Breast cancer detection from biopsy images using nucleus guided transfer learning and belief based fusion

Improving generalization capability of deep learning-based nuclei instance segmentation by non-deterministic train time and deterministic test time stain normalization

With the advent of digital pathology and microscopic systems that can scan and save whole slide histological images automatically, there is a growing trend to use computerized methods to analyze acquired images. Among different histopathological image analysis tasks, nuclei instance segmentation plays a fundamental role in a wide range of clinical and research applications. While many semi- and fully-automatic computerized methods have been proposed for nuclei instance segmentation, deep learning (DL)-based approaches have been shown to deliver the best performances. However, the performance of such approaches usually degrades when tested on unseen datasets. In this work, we propose a novel method to improve the generalization capability of a DL-based automatic segmentation approach. Besides utilizing one of the state-of-the-art DL-based models as a baseline, our method incorporates non-deterministic train time and deterministic test time stain normalization, and ensembling to boost the segmentation performance. We trained the model with one single training set and evaluated its segmentation performance on seven test datasets. Our results show that the proposed method provides up to 4.9%, 5.4%, and 5.9% better average performance in segmenting nuclei based on Dice score, aggregated Jaccard index, and panoptic quality score, respectively, compared to the baseline segmentation model.

The diagnostic value of multimodal imaging based on MR combined with ultrasound in benign and malignant breast diseases

We aimed to construct and validate a multimodality MRI combined with ultrasound based on radiomics for the evaluation of benign and malignant breast diseases. The preoperative enhanced MRI and ultrasound images of 131 patients with breast diseases confirmed by pathology in Aerospace Center Hospital from January 2021 to August 2023 were retrospectively analyzed, including 73 benign diseases and 58 malignant diseases. Ultrasound and 3.0 T multiparameter MRI scans were performed in all patients. Then, all the data were divided into training set and validation set in a 7:3 ratio. Regions of interest were drawn layer by layer based on ultrasound and MR enhanced sequences to extract radiomics features. The optimal radiomic features were selected by the best feature screening method. Logistic Regression classifier was used to establish models according to the best features, including ultrasound model, MRI model, ultrasound combined with MRI model. The model efficacy was evaluated by the area under the curve (AUC) of the receiver operating characteristic, sensitivity, specificity, and accuracy. The F-test based on ANOVA was used to screen out 20 best ultrasonic features, 11 best MR Features, and 14 best features from the combined model. Among them, texture features accounted for the largest proportion, accounting for 79%.The ultrasound combined with MR Image fusion model based on logistic regression classifier had the best diagnostic performance. The AUC of the training group and the validation group were 0.92 and 091, the sensitivity was 0.80 and 0.67, the specificity was 0.90 and 0.94, and the accuracy was 0.84 and 0.79, respectively. It was better than the simple ultrasound model (AUC of validation set was 0.82) or the simple MR model (AUC of validation set was 0.85). Compared with the traditional ultrasound or magnetic resonance diagnosis of breast diseases, the multimodal model of MRI combined with ultrasound based on radiomics can more accurately predict the benign and malignant breast diseases, thus providing a better basis for clinical diagnosis and treatment.

Ensemble-based multi-tissue classification approach of colorectal cancer histology images using a novel hybrid deep learning framework

Colorectal cancer (CRC) is the second leading cause of cancer death in the world, so digital pathology is essential for assessing prognosis. Due to the increasing resolution and quantity of whole slide images (WSIs), as well as the lack of annotated information, previous methodologies cannot be generalized as effective decision-making systems. Since deep learning (DL) methods can handle large-scale applications, they can provide a viable alternative to histopathology image (HI) analysis. DL architectures, however, may not be sufficient to classify CRC tissues based on anatomical histopathology data. A dilated ResNet (dResNet) structure and attention module are used to generate deep feature maps in order to classify multiple tissues in HIs. In addition, neighborhood component analysis (NCA) overcomes the constraint of computational complexity. Data is fed into a deep support vector machine (SVM) based on an ensemble learning algorithm called DeepSVM after the features have been selected. CRC-5000 and NCT-CRC-HE-100 K datasets were analyzed to validate and test the hybrid procedure. We demonstrate that the hybrid model achieves 98.75% and 99.76% accuracy on CRC datasets. The results showed that only pathologists' labels could successfully classify unseen WSIs. Furthermore, the hybrid deep learning method outperforms state-of-the-art approaches in terms of computational efficiency and time. Using the proposed mechanism for tissue analysis, it will be possible to correctly predict CRC based on accurate pathology image classification.

