Classifying breast masses in volumetric whole breast ultrasound data: a 2.5-dimensional approach

The aim of this paper is to investigate a 2.5-dimensional approach in classifying masses as benign or malignant in volumetric anisotropic voxel whole breast ultrasound data. In this paper, the term 2.5-dimensional refers to the use of a series of 2-dimensional images. While mammography is very effective in breast cancer screening in general, it is less sensitive in detecting breast cancer in younger women or women with dense breasts. Breast ultrasonography does not have the same limitation and is a valuable adjunct in breast cancer detection. The current study focuses on a new 2.5-dimensional approach in analyzing the volumetric whole breast ultrasound data for mass classification

Breast Cancer Assessment With Pulse-Echo Speed of Sound Ultrasound From Intrinsic Tissue Reflections: Proof-of-Concept

PURPOSE The aim of this study was to differentiate malignant and benign solid breast lesions with a novel ultrasound (US) technique, which measures speed of sound (SoS) using standard US transducers and intrinsic tissue reflections and scattering (speckles) as internal reference. MATERIALS AND METHODS This prospective, institutional review board-approved, Health Insurance Portability and Accountability Act-compliant prospective comparison study was performed with prior written informed consent from 20 women. Ten women with histological proven breast cancer and 10 with fibroadenoma were measured. A conventional US system with a linear probe was used for SoS-US (SonixTouch; Ultrasonix, Richmond, British Columbia, Canada). Tissue speckle reflections served as a timing reference for the US signals transmitted through the breasts. Relative phase inconsistencies were detected using plane wave measurements from different angular directions, and SoS images with 0.5-mm resolution were generated using a spatial domain reconstruction algorithm. The SoS of tumors were compared with the breast density of a larger cohort of 106 healthy women. RESULTS Breast lesions show focal increments ΔSoS (meters per second) with respect to the tissue background. Peak ΔSoS values were evaluated. Breast carcinoma showed significantly higher ΔSoS than fibroadenomas ([INCREMENT]SoS > 41.64 m/s: sensitivity, 90%; specificity, 80%; area under curve, 0.910) and healthy breast tissue of different densities (area under curve, 0.938; sensitivity, 90%; specificity, 96.5%). The lesion localization in SoS-US images was consistent with B-mode imaging and repeated SoS-US measurements were reproducible. CONCLUSIONS Using SoS-US, based on conventional US and tissue speckles as timing reference, breast carcinoma showed significantly higher SoS values than fibroadenoma and healthy breast tissue of different densities. The SoS presents a promising technique for differentiating solid breast lesions

Enhanced algorithms for lesion detection and recognition in ultrasound breast images

Mammography is the gold standard for breast cancer detection. However, it has very high false positive rates and is based on ionizing radiation. This has led to interest in using multi-modal approaches. One modality is diagnostic ultrasound, which is based on non-ionizing radiation and picks up many of the cancers that are generally missed by mammography. However, the presence of speckle noise in ultrasound images has a negative effect on image interpretation. Noise reduction, inconsistencies in capture and segmentation of lesions still remain challenging open research problems in ultrasound images. The target of the proposed research is to enhance the state-of-art computer vision algorithms used in ultrasound imaging and to investigate the role of computer processed images in human diagnostic performance. [Continues.

Recent Advances in Machine Learning Applied to Ultrasound Imaging

Machine learning (ML) methods are pervading an increasing number of fields of application because of their capacity to effectively solve a wide variety of challenging problems. The employment of ML techniques in ultrasound imaging applications started several years ago but the scientific interest in this issue has increased exponentially in the last few years. The present work reviews the most recent (2019 onwards) implementations of machine learning techniques for two of the most popular ultrasound imaging fields, medical diagnostics and non-destructive evaluation. The former, which covers the major part of the review, was analyzed by classifying studies according to the human organ investigated and the methodology (e.g., detection, segmentation, and/or classification) adopted, while for the latter, some solutions to the detection/classification of material defects or particular patterns are reported. Finally, the main merits of machine learning that emerged from the study analysis are summarized and discussed. © 2022 by the authors. Licensee MDPI, Basel, Switzerland

