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

Gravity Network for end-to-end small lesion detection

This paper introduces a novel one-stage end-to-end detector specifically designed to detect small lesions in medical images. Precise localization of small lesions presents challenges due to their appearance and the diverse contextual backgrounds in which they are found. To address this, our approach introduces a new type of pixel-based anchor that dynamically moves towards the targeted lesion for detection. We refer to this new architecture as GravityNet, and the novel anchors as gravity points since they appear to be "attracted" by the lesions. We conducted experiments on two well-established medical problems involving small lesions to evaluate the performance of the proposed approach: microcalcifications detection in digital mammograms and microaneurysms detection in digital fundus images. Our method demonstrates promising results in effectively detecting small lesions in these medical imaging tasks

Deep-Learning-Based Computer- Aided Systems for Breast Cancer Imaging: A Critical Review

[EN] This paper provides a critical review of the literature on deep learning applications in breast tumor diagnosis using ultrasound and mammography images. It also summarizes recent advances in computer-aided diagnosis/detection (CAD) systems, which make use of new deep learning methods to automatically recognize breast images and improve the accuracy of diagnoses made by radiologists. This review is based upon published literature in the past decade (January 2010-January 2020), where we obtained around 250 research articles, and after an eligibility process, 59 articles were presented in more detail. The main findings in the classification process revealed that new DL-CAD methods are useful and effective screening tools for breast cancer, thus reducing the need for manual feature extraction. The breast tumor research community can utilize this survey as a basis for their current and future studies.This project has been co-financed by the Spanish Government Grant PID2019-107790RB-C22, "Software development for a continuous PET crystal systems applied to breast cancer".Jiménez-Gaona, Y.; Rodríguez Álvarez, MJ.; Lakshminarayanan, V. (2020). Deep-Learning-Based Computer- Aided Systems for Breast Cancer Imaging: A Critical Review. Applied Sciences. 10(22):1-29. https://doi.org/10.3390/app10228298S1291022Jemal, A., Bray, F., Center, M. M., Ferlay, J., Ward, E., & Forman, D. (2011). Global cancer statistics. CA: A Cancer Journal for Clinicians, 61(2), 69-90. doi:10.3322/caac.20107Gao, F., Chia, K.-S., Ng, F.-C., Ng, E.-H., & Machin, D. (2002). Interval cancers following breast cancer screening in Singaporean women. International Journal of Cancer, 101(5), 475-479. doi:10.1002/ijc.10636Munir, K., Elahi, H., Ayub, A., Frezza, F., & Rizzi, A. (2019). 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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 BASED SEGMENTATION AND CLASSIFICATION FOR IMPROVED BREAST CANCER DETECTION

Breast Cancer is a leading killer of women globally. It is a serious health concern caused by calcifications or abnormal tissue growth in the breast. Doing a screening and identifying the nature of the tumor as benign or malignant is important to facilitate early intervention, which drastically decreases the mortality rate. Usually, it uses ultrasound images, since they are easily accessible to most people and have no drawbacks as such, unlike in the other most famous screening technique of mammograms where in some cases you may not get a clear scan. In this thesis, the approach to this problem is to build a stacked model which makes predictions on the basis of the shape, pattern, and spread of the tumor. To achieve this, typical steps are pre-processing of images followed by segmentation of the image and classification. For pre-processing, the proposed approach in this thesis uses histogram equalization that helps in improving the contrast of the image, making the tumor stand out from its surroundings, and making it easier for the segmentation step. Through segmentation, the approach uses UNet architecture with a ResNet backbone. The UNet architecture is made specifically for biomedical imaging. The aim of segmentation is to separate the tumor from the ultrasound image so that the classification model can make its predictions from this mask. The metric result of the F1-score for the segmentation model turned out to be 97.30%. For classification, the CNN base model is used for feature extraction from provided masks. These are then fed into a network and the predictions are done. The base CNN model used is ResNet50 and the neural network used for the output layer is a simple 8-layer network with ReLU activation in the hidden layers and softmax in the final decision-making layer. The ResNet weights are initialized from training on ImageNet. The ResNet50 returns 2048 features from each mask. These are then fed into the network for decision-making. The hidden layers of the neural network have 1024, 512, 256, 128, 64, 32, and 10 neurons respectively. The classification accuracy achieved for the proposed model was 98.61% with an F1 score of 98.41%. The detailed experimental results are presented along with comparative data

MOLECULAR ANALYSIS OF CANCER PROGRESSION WITH LABEL-FREE RAMAN SPECTROSCOPY

Due to its ability to probe water-containing samples using visible and near-infrared frequencies with high chemical specificity, Raman spectroscopy is an attractive tool for label-free investigation of biological samples. While Raman spectroscopy has been leveraged for exploratory studies in clinical cancer diagnostics, only limited studies have used it to understand the molecular mechanisms driving key characteristics of cancer progression. In this thesis, we present three progressively complex applications of Raman spectroscopy that take advantage of its specificity and synergistic combination with plasmonic nanoparticles and multivariate data analysis for molecular study of cancer. First, we used Au@SiO2 shell-isolated nanoparticle-enhanced Raman spectroscopy (SHINERS) to investigate the roles of microcalcification status and the composition of tumor microenvironment in breast tissue for identification of a range of breast pathologies. We developed a partial least squares-discriminant analysis-based classifier to correlate the spectra with their pathology to obtain high prediction accuracy. A parallel investigation of the genetic drivers of microcalcification formation in breast cancer cells revealed that stable silencing of the Osteopontin gene decreased the formation of hydroxyapatite in breast cancer cells and reduced their migration. Next, we demonstrated the ability to detect premetastatic changes in the lungs of mice bearing breast tumors, in advance of tumor cell seeding, using Raman spectroscopy and multivariate data analysis. Our measurements showed reliable differences in the collagen and proteoglycan features of the premetastatic lungs which uniquely identify the metastatic potential of the primary tumor. Consistent with histological assessment, our results hint at a continuous premetastatic niche formation model dependent on the metastatic potential of primary tumor. Finally, we exploited Raman mapping to elucidate radiation therapy-induced biomolecular changes in murine tumors and uncovered latent microenvironmental differences between treatment-resistant and -sensitive tumors. We used multivariate curve resolution-alternating least squares (MCR-ALS) and support vector machine (SVM) to quantify biomolecular differences in the tumor microenvironment and constructed classification models to predict therapy outcome and resistance. We found significant differences in lipid and collagen content between unirradiated and irradiated tumors. Taken together, these studies pave the way for applications of Raman spectroscopy beyond clinical diagnostics such as metastatic risk assessment and treatment monitoring