Can high-frequency ultrasound predict metastatic lymph nodes in patients with invasive breast cancer?

Aim To determine whether high-frequency ultrasound can predict the presence of metastatic axillary lymph nodes, with a high specificity and positive predictive value, in patients with invasive breast cancer. The clinical aim is to identify patients with axillary disease requiring surgery who would not normally, on clinical grounds, have an axillary dissection, so potentially improving outcome and survival rates. Materials and methods The ipsilateral and contralateral axillae of 42 consecutive patients with invasive breast cancer were scanned prior to treatment using a B-mode frequency of 13 MHz and a Power Doppler frequency of 7 MHz. The presence or absence of an echogenic centre for each lymph node detected was recorded, and measurements were also taken to determine the L/S ratio and the widest and narrowest part of the cortex. Power Doppler was also used to determine vascularity. The contralateral axilla was used as a control for each patient. Results In this study of patients with invasive breast cancer, ipsilateral lymph nodes with a cortical bulge ≥3 mm and/or at least two lymph nodes with absent echogenic centres indicated the presence of metastatic axillary lymph nodes (10 patients). The sensitivity and specificity were 52.6% and 100%, respectively, positive and negative predictive values were 100% and 71.9%, respectively, the P value was 0.001 and the Kappa score was 0.55.\ud Conclusion This would indicate that high-frequency ultrasound can be used to accurately predict metastatic lymph nodes in a proportion of patients with invasive breast cancer, which may alter patient management

Computer-aided detection and diagnosis of breast cancer in 2D and 3D medical imaging through multifractal analysis

This Thesis describes the research work performed in the scope of a doctoral research program and presents its conclusions and contributions. The research activities were carried on in the industry with Siemens S.A. Healthcare Sector, in integration with a research team. Siemens S.A. Healthcare Sector is one of the world biggest suppliers of products, services and complete solutions in the medical sector. The company offers a wide selection of diagnostic and therapeutic equipment and information systems. Siemens products for medical imaging and in vivo diagnostics include: ultrasound, computer tomography, mammography, digital breast tomosynthesis, magnetic resonance, equipment to angiography and coronary angiography, nuclear imaging, and many others. Siemens has a vast experience in Healthcare and at the beginning of this project it was strategically interested in solutions to improve the detection of Breast Cancer, to increase its competitiveness in the sector. The company owns several patents related with self-similarity analysis, which formed the background of this Thesis. Furthermore, Siemens intended to explore commercially the computer- aided automatic detection and diagnosis eld for portfolio integration. Therefore, with the high knowledge acquired by University of Beira Interior in this area together with this Thesis, will allow Siemens to apply the most recent scienti c progress in the detection of the breast cancer, and it is foreseeable that together we can develop a new technology with high potential. The project resulted in the submission of two invention disclosures for evaluation in Siemens A.G., two articles published in peer-reviewed journals indexed in ISI Science Citation Index, two other articles submitted in peer-reviewed journals, and several international conference papers. This work on computer-aided-diagnosis in breast led to innovative software and novel processes of research and development, for which the project received the Siemens Innovation Award in 2012. It was very rewarding to carry on such technological and innovative project in a socially sensitive area as Breast Cancer.No cancro da mama a deteção precoce e o diagnóstico correto são de extrema importância na prescrição terapêutica e caz e e ciente, que potencie o aumento da taxa de sobrevivência à doença. A teoria multifractal foi inicialmente introduzida no contexto da análise de sinal e a sua utilidade foi demonstrada na descrição de comportamentos siológicos de bio-sinais e até na deteção e predição de patologias. Nesta Tese, três métodos multifractais foram estendidos para imagens bi-dimensionais (2D) e comparados na deteção de microcalci cações em mamogramas. Um destes métodos foi também adaptado para a classi cação de massas da mama, em cortes transversais 2D obtidos por ressonância magnética (RM) de mama, em grupos de massas provavelmente benignas e com suspeição de malignidade. Um novo método de análise multifractal usando a lacunaridade tri-dimensional (3D) foi proposto para classi cação de massas da mama em imagens volumétricas 3D de RM de mama. A análise multifractal revelou diferenças na complexidade subjacente às localizações das microcalci cações em relação aos tecidos normais, permitindo uma boa exatidão da sua deteção em mamogramas. Adicionalmente, foram extraídas por análise multifractal características dos tecidos que permitiram identi car os casos tipicamente recomendados para biópsia em imagens 2D de RM de mama. A análise multifractal 3D foi e caz na classi cação de lesões mamárias benignas e malignas em imagens 3D de RM de mama. Este método foi mais exato para esta classi cação do que o método 2D ou o método padrão de análise de contraste cinético tumoral. Em conclusão, a análise multifractal fornece informação útil para deteção auxiliada por computador em mamogra a e diagnóstico auxiliado por computador em imagens 2D e 3D de RM de mama, tendo o potencial de complementar a interpretação dos radiologistas

