Matching of Mammographic Lesions in Different Breast Projections

De todos os cancros, cancro da mama é o que causa mais mortes entre mulheres. Programas de rastreio do cancro da mama podem ajudar a decrescer esta mortalidade, visto que deteção e tratamento do tumor em fases iniciais aumentam a taxa de sobrevivência. Normalmente, um par de radiologistas fazem a interpretação das mamografias, no entanto o processo é longo e cansativo. Isto incentivou o desenvolvimento de sistemas de diagnósitco auxiliado por computador (CADx), para substituir o segundo radiologista, fazendo melhor uso do tempo de especialistas. No entanto, sistemas CADx são associados a taxas elevadas de falsos positivos, dado que a maior parte detes apenas usam uma vista (craniocaudal ou mediolateral oblique) da mamografia. O radiologista, por sua vez, usa ambas as projeções, baseando o seu diagnóstico em diferenças visíveis entre as duas vistas. Quando se consideram as duas projeções da mamografia, a correspondência de lesões é um passo necessário para se fazer o diagnóstico. No entanto, isto é uma tarefa complexa, dado que podem existir vários candidatos a lesão, em cada uma das vistas, para se fazer correspondência. Neste trabalho, um sistema que faz correspondências entre lesões é proposto. Este é composto por três blocos: detetor de candidatos, extração de caraterísticas e correspondência de lesões. O primeiro é uma replicação do trabalho de Ribli et al., e o seu propósito é detetar possíveis candidatos a lesão. O segundo é a extração de vetores de caraterísticas de cada candidato, quer usando a backbone do detetor de candidatos, quer extraindo caraterísticas mais tradicionais, ou usando uma rede neuronal treinada com a triplet loss para distinguir lesões. O terceiro é o cálculo da distância entre os vetores de caraterísticas, usando também heurísticas para restringir possíveis pares de candidatos incorretos, e a ordenação de distâncias para atribuir a correspondência de cada lesão. Este trabalho oferece várias opções de possíveis extractores de caraterísticas e heurísticas a serem incroporados num sistema CADx que seja baseado em detetores de objetos. O facto do modelo treinado com a triplet loss ser competitivo com os restantos modelos, torna o sistema bastante mais viável, sendo que este oferece a possibilidade de a correspondência ser independente da deteção de candidatos. Heurísticas "hard" e "soft" são introduzidas como métodos para limitar correspondências. O sistema é capaz de fazer correspondências de forma satisfatória, dado que a sua exatidão ( 70%85%) é significativamente maior que a probabilidade aleatória (30%40%) dos dados usados. Heurísticas "hard" têm resultados encorajantes na precision@k, dado que estas rejeitam um número significativo de falsos positivos gerados pelo detetor de lesões.Of all cancer diseases, breast cancer is the most lethal among women. It has been shown that breast cancer screening programs can decrease mortality, since early detection increases the chances of survival. Usually, a pair of radiologists interpret the screening mammograms, however the process is long and exhausting. This has encouraged the development of computer aided diagnosis (CADx) systems to replace the second radiologist, making a better use of human-experts' time. But CADx systems are associated with high false positive rates, since most of them only use one view (craniocaudal or mediolateral oblique) of the screening mammogram. Radiologist, on the other hand, use both views; frequently reasoning about the diagnosis by noticeable differences between the two views. When considering both projections of a mammogram, lesion matching is a necessary step to perform diagnosis. However this is a complex task, since there might be various lesion candidates on both projections to match. In this work, a matching system is proposed. The system is a cascade of three blocks: candidates detector, feature extraction and lesion matching. The first is a replication of Ribli et al.'s Faster R-CNN and its purpose is to find possible lesion candidates. The second is the feature vector extraction of each candidate, either by using the candidates detector's backbone, handcrafted features or a siamese network model trained for distinguish lesions. The third is the calculus of the distance between feature vector, also using some heuristics to restrain possible non-lesion pairs, and the ranking of the distances to match the lesions. This work provides several options of possible feature extractors and heuristics to be incorporated into a CADx system based on object detectors. The fact that the triplet loss trained models obtained competitive results with the other features extractors is valuable, since it offers some independence between the detection and matching tasks. "Hard" heuristics and "soft" heurisitcs are introduced as methods to restrain matching. The system is able to detect matches satisfactorily, since its accuracy (70%85%) is significantly higher than chance level (30%40%). "Hard" heuristics proposals achieved encouraging results on precision@k, due to its match and candidates exclusion methods, which rejects a significant number of false positives generated by the object detector

