An automatic method to discriminate malignant masses from normal tissue in digital mammograms

Detection on Cell Cancer Using the Deep Transfer Learning and Histogram Based Image Focus Quality Assessment

In recent years, the number of studies using whole-slide imaging (WSIs) of histopathology slides has expanded significantly. For the development and validation of artificial intelligence (AI) systems, glass slides from retrospective cohorts including patient follow-up data have been digitized. It has become crucial to determine that the quality of such resources meets the minimum requirements for the development of AI in the future. The need for automated quality control is one of the obstacles preventing the clinical implementation of digital pathology work processes. As a consequence of the inaccuracy of scanners in determining the focus of the image, the resulting visual blur can render the scanned slide useless. Moreover, when scanned at a resolution of 20× or higher, the resulting picture size of a scanned slide is often enormous. Therefore, for digital pathology to be clinically relevant, computational algorithms must be used to rapidly and reliably measure the picture's focus quality and decide if an image requires re-scanning. We propose a metric for evaluating the quality of digital pathology images that uses a sum of even-derivative filter bases to generate a human visual-system-like kernel, which is described as the inverse of the lens' point spread function. This kernel is then used for a digital pathology image to change high-frequency image data degraded by the scanner's optics and assess the patch-level focus quality. Through several studies, we demonstrate that our technique correlates with ground-truth z-level data better than previous methods, and is computationally efficient. Using deep learning techniques, our suggested system is able to identify positive and negative cancer cells in images. We further expand our technique to create a local slide-level focus quality heatmap, which can be utilized for automated slide quality control, and we illustrate our method's value in clinical scan quality control by comparing it to subjective slide quality ratings. The proposed method, GoogleNet, VGGNet, and ResNet had accuracy values of 98.5%, 94.5%, 94.00%, and 95.00% respectively.

Deep learning for mass detection in Full Field Digital Mammograms

In recent years, the use of Convolutional Neural Networks (CNNs) in medical imaging has shown improved performance in terms of mass detection and classification compared to current state-of-the-art methods. This paper proposes a fully automated framework to detect masses in Full-Field Digital Mammograms (FFDM). This is based on the Faster Region-based Convolutional Neural Network (Faster-RCNN) model and is applied for detecting masses in the large-scale OPTIMAM Mammography Image Database (OMI-DB), which consists of ∼80,000 FFDMs mainly from Hologic and General Electric (GE) scanners. This research is the first to benchmark the performance of deep learning on OMI-DB. The proposed framework obtained a True Positive Rate (TPR) of 0.93 at 0.78 False Positive per Image (FPI) on FFDMs from the Hologic scanner. Transfer learning is then used in the Faster R-CNN model trained on Hologic images to detect masses in smaller databases containing FFDMs from the GE scanner and another public dataset INbreast (Siemens scanner). The detection framework obtained a TPR of 0.91±0.06 at 1.69 FPI for images from the GE scanner and also showed higher performance compared to state-of-the-art methods on the INbreast dataset, obtaining a TPR of 0.99±0.03 at 1.17 FPI for malignant and 0.85±0.08 at 1.0 FPI for benign masses, showing the potential to be used as part of an advanced CAD system for breast cancer screening.

Multicontext multitask learning networks for mass detection in mammogram

PURPOSE

In this paper, for the purpose of accurate and efficient mass detection, we propose a new deep learning framework, including two major stages: Suspicious region localization (SRL) and Multicontext Multitask Learning (MCMTL).

METHODS

In the first stage, SRL focuses on finding suspicious regions [regions of interest (ROIs)] and extracting multisize patches of these suspicious regions. A set of bounding boxes with different size is used to extract multisize patches, which aim to capture diverse context information. In the second stage, MCMTL networks integrate features from multisize patches of suspicious regions for classification and segmentation simultaneously, where the purpose of this stage is to keep the true positive suspicious regions and to reduce the false positive suspicious regions.

RESULTS

According to the experimental results on two public datasets (i.e., CBIS-DDSM and INBreast), our method achieves the overall performance of 0.812 TPR@2.53 FPI and 0.919 TPR@0.12 FPI on test sets, respectively.

CONCLUSIONS

Our proposed method suggests comparable performance to the state-of-the-art methods.

Cancer Diagnosis Using Deep Learning: A Bibliographic Review

In this paper, we first describe the basics of the field of cancer diagnosis, which includes steps of cancer diagnosis followed by the typical classification methods used by doctors, providing a historical idea of cancer classification techniques to the readers. These methods include Asymmetry, Border, Color and Diameter (ABCD) method, seven-point detection method, Menzies method, and pattern analysis. They are used regularly by doctors for cancer diagnosis, although they are not considered very efficient for obtaining better performance. Moreover, considering all types of audience, the basic evaluation criteria are also discussed. The criteria include the receiver operating characteristic curve (ROC curve), Area under the ROC curve (AUC), F1 score, accuracy, specificity, sensitivity, precision, dice-coefficient, average accuracy, and Jaccard index. Previously used methods are considered inefficient, asking for better and smarter methods for cancer diagnosis. Artificial intelligence and cancer diagnosis are gaining attention as a way to define better diagnostic tools. In particular, deep neural networks can be successfully used for intelligent image analysis. The basic framework of how this machine learning works on medical imaging is provided in this study, i.e., pre-processing, image segmentation and post-processing. The second part of this manuscript describes the different deep learning techniques, such as convolutional neural networks (CNNs), generative adversarial models (GANs), deep autoencoders (DANs), restricted Boltzmann's machine (RBM), stacked autoencoders (SAE), convolutional autoencoders (CAE), recurrent neural networks (RNNs), long short-term memory (LTSM), multi-scale convolutional neural network (M-CNN), multi-instance learning convolutional neural network (MIL-CNN). For each technique, we provide Python codes, to allow interested readers to experiment with the cited algorithms on their own diagnostic problems. The third part of this manuscript compiles the successfully applied deep learning models for different types of cancers. Considering the length of the manuscript, we restrict ourselves to the discussion of breast cancer, lung cancer, brain cancer, and skin cancer. The purpose of this bibliographic review is to provide researchers opting to work in implementing deep learning and artificial neural networks for cancer diagnosis a knowledge from scratch of the state-of-the-art achievements.

