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Baxter JSH, Eagleson R. Exploring the values underlying machine learning research in medical image analysis. Med Image Anal 2025; 102:103494. [PMID: 40020419 DOI: 10.1016/j.media.2025.103494] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2024] [Revised: 01/26/2025] [Accepted: 02/01/2025] [Indexed: 03/03/2025]
Abstract
Machine learning has emerged as a crucial tool for medical image analysis, largely due to recent developments in deep artificial neural networks addressing numerous, diverse clinical problems. As with any conceptual tool, the effective use of machine learning should be predicated on an understanding of its underlying motivations just as much as algorithms or theory - and to do so, we need to explore its philosophical foundations. One of these foundations is the understanding of how values, despite being non-empirical, nevertheless affect scientific research. This article has three goals: to introduce the reader to values in a way that is specific to medical image analysis; to characterise a particular set of technical decisions (what we call the end-to-end vs. separable learning spectrum) that are fundamental to machine learning for medical image analysis; and to create a simple and structured method to show how these values can be rigorously connected to these technical decisions. This better understanding of how the philosophy of science can clarify fundamental elements of how medical image analysis research is performed and can be improved.
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Affiliation(s)
- John S H Baxter
- Laboratoire Traitement du Signal et de l'Image (LTSI, INSERM UMR 1099), Université de Rennes, Rennes, France.
| | - Roy Eagleson
- Biomedical Engineering Graduate Program, Western University, London, Canada
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Li P, Zhong J, Chen H, Hong J, Li H, Li X, Shi P. An explainable and comprehensive BI-RADS assisted diagnosis pipeline for mammograms. Phys Med 2025; 132:104949. [PMID: 40049063 DOI: 10.1016/j.ejmp.2025.104949] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2024] [Revised: 02/10/2025] [Accepted: 02/21/2025] [Indexed: 03/26/2025] Open
Abstract
BACKGROUND AND OBJECTIVE The growing adoption of computer-aided diagnosis systems is transforming cancer diagnostics in mammography, but it still needs improvement in comprehensive diagnostics, early screening accuracy, and system explainability. To achieve these, we introduce an explainable pipeline designed to provide comprehensive diagnostic suggestions according to the Breast Imaging Reporting and Data System (BI-RADS) lexicon. METHODS The proposed pipeline employs a multi-task framework, with BI-RADS assessments as the main task, complemented by the classification of masses, calcifications, architectural distortions, and breast density. We develop the Multi-scale Feature Fusion with Spatial Attention (MFFSA) module and the Low-level Feature Spatial Attention (LLSA) block. The MFFSA module extracts features from small lesions by fusing multi-scale features. The LLSA block makes the fusion process focus on the details of lesions. The system's explainability is enhanced by two explainable methods, which clarify the effectiveness of the LLSA block in detecting small lesions and reveal how multi-scale features impact predictions in the MFFSA module. It also connects the prediction results of BI-RADS assessment with medical indicators. RESULTS Experiments on open-source mammography datasets of CBIS-DDSM, CDD-CESM and InBreast show the proposed method achieves an AUC of 91.9% (95% CI: 90.5%-93.2%), 91.8% (95% CI: 90.8%-92.8%) and 97.0% (95% CI: 94.7%-98.9%) respectively for the BI-RADS assessment task, and over 87% across all tasks. These results highlight the state-of-the-art performance and the pipeline's ability to provide precise and comprehensive diagnostic suggestions. CONCLUSIONS The proposed pipeline represents an advancement in applying artificial intelligence to mammography. Code available at https://github.com/jjjjjjjjj58/BI-RADS-Diagnosis-for-Mammograms.
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Affiliation(s)
- Peirong Li
- College of Computer and Cyber Security, Fujian Normal University, Fujian, China.
| | - Jing Zhong
- Department of Radiology, Clinical Oncology School of Fujian Medical University, Fujian Cancer Hospital, Fujian, China.
| | - Hongye Chen
- College of Clinical Medicine for Oncology, Fujian Medical University, Fujian, China.
| | - Jinsheng Hong
- Department of Radiotherapy, Cancer Center, The First Affiliated Hospital of Fujian Medical University, Fujian, China; Key Laboratory of Radiation Biology of Fujian Higher Education Institutions, The First Affiliated Hospital of Fujian Medical University, Fujian, China.
| | - Huachang Li
- College of Computer and Cyber Security, Fujian Normal University, Fujian, China.
| | - Xin Li
- College of Computer and Cyber Security, Fujian Normal University, Fujian, China.
| | - Peng Shi
- College of Computer and Cyber Security, Fujian Normal University, Fujian, China; Fujian Provincial Key Laboratory of Statistics and Artificial Intelligence, Fujian Normal University, Fujian, China.
