A minimum spanning forest based classification method for dedicated breast CT images

Prior information guided auto-contouring of breast gland for deformable image registration in postoperative breast cancer radiotherapy

Background

Contouring of breast gland in planning CT is important to postoperative radiotherapy of patients after breast conserving surgery (BCS). However, the contouring task is difficult because of the poorer contrast of breast gland in planning CT. To improve its efficiency and accuracy, prior information was introduced in a 3D U-Net model to predict the contour of breast gland automatically.

Methods

The preoperative CT was first aligned to the planning CT via affine registration. The resulting transform was then applied to the contour of breast gland in preoperative CT, and the corresponding contour in planning CT was obtained. This transformed contour was a preliminary estimation of breast gland in planning CT and was used as prior information in a 3D U-Net model to obtain a more accurate contour. For evaluation, the dice similarity coefficient (DSC) and Hausdorff distance (HD) were used to assess the deep learning (DL) model's prediction accuracy.

Results

The average DSC and HD of the prediction model were 0.775±0.065 and 44.979±20.565 for breast gland without the input of prior information, while the average values were 0.830±0.038 and 17.896±5.737 with the input of prior information (0.775 vs. 0.830, P=0.0014<0.05; 44.979 vs. 17.896, P=0.002<0.05).

Conclusions

The prediction accuracy was increased significantly with the introduction of prior information, which provided valuable geometrical distribution of target for model training. This method provides an effective way to identify low-contrast targets from surrounding tissues in CT and will be useful in other image modalities.

An unsupervised automatic segmentation algorithm for breast tissue classification of dedicated breast computed tomography images

PURPOSE

To develop and evaluate a new automatic classification algorithm to identify voxels containing skin, vasculature, adipose, and fibroglandular tissue in dedicated breast CT images.

METHODS

The proposed algorithm combines intensity- and region-based segmentation methods with energy minimizing splines and unsupervised data mining approaches for classifying and segmenting the different tissue types. Breast skin segmentation is achieved by a region-growing method which uses constraints from the previously extracted skin centerline to add robustness to the model and to reduce the false positive rate. An energy minimizing active contour model is then used to classify adipose tissue voxels by including gradient flow and region-based features. Finally, blood vessels are separated from fibroglandular tissue by a k-means clustering algorithm based on automatically extracted shape-based features. To evaluate the accuracy of the algorithm, two sets of 15 different patient breast CT scans, each acquired with different breast CT systems and acquisition settings were obtained. Three slices from each scan were manually segmented under the supervision of an experienced breast radiologist and considered the gold standard. Comparisons with manual segmentation were quantified using five similarity metrics: Dice similarity coefficient (DSC), sensitivity, conformity coefficient, and two Hausdorff distance measures. To evaluate the robustness to image noise, the segmentation was repeated after separately adding Gaussian noise with increasing standard deviation (in four steps, from 0.01 to 0.04) to an additional 15 slices from the first dataset. In addition, to evaluate vasculature classification, three different pre- and postcontrast injection patient breast CT images were classified and compared. Finally, DSC was also used for quantitative comparisons with previously proposed approaches for breast CT tissue classification using 10 images from the first dataset.

RESULTS

The algorithm showed a high accuracy in classifying the different tissue types for both breast CT systems, with an average DSC of 95% and 90% for the first and second image dataset, respectively. Furthermore, it demonstrated to be robust to image noise with a robustness to image noise of 85%, 83%, 79%, and 71% for the images corrupted with the four increasing noise levels. Previous methods for breast tissues classification resulted, for the tested dataset, in an average global DSC of 87%, while our approach resulted in a global average DSC of 94.5%.

CONCLUSIONS

The proposed algorithm resulted in accurate and robust breast tissue classification, with no prior training or threshold setting. Potential applications include breast density quantification and tissue pattern characterization (both biomarkers of cancer development), simulation-based radiation dose analysis, and patient data-based phantom design, which could be used for further breast imaging research.

Dosimetry in x-ray-based breast imaging

The estimation of the mean glandular dose to the breast (MGD) for x-ray based imaging modalities forms an essential part of quality control and is needed for risk estimation and for system design and optimisation. This review considers the development of methods for estimating the MGD for mammography, digital breast tomosynthesis (DBT) and dedicated breast CT (DBCT). Almost all of the methodology used employs Monte Carlo calculated conversion factors to relate the measurable quantity, generally the incident air kerma, to the MGD. After a review of the size and composition of the female breast, the various mathematical models used are discussed, with particular emphasis on models for mammography. These range from simple geometrical shapes, to the more recent complex models based on patient DBCT examinations. The possibility of patient-specific dose estimates is considered as well as special diagnostic views and the effect of breast implants. Calculations using the complex models show that the MGD for mammography is overestimated by about 30% when the simple models are used. The design and uses of breast-simulating test phantoms for measuring incident air kerma are outlined and comparisons made between patient and phantom-based dose estimates. The most widely used national and international dosimetry protocols for mammography are based on different simple geometrical models of the breast, and harmonisation of these protocols using more complex breast models is desirable.