Automatic mass detection in mammograms using deep convolutional neural networks

With recent advances in the field of deep learning, the use of convolutional neural networks (CNNs) in medical imaging has become very encouraging. The aim of our paper is to propose a patch-based CNN method for automated mass detection in full-field digital mammograms (FFDM). In addition to evaluating CNNs pretrained with the ImageNet dataset, we investigate the use of transfer learning for a particular domain adaptation. First, the CNN is trained using a large public database of digitized mammograms (CBIS-DDSM dataset), and then the model is transferred and tested onto the smaller database of digital mammograms (INbreast dataset). We evaluate three widely used CNNs (VGG16, ResNet50, InceptionV3) and show that the InceptionV3 obtains the best performance for classifying the mass and nonmass breast region for CBIS-DDSM. We further show the benefit of domain adaptation between the CBIS-DDSM (digitized) and INbreast (digital) datasets using the InceptionV3 CNN. Mass detection evaluation follows a fivefold cross-validation strategy using free-response operating characteristic curves. Results show that the transfer learning from CBIS-DDSM obtains a substantially higher performance with the best true positive rate (TPR) of 0.98 ± 0.02 at 1.67 false positives per image (FPI), compared with transfer learning from ImageNet with TPR of 0.91 ± 0.07 at 2.1 FPI. In addition, the proposed framework improves upon mass detection results described in the literature on the INbreast database, in terms of both TPR and FPI.

Classification of contrast-enhanced spectral mammography (CESM) images

PURPOSE

Contrast-enhanced spectral mammography (CESM) is a recently developed breast imaging technique. CESM relies on dual-energy acquisition following contrast agent injection to improve mammography sensitivity. CESM is comparable to contrast-enhanced MRI in terms of sensitivity, at a fraction of the cost. However, since lesion variability is large, even with the improved visibility provided by CESM, differentiation between benign and malignant enhancement is not accurate and a biopsy is usually performed for final assessment. Breast biopsies can be stressful to the patient and are expensive to healthcare systems. Moreover, as the biopsies results are most of the time benign, a specificity improvement in the radiologist diagnosis is required. This work presents a deep learning-based decision support system, which aims at improving the specificity of breast cancer diagnosis by CESM without affecting sensitivity.

METHODS

We compare two analysis approaches, fine-tuning a pretrained network and fully training a convolutional neural network, for classification of CESM breast mass as benign or malignant. Breast Imaging Reporting and Data Systems (BIRADS) is a radiological lexicon, used with breast images, to categorize lesions. We improve each classification network by incorporating BIRADS textual features as an additional input to the network. We evaluate two ways of BIRADS fusion as network input: feature fusion and decision fusion. This leads to multimodal network architectures. At classification, we also exploit information from apparently normal breast tissue in the CESM of the considered patient, leading to a patient-specific classification.

RESULTS

We evaluate performance using fivefold cross-validation, on 129 randomly selected breast lesions annotated by an experienced radiologist. Each annotation includes a contour of the mass in the image, biopsy-proven label of benign or malignant lesion and BIRADS descriptors. At 100% sensitivity, specificity of 66% was achieved using a multimodal network, which combines inputs at feature level and patient-specific classification.

CONCLUSIONS

The presented multimodal network may significantly reduce benign biopsies, without compromising sensitivity.

Can the spherical gold standards be used as an alternative to painted gold standards for the computerized detection of lesions using voxel-based classification?

PURPOSE

For the development of computer-assisted detection (CAD) software using voxel-based classification, gold standards defined by pixel-by-pixel painting, called painted gold standards, are desirable. However, for radiologists who define gold standards, a simplified method of definition is desirable. One of the simplest methods of defining gold standards is a spherical region, called a spherical gold standard. In this study, we investigated whether spherical gold standards can be used as an alternative to painted gold standards for computerized detection using voxel-based classification.

MATERIALS AND METHODS

The spherical gold standards were determined by the center of gravity and the maximum diameter. We compared two types of gold standard, painted gold standards and spherical gold standards, by two types of CAD software using voxel-based classification.

RESULTS

The time required to paint the area of one lesion was 4.7-6.5 times longer than the time required to define a spherical gold standard. For the same performance of the CAD software, the number of training cases required for the spherical gold standard was 1.6-7.6 times that for the painted gold standards.

CONCLUSION

Spherical gold standards can be used as an alternative to painted gold standards for the computerized detection of lesions with simple shapes.

Detection of masses in mammograms using a one-stage object detector based on a deep convolutional neural network

Several computer aided diagnosis (CAD) systems have been developed for mammography. They are widely used in certain countries such as the U.S. where mammography studies are conducted more frequently; however, they are not yet globally employed for clinical use due to their inconsistent performance, which can be attributed to their reliance on hand-crafted features. It is difficult to use hand-crafted features for mammogram images that vary due to factors such as the breast density of patients and differences in imaging devices. To address these problems, several studies have leveraged a deep convolutional neural network that does not require hand-crafted features. Among the recent object detectors, RetinaNet is particularly promising as it is a simpler one-stage object detector that is fast and efficient while achieving state-of-the-art performance. RetinaNet has been proven to perform conventional object detection tasks but has not been tested on detecting masses in mammograms. Thus, we propose a mass detection model based on RetinaNet. To validate its performance in diverse use cases, we construct several experimental setups using the public dataset INbreast and the in-house dataset GURO. In addition to training and testing on the same dataset (i.e., training and testing on INbreast), we evaluate our mass detection model in setups using additional training data (i.e., training on INbreast + GURO and testing on INbreast). We also evaluate our model in setups using pre-trained weights (i.e., using weights pre-trained on GURO, training and testing on INbreast). In all the experiments, our mass detection model achieves comparable or better performance than more complex state-of-the-art models including the two-stage object detector. Also, the results show that using the weights pre-trained on datasets achieves similar performance as directly using datasets in the training phase. Therefore, we make our mass detection model's weights pre-trained on both GURO and INbreast publicly available. We expect that researchers who train RetinaNet on their in-house dataset for the mass detection task can use our pre-trained weights to leverage the features extracted from the datasets.

