3,208 research outputs found
Small Lesions Evaluation Based on Unsupervised Cluster Analysis of Signal-Intensity Time Courses in Dynamic Breast MRI
An application of an unsupervised neural network-based computer-aided diagnosis (CAD) system is reported for the detection
and characterization of small indeterminate breast lesions, average size 1.1 mm, in dynamic contrast-enhanced MRI. This system
enables the extraction of spatial and temporal features of dynamic MRI data and additionally provides a segmentation with regard
to identification and regional subclassification of pathological breast tissue lesions. Lesions with an initial contrast enhancement
≥50% were selected with semiautomatic segmentation. This conventional segmentation analysis is based on the mean initial signal
increase and postinitial course of all voxels included in the lesion. In this paper, we compare the conventional segmentation analysis
with unsupervised classification for the evaluation of signal intensity time courses for the differential diagnosis of enhancing
lesions in breast MRI. The results suggest that the computerized analysis system based on unsupervised clustering has the potential to
increase the diagnostic accuracy of MRI mammography for small lesions and can be used as a basis for computer-aided diagnosis
of breast cancer with MR mammography
Pretreatment prognostic value of dynamic contrast-enhanced magnetic resonance imaging vascular, texture, shape, and size parameters compared with traditional survival indicators obtained from locally advanced breast cancer patients
Objectives: The aim of this study was to determine if associations exist between pretreatment dynamic contrast-enhanced (DCE) magnetic resonance imaging (MRI)-based metrics (vascular kinetics, texture, shape, size) and survival intervals. Furthermore, the aim of this study was to compare the prognostic value of DCE-MRI parameters against traditional pretreatment survival indicators. Materials and Methods: A retrospective study was undertaken. Approval had previously been granted for the retrospective use of such data, and the need for informed consent was waived. Prognostic value of pretreatment DCE-MRI parameters and clinical data was assessed via Cox proportional hazards models. The variables retained by the final overall survival Cox proportional hazards model were utilized to stratify risk of death within 5 years. Results: One hundred twelve subjects were entered into the analysis. Regarding disease-free survival-negative estrogen receptor status, T3 or higher clinical tumor stage, large ( > 9.8 cm 3 ) MR tumor volume, higher 95th percentile ( > 79%) percentage enhancement, and reduced ( > 0.22) circularity represented the retained model variables. Similar results were noted for the overall survival with negative estrogen receptor status, T3 or higher clinical tumor stage, and large ( > 9.8 cm 3 ) MR tumor volume, again all been retained by the model in addition to higher ( > 0.71) 25th percentile area under the enhancement curve. Accuracy of risk stratification based on either traditional (59%) or DCEMRI (65%) survival indicators performed to a similar level. However, combined traditional and MR risk stratification resulted in the highest accuracy (86%). Conclusions: Multivariate survival analysis has revealed thatmodel-retained DCEMRI variables provide independent prognostic information complementing traditional survival indicators and as such could help to appropriately stratify treatment
Pre and Post-hoc Diagnosis and Interpretation of Malignancy from Breast DCE-MRI
We propose a new method for breast cancer screening from DCE-MRI based on a
post-hoc approach that is trained using weakly annotated data (i.e., labels are
available only at the image level without any lesion delineation). Our proposed
post-hoc method automatically diagnosis the whole volume and, for positive
cases, it localizes the malignant lesions that led to such diagnosis.
Conversely, traditional approaches follow a pre-hoc approach that initially
localises suspicious areas that are subsequently classified to establish the
breast malignancy -- this approach is trained using strongly annotated data
(i.e., it needs a delineation and classification of all lesions in an image).
Another goal of this paper is to establish the advantages and disadvantages of
both approaches when applied to breast screening from DCE-MRI. Relying on
experiments on a breast DCE-MRI dataset that contains scans of 117 patients,
our results show that the post-hoc method is more accurate for diagnosing the
whole volume per patient, achieving an AUC of 0.91, while the pre-hoc method
achieves an AUC of 0.81. However, the performance for localising the malignant
lesions remains challenging for the post-hoc method due to the weakly labelled
dataset employed during training.Comment: Submitted to Medical Image Analysi
Performance of a fully automatic lesion detection system for breast DCE-MRI
PURPOSE: To describe and test a new fully automatic lesion detection system for breast DCE-MRI. MATERIALS AND METHODS: Studies were collected from two institutions adopting different DCE-MRI sequences, one with and the other one without fat-saturation. The detection pipeline consists of (i) breast segmentation, to identify breast size and location; (ii) registration, to correct for patient movements; (iii) lesion detection, to extract contrast-enhanced regions using a new normalization technique based on the contrast-uptake of mammary vessels; (iv) false positive (FP) reduction, to exclude contrast-enhanced regions other than lesions. Detection rate (number of system-detected malignant and benign lesions over the total number of lesions) and sensitivity (system-detected malignant lesions over the total number of malignant lesions) were assessed. The number of FPs was also assessed. RESULTS: Forty-eight studies with 12 benign and 53 malignant lesions were evaluated. Median lesion diameter was 6 mm (range, 5-15 mm) for benign and 26 mm (range, 5-75 mm) for malignant lesions. Detection rate was 58/65 (89%; 95% confidence interval [CI] 79%-95%) and sensitivity was 52/53 (98%; 95% CI 90%-99%). Mammary median FPs per breast was 4 (1st-3rd quartiles 3-7.25). CONCLUSION: The system showed promising results on MR datasets obtained from different scanners producing fat-sat or non-fat-sat images with variable temporal and spatial resolution and could potentially be used for early diagnosis and staging of breast cancer to reduce reading time and to improve lesion detection. Further evaluation is needed before it may be used in clinical practice
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