Multimodal data fusion for cancer biomarker discovery with deep learning

Technological advances now make it possible to study a patient from multiple angles with high-dimensional, high-throughput multi-scale biomedical data. In oncology, massive amounts of data are being generated ranging from molecular, histopathology, radiology to clinical records. The introduction of deep learning has significantly advanced the analysis of biomedical data. However, most approaches focus on single data modalities leading to slow progress in methods to integrate complementary data types. Development of effective multimodal fusion approaches is becoming increasingly important as a single modality might not be consistent and sufficient to capture the heterogeneity of complex diseases to tailor medical care and improve personalised medicine. Many initiatives now focus on integrating these disparate modalities to unravel the biological processes involved in multifactorial diseases such as cancer. However, many obstacles remain, including lack of usable data as well as methods for clinical validation and interpretation. Here, we cover these current challenges and reflect on opportunities through deep learning to tackle data sparsity and scarcity, multimodal interpretability, and standardisation of datasets.

The Systematic Review of Artificial Intelligence Applications in Breast Cancer Diagnosis

Several studies have demonstrated the value of artificial intelligence (AI) applications in breast cancer diagnosis. The systematic review of AI applications in breast cancer diagnosis includes several studies that compare breast cancer diagnosis and AI. However, they lack systematization, and each study appears to be conducted uniquely. The purpose and contributions of this study are to offer elaborative knowledge on the applications of AI in the diagnosis of breast cancer through citation analysis in order to categorize the main area of specialization that attracts the attention of the academic community, as well as thematic issue analysis to identify the species being researched in each category. In this study, a total number of 17,900 studies addressing breast cancer and AI published between 2012 and 2022 were obtained from these databases: IEEE, Embase: Excerpta Medica Database Guide-Ovid, PubMed, Springer, Web of Science, and Google Scholar. We applied inclusion and exclusion criteria to the search; 36 studies were identified. The vast majority of AI applications used classification models for the prediction of breast cancer. Howbeit, accuracy (99%) has the highest number of performance metrics, followed by specificity (98%) and area under the curve (0.95). Additionally, the Convolutional Neural Network (CNN) was the best model of choice in several studies. This study shows that the quantity and caliber of studies that use AI applications in breast cancer diagnosis will continue to rise annually. As a result, AI-based applications are viewed as a supplement to doctors' clinical reasoning, with the ultimate goal of providing quality healthcare that is both affordable and accessible to everyone worldwide.

Application of Deep Learning in Histopathology Images of Breast Cancer: A Review

With the development of artificial intelligence technology and computer hardware functions, deep learning algorithms have become a powerful auxiliary tool for medical image analysis. This study was an attempt to use statistical methods to analyze studies related to the detection, segmentation, and classification of breast cancer in pathological images. After an analysis of 107 articles on the application of deep learning to pathological images of breast cancer, this study is divided into three directions based on the types of results they report: detection, segmentation, and classification. We introduced and analyzed models that performed well in these three directions and summarized the related work from recent years. Based on the results obtained, the significant ability of deep learning in the application of breast cancer pathological images can be recognized. Furthermore, in the classification and detection of pathological images of breast cancer, the accuracy of deep learning algorithms has surpassed that of pathologists in certain circumstances. Our study provides a comprehensive review of the development of breast cancer pathological imaging-related research and provides reliable recommendations for the structure of deep learning network models in different application scenarios.

Breast Cancer Detection in Mammogram Images Using K-Means++ Clustering Based on Cuckoo Search Optimization

Traditional breast cancer detection algorithms require manual extraction of features from mammogram images and professional medical knowledge. Still, the quality of mammogram images hampers this and extracting high-quality features, which can result in very long processing times. Therefore, this paper proposes a new K-means++ clustering based on Cuckoo Search Optimization (KM++CSO) for breast cancer detection. The pre-processing method is used to improve the proposed KM++CSO method more segmentation efficiently. Furthermore, the interpretability is further enhanced using mathematical morphology and OTSU's threshold. To this end, we tested the effectiveness of the KM++CSO methods on the mammogram image analysis society of the Mini-Mammographic Image Analysis Society (Mini-MIAS), the Digital Database for Screening Mammography (DDSM), and the Breast Cancer Digital Repository (BCDR) dataset through cross-validation. We maximize the accuracy and Jaccard index score, which is a measure that indicates the similarity between detected cancer and their corresponding reference cancer regions. The experimental results showed that the detection method obtained an accuracy of 96.42% (Mini-MIAS), 95.49% (DDSM), and 96.92% (BCDR). On overage, the KM++CSO method obtained 96.27% accuracy for three publicly available datasets. In addition, the detection results provided the 91.05% Jaccard index score.