Automated Analysis of Unregistered Multi-View Mammograms With Deep Learning

We describe an automated methodology for the analysis of unregistered cranio-caudal (CC) and medio-lateral oblique (MLO) mammography views in order to estimate the patient's risk of developing breast cancer. The main innovation behind this methodology lies in the use of deep learning models for the problem of jointly classifying unregistered mammogram views and respective segmentation maps of breast lesions (i.e., masses and micro-calcifications). This is a holistic methodology that can classify a whole mammographic exam, containing the CC and MLO views and the segmentation maps, as opposed to the classification of individual lesions, which is the dominant approach in the field. We also demonstrate that the proposed system is capable of using the segmentation maps generated by automated mass and micro-calcification detection systems, and still producing accurate results. The semi-automated approach (using manually defined mass and micro-calcification segmentation maps) is tested on two publicly available data sets (INbreast and DDSM), and results show that the volume under ROC surface (VUS) for a 3-class problem (normal tissue, benign, and malignant) is over 0.9, the area under ROC curve (AUC) for the 2-class "benign versus malignant" problem is over 0.9, and for the 2-class breast screening problem (malignancy versus normal/benign) is also over 0.9. For the fully automated approach, the VUS results on INbreast is over 0.7, and the AUC for the 2-class "benign versus malignant" problem is over 0.78, and the AUC for the 2-class breast screening is 0.86.

Applying Quantitative CT Image Feature Analysis to Predict Response of Ovarian Cancer Patients to Chemotherapy

RATIONALE AND OBJECTIVES

The study aimed to investigate the role of applying quantitative image features computed from computed tomography (CT) images for early prediction of tumor response to chemotherapy in the clinical trials for treating ovarian cancer patients.

MATERIALS AND METHODS

A dataset involving 91 patients was retrospectively assembled. Each patient had two sets of pre- and post-therapy CT images. A computer-aided detection scheme was applied to segment metastatic tumors previously tracked by radiologists on CT images and computed image features. Two initial feature pools were built using image features computed from pre-therapy CT images only and image feature difference computed from both pre- and post-therapy images. A feature selection method was applied to select optimal features, and an equal-weighted fusion method was used to generate a new quantitative imaging marker from each pool to predict 6-month progression-free survival. The prediction accuracy between quantitative imaging markers and the Response Evaluation Criteria in Solid Tumors (RECIST) criteria was also compared.

RESULTS

The highest areas under the receiver operating characteristic curve are 0.684 ± 0.056 and 0.771 ± 0.050 when using a single image feature computed from pre-therapy CT images and feature difference computed from pre- and post-therapy CT images, respectively. Using two corresponding fusion-based image markers, the areas under the receiver operating characteristic curve significantly increased to 0.810 ± 0.045 and 0.829 ± 0.043 (P < 0.05), respectively. Overall prediction accuracy levels are 71.4%, 80.2%, and 74.7% when using two imaging markers and RECIST, respectively.

CONCLUSIONS

This study demonstrated the feasibility of predicting patients' response to chemotherapy using quantitative imaging markers computed from pre-therapy CT images. However, using image feature difference computed between pre- and post-therapy CT images yielded higher prediction accuracy.

iCAP: An Individualized Model Combining Gaze Parameters and Image-Based Features to Predict Radiologists' Decisions While Reading Mammograms

This study introduces an individualized tool for identifying mammogram interpretation errors, called eye-Computer Assisted Perception (iCAP). iCAP consists of two modules, one which processes areas marked by radiologists as suspicious for cancer and classifies these as False Positive (FP) or True Positive (TP) decisions, while the second module classifies fixated but not marked locations as False Negative (FN) or True-Negative (TN) decisions. iCAP relies on both radiologists' gaze-related parameters, extracted from eye tracking data, and image-based features. In order to evaluate iCAP, eye tracking data from eight breast radiologists reading 120 two-view digital mammograms were collected. Fifty-nine cases had biopsy proven cancer. For each radiologist, a user-specific support vector machine model was built to classify the radiologist' s reported areas as TPs or FPs and fixated locations as TNs or FNs. The performances of the classifiers were evaluated by utilizing leave-one-out cross validation. iCAP was tested retrospectively in a simulated scenario in which it was assumed that the radiologists would accept all iCAP decisions. Using iCAP led to an average increase of 12%±6% in the number of correctly localized cancer and an average decrease of 44.5%±22.7% in the number of FPs per image.

A deep learning approach for the analysis of masses in mammograms with minimal user intervention

We present an integrated methodology for detecting, segmenting and classifying breast masses from mammograms with minimal user intervention. This is a long standing problem due to low signal-to-noise ratio in the visualisation of breast masses, combined with their large variability in terms of shape, size, appearance and location. We break the problem down into three stages: mass detection, mass segmentation, and mass classification. For the detection, we propose a cascade of deep learning methods to select hypotheses that are refined based on Bayesian optimisation. For the segmentation, we propose the use of deep structured output learning that is subsequently refined by a level set method. Finally, for the classification, we propose the use of a deep learning classifier, which is pre-trained with a regression to hand-crafted feature values and fine-tuned based on the annotations of the breast mass classification dataset. We test our proposed system on the publicly available INbreast dataset and compare the results with the current state-of-the-art methodologies. This evaluation shows that our system detects 90% of masses at 1 false positive per image, has a segmentation accuracy of around 0.85 (Dice index) on the correctly detected masses, and overall classifies masses as malignant or benign with sensitivity (Se) of 0.98 and specificity (Sp) of 0.7.

Computer-aided classification of mammographic masses using visually sensitive image features

PURPOSE

To develop a new computer-aided diagnosis (CAD) scheme that computes visually sensitive image features routinely used by radiologists to develop a machine learning classifier and distinguish between the malignant and benign breast masses detected from digital mammograms.

