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Register a new userMAMMO: A Deep Learning Solution for Facilitating Radiologist-Machine Collaboration in Breast Cancer Diagnosis
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Added by
Trent Kyono
Publication date
2018
fields
Informatics Engineering
and research's language is
English
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With an aging and growing population, the number of women requiring either screening or symptomatic mammograms is increasing. To reduce the number of mammograms that need to be read by a radiologist while keeping the diagnostic accuracy the same or better than current clinical practice, we develop Man and Machine Mammography Oracle (MAMMO) - a clinical decision support system capable of triaging mammograms into those that can be confidently classified by a machine and those that cannot be, thus requiring the reading of a radiologist. The first component of MAMMO is a novel multi-view convolutional neural network (CNN) with multi-task learning (MTL). MTL enables the CNN to learn the radiological assessments known to be associated with cancer, such as breast density, conspicuity, suspicion, etc., in addition to learning the primary task of cancer diagnosis. We show that MTL has two advantages: 1) learning refined feature representations associated with cancer improves the classification performance of the diagnosis task and 2) issuing radiological assessments provides an additional layer of model interpretability that a radiologist can use to debug and scrutinize the diagnoses provided by the CNN. The second component of MAMMO is a triage network, which takes as input the radiological assessment and diagnostic predictions of the first networks MTL outputs and determines which mammograms can be correctly and confidently diagnosed by the CNN and which mammograms cannot, thus needing to be read by a radiologist. Results obtained on a private dataset of 8,162 patients show that MAMMO reduced the number of radiologist readings by 42.8% while improving the overall diagnostic accuracy in comparison to readings done by radiologists alone. We analyze the triage of patients decided by MAMMO to gain a better understanding of what unique mammogram characteristics require radiologists expertise.
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Breast cancer is one of the leading fatal disease worldwide with high risk control if early discovered. Conventional method for breast screening is x-ray mammography, which is known to be challenging for early detection of cancer lesions. The dense breast structure produced due to the compression process during imaging lead to difficulties to recognize small size abnormalities. Also, inter- and intra-variations of breast tissues lead to significant difficulties to achieve high diagnosis accuracy using hand-crafted features. Deep learning is an emerging machine learning technology that requires a relatively high computation power. Yet, it proved to be very effective in several difficult tasks that requires decision making at the level of human intelligence. In this paper, we develop a new network architecture inspired by the U-net structure that can be used for effective and early detection of breast cancer. Results indicate a high rate of sensitivity and specificity that indicate potential usefulness of the proposed approach in clinical use.
Multi-instance multi-label (MIML) learning is a challenging problem in many aspects. Such learning approaches might be useful for many medical diagnosis applications including breast cancer detection and classification. In this study subset of digiPATH dataset (whole slide digital breast cancer histopathology images) are used for training and evaluation of six state-of-the-art MIML methods. At the end, performance comparison of these approaches are given by means of effective evaluation metrics. It is shown that MIML-kNN achieve the best performance that is %65.3 average precision, where most of other methods attain acceptable results as well.
Purpose: To determine whether deep learning models can distinguish between breast cancer molecular subtypes based on dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI). Materials and methods: In this institutional review board-approved single-center study, we analyzed DCE-MR images of 270 patients at our institution. Lesions of interest were identified by radiologists. The task was to automatically determine whether the tumor is of the Luminal A subtype or of another subtype based on the MR image patches representing the tumor. Three different deep learning approaches were used to classify the tumor according to their molecular subtypes: learning from scratch where only tumor patches were used for training, transfer learning where networks pre-trained on natural images were fine-tuned using tumor patches, and off-the-shelf deep features where the features extracted by neural networks trained on natural images were used for classification with a support vector machine. Network architectures utilized in our experiments were GoogleNet, VGG, and CIFAR. We used 10-fold crossvalidation method for validation and area under the receiver operating characteristic (AUC) as the measure of performance. Results: The best AUC performance for distinguishing molecular subtypes was 0.65 (95% CI:[0.57,0.71]) and was achieved by the off-the-shelf deep features approach. The highest AUC performance for training from scratch was 0.58 (95% CI:[0.51,0.64]) and the best AUC performance for transfer learning was 0.60 (95% CI:[0.52,0.65]) respectively. For the off-the-shelf approach, the features extracted from the fully connected layer performed the best. Conclusion: Deep learning may play a role in discovering radiogenomic associations in breast cancer.
In the last few years, deep learning classifiers have shown promising results in image-based medical diagnosis. However, interpreting the outputs of these models remains a challenge. In cancer diagnosis, interpretability can be achieved by localizing the region of the input image responsible for the output, i.e. the location of a lesion. Alternatively, segmentation or detection models can be trained with pixel-wise annotations indicating the locations of malignant lesions. Unfortunately, acquiring such labels is labor-intensive and requires medical expertise. To overcome this difficulty, weakly-supervised localization can be utilized. These methods allow neural network classifiers to output saliency maps highlighting the regions of the input most relevant to the classification task (e.g. malignant lesions in mammograms) using only image-level labels (e.g. whether the patient has cancer or not) during training. When applied to high-resolution images, existing methods produce low-resolution saliency maps. This is problematic in applications in which suspicious lesions are small in relation to the image size. In this work, we introduce a novel neural network architecture to perform weakly-supervised segmentation of high-resolution images. The proposed model selects regions of interest via coarse-level localization, and then performs fine-grained segmentation of those regions. We apply this model to breast cancer diagnosis with screening mammography, and validate it on a large clinically-realistic dataset. Measured by Dice similarity score, our approach outperforms existing methods by a large margin in terms of localization performance of benign and malignant lesions, relatively improving the performance by 39.6% and 20.0%, respectively. Code and the weights of some of the models are available at https://github.com/nyukat/GLAM
This paper constructs a novel intelligent medical diagnosis system, which can realize automatic communication and breast cancer pathological image recognition. This system contains two main parts, including a pre-training chatbot called M-Chatbot and an improved neural network model of EfficientNetV2-S named EfficientNetV2-SA, in which the activation function in top layers is replaced by ACON-C. Using information retrieval mechanism, M-Chatbot instructs patients to send breast pathological image to EfficientNetV2-SA network, and then the classifier trained by transfer learning will return the diagnosis results. We verify the performance of our chatbot and classification on the extrinsic metrics and BreaKHis dataset, respectively. The task completion rate of M-Chatbot reached 63.33%. For the BreaKHis dataset, the highest accuracy of EfficientNetV2-SA network have achieved 84.71%. All these experimental results illustrate that the proposed model can improve the accuracy performance of image recognition and our new intelligent medical diagnosis system is successful and efficient in providing automatic diagnosis of breast cancer.
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