve as a second opinion tool to help radiologists avoid running into oversight errors. The scientific community has made much progress in this topic, and several approaches have been proposed along the way. Following a bottom-up narrative, this paper surveys different scientific methodologies and techniques to detect suspicious regions in mammograms spanning from methods based on low-level image features to the most recent novelties in AI-based approaches. Both theoretical and practical grounds are provided across the paper sections to highlight the pros and cons of different methodologies. The paper's main scope is to let readers embark on a journey through a fully comprehensive description of techniques, strategies and datasets on the topic