METHODS

An image dataset including 301 breast masses was retrospectively selected. From each segmented mass region, we computed image features that mimic five categories of visually sensitive features routinely used by radiologists in reading mammograms. We then selected five optimal features in the five feature categories and applied logistic regression models for classification. A new CAD interface was also designed to show lesion segmentation, computed feature values and classification score.

RESULTS

Areas under ROC curves (AUC) were 0.786±0.026 and 0.758±0.027 when to classify mass regions depicting on two view images, respectively. By fusing classification scores computed from two regions, AUC increased to 0.806±0.025.

CONCLUSION

This study demonstrated a new approach to develop CAD scheme based on 5 visually sensitive image features. Combining with a "visual aid" interface, CAD results may be much more easily explainable to the observers and increase their confidence to consider CAD generated classification results than using other conventional CAD approaches, which involve many complicated and visually insensitive texture features.

Large scale deep learning for computer aided detection of mammographic lesions

Recent advances in machine learning yielded new techniques to train deep neural networks, which resulted in highly successful applications in many pattern recognition tasks such as object detection and speech recognition. In this paper we provide a head-to-head comparison between a state-of-the art in mammography CAD system, relying on a manually designed feature set and a Convolutional Neural Network (CNN), aiming for a system that can ultimately read mammograms independently. Both systems are trained on a large data set of around 45,000 images and results show the CNN outperforms the traditional CAD system at low sensitivity and performs comparable at high sensitivity. We subsequently investigate to what extent features such as location and patient information and commonly used manual features can still complement the network and see improvements at high specificity over the CNN especially with location and context features, which contain information not available to the CNN. Additionally, a reader study was performed, where the network was compared to certified screening radiologists on a patch level and we found no significant difference between the network and the readers.

An Approach to the Detection of Lesions in Mammograms Using Fuzzy Image Processing

An algorithm was developed in this study, using rule-based fuzzy logic, to enable masses that are hard to recognize or detect in mammograms to become more readily perceptible. Small lesions, such as microcalcifications and other masses that are hard to recognize, especially on film-scan mammograms, were processed through segmentation. A total of 40 mammograms were used and they were classified by radiologists into three groups: those with microcalcifications ( n = 15), those with tumours ( n = 15), and those with no lesions ( n = 10). Five mammograms were taken as training data sets from each of the groups with microcalcifications and tumours. The algorithm was then applied to data not taken for training. The algorithm achieved a mean accuracy of 99% compared with the findings of the radiologists.

An automated confirmatory system for analysis of mammograms

This paper presents an integrated system for the automatic analysis of mammograms to assist radiologists in confirming their diagnosis in mammography screening. The proposed automated confirmatory system (ACS) can process a digitalized mammogram online, and generates a high quality filtered segmentation of an image for biological interpretation and a texture-feature based diagnosis. We use a serial of image pre-processing and segmentation techniques, including 2D median filtering, seeded region growing (SRG) algorithm, image contrast enhancement, to remove noise, delete radiopaque artifacts and eliminate the projection of the pectoral muscle from a digitalized mammogram. We also develop an entire-image texture-feature based classification method, by combining a Rough-set approach to extract five fundamental texture features from images, and then an Artificial Neural Network technique to classify a mammogram as: normal; indicating the presence of a benign lump; or representing a malignant tumor. Here, 222 random images from the Mammographic Image Analysis Society (MIAS) database are used for the offline ACS training. Once the system is tuned and trained, it is ready for the automated use for the analysis and diagnosis of new mammograms. To test the trained system, a separate set of 100 random images from the MIAS and another set of 100 random images from the independent BancoWeb database are selected. The proposed ACS is shown to be successful in confirming diagnosis of mammograms from the two independent databases.

A new and fast image feature selection method for developing an optimal mammographic mass detection scheme

PURPOSE

Selecting optimal features from a large image feature pool remains a major challenge in developing computer-aided detection (CAD) schemes of medical images. The objective of this study is to investigate a new approach to significantly improve efficacy of image feature selection and classifier optimization in developing a CAD scheme of mammographic masses.

METHODS

An image dataset including 1600 regions of interest (ROIs) in which 800 are positive (depicting malignant masses) and 800 are negative (depicting CAD-generated false positive regions) was used in this study. After segmentation of each suspicious lesion by a multilayer topographic region growth algorithm, 271 features were computed in different feature categories including shape, texture, contrast, isodensity, spiculation, local topological features, as well as the features related to the presence and location of fat and calcifications. Besides computing features from the original images, the authors also computed new texture features from the dilated lesion segments. In order to select optimal features from this initial feature pool and build a highly performing classifier, the authors examined and compared four feature selection methods to optimize an artificial neural network (ANN) based classifier, namely: (1) Phased Searching with NEAT in a Time-Scaled Framework, (2) A sequential floating forward selection (SFFS) method, (3) A genetic algorithm (GA), and (4) A sequential forward selection (SFS) method. Performances of the four approaches were assessed using a tenfold cross validation method.

RESULTS

Among these four methods, SFFS has highest efficacy, which takes 3%-5% of computational time as compared to GA approach, and yields the highest performance level with the area under a receiver operating characteristic curve (AUC) = 0.864 ± 0.034. The results also demonstrated that except using GA, including the new texture features computed from the dilated mass segments improved the AUC results of the ANNs optimized using other three feature selection methods. In addition, among 271 features, the shape, local morphological features, fat and calcification based features were the most frequently selected features to build ANNs.

CONCLUSIONS

Although conventional GA is a powerful tool in optimizing classifiers used in CAD schemes of medical images, it is very computationally intensive. This study demonstrated that using a new SFFS based approach enabled to significantly improve efficacy of image feature selection for developing CAD schemes.

Spatially-Adaptive Reconstruction in Computed Tomography Using Neural Networks

We propose a supervised machine learning approach for boosting existing signal and image recovery methods and demonstrate its efficacy on example of image reconstruction in computed tomography. Our technique is based on a local nonlinear fusion of several image estimates, all obtained by applying a chosen reconstruction algorithm with different values of its control parameters. Usually such output images have different bias/variance trade-off. The fusion of the images is performed by feed-forward neural network trained on a set of known examples. Numerical experiments show an improvement in reconstruction quality relatively to existing direct and iterative reconstruction methods.

