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Register a new userA Hypersensitive Breast Cancer Detector
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Added by
Jason Su
Publication date
2020
fields
Informatics Engineering
and research's language is
English
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Early detection of breast cancer through screening mammography yields a 20-35% increase in survival rate; however, there are not enough radiologists to serve the growing population of women seeking screening mammography. Although commercial computer aided detection (CADe) software has been available to radiologists for decades, it has failed to improve the interpretation of full-field digital mammography (FFDM) images due to its low sensitivity over the spectrum of findings. In this work, we leverage a large set of FFDM images with loose bounding boxes of mammographically significant findings to train a deep learning detector with extreme sensitivity. Building upon work from the Hourglass architecture, we train a model that produces segmentation-like images with high spatial resolution, with the aim of producing 2D Gaussian blobs centered on ground-truth boxes. We replace the pixel-wise $L_2$ norm with a weak-supervision loss designed to achieve high sensitivity, asymmetrically penalizing false positives and false negatives while softening the noise of the loose bounding boxes by permitting a tolerance in misaligned predictions. The resulting system achieves a sensitivity for malignant findings of 0.99 with only 4.8 false positive markers per image. When utilized in a CADe system, this model could enable a novel workflow where radiologists can focus their attention with trust on only the locations proposed by the model, expediting the interpretation process and bringing attention to potential findings that could otherwise have been missed. Due to its nearly perfect sensitivity, the proposed detector can also be used as a high-performance proposal generator in two-stage detection systems.
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Medical images differ from natural images in significantly higher resolutions and smaller regions of interest. Because of these differences, neural network architectures that work well for natural images might not be applicable to medical image analysis. In this work, we extend the globally-aware multiple instance classifier, a framework we proposed to address these unique properties of medical images. This model first uses a low-capacity, yet memory-efficient, network on the whole image to identify the most informative regions. It then applies another higher-capacity network to collect details from chosen regions. Finally, it employs a fusion module that aggregates global and local information to make a final prediction. While existing methods often require lesion segmentation during training, our model is trained with only image-level labels and can generate pixel-level saliency maps indicating possible malignant findings. We apply the model to screening mammography interpretation: predicting the presence or absence of benign and malignant lesions. On the NYU Breast Cancer Screening Dataset, consisting of more than one million images, our model achieves an AUC of 0.93 in classifying breasts with malignant findings, outperforming ResNet-34 and Faster R-CNN. Compared to ResNet-34, our model is 4.1x faster for inference while using 78.4% less GPU memory. Furthermore, we demonstrate, in a reader study, that our model surpasses radiologist-level AUC by a margin of 0.11. The proposed model is available online: https://github.com/nyukat/GMIC.
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.
Breast cancer is the malignant tumor that causes the highest number of cancer deaths in females. Digital mammograms (DM or 2D mammogram) and digital breast tomosynthesis (DBT or 3D mammogram) are the two types of mammography imagery that are used in clinical practice for breast cancer detection and diagnosis. Radiologists usually read both imaging modalities in combination; however, existing computer-aided diagnosis tools are designed using only one imaging modality. Inspired by clinical practice, we propose an innovative convolutional neural network (CNN) architecture for breast cancer classification, which uses both 2D and 3D mammograms, simultaneously. Our experiment shows that the proposed method significantly improves the performance of breast cancer classification. By assembling three CNN classifiers, the proposed model achieves 0.97 AUC, which is 34.72% higher than the methods using only one imaging modality.
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.
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
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