Elicitation and representation of expert knowledge for computer aided diagnosis in mammography

To study how professional radiologists describe, interpret and make decisions about micro-calcifications in mammograms. The purpose was to develop a model of the radiologists' decision making for use in CADMIUM II, a computerized aid for mammogram interpretation that combines symbolic reasoning with image processing

A New Computer-Aided Diagnosis System with Modified Genetic Feature Selection for BI-RADS Classification of Breast Masses in Mammograms

Mammography remains the most prevalent imaging tool for early breast cancer screening. The language used to describe abnormalities in mammographic reports is based on the breast Imaging Reporting and Data System (BI-RADS). Assigning a correct BI-RADS category to each examined mammogram is a strenuous and challenging task for even experts. This paper proposes a new and effective computer-aided diagnosis (CAD) system to classify mammographic masses into four assessment categories in BI-RADS. The mass regions are first enhanced by means of histogram equalization and then semiautomatically segmented based on the region growing technique. A total of 130 handcrafted BI-RADS features are then extrcated from the shape, margin, and density of each mass, together with the mass size and the patient's age, as mentioned in BI-RADS mammography. Then, a modified feature selection method based on the genetic algorithm (GA) is proposed to select the most clinically significant BI-RADS features. Finally, a back-propagation neural network (BPN) is employed for classification, and its accuracy is used as the fitness in GA. A set of 500 mammogram images from the digital database of screening mammography (DDSM) is used for evaluation. Our system achieves classification accuracy, positive predictive value, negative predictive value, and Matthews correlation coefficient of 84.5%, 84.4%, 94.8%, and 79.3%, respectively. To our best knowledge, this is the best current result for BI-RADS classification of breast masses in mammography, which makes the proposed system promising to support radiologists for deciding proper patient management based on the automatically assigned BI-RADS categories

Towards a New Science of a Clinical Data Intelligence

In this paper we define Clinical Data Intelligence as the analysis of data generated in the clinical routine with the goal of improving patient care. We define a science of a Clinical Data Intelligence as a data analysis that permits the derivation of scientific, i.e., generalizable and reliable results. We argue that a science of a Clinical Data Intelligence is sensible in the context of a Big Data analysis, i.e., with data from many patients and with complete patient information. We discuss that Clinical Data Intelligence requires the joint efforts of knowledge engineering, information extraction (from textual and other unstructured data), and statistics and statistical machine learning. We describe some of our main results as conjectures and relate them to a recently funded research project involving two major German university hospitals.Comment: NIPS 2013 Workshop: Machine Learning for Clinical Data Analysis and Healthcare, 201

DEVELOPING NOVEL COMPUTER-AIDED DETECTION AND DIAGNOSIS SYSTEMS OF MEDICAL IMAGES

Reading medical images to detect and diagnose diseases is often difficult and has large inter-reader variability. To address this issue, developing computer-aided detection and diagnosis (CAD) schemes or systems of medical images has attracted broad research interest in the last several decades. Despite great effort and significant progress in previous studies, only limited CAD schemes have been used in clinical practice. Thus, developing new CAD schemes is still a hot research topic in medical imaging informatics field. In this dissertation, I investigate the feasibility of developing several new innovative CAD schemes for different application purposes. First, to predict breast tumor response to neoadjuvant chemotherapy and reduce unnecessary aggressive surgery, I developed two CAD schemes of breast magnetic resonance imaging (MRI) to generate quantitative image markers based on quantitative analysis of global kinetic features. Using the image marker computed from breast MRI acquired pre-chemotherapy, CAD scheme enables to predict radiographic complete response (CR) of breast tumors to neoadjuvant chemotherapy, while using the imaging marker based on the fusion of kinetic and texture features extracted from breast MRI performed after neoadjuvant chemotherapy, CAD scheme can better predict the pathologic complete response (pCR) of the patients. Second, to more accurately predict prognosis of stroke patients, quantifying brain hemorrhage and ventricular cerebrospinal fluid depicting on brain CT images can play an important role. For this purpose, I developed a new interactive CAD tool to segment hemorrhage regions and extract radiological imaging marker to quantitatively determine the severity of aneurysmal subarachnoid hemorrhage at presentation and correlate the estimation with various homeostatic/metabolic derangements and predict clinical outcome. Third, to improve the efficiency of primary antibody screening processes in new cancer drug development, I developed a CAD scheme to automatically identify the non-negative tissue slides, which indicate reactive antibodies in digital pathology images. Last, to improve operation efficiency and reliability of storing digital pathology image data, I developed a CAD scheme using optical character recognition algorithm to automatically extract metadata from tissue slide label images and reduce manual entry for slide tracking and archiving in the tissue pathology laboratories. In summary, in these studies, we developed and tested several innovative approaches to identify quantitative imaging markers with high discriminatory power. In all CAD schemes, the graphic user interface-based visual aid tools were also developed and implemented. Study results demonstrated feasibility of applying CAD technology to several new application fields, which has potential to assist radiologists, oncologists and pathologists improving accuracy and consistency in disease diagnosis and prognosis assessment of using medical image