Optimization of Network Topology in Computer-Aided Detection Schemes Using Phased Searching with NEAT in a Time-Scaled Framework

In the field of computer-aided mammographic mass detection, many different features and classifiers have been tested. Frequently, the relevant features and optimal topology for the artificial neural network (ANN)-based approaches at the classification stage are unknown, and thus determined by trial-and-error experiments. In this study, we analyzed a classifier that evolves ANNs using genetic algorithms (GAs), which combines feature selection with the learning task. The classifier named "Phased Searching with NEAT in a Time-Scaled Framework" was analyzed using a dataset with 800 malignant and 800 normal tissue regions in a 10-fold cross-validation framework. The classification performance measured by the area under a receiver operating characteristic (ROC) curve was 0.856 ± 0.029. The result was also compared with four other well-established classifiers that include fixed-topology ANNs, support vector machines (SVMs), linear discriminant analysis (LDA), and bagged decision trees. The results show that Phased Searching outperformed the LDA and bagged decision tree classifiers, and was only significantly outperformed by SVM. Furthermore, the Phased Searching method required fewer features and discarded superfluous structure or topology, thus incurring a lower feature computational and training and validation time requirement. Analyses performed on the network complexities evolved by Phased Searching indicate that it can evolve optimal network topologies based on its complexification and simplification parameter selection process. From the results, the study also concluded that the three classifiers - SVM, fixed-topology ANN, and Phased Searching with NeuroEvolution of Augmenting Topologies (NEAT) in a Time-Scaled Framework - are performing comparably well in our mammographic mass detection scheme.

Optimization of breast mass classification using sequential forward floating selection (SFFS) and a support vector machine (SVM) model

PURPOSE

Improving radiologists' performance in classification between malignant and benign breast lesions is important to increase cancer detection sensitivity and reduce false-positive recalls. For this purpose, developing computer-aided diagnosis schemes has been attracting research interest in recent years. In this study, we investigated a new feature selection method for the task of breast mass classification.

METHODS

We initially computed 181 image features based on mass shape, spiculation, contrast, presence of fat or calcifications, texture, isodensity, and other morphological features. From this large image feature pool, we used a sequential forward floating selection (SFFS)-based feature selection method to select relevant features and analyzed their performance using a support vector machine (SVM) model trained for the classification task. On a database of 600 benign and 600 malignant mass regions of interest, we performed the study using a tenfold cross-validation method. Feature selection and optimization of the SVM parameters were conducted on the training subsets only.

RESULTS

The area under the receiver operating characteristic curve [Formula: see text] was obtained for the classification task. The results also showed that the most frequently selected features by the SFFS-based algorithm in tenfold iterations were those related to mass shape, isodensity, and presence of fat, which are consistent with the image features frequently used by radiologists in the clinical environment for mass classification. The study also indicated that accurately computing mass spiculation features from the projection mammograms was difficult, and failed to perform well for the mass classification task due to tissue overlap within the benign mass regions.

CONCLUSION

In conclusion, this comprehensive feature analysis study provided new and valuable information for optimizing computerized mass classification schemes that may have potential to be useful as a "second reader" in future clinical practice.

Mass detection in reconstructed digital breast tomosynthesis volumes with a computer-aided detection system trained on 2D mammograms

PURPOSE

To develop a computer-aided detection (CAD) system for masses in digital breast tomosynthesis (DBT) which can make use of an existing CAD system for detection of breast masses in full-field digital mammography (FFDM). This approach has the advantage that large digital screening databases that are becoming available can be used for training. DBT is currently not used for screening which makes it hard to obtain sufficient data for training.

METHODS

The proposed CAD system is applied to reconstructed DBT volumes and consists of two stages. In the first stage, an existing 2D CAD system is applied to slabs composed of multiple DBT slices, after processing the slabs to a representation similar to that of the FFDM training data. In the second stage, the authors group detections obtained in the slabs that detect the same object and determine the 3D location of the grouped findings using one of three different approaches, including one that uses a set of features extracted from the DBT slabs. Experiments were conducted to determine performance of the CAD system, the optimal slab thickness for this approach and the best method to establish the 3D location. Experiments were performed using a database of 192 patients (752 DBT volumes). In 49 patients, one or more malignancies were present which were described as a mass, architectural distortion, or asymmetry. Free response receiver operating characteristic analysis and bootstrapping were used for statistical evaluation.

RESULTS

Best performance was obtained when slab thickness was in the range of 1-2 cm. Using the feature based 3D localization procedure developed in the study, accurate 3D localization could be obtained in most cases. Case sensitivities of 80% and 90% were achieved at 0.35 and 0.99 false positives per volume, respectively.

CONCLUSIONS

This study indicates that there may be a large benefit in using 2D mammograms for the development of CAD for DBT and that there is no need to exclusively limit development to DBT data.

Quantifying tumour heterogeneity with CT

Heterogeneity is a key feature of malignancy associated with adverse tumour biology. Quantifying heterogeneity could provide a useful non-invasive imaging biomarker. Heterogeneity on computed tomography (CT) can be quantified using texture analysis which extracts spatial information from CT images (unenhanced, contrast-enhanced and derived images such as CT perfusion) that may not be perceptible to the naked eye. The main components of texture analysis can be categorized into image transformation and quantification. Image transformation filters the conventional image into its basic components (spatial, frequency, etc.) to produce derived subimages. Texture quantification techniques include structural-, model- (fractal dimensions), statistical- and frequency-based methods. The underlying tumour biology that CT texture analysis may reflect includes (but is not limited to) tumour hypoxia and angiogenesis. Emerging studies show that CT texture analysis has the potential to be a useful adjunct in clinical oncologic imaging, providing important information about tumour characterization, prognosis and treatment prediction and response.