MixPatch: A New Method for Training Histopathology Image Classifiers

CNN-based image processing has been actively applied to histopathological analysis to detect and classify cancerous tumors automatically. However, CNN-based classifiers generally predict a label with overconfidence, which becomes a serious problem in the medical domain. The objective of this study is to propose a new training method, called MixPatch, designed to improve a CNN-based classifier by specifically addressing the prediction uncertainty problem and examine its effectiveness in improving diagnosis performance in the context of histopathological image analysis. MixPatch generates and uses a new sub-training dataset, which consists of mixed-patches and their predefined ground-truth labels, for every single mini-batch. Mixed-patches are generated using a small size of clean patches confirmed by pathologists while their ground-truth labels are defined using a proportion-based soft labeling method. Our results obtained using a large histopathological image dataset shows that the proposed method performs better and alleviates overconfidence more effectively than any other method examined in the study. More specifically, our model showed 97.06% accuracy, an increase of 1.6% to 12.18%, while achieving 0.76% of expected calibration error, a decrease of 0.6% to 6.3%, over the other models. By specifically considering the mixed-region variation characteristics of histopathology images, MixPatch augments the extant mixed image methods for medical image analysis in which prediction uncertainty is a crucial issue. The proposed method provides a new way to systematically alleviate the overconfidence problem of CNN-based classifiers and improve their prediction accuracy, contributing toward more calibrated and reliable histopathology image analysis.

Effective active learning in digital pathology: A case study in tumor infiltrating lymphocytes

BACKGROUND AND OBJECTIVE

Deep learning methods have demonstrated remarkable performance in pathology image analysis, but they require a large amount of annotated training data from expert pathologists. The aim of this study is to minimize the data annotation need in these analyses.

METHODS

Active learning (AL) is an iterative approach to training deep learning models. It was used in our context with a Tumor Infiltrating Lymphocytes (TIL) classification task to minimize annotation. State-of-the-art AL methods were evaluated with the TIL application and we have proposed and evaluated a more efficient and effective AL acquisition method. The proposed method uses data grouping based on imaging features and model prediction uncertainty to select meaningful training samples (image patches).

RESULTS

An experimental evaluation with a collection of cancer tissue images shows that: (i) Our approach reduces the number of patches required to attain a given AUC as compared to other approaches, and (ii) our optimization (subpooling) leads to AL execution time improvement of about 2.12×.

CONCLUSIONS

This strategy enabled TIL based deep learning analyses using smaller annotation demand. We expect this approach may be used to build other analyses in digital pathology with fewer training samples.

Building Efficient CNN Architectures for Histopathology Images Analysis: A Case-Study in Tumor-Infiltrating Lymphocytes Classification

Background

Deep learning methods have demonstrated remarkable performance in pathology image analysis, but they are computationally very demanding. The aim of our study is to reduce their computational cost to enable their use with large tissue image datasets.

Methods

We propose a method called Network Auto-Reduction (NAR) that simplifies a Convolutional Neural Network (CNN) by reducing the network to minimize the computational cost of doing a prediction. NAR performs a compound scaling in which the width, depth, and resolution dimensions of the network are reduced together to maintain a balance among them in the resulting simplified network. We compare our method with a state-of-the-art solution called ResRep. The evaluation is carried out with popular CNN architectures and a real-world application that identifies distributions of tumor-infiltrating lymphocytes in tissue images.

Results

The experimental results show that both ResRep and NAR are able to generate simplified, more efficient versions of ResNet50 V2. The simplified versions by ResRep and NAR require 1.32× and 3.26× fewer floating-point operations (FLOPs), respectively, than the original network without a loss in classification power as measured by the Area under the Curve (AUC) metric. When applied to a deeper and more computationally expensive network, Inception V4, NAR is able to generate a version that requires 4× lower than the original version with the same AUC performance.

