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

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

Using Contextual Learning to Improve Diagnostic Accuracy: Application in Breast Cancer Screening

Abstract-Clinicians need to routinely make management decisions about patients who are at risk for a disease such as breast cancer. This paper presents a novel clinical decision support system that is capable of helping physicians make diagnostic decisions. We apply this support system to improve the specificity of breast cancer screening. The system utilizes clinical context (e.g., demographics, medical history) to minimize the false positive rates while avoiding false negatives. An online contextual learning algorithm is used to update the diagnostic strategy presented to the physicians over time. We analytically evaluate the diagnostic performance loss of the proposed algorithm, in which the true patient distribution is not known and needs to be learned, as compared with the optimal strategy where all information is assumed known, and prove that the false positive rate of the proposed learning algorithm asymptotically converges to the optimum. Moreover, the relevancy of each contextual information is assessed, enabling the approach to identify specific contexts that provide the most value of information in reducing diagnostic errors. Experiments were conducted using patient data collected from a large academic medical center. Our proposed approach outperforms the current clinical practice by 36% in terms of false positive rate given a 2% false negative rate. Index Terms-Breast cancer, cancer screening, computer-aided diagnosis system, online learning, contextual learning, multiarmed bandit

AN AUTOMATED COMPUTER-AIDED DETECTION (CADe) AND DIAGNOSIS (CADx) SYSTEM FOR BREAST MICROCALCIFICATIONS IN MAMMOGRAMS

ABSTRACTAn automated computer aided diagnosis system has been proposed for detection of microcalcification (MC) clusters in mammograms. The proposed system is a whole system including suspicious regions identification, MCs detection, false positive reduction and benign/malign classification. For classification of suspicious microcalcification regions, a multilayer perceptron (MLP) neural network was used with grey level co-occurrence matrix (GLCM) and statistical features.  Then to decrease the false positive classification ratio, we used cascade correlation neural network (CCNN) with grey level run length matrix (GLRLM) features. In the last step, hybrid form of discriminant analysis and support vector machine (SVM) methods were used with GLRLM features for benign/malign classification of detected MC clusters. The open access Mammographic Image Analysis Society (MIAS) database was used for the study. Experimental results show that the proposed algorithm obtained 86% sensitivity, 98.3% specificity and 1.163 FPpI rates for detection an for diagnosis of breast cancer, the obtained sensitivity and specificity values are 100% and 100% respectively. Despite the vision difficulty of MC clusters, the novel system provides very satisfactory results. Furthermore, the developed system is fully automatic whole system which gives outputs as percentages and transformed assessment categories. Keywords: Mammograms, Breast cancer, Computer aided diagnosis, Cascade correlation neural network (CCNN), Grey level co-occurrence matrix (GLCM), Grey level run length matrix (GLRLM). 

Imaging of the Breast

Early detection of breast cancer combined with targeted therapy offers the best outcome for breast cancer patients. This volume deal with a wide range of new technical innovations for improving breast cancer detection, diagnosis and therapy. There is a special focus on improvements in mammographic image quality, image analysis, magnetic resonance imaging of the breast and molecular imaging. A chapter on targeted therapy explores the option of less radical postoperative therapy for women with early, screen-detected breast cancers

Artificial intelligence in cancer imaging: Clinical challenges and applications

Judgement, as one of the core tenets of medicine, relies upon the integration of multilayered data with nuanced decision making. Cancer offers a unique context for medical decisions given not only its variegated forms with evolution of disease but also the need to take into account the individual condition of patients, their ability to receive treatment, and their responses to treatment. Challenges remain in the accurate detection, characterization, and monitoring of cancers despite improved technologies. Radiographic assessment of disease most commonly relies upon visual evaluations, the interpretations of which may be augmented by advanced computational analyses. In particular, artificial intelligence (AI) promises to make great strides in the qualitative interpretation of cancer imaging by expert clinicians, including volumetric delineation of tumors over time, extrapolation of the tumor genotype and biological course from its radiographic phenotype, prediction of clinical outcome, and assessment of the impact of disease and treatment on adjacent organs. AI may automate processes in the initial interpretation of images and shift the clinical workflow of radiographic detection, management decisions on whether or not to administer an intervention, and subsequent observation to a yet to be envisioned paradigm. Here, the authors review the current state of AI as applied to medical imaging of cancer and describe advances in 4 tumor types (lung, brain, breast, and prostate) to illustrate how common clinical problems are being addressed. Although most studies evaluating AI applications in oncology to date have not been vigorously validated for reproducibility and generalizability, the results do highlight increasingly concerted efforts in pushing AI technology to clinical use and to impact future directions in cancer care

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