Automatic detection of lesions in lung regions that are segmented using spatial relations

This article presents a novel approach for the automatic detection of lesions and selection of features on chest radiographs. We have illustrated the importance of accurate segmentation, which is based on spatial relationships between the lung structures, as a preprocessing step in a Computer Aided Diagnosis (CAD) scheme. Then, three suitable combinations of features have been identified using the forward stepwise selection method from the original images and their transformed ones. Experimental results show that our segmentation approach and the suppression of skeletal structures improve the detection accuracy. The selected features can describe efficiently different kinds of chest lesions.

Heterogeneity of focal breast lesions and surrounding tissue assessed by mammographic texture analysis: preliminary evidence of an association with tumor invasion and estrogen receptor status

AIM

This pilot study investigates whether heterogeneity in focal breast lesions and surrounding tissue assessed on mammography is potentially related to cancer invasion and hormone receptor status.

MATERIALS AND METHODS

Texture analysis (TA) assessed the heterogeneity of focal lesions and their surrounding tissues in digitized mammograms from 11 patients randomly selected from an imaging archive [ductal carcinoma in situ (DCIS) only, n = 4; invasive carcinoma (IC) with DCIS, n = 3; IC only, n = 4]. TA utilized band-pass image filtration to highlight image features at different spatial frequencies (filter values: 1.0-2.5) from fine to coarse texture. The distribution of features in the derived images was quantified using uniformity.

RESULTS

Significant differences in uniformity were observed between patient groups for all filter values. With medium scale filtration (filter value = 1.5) pure DCIS was more uniform (median = 0.281) than either DCIS with IC (median = 0.246, p = 0.0102) or IC (median = 0.249, p = 0.0021). Lesions with high levels of estrogen receptor expression were more uniform, most notably with coarse filtration (filter values 2.0 and 2.5, r(s) = 0.812, p = 0.002). Comparison of uniformity values in focal lesions and surrounding tissue showed significant differences between DCIS with or without IC versus IC (p = 0.0009).

CONCLUSION

This pilot study shows the potential for computer-based assessments of heterogeneity within focal mammographic lesions and surrounding tissue to identify adverse pathological features in mammographic lesions. The technique warrants further investigation as a possible adjunct to existing computer aided diagnosis systems.

Optimizing Case-based detection performance in a multiview CAD system for mammography

When reading mammograms, radiologists combine information from multiple views to detect abnormalities. Most computer-aided detection (CAD) systems, however, use primitive methods for inclusion of multiview context or analyze each view independently. In previous research it was found that in mammography lesion-based detection performance of CAD systems can be improved when correspondences between MLO and CC views are taken into account. However, detection at case level detection did not improve. In this paper, we propose a new learning method for multiview CAD systems, which is aimed at optimizing case-based detection performance. The method builds on a single-view lesion detection system and a correspondence classifier. The latter provides class probabilities for the various types of region pairs and correspondence features. The correspondence classifier output is used to bias the selection of training patterns for a multiview CAD system. In this way training can be forced to focus on optimization of case-based detection performance. The method is applied to the problem of detecting malignant masses and architectural distortions. Experiments involve 454 mammograms consisting of four views with a malignant region visible in at least one of the views. To evaluate performance, five-fold cross validation and FROC analysis was performed. Bootstrapping was used for statistical analysis. A significant increase of case-based detection performance was found when the proposed method was used. Mean sensitivity increased by 4.7% in the range of 0.01-0.5 false positives per image.

Enhanced CellClassifier: a multi-class classification tool for microscopy images

BACKGROUND

Light microscopy is of central importance in cell biology. The recent introduction of automated high content screening has expanded this technology towards automation of experiments and performing large scale perturbation assays. Nevertheless, evaluation of microscopy data continues to be a bottleneck in many projects. Currently, among open source software, CellProfiler and its extension Analyst are widely used in automated image processing. Even though revolutionizing image analysis in current biology, some routine and many advanced tasks are either not supported or require programming skills of the researcher. This represents a significant obstacle in many biology laboratories.

RESULTS

We have developed a tool, Enhanced CellClassifier, which circumvents this obstacle. Enhanced CellClassifier starts from images analyzed by CellProfiler, and allows multi-class classification using a Support Vector Machine algorithm. Training of objects can be done by clicking directly "on the microscopy image" in several intuitive training modes. Many routine tasks like out-of focus exclusion and well summary are also supported. Classification results can be integrated with other object measurements including inter-object relationships. This makes a detailed interpretation of the image possible, allowing the differentiation of many complex phenotypes. For the generation of the output, image, well and plate data are dynamically extracted and summarized. The output can be generated as graphs, Excel-files, images with projections of the final analysis and exported as variables.

CONCLUSION

Here we describe Enhanced CellClassifier which allows multiple class classification, elucidating complex phenotypes. Our tool is designed for the biologist who wants both, simple and flexible analysis of images without requiring programming skills. This should facilitate the implementation of automated high-content screening.

Use of normal tissue context in computer-aided detection of masses in mammograms

When reading mammograms, radiologists do not only look at local properties of suspicious regions but also take into account more general contextual information. This suggests that context may be used to improve the performance of computer-aided detection (CAD) of malignant masses in mammograms. In this study, we developed a set of context features that represent suspiciousness of normal tissue in the same case. For each candidate mass region, three normal reference areas were defined in the image at hand. Corresponding areas were also defined in the contralateral image and in different projections. Evaluation of the context features was done using 10-fold cross validation and case based bootstrapping. Free response receiver operating characteristic (FROC) curves were computed for feature sets including context features and a feature set without context. Results show that the mean sensitivity in the interval of 0.05-0.5 false positives/image increased more than 6% when context features were added. This increase was significant ( p < 0.0001). Context computed using multiple views yielded a better performance than using a single view (mean sensitivity increase of 2.9%, p < 0.0001). Besides the importance of using multiple views, results show that best CAD performance was obtained when multiple context features were combined that are based on different reference areas in the mammogram.