Conclusions

NAR is able to achieve substantial reductions in the execution cost of two popular CNN architectures, while resulting in small or no loss in model accuracy. Such cost savings can significantly improve the use of deep learning methods in digital pathology. They can enable studies with larger tissue image datasets and facilitate the use of less expensive and more accessible graphics processing units (GPUs), thus reducing the computing costs of a study.

Multi-Classification of Breast Cancer Lesions in Histopathological Images Using DEEP_Pachi: Multiple Self-Attention Head

Introduction and Background: Despite fast developments in the medical field, histological diagnosis is still regarded as the benchmark in cancer diagnosis. However, the input image feature extraction that is used to determine the severity of cancer at various magnifications is harrowing since manual procedures are biased, time consuming, labor intensive, and error-prone. Current state-of-the-art deep learning approaches for breast histopathology image classification take features from entire images (generic features). Thus, they are likely to overlook the essential image features for the unnecessary features, resulting in an incorrect diagnosis of breast histopathology imaging and leading to mortality. Methods: This discrepancy prompted us to develop DEEP_Pachi for classifying breast histopathology images at various magnifications. The suggested DEEP_Pachi collects global and regional features that are essential for effective breast histopathology image classification. The proposed model backbone is an ensemble of DenseNet201 and VGG16 architecture. The ensemble model extracts global features (generic image information), whereas DEEP_Pachi extracts spatial information (regions of interest). Statistically, the evaluation of the proposed model was performed on publicly available dataset: BreakHis and ICIAR 2018 Challenge datasets. Result: A detailed evaluation of the proposed model’s accuracy, sensitivity, precision, specificity, and f1-score metrics revealed the usefulness of the backbone model and the DEEP_Pachi model for image classifying. The suggested technique outperformed state-of-the-art classifiers, achieving an accuracy of 1.0 for the benign class and 0.99 for the malignant class in all magnifications of BreakHis datasets and an accuracy of 1.0 on the ICIAR 2018 Challenge dataset. Conclusion: The acquired findings were significantly resilient and proved helpful for the suggested system to assist experts at big medical institutions, resulting in early breast cancer diagnosis and a reduction in the death rate.

CCDC134 as a Prognostic-Related Biomarker in Breast Cancer Correlating With Immune Infiltrates

Background

The expression of Coiled-Coil Domain Containing 134(CCDC134) is up-regulated in different pan-cancer species. However, its prognostic value and correlation with immune infiltration in breast cancer are unclear. Therefore, we evaluated the prognostic role of CCDC134 in breast cancer and its correlation with immune invasion.

Methods

We downloaded the transcription profile of CCDC134 between breast cancer and normal tissues from the Cancer Genome Atlas (TCGA). CCDC134 protein expression was assessed by the Clinical Proteomic Cancer Analysis Consortium (CPTAC) and the Human Protein Atlas. Gene set enrichment analysis (GSEA) was also used for pathway analysis. Receiver operating characteristic (ROC) curve was used to differentiate breast cancer from adjacent normal tissues. Kaplan-Meier method was used to evaluate the effect of CCDC134 on survival rate. The protein-protein interaction (PPI) network is built from STRING. Function expansion analysis is performed using the ClusterProfiler package. Through tumor Immune Estimation Resource (TIMER) and tumor Immune System Interaction database (TISIDB) to determine the relationship between CCDC134 expression level and immune infiltration. CTD database is used to predict drugs that inhibit CCDC134 and PubChem database is used to determine the molecular structure of identified drugs.

Results

The expression of CCDC134 in breast cancer tissues was significantly higher than that of CCDC134 mRNA expression in adjacent normal tissues. ROC curve analysis showed that the AUC value of CCDC134 was 0.663. Kaplan-meier survival analysis showed that patients with high CCDC134 had a lower prognosis (57.27 months vs 36.96 months, P = 2.0E-6). Correlation analysis showed that CCDC134 mRNA expression was associated with tumor purity immune invasion. In addition, CTD database analysis identified abrine, Benzo (A) Pyrene, bisphenol A, Soman, Sunitinib, Tetrachloroethylene, Valproic Acid as seven targeted therapy drugs that may be effective treatments for seven targeted therapeutics. It may be an effective treatment for inhibiting CCDC134.