Studies on deep learning approach in breast lesions detection and cancer diagnosis in mammograms

Breast cancer accounts for the largest proportion of newly diagnosed cancers in women recently. Early diagnosis of breast cancer can improve treatment outcomes and reduce mortality. Mammography is convenient and reliable, which is the most commonly used method for breast cancer screening. However, manual examinations are limited by the cost and experience of radiologists, which introduce a high false positive rate and false examination. Therefore, a high-performance computer-aided diagnosis (CAD) system is significant for lesions detection and cancer diagnosis. Traditional CADs for cancer diagnosis require a large number of features selected manually and remain a high false positive rate. The methods based on deep learning can automatically extract image features through the network, but their performance is limited by the problems of multicenter data biases, the complexity of lesion features, and the high cost of annotations. Therefore, it is necessary to propose a CAD system to improve the ability of lesion detection and cancer diagnosis, which is optimized for the above problems. This thesis aims to utilize deep learning methods to improve the CADs' performance and effectiveness of lesion detection and cancer diagnosis. Starting from the detection of multi-type lesions using deep learning methods based on full consideration of characteristics of mammography, this thesis explores the detection method of microcalcification based on multiscale feature fusion and the detection method of mass based on multi-view enhancing. Then, a classification method based on multi-instance learning is developed, which integrates the detection results from the above methods, to realize the precise lesions detection and cancer diagnosis in mammography. For the detection of microcalcification, a microcalcification detection network named MCDNet is proposed to overcome the problems of multicenter data biases, the low resolution of network inputs, and scale differences between microcalcifications. In MCDNet, Adaptive Image Adjustment mitigates the impact of multicenter biases and maximizes the input effective pixels. Then, the proposed pyramid network with shortcut connections ensures that the feature maps for detection contain more precise localization and classification information about multiscale objects. In the structure, trainable Weighted Feature Fusion is proposed to improve the detection performance of both scale objects by learning the contribution of feature maps in different stages. The experiments show that MCDNet outperforms other methods on robustness and precision. In case the average number of false positives per image is 1, the recall rates of benign and malignant microcalcification are 96.8% and 98.9%, respectively. MCDNet can effectively help radiologists detect microcalcifications in clinical applications. For the detection of breast masses, a weakly supervised multi-view enhancing mass detection network named MVMDNet is proposed to solve the lack of lesion-level labels. MVMDNet can be trained on the image-level labeled dataset and extract the extra localization information by exploring the geometric relation between multi-view mammograms. In Multi-view Enhancing, Spatial Correlation Attention is proposed to extract correspondent location information between different views while Sigmoid Weighted Fusion module fuse diagnostic and auxiliary features to improve the precision of localization. CAM-based Detection module is proposed to provide detections for mass through the classification labels. The results of experiments on both in-house dataset and public dataset, [email protected] and [email protected] (recall rate@average number of false positive per image), demonstrate MVMDNet achieves state-of-art performances among weakly supervised methods and has robust generalization ability to alleviate the multicenter biases. In the study of cancer diagnosis, a breast cancer classification network named CancerDNet based on Multi-instance Learning is proposed. CancerDNet successfully solves the problem that the features of lesions are complex in whole image classification utilizing the lesion detection results from the previous chapters. Whole Case Bag Learning is proposed to combined the features extracted from four-view, which works like a radiologist to realize the classification of each case. Low-capacity Instance Learning and High-capacity Instance Learning successfully integrate the detections of multi-type lesions into the CancerDNet, so that the model can fully consider lesions with complex features in the classification task. CancerDNet achieves the AUC of 0.907 and AUC of 0.925 on the in-house and the public datasets, respectively, which is better than current methods. The results show that CancerDNet achieves a high-performance cancer diagnosis. In the works of the above three parts, this thesis fully considers the characteristics of mammograms and proposes methods based on deep learning for lesions detection and cancer diagnosis. The results of experiments on in-house and public datasets show that the methods proposed in this thesis achieve the state-of-the-art in the microcalcifications detection, masses detection, and the case-level classification of cancer and have a strong ability of multicenter generalization. The results also prove that the methods proposed in this thesis can effectively assist radiologists in making the diagnosis while saving labor costs