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Synthesizing lesions using contextual GANs improves breast cancer classification on mammograms

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 Added by Eric Wu
 Publication date 2020
and research's language is English




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Data scarcity and class imbalance are two fundamental challenges in many machine learning applications to healthcare. Breast cancer classification in mammography exemplifies these challenges, with a malignancy rate of around 0.5% in a screening population, which is compounded by the relatively small size of lesions (~1% of the image) in malignant cases. Simultaneously, the prevalence of screening mammography creates a potential abundance of non-cancer exams to use for training. Altogether, these characteristics lead to overfitting on cancer cases, while under-utilizing non-cancer data. Here, we present a novel generative adversarial network (GAN) model for data augmentation that can realistically synthesize and remove lesions on mammograms. With self-attention and semi-supervised learning components, the U-net-based architecture can generate high resolution (256x256px) outputs, as necessary for mammography. When augmenting the original training set with the GAN-generated samples, we find a significant improvement in malignancy classification performance on a test set of real mammogram patches. Overall, the empirical results of our algorithm and the relevance to other medical imaging paradigms point to potentially fruitful further applications.



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Background and Aim: Recently, deep learning using convolutional neural network has been used successfully to classify the images of breast cells accurately. However, the accuracy of manual classification of those histopathological images is comparatively low. This research aims to increase the accuracy of the classification of breast cancer images by utilizing a Patch-Based Classifier (PBC) along with deep learning architecture. Methodology: The proposed system consists of a Deep Convolutional Neural Network (DCNN) that helps in enhancing and increasing the accuracy of the classification process. This is done by the use of the Patch-based Classifier (PBC). CNN has completely different layers where images are first fed through convolutional layers using hyperbolic tangent function together with the max-pooling layer, drop out layers, and SoftMax function for classification. Further, the output obtained is fed to a patch-based classifier that consists of patch-wise classification output followed by majority voting. Results: The results are obtained throughout the classification stage for breast cancer images that are collected from breast-histology datasets. The proposed solution improves the accuracy of classification whether or not the images had normal, benign, in-situ, or invasive carcinoma from 87% to 94% with a decrease in processing time from 0.45 s to 0.2s on average. Conclusion: The proposed solution focused on increasing the accuracy of classifying cancer in the breast by enhancing the image contrast and reducing the vanishing gradient. Finally, this solution for the implementation of the Contrast Limited Adaptive Histogram Equalization (CLAHE) technique and modified tangent function helps in increasing the accuracy.
We trained and evaluated a localization-based deep CNN for breast cancer screening exam classification on over 200,000 exams (over 1,000,000 images). Our model achieves an AUC of 0.919 in predicting malignancy in patients undergoing breast cancer screening, reducing the error rate of the baseline (Wu et al., 2019a) by 23%. In addition, the models generates bounding boxes for benign and malignant findings, providing interpretable predictions.
Breast cancer remains a global challenge, causing over 1 million deaths globally in 2018. To achieve earlier breast cancer detection, screening x-ray mammography is recommended by health organizations worldwide and has been estimated to decrease breast cancer mortality by 20-40%. Nevertheless, significant false positive and false negative rates, as well as high interpretation costs, leave opportunities for improving quality and access. To address these limitations, there has been much recent interest in applying deep learning to mammography; however, obtaining large amounts of annotated data poses a challenge for training deep learning models for this purpose, as does ensuring generalization beyond the populations represented in the training dataset. Here, we present an annotation-efficient deep learning approach that 1) achieves state-of-the-art performance in mammogram classification, 2) successfully extends to digital breast tomosynthesis (DBT; 3D mammography), 3) detects cancers in clinically-negative prior mammograms of cancer patients, 4) generalizes well to a population with low screening rates, and 5) outperforms five-out-of-five full-time breast imaging specialists by improving absolute sensitivity by an average of 14%. Our results demonstrate promise towards software that can improve the accuracy of and access to screening mammography worldwide.
Mammography remains the most prevalent imaging tool for early breast cancer screening. The language used to describe abnormalities in mammographic reports is based on the breast Imaging Reporting and Data System (BI-RADS). Assigning a correct BI-RADS category to each examined mammogram is a strenuous and challenging task for even experts. This paper proposes a new and effective computer-aided diagnosis (CAD) system to classify mammographic masses into four assessment categories in BI-RADS. The mass regions are first enhanced by means of histogram equalization and then semiautomatically segmented based on the region growing technique. A total of 130 handcrafted BI-RADS features are then extrcated from the shape, margin, and density of each mass, together with the mass size and the patients age, as mentioned in BI-RADS mammography. Then, a modified feature selection method based on the genetic algorithm (GA) is proposed to select the most clinically significant BI-RADS features. Finally, a back-propagation neural network (BPN) is employed for classification, and its accuracy is used as the fitness in GA. A set of 500 mammogram images from the digital database of screening mammography (DDSM) is used for evaluation. Our system achieves classification accuracy, positive predictive value, negative predictive value, and Matthews correlation coefficient of 84.5%, 84.4%, 94.8%, and 79.3%, respectively. To our best knowledge, this is the best current result for BI-RADS classification of breast masses in mammography, which makes the proposed system promising to support radiologists for deciding proper patient management based on the automatically assigned BI-RADS categories.
Accurate breast lesion risk estimation can significantly reduce unnecessary biopsies and help doctors decide optimal treatment plans. Most existing computer-aided systems rely solely on mammogram features to classify breast lesions. While this approach is convenient, it does not fully exploit useful information in clinical reports to achieve the optimal performance. Would clinical features significantly improve breast lesion classification compared to using mammograms alone? How to handle missing clinical information caused by variation in medical practice? What is the best way to combine mammograms and clinical features? There is a compelling need for a systematic study to address these fundamental questions. This paper investigates several multimodal deep networks based on feature concatenation, cross-attention, and co-attention to combine mammograms and categorical clinical variables. We show that the proposed architectures significantly increase the lesion classification performance (average area under ROC curves from 0.89 to 0.94). We also evaluate the model when clinical variables are missing.
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