Mammography-based screening has helped reduce the breast cancer mortality rate, but has also been associated with potential harms due to low specificity, leading to unnecessary exams or procedures, and low sensitivity. Digital breast tomosynthesis (DBT) improves on conventional mammography by increasing both sensitivity and specificity and is becoming common in clinical settings. However, deep learning (DL) models have been developed mainly on conventional 2D full-field digital mammography (FFDM) or scanned film images. Due to a lack of large annotated DBT datasets, it is difficult to train a model on DBT from scratch. In this work, we present methods to generalize a model trained on FFDM images to DBT images. In particular, we use average histogram matching (HM) and DL fine-tuning methods to generalize a FFDM model to the 2D maximum intensity projection (MIP) of DBT images. In the proposed approach, the differences between the FFDM and DBT domains are reduced via HM and then the base model, which was trained on abundant FFDM images, is fine-tuned. When evaluating on image patches extracted around identified findings, we are able to achieve similar areas under the receiver operating characteristic curve (ROC AUC) of $\sim 0.9$ for FFDM and $\sim 0.85$ for MIP images, as compared to a ROC AUC of $\sim 0.75$ when tested directly on MIP images.
DeepHealth, Inc.（深健公司）；Rhode Island Hospital（罗德岛医院）；Brown University（布朗大学）；Henan Provincial People’s Hospital（河南省人民医院）；Medford Radiology Group（梅德福放射学集团）；University of Massachusetts Medical School（马萨诸塞大学医学院）
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 p…
A novel hierarchical model is introduced to solve a general problem of detecting groups of similar objects. Under this model, detection of groups is performed in hierarchically organized layers while each layer represents a scope for target objects. The processing of these layers involves sequential extraction of appearance features for an individual object, consistency measurement features for nearby objects, and finally the distribution features for all objects within the group. Using the concept of scope-based normalization, the extracted features not only enhance local contrast of an indiv…
Automated methods for breast cancer detection have focused on 2D mammography and have largely ignored 3D digital breast tomosynthesis (DBT), which is frequently used in clinical practice. The two key challenges in developing automated methods for DBT classification are handling the variable number of slices and retaining slice-to-slice changes. We propose a novel deep 2D convolutional neural network (CNN) architecture for DBT classification that simultaneously overcomes both challenges. Our approach operates on the full volume, regardless of the number of slices, and allows the use of pre-trai…
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, w…
Purpose: To develop a Breast Imaging Reporting and Data System (BI-RADS) breast density deep learning (DL) model in a multi-site setting for synthetic two-dimensional mammography (SM) images derived from digital breast tomosynthesis exams using full-field digital mammography (FFDM) images and limited SM data. Materials and Methods: A DL model was trained to predict BI-RADS breast density using FFDM images acquired from 2008 to 2017 (Site 1: 57492 patients, 187627 exams, 750752 images) for this retrospective study. The FFDM model was evaluated using SM datasets from two institutions (Site 1: 38…
A Multi-Modal AI System for Screening Mammography: Integrating 2D and 3D Imaging to Improve Breast Cancer Detection in a Prospective Clinical Study
Vilcek Institute of Graduate Biomedical Sciences, NYU Grossman School of Medicine（NYU Grossman医学院Vilcek研究生生物医学科学研究所）；NYU Grossman School of Medicine（NYU Grossman医学院）；Center for Data Science, New York University（纽约大学数据科学中心）；Emory University（埃默里大学）；Visage Imaging, Inc.（Visage成像公司）
From Density to Biopsy Decisions and Malignancy Prediction: A Benchmark Study of Multimodal Large Language Models Against Radiologists in Digital and Contrast-Enhanced Mammography
Danube Private University（多瑙河私立大学）；Urmia University of Medical Science（乌尔米耶医科大学）；Yeditepe University（耶迪特佩大学）；Kartal Dr. LÜtfi Kırdar City Hospital（卡尔塔尔·卢特菲·克尔达尔博士市立医院）；Iran University of Medical Sciences（伊朗医科大学）；University of Padova（帕多瓦大学）；Bahçeşehir University（巴赫切谢希尔大学）；Mooney's Bay Pain Clinic（穆尼湾疼痛诊所）；Arden University（雅顿大学）；University Hospital Cologne（科隆大学医院）；University of Southern Queensland（南昆士兰大学）；Austrian Center for Medical Innovation and Technology（奥地利医学创新与技术中心）
Computer-aided detection systems based on deep learning have shown great potential in breast cancer detection. However, the lack of domain generalization of artificial neural networks is an important obstacle to their deployment in changing clinical environments. In this work, we explore the domain generalization of deep learning methods for mass detection in digital mammography and analyze in-depth the sources of domain shift in a large-scale multi-center setting. To this end, we compare the performance of eight state-of-the-art detection methods, including Transformer-based models, trained i…
Radboud University Medical Center（拉德堡德大学医学中心）；Delft University of Technology（代尔夫特理工大学）；KTH Royal Institute of Technology（瑞典皇家理工学院）；Elekta（医科达）；Dutch Expert Centre for Screening（荷兰筛查专家中心）
Digital breast tomosynthesis is rapidly replacing digital mammography as the basic x-ray technique for evaluation of the breasts. However, the sparse sampling and limited angular range gives rise to different artifacts, which manufacturers try to solve in several ways. In this study we propose an extension of the Learned Primal-Dual algorithm for digital breast tomosynthesis. The Learned Primal-Dual algorithm is a deep neural network consisting of several `reconstruction blocks', which take in raw sinogram data as the initial input, perform a forward and a backward pass by taking projections a…