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Alhusari K, Dhou S. Machine Learning-Based Approaches for Breast Density Estimation from Mammograms: A Comprehensive Review. J Imaging 2025; 11:38. [PMID: 39997539 PMCID: PMC11856162 DOI: 10.3390/jimaging11020038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2024] [Revised: 01/20/2025] [Accepted: 01/23/2025] [Indexed: 02/26/2025] Open
Abstract
Breast cancer, as of 2022, is the most prevalent type of cancer in women. Breast density-a measure of the non-fatty tissue in the breast-is a strong risk factor for breast cancer that can be estimated from mammograms. The importance of studying breast density is twofold. First, high breast density can be a factor in lowering mammogram sensitivity, as dense tissue can mask tumors. Second, higher breast density is associated with an increased risk of breast cancer, making accurate assessments vital. This paper presents a comprehensive review of the mammographic density estimation literature, with an emphasis on machine-learning-based approaches. The approaches reviewed can be classified as visual, software-, machine learning-, and segmentation-based. Machine learning methods can be further broken down into two categories: traditional machine learning and deep learning approaches. The most commonly utilized models are support vector machines (SVMs) and convolutional neural networks (CNNs), with classification accuracies ranging from 76.70% to 98.75%. Major limitations of the current works include subjectivity and cost-inefficiency. Future work can focus on addressing these limitations, potentially through the use of unsupervised segmentation and state-of-the-art deep learning models such as transformers. By addressing the current limitations, future research can pave the way for more reliable breast density estimation methods, ultimately improving early detection and diagnosis.
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Affiliation(s)
- Khaldoon Alhusari
- Department of Computer Science and Engineering, American University of Sharjah, Sharjah P.O. Box 26666, United Arab Emirates;
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P MD, A M, Ali Y, V S. Effective BCDNet-based breast cancer classification model using hybrid deep learning with VGG16-based optimal feature extraction. BMC Med Imaging 2025; 25:12. [PMID: 39780045 PMCID: PMC11707918 DOI: 10.1186/s12880-024-01538-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2024] [Accepted: 12/17/2024] [Indexed: 01/11/2025] Open
Abstract
PROBLEM Breast cancer is a leading cause of death among women, and early detection is crucial for improving survival rates. The manual breast cancer diagnosis utilizes more time and is subjective. Also, the previous CAD models mostly depend on manmade visual details that are complex to generalize across ultrasound images utilizing distinct techniques. Distinct imaging tools have been utilized in previous works such as mammography and MRI. However, these imaging tools are costly and less portable than ultrasound imaging. Also, ultrasound imaging is a non-invasive method commonly used for breast cancer screening. Hence, the paper presents a novel deep learning model, BCDNet, for classifying breast tumors as benign or malignant using ultrasound images. AIM The primary aim of the study is to design an effective breast cancer diagnosis model that can accurately classify tumors in their early stages, thus reducing mortality rates. The model aims to optimize the weight and parameters using the RPAOSM-ESO algorithm to enhance accuracy and minimize false negative rates. METHODS The BCDNet model utilizes transfer learning from a pre-trained VGG16 network for feature extraction and employs an AHDNAM classification approach, which includes ASPP, DTCN, 1DCNN, and an attention mechanism. The RPAOSM-ESO algorithm is used to fine-tune the weights and parameters. RESULTS The RPAOSM-ESO-BCDNet-based breast cancer diagnosis model provided 94.5 accuracy rates. This value is relatively higher than the previous models such as DTCN (88.2), 1DCNN (89.6), MobileNet (91.3), and ASPP-DTC-1DCNN-AM (93.8). Hence, it is guaranteed that the designed RPAOSM-ESO-BCDNet produces relatively accurate solutions for the classification than the previous models. CONCLUSION The BCDNet model, with its sophisticated feature extraction and classification techniques optimized by the RPAOSM-ESO algorithm, shows promise in accurately classifying breast tumors using ultrasound images. The study suggests that the model could be a valuable tool in the early detection of breast cancer, potentially saving lives and reducing the burden on healthcare systems.
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Affiliation(s)
- Meenakshi Devi P
- Department of Information Technology, K.S.R. College of Engineering, Tiruchengode, Tamilnadu, 637215, India
| | - Muna A
- Centre for Research Impact & Outcome, Chitkara University Institute of Engineering and Technology, Chitkara University, Rajpura, Punjab, 140401, India
| | - Yasser Ali
- Chitkara Centre for Research and Development, Chitkara University, Baddi, Himachal Pradesh, 174103, India
| | - Sumanth V
- Department of Information Technology, Manipal Institute of Technology Bengaluru, Manipal Academy of Higher Education, Manipal, Karnataka, 576104, India.
