Automatic detection of the nipple in screen-film and full-field digital mammograms using a novel Hessian-based method

Prediction of Short-Term Breast Cancer Risk with Fusion of CC- and MLO-Based Risk Models in Four-View Mammograms

This study performed and assessed a novel program to improve the accuracy of short-term breast cancer risk prediction by using information from craniocaudal (CC) and mediolateral-oblique (MLO) views of two breasts. An age-matched dataset of 556 patients with at least two sequential full-field digital mammography examinations was applied. In the second examination, 278 cases were diagnosed and pathologically verified as cancer, and 278 were negative, while all cases in the first examination were negative (not recalled). Two generalized linear-model-based risk prediction models were established with global- and local-based bilateral asymmetry features for CC and MLO views first. Then, a new fusion risk model was developed by fusing prediction results of the CC- and MLO-based risk models with an adaptive alpha-integration-based fusion method. The AUC of the fusion risk model was 0.72 ± 0.02, which was significantly higher than the AUC of CC- or MLO-based risk model (P < 0.05). The maximum odds ratio for CC- and MLO-based risk models were 8.09 and 5.25, respectively, and increased to 11.99 for the fusion risk model. For subgroups of patients aged 37-49 years, 50-65 years, and 66-87 years, the AUCs of 0.73, 0.71, and 0.75 for the fusion risk model were higher than AUC for CC- and MLO-based risk models. For the BIRADS 2 and 3 subgroups, the AUC values were 0.72 and 0.71 respectively for the fusion risk model which were higher than the AUC for the CC- and MLO-based risk models. This study demonstrated that the fusion risk model we established could effectively derive and integrate supplementary and useful information extracted from both CC and MLO view images and adaptively fuse them to increase the predictive power of the short-term breast cancer risk assessment model.

A Radiomic feature-based Nipple Detection Algorithm on Digital Mammography

PURPOSE

In the diagnosis and detection of breast lesions, the nipple is an important anatomical landmark which can be used for the registration on multiview mammograms. In this study, we propose a new detection algorithm for nipples on digital mammography (DM) by applying pixel classification based on geometric and radiomic features extracted from breast boundary regions.

METHODS

The imaging characteristics of nipples are closely related to the visibility on mammograms. To locate the nipple on mammogram, a searching area is first determined based on the breast boundary and chest wall orientation. Two different approaches are developed for obvious and subtle nipples, respectively. For obvious nipples, top hat transformation is employed to detect the nipple region, whose geometric center is regarded as the nipple position. For subtle nipples, the curved searching area near the breast boundary is mapped onto a Cartesian plane through a revised rubber band straightening transformation. On the straightened searching area, the geometric and radiomic features are calculated along the normal direction of the breast boundary, and a random forest classifier is trained for subtle nipple localization.

RESULTS

Seven hundred and twenty-one DMs were collected for the evaluation of the proposed algorithm. The locations of nipples are manually identified by an experienced radiologist as the reference standard. The average Euclidean distance between the computed nipple position and the reference standard was 2.69 mm (obvious) and 7.81 mm (subtle), respectively. A total of 97.61% of the obvious nipples (613/628) and 88.17% of the subtle nipples (82/93) were detected within a 10-mm radius centered from the reference standard.

CONCLUSIONS

The evaluation results show that the proposed method is effective for nipple detection on DM, especially for subtle nipple detection.

Assessment of global and local region-based bilateral mammographic feature asymmetry to predict short-term breast cancer risk

This study aims to develop and test a new imaging marker-based short-term breast cancer risk prediction model. An age-matched dataset of 566 screening mammography cases was used. All 'prior' images acquired in the two screening series were negative, while in the 'current' screening images, 283 cases were positive for cancer and 283 cases remained negative. For each case, two bilateral cranio-caudal view mammograms acquired from the 'prior' negative screenings were selected and processed by a computer-aided image processing scheme, which segmented the entire breast area into nine strip-based local regions, extracted the element regions using difference of Gaussian filters, and computed both global- and local-based bilateral asymmetrical image features. An initial feature pool included 190 features related to the spatial distribution and structural similarity of grayscale values, as well as of the magnitude and phase responses of multidirectional Gabor filters. Next, a short-term breast cancer risk prediction model based on a generalized linear model was built using an embedded stepwise regression analysis method to select features and a leave-one-case-out cross-validation method to predict the likelihood of each woman having image-detectable cancer in the next sequential mammography screening. The area under the receiver operating characteristic curve (AUC) values significantly increased from 0.5863  ±  0.0237 to 0.6870  ±  0.0220 when the model trained by the image features extracted from the global regions and by the features extracted from both the global and the matched local regions (p  =  0.0001). The odds ratio values monotonically increased from 1.00-8.11 with a significantly increasing trend in slope (p  =  0.0028) as the model-generated risk score increased. In addition, the AUC values were 0.6555  ±  0.0437, 0.6958  ±  0.0290, and 0.7054  ±  0.0529 for the three age groups of 37-49, 50-65, and 66-87 years old, respectively. AUC values of 0.6529  ±  0.1100, 0.6820  ±  0.0353, 0.6836  ±  0.0302 and 0.8043  ±  0.1067 were yielded for the four mammography density sub-groups (BIRADS from 1-4), respectively. This study demonstrated that bilateral asymmetry features extracted from local regions combined with the global region in bilateral negative mammograms could be used as a new imaging marker to assist in the prediction of short-term breast cancer risk.