Anniversary paper: History and status of CAD and quantitative image analysis: the role of Medical Physics and AAPM

The roles of physicists in medical imaging have expanded over the years, from the study of imaging systems (sources and detectors) and dose to the assessment of image quality and perception, the development of image processing techniques, and the development of image analysis methods to assist in detection and diagnosis. The latter is a natural extension of medical physicists' goals in developing imaging techniques to help physicians acquire diagnostic information and improve clinical decisions. Studies indicate that radiologists do not detect all abnormalities on images that are visible on retrospective review, and they do not always correctly characterize abnormalities that are found. Since the 1950s, the potential use of computers had been considered for analysis of radiographic abnormalities. In the mid-1980s, however, medical physicists and radiologists began major research efforts for computer-aided detection or computer-aided diagnosis (CAD), that is, using the computer output as an aid to radiologists-as opposed to a completely automatic computer interpretation-focusing initially on methods for the detection of lesions on chest radiographs and mammograms. Since then, extensive investigations of computerized image analysis for detection or diagnosis of abnormalities in a variety of 2D and 3D medical images have been conducted. The growth of CAD over the past 20 years has been tremendous-from the early days of time-consuming film digitization and CPU-intensive computations on a limited number of cases to its current status in which developed CAD approaches are evaluated rigorously on large clinically relevant databases. CAD research by medical physicists includes many aspects-collecting relevant normal and pathological cases; developing computer algorithms appropriate for the medical interpretation task including those for segmentation, feature extraction, and classifier design; developing methodology for assessing CAD performance; validating the algorithms using appropriate cases to measure performance and robustness; conducting observer studies with which to evaluate radiologists in the diagnostic task without and with the use of the computer aid; and ultimately assessing performance with a clinical trial. Medical physicists also have an important role in quantitative imaging, by validating the quantitative integrity of scanners and developing imaging techniques, and image analysis tools that extract quantitative data in a more accurate and automated fashion. As imaging systems become more complex and the need for better quantitative information from images grows, the future includes the combined research efforts from physicists working in CAD with those working on quantitative imaging systems to readily yield information on morphology, function, molecular structure, and more-from animal imaging research to clinical patient care. A historical review of CAD and a discussion of challenges for the future are presented here, along with the extension to quantitative image analysis.

A pilot study of architectural distortion detection in mammograms based on characteristics of line shadows

OBJECTIVE

We present herein a novel algorithm for architectural distortion detection that utilizes the point convergence index with the likelihood of lines (e.g., spiculations) relating to architectural distortion.

MATERIALS AND METHODS

Validation was performed using 25 computed radiography (CR) mammograms, each of which has an architectural distortion with radiating spiculations. The proposed method comprises five steps. First, the lines were extracted on mammograms, such as spiculations of architectural distortion as well as lines in the mammary gland. Second, the likelihood of spiculation for each extracted line was calculated. In the third step, point convergence index weighted by this likelihood was evaluated at each pixel to enhance distortion only. Fourth, local maxima of the index were extracted as candidates for the distortion, then classified based on nine features in the last step.

RESULTS

Point convergence index without the proposed likelihood generated 84.48/image false-positives (FPs) on average. Conversely, the proposed index succeeded in decreasing this number to 12.48/image on average when sensitivity was 100%. After the classification step, number of FPs was reduced to 0.80/image with 80.0% sensitivity.

CONCLUSION

Combination of the likelihood of lines with point convergence index is effective in extracting architectural distortion with radiating spiculations.

A model-based framework for the detection of spiculated masses on mammography

The detection of lesions on mammography is a repetitive and fatiguing task. Thus, computer-aided detection systems have been developed to aid radiologists. The detection accuracy of current systems is much higher for clusters of microcalcifications than for spiculated masses. In this article, the authors present a new model-based framework for the detection of spiculated masses. The authors have invented a new class of linear filters, spiculated lesion filters, for the detection of converging lines or spiculations. These filters are highly specific narrowband filters, which are designed to match the expected structures of spiculated masses. As a part of this algorithm, the authors have also invented a novel technique to enhance spicules on mammograms. This entails filtering in the radon domain. They have also developed models to reduce the false positives due to normal linear structures. A key contribution of this work is that the parameters of the detection algorithm are based on measurements of physical properties of spiculated masses. The results of the detection algorithm are presented in the form of free-response receiver operating characteristic curves on images from the Mammographic Image Analysis Society and Digital Database for Screening Mammography databases.

Combining two mammographic projections in a computer aided mass detection method

A method is presented to improve computer aided detection (CAD) results for masses in mammograms by fusing information obtained from two views of the same breast. It is based on a previously developed approach to link potentially suspicious regions in mediolateral oblique (MLO) and craniocaudal (CC) views. Using correspondence between regions, we extended our CAD scheme by building a cascaded multiple-classifier system, in which the last stage computes suspiciousness of an initially detected region conditional on the existence and similarity of a linked candidate region in the other view. We compared the two-view detection system with the single-view detection method using free-response receiver operating characteristic (FROC) analysis and cross validation. The dataset used in the evaluation consisted of 948 four-view mammograms, including 412 cancer cases with a mass, architectural distortion, or asymmetry. A statistically significant improvement was found in the lesion based detection performance. At a false positive (FP) rate of 0.1 FP/image, the lesion sensitivity improved from 56% to 61%. Case based sensitivity did not improve.

Generation and application of a probabilistic breast cancer atlas

Computer-aided detection (CAD) has become increasingly common in recent years as a tool in catching breast cancer in its early, more treatable stages. More and more breast centers are using CAD as studies continue to demonstrate its effectiveness. As the technology behind CAD improves, so do its results and its impact on society. In trying to improve the sensitivity and specificity of CAD algorithms, a good deal of work has been done on feature extraction, the generation of mathematical representations of mammographic features which can help distinguish true cancerous lesions from false ones. One feature that is not currently seen in the literature that physicians rely on in making their decisions is location within the breast. This is a difficult feature to calculate as it requires a good deal of prior knowledge as well as some way of accounting for the tremendous variability present in breast shapes. In this paper, we present a method for the generation and implementation of a probabilistic breast cancer atlas. We then validate this method on data from the Digital Database for Screening Mammography (DDSM).

