AI-enhanced diagnosis of challenging lesions in breast MRI: a methodology and application primer

Computer-aided diagnosis (CAD) systems have become an important tool in the assessment of breast tumors with magnetic resonance imaging (MRI). CAD systems can be used for the detection and diagnosis of breast tumors as a “second opinion” review complementing the radiologist’s review. CAD systems have many common parts such as image pre-processing, tumor feature extraction and data classification that are mostly based on machine learning (ML) techniques. In this review paper, we describe the application of ML-based CAD systems in MRI of the breast covering the detection of diagnostically challenging lesions such as non-mass enhancing (NME) lesions, multiparametric MRI, neo-adjuvant chemotherapy (NAC) and radiomics all applied to NME. Since ML has been widely used in the medical imaging community, we provide an overview about the state-ofthe-art and novel techniques applied as classifiers to CAD systems. The differences in the CAD systems in MRI of the breast for several standard and novel applications for NME are explained in detail to provide important examples illustrating: (i) CAD for the detection and diagnosis, (ii) CAD in multi-parametric imaging (iii) CAD in NAC and (iv) breast cancer radiomics. We aim to provide a comparison between these CAD applications and to illustrate a global view on intelligent CAD systems based on ANN in MRI of the breast

AI-Enhanced Diagnosis of Challenging Lesions in BreastMRI:A Methodology and Application Primer

Computer‐aided diagnosis (CAD) systems have become an important tool in the assessment of breast tumors with magnetic resonance imaging (MRI). CAD systems can be used for the detection and diagnosis of breast tumors as a “second opinion” review complementing the radiologist's review. CAD systems have many common parts, such as image preprocessing, tumor feature extraction, and data classification that are mostly based on machine‐learning (ML) techniques. In this review article, we describe applications of ML‐based CAD systems in MRI covering the detection of diagnostically challenging lesions of the breast such as nonmass enhancing (NME) lesions, and furthermore discuss how multiparametric MRI and radiomics can be applied to the study of NME, including prediction of response to neoadjuvant chemotherapy (NAC). Since ML has been widely used in the medical imaging community, we provide an overview about the state‐of‐the‐art and novel techniques applied as classifiers to CAD systems. The differences in the CAD systems in MRI of the breast for several standard and novel applications for NME are explained in detail to provide important examples, illustrating: 1) CAD for detection and diagnosis, 2) CAD in multiparametric imaging, 3) CAD in NAC, and 4) breast cancer radiomics. We aim to provide a comparison between these CAD applications and to illustrate a global view on intelligent CAD systems based on machine and deep learning in MRI of the breast. LEVEL OF EVIDENCE: 2 TECHNICAL EFFICACY STAGE:

Computer-Aided Diagnosis of Diagnostically Challenging Lesions in Breast MRI: A Comparison between a Radiomics and a Feature-Selective Approach

International audienceDiagnostically challenging lesions pose a challenge both for the radiological reading and also for current CAD systems. They are not well-defined in both morphology (geometric shape) and kinetics (temporal enhancement) and pose a problem to lesion detection and classification. Their strong phenotypic differences can be visualized by MRI. Radiomics represents a novel approach to achieve a detailed quantification of the tumour phenotypes by analyzing a large number of image descriptors. In this paper, we apply a quantitative radiomics approach based on shape, texture and kinetics tumor features and evaluate it in comparison to a reduced-order feature approach in a computer-aided diagnosis system applied to diagnostically challenging lesions