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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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Purpose: We propose a deep learning-based computer-aided detection (CADe) method to detect breast lesions in ultrafast DCE-MRI sequences. This method uses both the three-dimensional spatial information and temporal information obtained from the early-phase of the dynamic acquisition. Methods: The proposed CADe method, based on a modified 3D RetinaNet model, operates on ultrafast T1 weighted sequences, which are preprocessed for motion compensation, temporal normalization, and are cropped before passing into the model. The model is optimized to enable the detection of relatively small breast lesions in a screening setting, focusing on detection of lesions that are harder to differentiate from confounding structures inside the breast. Results: The method was developed based on a dataset consisting of 489 ultrafast MRI studies obtained from 462 patients containing a total of 572 lesions (365 malignant, 207 benign) and achieved a detection rate, sensitivity, and detection rate of benign lesions of 0.90 (0.876-0.934), 0.95 (0.934-0.980), and 0.81 (0.751-0.871) at 4 false positives per normal breast with 10-fold cross-testing, respectively. Conclusions: The deep learning architecture used for the proposed CADe application can efficiently detect benign and malignant lesions on ultrafast DCE-MRI. Furthermore, utilizing the less visible hard-to detect-lesions in training improves the learning process and, subsequently, detection of malignant breast lesions.
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.
Ultrasound (US) is one of the most commonly used imaging modalities in both diagnosis and surgical interventions due to its low-cost, safety, and non-invasive characteristic. US image segmentation is currently a unique challenge because of the presence of speckle noise. As manual segmentation requires considerable efforts and time, the development of automatic segmentation algorithms has attracted researchers attention. Although recent methodologies based on convolutional neural networks have shown promising performances, their success relies on the availability of a large number of training data, which is prohibitively difficult for many applications. Therefore, in this study we propose the use of simulated US images and natural images as auxiliary datasets in order to pre-train our segmentation network, and then to fine-tune with limited in vivo data. We show that with as little as 19 in vivo images, fine-tuning the pre-trained network improves the dice score by 21% compared to training from scratch. We also demonstrate that if the same number of natural and simulation US images is available, pre-training on simulation data is preferable.
Automatic breast lesion segmentation in ultrasound helps to diagnose breast cancer, which is one of the dreadful diseases that affect women globally. Segmenting breast regions accurately from ultrasound image is a challenging task due to the inherent speckle artifacts, blurry breast lesion boundaries, and inhomogeneous intensity distributions inside the breast lesion regions. Recently, convolutional neural networks (CNNs) have demonstrated remarkable results in medical image segmentation tasks. However, the convolutional operations in a CNN often focus on local regions, which suffer from limited capabilities in capturing long-range dependencies of the input ultrasound image, resulting in degraded breast lesion segmentation accuracy. In this paper, we develop a deep convolutional neural network equipped with a global guidance block (GGB) and breast lesion boundary detection (BD) modules for boosting the breast ultrasound lesion segmentation. The GGB utilizes the multi-layer integrated feature map as a guidance information to learn the long-range non-local dependencies from both spatial and channel domains. The BD modules learn additional breast lesion boundary map to enhance the boundary quality of a segmentation result refinement. Experimental results on a public dataset and a collected dataset show that our network outperforms other medical image segmentation methods and the recent semantic segmentation methods on breast ultrasound lesion segmentation. Moreover, we also show the application of our network on the ultrasound prostate segmentation, in which our method better identifies prostate regions than state-of-the-art networks.
Ischemic stroke lesion segmentation from Computed Tomography Perfusion (CTP) images is important for accurate diagnosis of stroke in acute care units. However, it is challenged by low image contrast and resolution of the perfusion parameter maps, in addition to the complex appearance of the lesion. To deal with this problem, we propose a novel framework based on synthesized pseudo Diffusion-Weighted Imaging (DWI) from perfusion parameter maps to obtain better image quality for more accurate segmentation. Our framework consists of three components based on Convolutional Neural Networks (CNNs) and is trained end-to-end. First, a feature extractor is used to obtain both a low-level and high-level compact representation of the raw spatiotemporal Computed Tomography Angiography (CTA) images. Second, a pseudo DWI generator takes as input the concatenation of CTP perfusion parameter maps and our extracted features to obtain the synthesized pseudo DWI. To achieve better synthesis quality, we propose a hybrid loss function that pays more attention to lesion regions and encourages high-level contextual consistency. Finally, we segment the lesion region from the synthesized pseudo DWI, where the segmentation network is based on switchable normalization and channel calibration for better performance. Experimental results showed that our framework achieved the top performance on ISLES 2018 challenge and: 1) our method using synthesized pseudo DWI outperformed methods segmenting the lesion from perfusion parameter maps directly; 2) the feature extractor exploiting additional spatiotemporal CTA images led to better synthesized pseudo DWI quality and higher segmentation accuracy; and 3) the proposed loss functions and network structure improved the pseudo DWI synthesis and lesion segmentation performance.
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