Computer-aided Detection of Breast Cancer in Digital Tomosynthesis Imaging Using Deep and Multiple Instance Learning

Breast cancer is the most common cancer among women in the world. Nevertheless, early detection of breast cancer improves the chance of successful treatment. Digital breast tomosynthesis (DBT) as a new tomographic technique was developed to minimize the limitations of conventional digital mammography screening. A DBT is a quasi-three-dimensional image that is reconstructed from a small number of two-dimensional (2D) low-dose X-ray images. The 2D X-ray images are acquired over a limited angular around the breast. Our research aims to introduce computer-aided detection (CAD) frameworks to detect early signs of breast cancer in DBTs. In this thesis, we propose three CAD frameworks for detection of breast cancer in DBTs. The first CAD framework is based on hand-crafted feature extraction. Concerning early signs of breast cancer: mass, micro-calcifications, and bilateral asymmetry between left and right breast, the system includes three separate channels to detect each sign. Next two CAD frameworks automatically learn complex patterns of 2D slices using the deep convolutional neural network and the deep cardinality-restricted Boltzmann machines. Finally, the CAD frameworks employ a multiple-instance learning approach with randomized trees algorithm to classify DBT images based on extracted information from 2D slices. The frameworks operate on 2D slices which are generated from DBT volumes. These frameworks are developed and evaluated using 5,040 2D image slices obtained from 87 DBT volumes. We demonstrate the validation and usefulness of the proposed CAD frameworks within empirical experiments for detecting breast cancer in DBTs

Multi-Modal Medical Imaging Analysis with Modern Neural Networks

Medical imaging is an important non-invasive tool for diagnostic and treatment purposes in medical practice. However, interpreting medical images is a time consuming and challenging task. Computer-aided diagnosis (CAD) tools have been used in clinical practice to assist medical practitioners in medical imaging analysis since the 1990s. Most of the current generation of CADs are built on conventional computer vision techniques, such as manually defined feature descriptors. Deep convolutional neural networks (CNNs) provide robust end-to-end methods that can automatically learn feature representations. CNNs are a promising building block of next-generation CADs. However, applying CNNs to medical imaging analysis tasks is challenging. This dissertation addresses three major issues that obstruct utilizing modern deep neural networks on medical image analysis tasks---lack of domain knowledge in architecture design, lack of labeled data in model training, and lack of uncertainty estimation in deep neural networks. We evaluated the proposed methods on six large, clinically-relevant datasets. The result shows that the proposed methods can significantly improve the deep neural network performance on medical imaging analysis tasks

Automatic Breast Density Classification on Tomosynthesis Images

Breast cancer (BC) is the type of cancer that most greatly affects women globally hence its early detection is essential to guarantee an effective treatment. Although digital mammography (DM) is the main method of BC detection, it has low sensitivity with about 30% of positive cases undetected due to the superimposition of breast tissue when crossed by the X-ray beam. Digital breast tomosynthesis (DBT) does not share this limi tation, allowing the visualization of individual breast slices due to its image acquisition system. Consecutively, DBT was the object of this study as a means of determining one of the main risk factors for BC: breast density (BD). This thesis was aimed at developing an algorithm that, taking advantage of the 3D nature of DBT images, automatically clas sifies them in terms of BD. Thus, a quantitative, objective and reproducible classification was obtained, which will contribute to ascertain the risk of BC. The algorithm was developed in MATLAB and later transferred to a user interface that was compiled into an executable application. Using 350 images from the VICTRE database for the first classification phase – group 1 (ACR1+ACR2) versus group 2 (ACR3+ACR4), the highest AUC value of 0,9797 was obtained. In the classification within groups 1 and 2, the AUC obtained was 0,7461 and 0,6736, respectively. The algorithm attained an accuracy of 82% for these images. Sixteen exams provided by Hospital da Luz were also evaluated, with an overall accuracy of 62,5%. Therefore, a user-friendly and intuitive application was created that prioritizes the use of DBT as a diagnostic method and allows an objective classification of BD. This study is a first step towards preparing medical institutions for the compulsoriness of assessing BD, at a time when BC is still a very present pathology that shortens the lives of thousands of people

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. 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