Mammography

In this volume, the topics are constructed from a variety of contents: the bases of mammography systems, optimization of screening mammography with reference to evidence-based research, new technologies of image acquisition and its surrounding systems, and case reports with reference to up-to-date multimodality images of breast cancer. Mammography has been lagged in the transition to digital imaging systems because of the necessity of high resolution for diagnosis. However, in the past ten years, technical improvement has resolved the difficulties and boosted new diagnostic systems. We hope that the reader will learn the essentials of mammography and will be forward-looking for the new technologies. We want to express our sincere gratitude and appreciation?to all the co-authors who have contributed their work to this volume

Feature analysis methods for intelligent breast imaging parameter optimisation using CMOS active pixel sensors

This thesis explores the concept of real time imaging parameter optimisation in digital mammography using statistical information extracted from the breast during a scan. Transmission and Energy dispersive x-ray diffraction (EDXRD) imaging were the two very different imaging modalities investigated. An attempt to determine if either could be used in a real time imaging system enabling differentiation between healthy and suspicious tissue regions was made. This would consequently enable local regions (potentially cancerous regions) within the breast to be imaged using optimised imaging parameters. The performance of possible statistical feature functions that could be used as information extraction tools were investigated using low exposure breast tissue images. The images were divided into eight regions of interest, seven regions corresponding to suspicious tissue regions marked by a radiologist, where the final region was obtained from a location in the breast consisting solely of healthy tissue. Results obtained from this investigation showed that a minimum of 82% of the suspicious tissue regions were highlighted in all images, whilst the total exposure incident on the sample was reduced in all instances. Three out of the seven (42%) intelligent images resulted in an increased contrast to noise ratio (CNR) compared to the conventionally produced transmission images. Three intelligent images were of similar diagnostic quality to their conventional counter parts whilst one was considerably lower. EDXRD measurements were made on breast tissue samples containing potentially cancerous tissue regions. As the technique is known to be able to distinguish between breast tissue types, diffraction signals were used to produce images corresponding to three suspicious tissue regions consequently enabling pixel intensities within the images to be analysed. A minimum of approximately 70% of the suspicious tissue regions were highlighted in each image, with at least 50% of each image remaining unsuspicious, hence was imaged with a reduced incident exposure

Applying novel machine learning technology to optimize computer-aided detection and diagnosis of medical images

The purpose of developing Computer-Aided Detection (CAD) schemes is to assist physicians (i.e., radiologists) in interpreting medical imaging findings and reducing inter-reader variability more accurately. In developing CAD schemes, Machine Learning (ML) plays an essential role because it is widely used to identify effective image features from complex datasets and optimally integrate them with the classifiers, which aims to assist the clinicians to more accurately detect early disease, classify disease types and predict disease treatment outcome. In my dissertation, in different studies, I assess the feasibility of developing several novel CAD systems in the area of medical imaging for different purposes. The first study aims to develop and evaluate a new computer-aided diagnosis (CADx) scheme based on analysis of global mammographic image features to predict the likelihood of cases being malignant. CADx scheme is applied to pre-process mammograms, generate two image maps in the frequency domain using discrete cosine transform and fast Fourier transform, compute bilateral image feature differences from left and right breasts, and apply a support vector machine (SVM) method to predict the likelihood of the case being malignant. This study demonstrates the feasibility of developing a new global image feature analysis based CADx scheme of mammograms with high performance. This new CADx approach is more efficient in development and potentially more robust in future applications by avoiding difficulty and possible errors in breast lesion segmentation. In the second study, to automatically identify a set of effective mammographic image features and build an optimal breast cancer risk stratification model, I investigate advantages of applying a machine learning approach embedded with a locally preserving projection (LPP) based feature combination and regeneration algorithm to predict short-term breast cancer risk. To this purpose, a computer-aided image processing scheme is applied to segment fibro-glandular tissue depicted on mammograms and initially compute 44 features related to the bilateral asymmetry of mammographic tissue density distribution between left and right breasts. Next, an embedded LLP algorithm optimizes the feature space and regenerates a new operational vector with 4 features using a maximal variance approach. This study demonstrates that applying the LPP algorithm effectively reduces feature dimensionality, and yields higher and potentially more robust performance in predicting short-term breast cancer risk. In the third study, to more precisely classify malignant lesions, I investigate the feasibility of applying a random projection algorithm to build an optimal feature vector from the initially CAD-generated large feature pool and improve the performance of the machine learning model. In this process, a CAD scheme is first applied to segment mass regions and initially compute 181 features. An SVM model embedded with the feature dimensionality reduction method is then built to predict the likelihood of lesions being malignant. This study demonstrates that the random project algorithm is a promising method to generate optimal feature vectors to improve the performance of machine learning models of medical images. The last study aims to develop and test a new CAD scheme of chest X-ray images to detect coronavirus (COVID-19) infected pneumonia. To this purpose, the CAD scheme first applies two image preprocessing steps to remove the majority of diaphragm regions, process the original image using a histogram equalization algorithm, and a bilateral low-pass filter. Then, the original image and two filtered images are used to form a pseudo color image. This image is fed into three input channels of a transfer learning-based convolutional neural network (CNN) model to classify chest X-ray images into 3 classes of COVID-19 infected pneumonia, other community-acquired no-COVID-19 infected pneumonia, and normal (non-pneumonia) cases. This study demonstrates that adding two image preprocessing steps and generating a pseudo color image plays an essential role in developing a deep learning CAD scheme of chest X-ray images to improve accuracy in detecting COVID-19 infected pneumonia. In summary, I developed and presented several image pre-processing algorithms, feature extraction methods, and data optimization techniques to present innovative approaches for quantitative imaging markers based on machine learning systems in all these studies. The studies' simulation and results show the discriminative performance of the proposed CAD schemes on different application fields helpful to assist radiologists on their assessments in diagnosing disease and improve their overall performance