Novel 3D Ultrasound Elastography Techniques for In Vivo Breast Tumor Imaging and Nonlinear Characterization

Breast cancer comprises about 29% of all types of cancer in women worldwide. This type of cancer caused what is equivalent to 14% of all female deaths due to cancer. Nowadays, tissue biopsy is routinely performed, although about 80% of the performed biopsies yield a benign result. Biopsy is considered the most costly part of breast cancer examination and invasive in nature. To reduce unnecessary biopsy procedures and achieve early diagnosis, ultrasound elastography was proposed.;In this research, tissue displacement fields were estimated using ultrasound waves, and used to infer the elastic properties of tissues. Ultrasound radiofrequency data acquired at consecutive increments of tissue compression were used to compute local tissue strains using a cross correlation method. In vitro and in vivo experiments were conducted on different tissue types to demonstrate the ability to construct 2D and 3D elastography that helps distinguish stiff from soft tissues. Based on the constructed strain volumes, a novel nonlinear classification method for human breast tumors is introduced. Multi-compression elastography imaging is elucidated in this study to differentiate malignant from benign tumors, based on their nonlinear mechanical behavior under compression. A pilot study on ten patients was performed in vivo, and classification results were compared with biopsy diagnosis - the gold standard. Various nonlinear parameters based on different models, were evaluated and compared with two commonly used parameters; relative stiffness and relative tumor size. Moreover, different types of strain components were constructed in 3D for strain imaging, including normal axial, first principal, maximum shear and Von Mises strains. Interactive segmentation algorithms were also evaluated and applied on the constructed volumes, to delineate the stiff tissue by showing its isolated 3D shape.;Elastography 3D imaging results were in good agreement with the biopsy outcomes, where the new classification method showed a degree of discrepancy between benign and malignant tumors better than the commonly used parameters. The results show that the nonlinear parameters were found to be statistically significant with p-value \u3c0.05. Moreover, one parameter; power-law exponent, was highly statistically significant having p-value \u3c 0.001. Additionally, volumetric strain images reconstructed using the maximum shear strains provided an enhanced tumor\u27s boundary from the surrounding soft tissues. This edge enhancement improved the overall segmentation performance, and diminished the boundary leakage effect. 3D segmentation provided an additional reliable means to determine the tumor\u27s size by estimating its volume.;In summary, the proposed elastographic techniques can help predetermine the tumor\u27s type, shape and size that are considered key features helping the physician to decide the sort and extent of the treatment. The methods can also be extended to diagnose other types of tumors, such as prostate and cervical tumors. This research is aimed toward the development of a novel \u27virtual biopsy\u27 method that may reduce the number of unnecessary painful biopsies, and diminish the increasingly risk of cancer

Morphological quantitation software in breast MRI: application to neoadjuvant chemotherapy patients

The work in this thesis examines the use of texture analysis techniques and shape descriptors to analyse MR images of the breast and their application as a potential quantitative tool for prognostic indication.Textural information is undoubtedly very heavily used in a radiologist’s decision making process. However, subtle variations in texture are often missed, thus by quantitatively analysing MR images the textural properties that would otherwise be impossible to discern by simply visually inspecting the image can be obtained. Texture analysis is commonly used in image classification of aerial and satellite photography, studies have also focussed on utilising texture in MRI especially in the brain. Recent research has focussed on other organs such as the breast wherein lesion morphology is known to be an important diagnostic and prognostic indicator. Recent work suggests benefits in assessing lesion texture in dynamic contrast-enhanced (DCE) images, especially with regards to changes during the initial enhancement and subsequent washout phases. The commonest form of analysis is the spatial grey-level dependence matrix method, but there is no direct evidence concerning the most appropriate pixel separation and number of grey levels to utilise in the required co-occurrence matrix calculations. The aim of this work is to systematically assess the efficacy of DCE-MRI based textural analysis in predicting response to chemotherapy in a cohort of breast cancer patients. In addition an attempt was made to use shape parameters in order to assess tumour surface irregularity, and as a predictor of response to chemotherapy.In further work this study aimed to texture map DCE MR images of breast patients utilising the co-occurrence method but on a pixel by pixel basis in order to determine threshold values for normal, benign and malignant tissue and ultimately creating functionality within the in house developed software to highlight hotspots outlining areas of interest (possible lesions). Benign and normal data was taken from MRI screening data and malignant data from patients referred with known malignancies.This work has highlighted that textural differences between groups (based on response, nodal status, triple negative and biopsy grade groupings) are apparent and appear to be most evident 1-3 minutes post-contrast administration. Whilst the large number of statistical tests undertaken necessitates a degree of caution in interpreting the results, the fact that significant differences for certain texture parameters and groupings are consistently observed is encouraging.With regards to shape analysis this thesis has highlighted that some differences between groups were seen in shape descriptors but that shape may be limited as a prognostic indicator. Using textural analysis gave a higher proportion of significant differences whilst shape analysis results showed inconsistency across time points.With regards to the mapping this work successfully analysed the texture maps for each case and established lesion detection is possible. The study successfully highlighted hotspots in the breast patients data post texture mapping, and has demonstrated the relationship between sensitivity and false positive rate via hotspot thresholding