Universidad Técnica Particular de Loja（洛哈技术大学）；Universitat Politécnica de Valencia（瓦伦西亚理工大学）；University of Waterloo（滑铁卢大学）
Breast cancer is the most common invasive cancer in women, and the second main cause of death. Breast cancer screening is an efficient method to detect indeterminate breast lesions early. The common approaches of screening for women are tomosynthesis and mammography images. However, the traditional manual diagnosis requires an intense workload by pathologists, who are prone to diagnostic errors. Thus, the aim of this study is to build a deep convolutional neural network method for automatic detection, segmentation, and classification of breast lesions in mammography images. Based on deep learn…
Digital Breast Tomosynthesis (DBT) provides an insight into the fine details of normal fibroglandular tissues and abnormal lesions by reconstructing a pseudo-3D image of the breast. In this respect, DBT overcomes a major limitation of conventional X-ray mammography by reducing the confounding effects caused by the superposition of breast tissue. In a breast cancer screening or diagnostic context, a radiologist is interested in detecting change, which might be indicative of malignant disease. To help automate this task image registration is required to establish spatial correspondence between t…
University Hospital of Zurich（苏黎世大学医院）；ETH Zurich（苏黎世联邦理工学院）；Memorial Sloan Kettering Cancer Center（纪念斯隆凯特琳癌症中心）
$\textbf{Purpose}$ To train a cycle-consistent generative adversarial network (CycleGAN) on mammographic data to inject or remove features of malignancy, and to determine whether these AI-mediated attacks can be detected by radiologists. $\textbf{Material and Methods}$ From the two publicly available datasets, BCDR and INbreast, we selected images from cancer patients and healthy controls. An internal dataset served as test data, withheld during training. We ran two experiments training CycleGAN on low and higher resolution images ($256 \times 256$ px and $512 \times 408$ px). Three radiologis…
Purpose: To develop and evaluate the accuracy of a multi-view deep learning approach to the analysis of high-resolution synthetic mammograms from digital breast tomosynthesis screening cases, and to assess the effect on accuracy of image resolution and training set size. Materials and Methods: In a retrospective study, 21,264 screening digital breast tomosynthesis (DBT) exams obtained at our institution were collected along with associated radiology reports. The 2D synthetic mammographic images from these exams, with varying resolutions and data set sizes, were used to train a multi-view deep …
Radboud University Medical Center（拉德堡德大学医学中心）；Delft University of Technology（代尔夫特理工大学）
Computer-aided detection or decision support systems aim to improve breast cancer screening programs by helping radiologists to evaluate digital mammography (DM) exams. Commonly such methods proceed in two steps: selection of candidate regions for malignancy, and later classification as either malignant or not. In this study, we present a candidate detection method based on deep learning to automatically detect and additionally segment soft tissue lesions in DM. A database of DM exams (mostly bilateral and two views) was collected from our institutional archive. In total, 7196 DM exams (28294 …
Department of Medicine I, LMU University Hospital, LMU Munich, Germany（慕尼黑大学医学部第一部门，LMU大学医院，慕尼黑，德国）；Lunit Inc.（Lunit公司）
Large annotated datasets are essential for training robust Computer-Aided Diagnosis (CAD) models for breast cancer detection or risk prediction. However, acquiring such datasets with fine-detailed annotation is both costly and time-consuming. Vision-Language Models (VLMs), such as CLIP, which are pre-trained on large image-text pairs, offer a promising solution by enhancing robustness and data efficiency in medical imaging tasks. This paper introduces a novel Multi-View Mammography and Language Model for breast cancer classification and risk prediction, trained on a dataset of paired mammogram…
University of Kentucky（肯塔基大学）；Miami University（迈阿密大学）
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 classi…
When we deploy machine learning models in high-stakes medical settings, we must ensure these models make accurate predictions that are consistent with known medical science. Inherently interpretable networks address this need by explaining the rationale behind each decision while maintaining equal or higher accuracy compared to black-box models. In this work, we present a novel interpretable neural network algorithm that uses case-based reasoning for mammography. Designed to aid a radiologist in their decisions, our network presents both a prediction of malignancy and an explanation of that pr…
Early detection and analysis of calcifications in mammogram images is crucial in a breast cancer diagnosis workflow. Management of calcifications that require immediate follow-up and further analyzing its benignancy or malignancy can result in a better prognosis. Recent studies have shown that deep learning-based algorithms can learn robust representations to analyze suspicious calcifications in mammography. In this work, we demonstrate that randomly equalizing the histograms of calcification patches as a data augmentation technique can significantly improve the classification performance for …
Towards order of magnitude X-ray dose reduction in breast cancer imaging using phase contrast and deep denoising
The University of Melbourne（墨尔本大学）；The University of Sydney（悉尼大学）；Eastern Health（东部健康）；Monash Health（莫纳什健康）；Monash University（莫纳什大学）；Australian Synchrotron, ANSTO（澳大利亚同步辐射中心，ANSTO）；Commonwealth Scientific and Industrial Research Organisation（澳大利亚联邦科学与工业研究组织）