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

COMPUTER AIDED SYSTEM FOR BREAST CANCER DIAGNOSIS USING CURVELET TRANSFORM

Breast cancer is a leading cause of death among women worldwide. Early detection is the key for improving breast cancer prognosis. Digital mammography remains one of the most suitable tools for early detection of breast cancer. Hence, there are strong needs for the development of computer aided diagnosis (CAD) systems which have the capability to help radiologists in decision making. The main goal is to increase the diagnostic accuracy rate. In this thesis we developed a computer aided system for the diagnosis and detection of breast cancer using curvelet transform. Curvelet is a multiscale transform which possess directionality and anisotropy, and it breaks some inherent limitations of wavelet in representing edges in images. We started this study by developing a diagnosis system. Five feature extraction methods were developed with curvelet and wavelet coefficients to differentiate between different breast cancer classes. The results with curvelet and wavelet were compared. The experimental results show a high performance of the proposed methods and classification accuracy rate achieved 97.30%. The thesis then provides an automatic system for breast cancer detection. An automatic thresholding algorithm was used to separate the area composed of the breast and the pectoral muscle from the background of the image. Subsequently, a region growing algorithm was used to locate the pectoral muscle and suppress it from the breast. Then, the work concentrates on the segmentation of region of interest (ROI). Two methods are suggested to accomplish the segmentation stage: an adaptive thresholding method and a pattern matching method. Once the ROI has been identified, an automatic cropping is performed to extract it from the original mammogram. Subsequently, the suggested feature extraction methods were applied to the segmented ROIs. Finally, the K-Nearest Neighbor (KNN) and Support Vector Machine (SVM) classifiers were used to determine whether the region is abnormal or normal. At this level, the study focuses on two abnormality types (mammographic masses and architectural distortion). Experimental results show that the introduced methods have very high detection accuracies. The effectiveness of the proposed methods has been tested with Mammographic Image Analysis Society (MIAS) dataset. Throughout the thesis all proposed methods and algorithms have been applied with both curvelet and wavelet for comparison and statistical tests were also performed. The overall results show that curvelet transform performs better than wavelet and the difference is statistically significant

Automated segmentation of radiodense tissue in digitized mammograms using a constrained Neyman-Pearson classifier

Breast cancer is the second leading cause of cancer related mortality among American women. Mammography screening has emerged as a reliable non-invasive technique for early detection of breast cancer. The radiographic appearance of the female breast consists of radiolucent (dark) regions and radiodense (light) regions due to connective and epithelial tissue. It has been established that the percentage of radiodense tissue in a patient\u27s breast can be used as a marker for predicting breast cancer risk. This thesis presents the design, development and validation of a novel automated algorithm for estimating the percentage of radiodense tissue in a digitized mammogram. The technique involves determining a dynamic threshold for segmenting radiodense indications in mammograms. Both the mammographic image and the threshold are modeled as Gaussian random variables and a constrained Neyman-Pearson criteria has been developed for segmenting radiodense tissue. Promising results have been obtained using the proposed technique. Mammograms have been obtained from an existing cohort of women enrolled in the Family Risk Analysis Program at Fox Chase Cancer Center (FCCC). The proposed technique has been validated using a set of ten images with percentages of radiodense tissue, estimated by a trained radiologist using previously established methods. This work is intended to support a concurrent study at the FCCC exploring the association between dietary patterns and breast cancer risk

A Novel Hybrid K-Means and GMM Machine Learning Model for Breast Cancer Detection

Breast cancer is the second leading cause of death among a large number of women worldwide. It may be challenging for radiologists to diagnose and treat breast cancer. Consequently, primary care improves disease prevention and death. Early detection increases treatment options and saves life, which is the major target of this research. This research indicates the versatility of the methodology by integrating contemporary segmentation approaches with machine learning methods, which are developing areas of research. In the pre-processing process, an adaptive median filter is utilized for noise removal, enhancement of image quality, conservation of edges, and smoothing. This research makes a significant contribution by proposing a new parameter for evaluating K-means and a Gaussian mixture model (GMM) performance. A hybrid combination of segmentation and detection was applied to breast cancer. The proposed technique is significant for classifying benign and malignant tumors. The simulated results are discussed and evaluated to determine the competence of this method for the early diagnosis of breast cancer. This method allows medical experts to recognize breast cancer at a faster rate and provide higher accuracy. An ANOVA test was used to determine the multi-variant analysis and prediction rate for the proposed method

Spatially varying threshold models for the automated segmentation of radiodense tissue in digitized mammograms

The percentage of radiodense (bright) tissue in a mammogram has been correlated to an increased risk of breast cancer. This thesis presents an automated method to quantify the amount of radiodense tissue found in a digitized mammogram. The algorithm employs a radial basis function neural network in order to segment the breast tissue region from the remainder of the X-ray. A spatially varying Neyman-Pearson threshold is used to calculate the percentage of radiodense tissue and compensate for the effects of tissue compression that occurs during a mammography procedure. Results demonstrating the efficacy of the technique are demonstrated by exercising the algorithm on two separate sets of mammograms - one obtained from Brigham Women\u27s Hospital, Harvard Medical School and the other set obtained from Fox Chase Cancer Center and digitized at Rowan University. The results of the algorithm compare favorably with a previously established manual segmentation technique