Conclusion

In breast cancer, upregulated CCDC134 is significantly associated with lower survival and immune infiltrates invasion. Our study suggests that CCDC134 can serve as a biomarker of poor prognosis and a potential immunotherapy target in breast cancer. Seven drugs with significant potential to inhibit CCDC134 were identified.

Artificial intelligence for breast cancer analysis: Trends & directions

Breast cancer is one of the leading causes of death among women. Early detection of breast cancer can significantly improve the lives of millions of women across the globe. Given importance of finding solution/framework for early detection and diagnosis, recently many AI researchers are focusing to automate this task. The other reasons for surge in research activities in this direction are advent of robust AI algorithms (deep learning), availability of hardware that can run/train those robust and complex AI algorithms and accessibility of large enough dataset required for training AI algorithms. Different imaging modalities that have been exploited by researchers to automate the task of breast cancer detection are mammograms, ultrasound, magnetic resonance imaging, histopathological images or any combination of them. This article analyzes these imaging modalities and presents their strengths and limitations. It also enlists resources from where their datasets can be accessed for research purpose. This article then summarizes AI and computer vision based state-of-the-art methods proposed in the last decade to detect breast cancer using various imaging modalities. Primarily, in this article we have focused on reviewing frameworks that have reported results using mammograms as it is the most widely used breast imaging modality that serves as the first test that medical practitioners usually prescribe for the detection of breast cancer. Another reason for focusing on mammogram imaging modalities is the availability of its labelled datasets. Datasets availability is one of the most important aspects for the development of AI based frameworks as such algorithms are data hungry and generally quality of dataset affects performance of AI based algorithms. In a nutshell, this research article will act as a primary resource for the research community working in the field of automated breast imaging analysis.

Breast histopathological image analysis using image processing techniques for diagnostic puposes: A methodological review

Breast cancer in women is the second most common cancer worldwide. Early detection of breast cancer can reduce the risk of human life. Non-invasive techniques such as mammograms and ultrasound imaging are popularly used to detect the tumour. However, histopathological analysis is necessary to determine the malignancy of the tumour as it analyses the image at the cellular level. Manual analysis of these slides is time consuming, tedious, subjective and are susceptible to human errors. Also, at times the interpretation of these images are inconsistent between laboratories. Hence, a Computer-Aided Diagnostic system that can act as a decision support system is need of the hour. Moreover, recent developments in computational power and memory capacity led to the application of computer tools and medical image processing techniques to process and analyze breast cancer histopathological images. This review paper summarizes various traditional and deep learning based methods developed to analyze breast cancer histopathological images. Initially, the characteristics of breast cancer histopathological images are discussed. A detailed discussion on the various potential regions of interest is presented which is crucial for the development of Computer-Aided Diagnostic systems. We summarize the recent trends and choices made during the selection of medical image processing techniques. Finally, a detailed discussion on the various challenges involved in the analysis of BCHI is presented along with the future scope.

REUR: A unified deep framework for signet ring cell detection in low-resolution pathological images

Detecting signet ring cells (SRCs) in pathological images is essential for carcinoma diagnosis. However, it is time consuming for pathologists to detect SRCs manually from pathological images, and the accuracy of detecting them is also relatively low because of their small sizes. Recently, the exploration of deep learning methods in pathology analysis has been widely investigated by researchers. Nevertheless, the automatic detection of SRCs from real pathological images faces two problems. One is that labeled pathological images are insufficient and usually incomplete. The other is that the training data and the real clinical data have a large difference in resolution. Hence, adopting the transfer learning method affects the performance of deep learning methods. To address these two problems, we present a unified framework named REUR [RetinaNet combining USRNet (unfolding super-resolution network) with the RGHMC (revised gradient harmonizing mechanism classification) loss] that can accurately detect SRCs in low-resolution (LR) pathological images. First, the framework with the super-resolution (SR) module can address the difference in resolution between the training data and the real clinical data. Second, the framework with the label correction module can obtain the revised ground-truth labels from noisy examples, which are embedded into the gradient harmonizing mechanism to acquire the RGHMC loss. The results of the numerical experiments showed that the framework can perform better than other one-stage detectors based on the RetinaNet architecture in the high-resolution (HR) noisy dataset. It achieved a kappa value of 0.74 and an accuracy of 0.89 in the test with 27 randomly selected whole slide images (WSIs), and, thus, it can assist pathologists in better analyzing WSIs. The framework provides an essential method in computer-aided diagnosis for medical applications.