Breast pectoral muscle segmentation in mammograms using a modified holistically-nested edge detection network

This paper presents a method for automatic breast pectoral muscle segmentation in mediolateral oblique mammograms using a Convolutional Neural Network (CNN) inspired by the Holistically-nested Edge Detection (HED) network. Most of the existing methods in the literature are based on hand-crafted models such as straight-line, curve-based techniques or a combination of both. Unfortunately, such models are insufficient when dealing with complex shape variations of the pectoral muscle boundary and when the boundary is unclear due to overlapping breast tissue. To compensate for these issues, we propose a neural network framework that incorporates multi-scale and multi-level learning, capable of learning complex hierarchical features to resolve spatial ambiguity in estimating the pectoral muscle boundary. For this purpose, we modified the HED network architecture to specifically find ‘contour-like’ objects in mammograms. The proposed framework produced a probability map that can be used to estimate the initial pectoral muscle boundary. Subsequently, we process these maps by extracting morphological properties to find the actual pectoral muscle boundary. Finally, we developed two different post-processing steps to find the actual pectoral muscle boundary. Quantitative evaluation results show that the proposed method is comparable with alternative state-of-the-art methods producing on average values of 94.8 ± 8.5% and 97.5 ± 6.3% for the Jaccard and Dice similarity metrics, respectively, across four different databases

Computer aided diagnosis system for breast cancer using deep learning.