Quantification of tumour heterogenity in MRI

Cancer is the leading cause of death that touches us all, either directly or indirectly. It is estimated that the number of newly diagnosed cases in the Netherlands will increase to 123,000 by the year 2020. General Dutch statistics are similar to those in the UK, i.e. over the last ten years, the age-standardised incidence rate1 has stabilised at around 355 females and 415 males per 100,000. Figure 1 shows the cancer incidence per gender. In the UK, the rise in lifetime risk of cancer is more than one in three and depends on many factors, including age, lifestyle and genetic makeup

Functional Magnetic Resonance Imaging of Breast Cancer

This thesis examines the use of magnetic resonance imaging (MRI) techniques in the detection of breast cancer and the prediction of pathological complete response (pCR) to neoadjuvant chemotherapy (NACT). This thesis compares the diagnostic performance of diffusion-weighted imaging (DWI) models in the breast using a systematic review and meta-analysis. Advanced diffusion models have been proposed that may improve the performance of standard DWI using the apparent diffusion coefficient (ADC) to discriminate between malignant and benign breast lesions. Pooling the results from 73 studies, comparable diagnostic accuracy is shown using the ADC and parameters from the intra-voxel incoherent motion (IVIM) and diffusion tensor imaging (DTI) models. This work highlights a lack of standardisation in DWI protocols and methodology. Conventional acquisition techniques used in DWI often suffer from image artefacts and low spatial resolution. A multi-shot DWI technique, multiplexed sensitivity encoding (MUSE), can improve the image quality of DWI. A MUSE protocol has been optimised through a series of phantom experiments and validated in 20 patients. Comparing MUSE to conventional DWI, statistically significant improvements are shown in distortion and blurring metrics and qualitative image quality metrics such as lesion conspicuity and diagnostic confidence, increasing the clinical utility of DWI. This thesis investigates the use of dynamic contrast-enhanced MRI (DCE-MRI) in the detection of breast cancer and the prediction of pCR. Abbreviated MRI (ABB-MRI) protocols have gained increasing attention for the detection of breast cancer, acquiring a shortened version of a full diagnostic protocol (FDP-MRI) in a fraction of the time, reducing the cost of the examination. The diagnostic performance of abbreviated and full diagnostic protocols is systematically compared using a meta-analysis. Pooling 13 studies, equivalent diagnostic accuracy is shown for ABB-MRI in cohorts enriched with cancers, and lower but not significantly different diagnostic performance is shown in screening cohorts. Higher order imaging features derived from pre-treatment DCE-MRI could be used to predict pCR and inform decisions regarding targeted treatment, avoiding unnecessary toxicity. Using data from 152 patients undergoing NACT, radiomics features are extracted from baseline DCE-MRI and machine learning models trained to predict pCR with moderate accuracy. The stability of feature selection using logistic regression classification is demonstrated and a comparison of models trained using features from different time points in the dynamic series demonstrates that a full dynamic series enables the most accurate prediction of pCR.GE Healthcare funded PhD Studentshi