Computerized detection of breast masses in digitized mammograms

We propose a system to detect malignant masses on mammograms. We investigated the behavior of an iris filter at different scales. After iris filter was applied, suspicious regions were segmented by means of an adaptive threshold. Suspected regions were characterized with features based on the iris filter output and, gray level, texture, contour-related, and morphological features extracted from the image. A backpropagation neural network classifier was trained to reduce the number of false positives. The system was developed and evaluated with two completely independent data sets. Results for a test set of 66 malignant and 49 normal cases, evaluated with free-response receiver operating characteristic analysis, yielded a sensitivity of 88% and 94% at 1.02 false positives per image for lesion-based and case-based evaluation, respectively. Results suggest that the proposed method could help radiologists as a second reader in mammographic screening.

Characterization of difference of Gaussian filters in the detection of mammographic regions

In this article, we present a characterization of the effect of difference of Gaussians (DoG) filters in the detection of mammographic regions. DoG filters have been used previously in mammographic mass computer-aided detection (CAD) systems. As DoG filters are constructed from the subtraction of two bivariate Gaussian distributions, they require the specification of three parameters: the size of the filter template and the standard deviations of the constituent Gaussians. The influence of these three parameters in the detection of mammographic masses has not been characterized. In this work, we aim to determine how the parameters affect (1) the physical descriptors of the detected regions, (2) the true and false positive rates, and (3) the classification performance of the individual descriptors. To this end, 30 DoG filters are created from the combination of three template sizes and four values for each of the Gaussians' standard deviations. The filters are used to detect regions in a study database of 181 craniocaudal-view mammograms extracted from the Digital Database for Screening Mammography. To describe the physical characteristics of the identified regions, morphological and textural features are extracted from each of the detected regions. Differences in the mean values of the features caused by altering the DoG parameters are examined through statistical and empirical comparisons. The parameters' effects on the true and false positive rate are determined by examining the mean malignant sensitivities and false positives per image (FPpI). Finally, the effect on the classification performance is described by examining the variation in FPpI at the point where 81% of the malignant masses in the study database are detected. Overall, the findings of the study indicate that increasing the standard deviations of the Gaussians used to construct a DoG filter results in a dramatic decrease in the number of regions identified at the expense of missing a small number of malignancies. The sharp reduction in the number of identified regions allowed the identification of textural differences between large and small mammographic regions. We find that the classification performances of the features that achieve the lowest average FPpI are influenced by all three of the parameters.

A ranklet-based image representation for mass classification in digital mammograms

Regions of interest (ROIs) found on breast radiographic images are classified as either tumoral mass or normal tissue by means of a support vector machine classifier. Classification features are the coefficients resulting from the specific image representation used to encode each ROI. Pixel and wavelet image representations have already been discussed in one of our previous works. To investigate the possibility of improving classification performances, a novel nonparametric, orientation-selective, and multiresolution image representation is developed and evaluated, namely a ranklet image representation. A dataset consisting of 1000 ROIs representing biopsy-proven tumoral masses (either benign or malignant) and 5000 ROIs representing normal breast tissue is used. ROIs are extracted from the digital database for screening mammography collected by the University of South Florida. Classification performances are evaluated using the area Az under the receiver operating characteristic curve. By achieving Az values of 0.978 +/- 0.003 and 90% sensitivity with a false positive fraction value of 4.5%, experiments demonstrate classification results higher than those reached by the previous image representations. In particular, the improvement on the Az value over that achieved by the wavelet image representation is statistically relevant with the two-tailed p value <0.0001. Besides, owing to the tolerance that the ranklet image representation reveals to variations in the ROIs' gray-level intensity histogram, this approach discloses to be robust also when tested on radiographic images having gray-level intensity histogram remarkably different from that used for training.

Interval change analysis to improve computer aided detection in mammography

We are developing computer aided diagnosis (CAD) techniques to study interval changes between two consecutive mammographic screening rounds. We have previously developed methods for the detection of malignant masses based on features extracted from single mammographic views. The goal of the present work was to improve our detection method by including temporal information in the CAD program. Toward this goal, we have developed a regional registration technique. This technique links a suspicious location on the current mammogram with a corresponding location on the prior mammogram. The novelty of our method is that the search for correspondence is done in feature space. This has the advantage that very small lesions and architectural distortions may be found as well. Following the linking process several features are calculated for the current and prior region. Temporal features are obtained by combining the feature values from both regions. We evaluated the detection performance with and without the use of temporal features on a data set containing 2873 temporal film pairs from 938 patients. There were 589 cases in which the current mammogram contained exactly one malignant mass. Cross validation was used to partition the data set into a train set and a test set. The train set was used for feature selection and classifier training, the test set for classifier evaluation. FROC (free response operating characteristic) analysis showed an improvement in detection performance with the use of temporal features.

Use of border information in the classification of mammographic masses

We are developing a new method to characterize the margin of a mammographic mass lesion to improve the classification of benign and malignant masses. Towards this goal, we designed features that measure the degree of sharpness and microlobulation of mass margins. We calculated these features in a border region of the mass defined as a thin band along the mass contour. The importance of these features in the classification of benign and malignant masses was studied in relation to existing features used for mammographic mass detection. Features were divided into three groups, each representing a different mass segment: the interior region of a mass, the border and the outer area. The interior and the outer area of a mass were characterized using contrast and spiculation measures. Classification was done in two steps. First, features representing each of the three mass segments were merged into a neural network classifier resulting in a single regional classification score for each segment. Secondly, a classifier combined the three single scores into a final output to discriminate between benign and malignant lesions. We compared the classification performance of each regional classifier and the combined classifier on a data set of 1076 biopsy proved masses (590 malignant and 486 benign) from 481 women included in the Digital Database for Screening Mammography. Receiver operating characteristic (ROC) analysis was used to evaluate the accuracy of the classifiers. The area under the ROC curve (A(z)) was 0.69 for the interior mass segment, 0.76 for the border segment and 0.75 for the outer mass segment. The performance of the combined classifier was 0.81 for image-based and 0.83 for case-based evaluation. These results show that the combination of information from different mass segments is an effective approach for computer-aided characterization of mammographic masses. An advantage of this approach is that it allows the assessment of the contribution of regions rather than individual features. Results suggest that the border and the outer areas contained the most valuable information for discrimination between benign and malignant masses.