A transfer learning with structured filter pruning approach for improved breast cancer classification on point-of-care devices

BACKGROUND AND OBJECTIVE

A significant progress has been made in automated medical diagnosis with the advent of deep learning methods in recent years. However, deploying a deep learning model for mobile and small-scale, low-cost devices is a major bottleneck. Further, breast cancer is more prevalent currently, and ductal carcinoma being its most common type. Although many machine/deep learning methods have already been investigated, still, there is a need for further improvement.

METHOD

This paper proposes a novel deep convolutional neural network (CNN) based transfer learning approach complemented with structured filter pruning for histopathological image classification, and to bring down the run-time resource requirement of the trained deep learning models. In the proposed method, first, the less important filters are pruned from the convolutional layers and then the pruned models are trained on the histopathological image dataset.

RESULTS

We performed extensive experiments using three popular pre-trained CNNs, VGG19, ResNet34, and ResNet50. With VGG19 pruned model, we achieved an accuracy of 91.25% outperforming earlier methods on the same dataset and architecture while reducing 63.46% FLOPs. Whereas, with the ResNet34 pruned model, the accuracy increases to 91.80% with 40.63% fewer FLOPs. Moreover, with the ResNet50 model, we achieved an accuracy of 92.07% with 30.97% less FLOPs.

CONCLUSION

The experimental results reveal that the pre-trained model's performance complemented with filter pruning exceeds original pre-trained models. Another important outcome of the research is that the pruned model with reduced resource requirements can be deployed in point-of-care devices for automated diagnosis applications with ease.

Deep convolutional neural network and emotional learning based breast cancer detection using digital mammography

Breast cancer is one of the deadly diseases among women. However, the chances of death are highly reduced if it gets diagnosed and treated at its early stage. Mammography is one of the reliable methods used by the radiologist to detect breast cancer at its initial stage. Therefore, an automatic and secure breast cancer detection system that accurately detects abnormalities not only increases the radiologist's diagnostic confidence but also provides more objective evidence. In this work, an automatic Diverse Features based Breast Cancer Detection (DFeBCD) system is proposed to classify a mammogram as normal or abnormal. Four sets of distinct feature types are used. Among them, features based on taxonomic indexes, statistical measures and local binary patterns are static. The proposed DFeBCD dynamically extracts the fourth set of features from mammogram images using a highway-network based deep convolution neural network (CNN). Two classifiers, Support Vector Machine (SVM) and Emotional Learning inspired Ensemble Classifier (ELiEC), are trained on these distinct features using a standard IRMA mammogram dataset. The reliability of the system performance is ensured by applying 5-folds cross-validation. Through experiments, we have observed that the performance of the DFeBCD system on dynamically generated features through highway network-based CNN is better than that of all the three individual sets of ad-hoc features. Furthermore, the hybridization of all four types of features improves the system's performance by nearly 2-3%. The performance of both the classifiers is comparable using the individual sets of ad-hoc features. However, the ELiEC classifier's performance is better than SVM using both hybrid and dynamic features.

Second-Generation Digital Health Platforms: Placing the Patient at the Center and Focusing on Clinical Outcomes

Artificial intelligence (AI) digital health systems have drawn much attention over the last decade. However, their implementation into medical practice occurs at a much slower pace than expected. This paper reviews some of the achievements of first-generation AI systems, and the barriers facing their implementation into medical practice. The development of second-generation AI systems is discussed with a focus on overcoming some of these obstacles. Second-generation systems are aimed at focusing on a single subject and on improving patients' clinical outcomes. A personalized closed-loop system designed to improve end-organ function and the patient's response to chronic therapies is presented. The system introduces a platform which implements a personalized therapeutic regimen and introduces quantifiable individualized-variability patterns into its algorithm. The platform is designed to achieve a clinically meaningful endpoint by ensuring that chronic therapies will have sustainable effect while overcoming compensatory mechanisms associated with disease progression and drug resistance. Second-generation systems are expected to assist patients and providers in adopting and implementing of these systems into everyday care.