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

Novel Computer-Aided Diagnosis Schemes for Radiological Image Analysis

The computer-aided diagnosis (CAD) scheme is a powerful tool in assisting clinicians (e.g., radiologists) to interpret medical images more accurately and efficiently. In developing high-performing CAD schemes, classic machine learning (ML) and deep learning (DL) algorithms play an essential role because of their advantages in capturing meaningful patterns that are important for disease (e.g., cancer) diagnosis and prognosis from complex datasets. This dissertation, organized into four studies, investigates the feasibility of developing several novel ML-based and DL-based CAD schemes for different cancer research purposes. The first study aims to develop and test a unique radiomics-based CT image marker that can be used to detect lymph node (LN) metastasis for cervical cancer patients. A total of 1,763 radiomics features were first computed from the segmented primary cervical tumor depicted on one CT image with the maximal tumor region. Next, a principal component analysis algorithm was applied on the initial feature pool to determine an optimal feature cluster. Then, based on this optimal cluster, machine learning models (e.g., support vector machine (SVM)) were trained and optimized to generate an image marker to detect LN metastasis. The SVM based imaging marker achieved an AUC (area under the ROC curve) value of 0.841 ± 0.035. This study initially verifies the feasibility of combining CT images and the radiomics technology to develop a low-cost image marker for LN metastasis detection among cervical cancer patients. In the second study, the purpose is to develop and evaluate a unique global mammographic image feature analysis scheme to identify case malignancy for breast cancer. From the entire breast area depicted on the mammograms, 59 features were initially computed to characterize the breast tissue properties in both the spatial and frequency domain. Given that each case consists of two cranio-caudal and two medio-lateral oblique view images of left and right breasts, two feature pools were built, which contain the computed features from either two positive images of one breast or all the four images of two breasts. For each feature pool, a particle swarm optimization (PSO) method was applied to determine the optimal feature cluster followed by training an SVM classifier to generate a final score for predicting likelihood of the case being malignant. The classification performances measured by AUC were 0.79±0.07 and 0.75±0.08 when applying the SVM classifiers trained using image features computed from two-view and four-view images, respectively. This study demonstrates the potential of developing a global mammographic image feature analysis-based scheme to predict case malignancy without including an arduous segmentation of breast lesions. In the third study, given that the performance of DL-based models in the medical imaging field is generally bottlenecked by a lack of sufficient labeled images, we specifically investigate the effectiveness of applying the latest transferring generative adversarial networks (GAN) technology to augment limited data for performance boost in the task of breast mass classification. This transferring GAN model was first pre-trained on a dataset of 25,000 mammogram patches (without labels). Then its generator and the discriminator were fine-tuned on a much smaller dataset containing 1024 labeled breast mass images. A supervised loss was integrated with the discriminator, such that it can be used to directly classify the benign/malignant masses. Our proposed approach improved the classification accuracy by 6.002%, when compared with the classifiers trained without traditional data augmentation. This investigation may provide a new perspective for researchers to effectively train the GAN models on a medical imaging task with only limited datasets. Like the third study, our last study also aims to alleviate DL models’ reliance on large amounts of annotations but uses a totally different approach. We propose employing a semi-supervised method, i.e., virtual adversarial training (VAT), to learn and leverage useful information underlying in unlabeled data for better classification of breast masses. Accordingly, our VAT-based models have two types of losses, namely supervised and virtual adversarial losses. The former loss acts as in supervised classification, while the latter loss works towards enhancing the model’s robustness against virtual adversarial perturbation, thus improving model generalizability. A large CNN and a small CNN were used in this investigation, and both were trained with and without the adversarial loss. When the labeled ratios were 40% and 80%, VAT-based CNNs delivered the highest classification accuracy of 0.740±0.015 and 0.760±0.015, respectively. The experimental results suggest that the VAT-based CAD scheme can effectively utilize meaningful knowledge from unlabeled data to better classify mammographic breast mass images. In summary, several innovative approaches have been investigated and evaluated in this dissertation to develop ML-based and DL-based CAD schemes for the diagnosis of cervical cancer and breast cancer. The promising results demonstrate the potential of these CAD schemes in assisting radiologists to achieve a more accurate interpretation of radiological images