The recent rise of big data technology surrounding the electronic systems and developed toolkits gave birth to new promises for Artificial Intelligence (AI). With the continuous use of data-centric systems and machines in our lives, such as social media, surveys, emails, reports, etc., there is no doubt that data has gained the center of attention by scientists and motivated them to provide more decision-making and operational support systems across multiple domains. With the recent breakthroughs in artificial intelligence, the use of machine learning and deep learning models have achieved remarkable advances in computer vision, ecommerce, cybersecurity, and healthcare. Particularly, numerous applications provided efficient solutions to assist radiologists and doctors for medical imaging analysis, which has remained the essence of the visual representation that is used to construct the final observation and diagnosis. Medical research in cancerology and oncology has been recently blended with the knowledge gained from computer engineering and data science experts. In this context, an automatic assistance or commonly known as Computer-aided Diagnosis (CAD) system has become a popular area of research and development in the last decades. As a result, the CAD systems have been developed using multidisciplinary knowledge and expertise and they have been used to analyze the patient information to assist clinicians and practitioners in their decision-making process. Treating and preventing cancer remains a crucial task that radiologists and oncologists face every day to detect and investigate abnormal tumors. Therefore, a CAD system could be developed to provide decision support for many applications in the cancer patient care processes, such as lesion detection, characterization, cancer staging, tumors assessment, recurrence, and prognosis prediction. Breast cancer has been considered one of the common types of cancers in females across the world. It was also considered the leading cause of mortality among women, and it has been increased drastically every year. Early detection and diagnosis of abnormalities in screened breasts has been acknowledged as the optimal solution to examine the risk of developing breast cancer and thus reduce the increasing mortality rate. Accordingly, this dissertation proposes a new state-of-the-art CAD system for breast cancer diagnosis that is based on deep learning technology and cutting-edge computer vision techniques. Mammography screening has been recognized as the most effective tool to early detect breast lesions for reducing the mortality rate. It helps reveal abnormalities in the breast such as Mass lesion, Architectural Distortion, Microcalcification. With the number of daily patients that were screened is continuously increasing, having a second reading tool or assistance system could leverage the process of breast cancer diagnosis. Mammograms could be obtained using different modalities such as X-ray scanner and Full-Field Digital mammography (FFDM) system. The quality of the mammograms, the characteristics of the breast (i.e., density, size) or/and the tumors (i.e., location, size, shape) could affect the final diagnosis. Therefore, radiologists could miss the lesions and consequently they could generate false detection and diagnosis. Therefore, this work was motivated to improve the reading of mammograms in order to increase the accuracy of the challenging tasks. The efforts presented in this work consists of new design and implementation of neural network models for a fully integrated CAD system dedicated to breast cancer diagnosis. The approach is designed to automatically detect and identify breast lesions from the entire mammograms at a first step using fusion models’ methodology. Then, the second step only focuses on the Mass lesions and thus the proposed system should segment the detected bounding boxes of the Mass lesions to mask their background. A new neural network architecture for mass segmentation was suggested that was integrated with a new data enhancement and augmentation technique. Finally, a third stage was conducted using a stacked ensemble of neural networks for classifying and diagnosing the pathology (i.e., malignant, or benign), the Breast Imaging Reporting and Data System (BI-RADS) assessment score (i.e., from 2 to 6), or/and the shape (i.e., round, oval, lobulated, irregular) of the segmented breast lesions. Another contribution was achieved by applying the first stage of the CAD system for a retrospective analysis and comparison of the model on Prior mammograms of a private dataset. The work was conducted by joining the learning of the detection and classification model with the image-to-image mapping between Prior and Current screening views. Each step presented in the CAD system was evaluated and tested on public and private datasets and consequently the results have been fairly compared with benchmark mammography datasets. The integrated framework for the CAD system was also tested for deployment and showcase. The performance of the CAD system for the detection and identification of breast masses reached an overall accuracy of 97%. The segmentation of breast masses was evaluated together with the previous stage and the approach achieved an overall performance of 92%. Finally, the classification and diagnosis step that defines the outcome of the CAD system reached an overall pathology classification accuracy of 96%, a BIRADS categorization accuracy of 93%, and a shape classification accuracy of 90%. Results given in this dissertation indicate that our suggested integrated framework might surpass the current deep learning approaches by using all the proposed automated steps. Limitations of the proposed work could occur on the long training time of the different methods which is due to the high computation of the developed neural networks that have a huge number of the trainable parameters. Future works can include new orientations of the methodologies by combining different mammography datasets and improving the long training of deep learning models. Moreover, motivations could upgrade the CAD system by using annotated datasets to integrate more breast cancer lesions such as Calcification and Architectural distortion. The proposed framework was first developed to help detect and identify suspicious breast lesions in X-ray mammograms. Next, the work focused only on Mass lesions and segment the detected ROIs to remove the tumor’s background and highlight the contours, the texture, and the shape of the lesions. Finally, the diagnostic decision was predicted to classify the pathology of the lesions and investigate other characteristics such as the tumors’ grading assessment and type of the shape. The dissertation presented a CAD system to assist doctors and experts to identify the risk of breast cancer presence. Overall, the proposed CAD method incorporates the advances of image processing, deep learning, and image-to-image translation for a biomedical application