Towards localization of malignant sites of asymmetry across bilateral mammograms

BACKGROUND AND OBJECTIVES

The analysis of patterns of asymmetry between the left and right mammograms of a patient can provide meaningful insights into the presence of an underlying tumor in its early stage. However, the identification of breast cancer by investigating bilateral asymmetry is difficult to perform due to the indistinct and borderline nature of the asymmetric signs as they appear on mammograms.

METHODS

In this study, to increase the positive-predictive value of asymmetry in mammographic screening, a novel computerized approach for the automatic localization of malignant sites of asymmetry in mammograms is proposed. The sites of anatomical correspondence between the right and left regions of each radiographic projection were extracted by means of two bilateral masking procedures, inspired by radiologists' criteria in interpreting mammograms and based on the use of detected landmarking structures. Relative variations of spatial patterns of intensity values and of orientations of directional components within each site were quantified by combining multidirectional Gabor filters and indices of structural similarity. The localization of the sites of malignant asymmetry was performed by coupling two quadratic discriminant analysis classifiers, one for each masking procedure, that assigned the likelihood of malignancy to each site of correspondence.

RESULTS

The performance of the proposed method was assessed on 94 mammographic images from two publicly available databases and containing at least one asymmetric site. Sensitivity, specificity and balanced accuracy levels of 0.83 (0.09), 0.75 (0.06), and 0.79 (0.04), respectively were obtained in the classification of malignant asymmetric sites vs benign/normal sites using cross-validation. In addition, a further blind test on a dataset of Full Field Digital Mammograms achieved levels of sensitivity, specificity, and balanced accuracy of 0.86, 0.65, and 0.75, respectively.

CONCLUSIONS

The achieved performance indicates that the proposed system is effective in localizing sites of malignant asymmetry and it is expected to improve computer-aided diagnosis of breast cancer.

Analysis of structural similarity in mammograms for detection of bilateral asymmetry

We hypothesize that quantification of structural similarity or dissimilarity between paired mammographic regions can be effective in detecting asymmetric signs of breast cancer. Bilateral masking procedures are applied for this purpose by using automatically detected anatomical landmarks. Changes in structural information of the extracted regions are investigated using spherical semivariogram descriptors and correlation-based structural similarity indices in the spatial and complex wavelet domains. The spatial distribution of grayscale values as well as of the magnitude and phase responses of multidirectional Gabor filters are used to represent the structure of mammographic density and of the directional components of breast tissue patterns, respectively. A total of 188 mammograms from the DDSM and mini-MIAS databases, consisting of 47 asymmetric cases and 47 normal cases, were analyzed. For the combined dataset of mammograms, areas under the receiver operating characteristic curves of 0.83, 0.77, and 0.87 were obtained, respectively, with linear discriminant analysis, the Bayesian classifier, and an artificial neural network with radial basis functions, using the features selected by stepwise logistic regression and leave-one-patient-out cross-validation. Two-view analysis provided accuracy up to 0.94, with sensitivity and specificity of 1 and 0.88, respectively.

Development and validation of a fully automated system for detection and diagnosis of mammographic lesions

We present a comprehensive and fully automated system for computer-aided detection and diagnosis of masses in mammograms. Novel methods for detection include: selection of suspicious focal areas based on analysis of the gradient vector field, rejection of oriented components of breast tissue using multidirectional Gabor filtering, and use of differential features for rejection of false positives (FPs) via clustering of the surrounding fibroglandular tissue. The diagnosis step is based on extraction of contour-independent features for characterization of lesions as benign or malignant from automatically detected circular and annular regions. A new unified 3D free-response receiver operating characteristic framework is introduced for global analysis of two binary categorization problems in cascade. In total, 3,080 suspicious focal areas were extracted from a set of 156 full-field digital mammograms, including 26 malignant tumors, 120 benign lesions, and 18 normal mammograms. The proposed system detected and diagnosed malignant tumors with a sensitivity of 0.96, 0.92, and 0.88 at, respectively, 1.83, 0.46, and 0.45 FPs/image, with two stages of stepwise logistic regression for selection of features, a cascade of Fisher linear discriminant analysis and an artificial neural network with radial basis functions, and leave-one-patient-out cross-validation.