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Biroš M, Kvak D, Dandár J, Hrubý R, Janů E, Atakhanova A, Al-antari MA. Enhancing Accuracy in Breast Density Assessment Using Deep Learning: A Multicentric, Multi-Reader Study. Diagnostics (Basel) 2024; 14:1117. [PMID: 38893643 PMCID: PMC11172127 DOI: 10.3390/diagnostics14111117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2024] [Revised: 05/20/2024] [Accepted: 05/24/2024] [Indexed: 06/21/2024] Open
Abstract
The evaluation of mammographic breast density, a critical indicator of breast cancer risk, is traditionally performed by radiologists via visual inspection of mammography images, utilizing the Breast Imaging-Reporting and Data System (BI-RADS) breast density categories. However, this method is subject to substantial interobserver variability, leading to inconsistencies and potential inaccuracies in density assessment and subsequent risk estimations. To address this, we present a deep learning-based automatic detection algorithm (DLAD) designed for the automated evaluation of breast density. Our multicentric, multi-reader study leverages a diverse dataset of 122 full-field digital mammography studies (488 images in CC and MLO projections) sourced from three institutions. We invited two experienced radiologists to conduct a retrospective analysis, establishing a ground truth for 72 mammography studies (BI-RADS class A: 18, BI-RADS class B: 43, BI-RADS class C: 7, BI-RADS class D: 4). The efficacy of the DLAD was then compared to the performance of five independent radiologists with varying levels of experience. The DLAD showed robust performance, achieving an accuracy of 0.819 (95% CI: 0.736-0.903), along with an F1 score of 0.798 (0.594-0.905), precision of 0.806 (0.596-0.896), recall of 0.830 (0.650-0.946), and a Cohen's Kappa (κ) of 0.708 (0.562-0.841). The algorithm achieved robust performance that matches and in four cases exceeds that of individual radiologists. The statistical analysis did not reveal a significant difference in accuracy between DLAD and the radiologists, underscoring the model's competitive diagnostic alignment with professional radiologist assessments. These results demonstrate that the deep learning-based automatic detection algorithm can enhance the accuracy and consistency of breast density assessments, offering a reliable tool for improving breast cancer screening outcomes.
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Affiliation(s)
- Marek Biroš
- Carebot, Ltd., 128 00 Prague, Czech Republic; (M.B.); (J.D.); (R.H.); (A.A.)
| | - Daniel Kvak
- Carebot, Ltd., 128 00 Prague, Czech Republic; (M.B.); (J.D.); (R.H.); (A.A.)
- Department of Simulation Medicine, Faculty of Medicine, Masaryk University, 625 00 Brno, Czech Republic
| | - Jakub Dandár
- Carebot, Ltd., 128 00 Prague, Czech Republic; (M.B.); (J.D.); (R.H.); (A.A.)
| | - Robert Hrubý
- Carebot, Ltd., 128 00 Prague, Czech Republic; (M.B.); (J.D.); (R.H.); (A.A.)
| | - Eva Janů
- Department of Radiology, Masaryk Memorial Cancer Institute, 602 00 Brno, Czech Republic
| | - Anora Atakhanova
- Carebot, Ltd., 128 00 Prague, Czech Republic; (M.B.); (J.D.); (R.H.); (A.A.)
| | - Mugahed A. Al-antari
- Department of Artificial Intelligence and Data Science, Daeyang AI Center, Sejong University, Seoul 05006, Republic of Korea;
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Zhong Y, Piao Y, Tan B, Liu J. A multi-task fusion model based on a residual-Multi-layer perceptron network for mammographic breast cancer screening. COMPUTER METHODS AND PROGRAMS IN BIOMEDICINE 2024; 247:108101. [PMID: 38432087 DOI: 10.1016/j.cmpb.2024.108101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Revised: 01/13/2024] [Accepted: 02/23/2024] [Indexed: 03/05/2024]
Abstract
BACKGROUND AND OBJECTIVE Deep learning approaches are being increasingly applied for medical computer-aided diagnosis (CAD). However, these methods generally target only specific image-processing tasks, such as lesion segmentation or benign state prediction. For the breast cancer screening task, single feature extraction models are generally used, which directly extract only those potential features from the input mammogram that are relevant to the target task. This can lead to the neglect of other important morphological features of the lesion as well as other auxiliary information from the internal breast tissue. To obtain more comprehensive and objective diagnostic results, in this study, we developed a multi-task fusion model that combines multiple specific tasks for CAD of mammograms. METHODS We first trained a set of separate, task-specific models, including a density classification model, a mass segmentation model, and a lesion benignity-malignancy classification model, and then developed a multi-task fusion model that incorporates all of the mammographic features from these different tasks to yield comprehensive and refined prediction results for breast cancer diagnosis. RESULTS The experimental results showed that our proposed multi-task fusion model outperformed other related state-of-the-art models in both breast cancer screening tasks in the publicly available datasets CBIS-DDSM and INbreast, achieving a competitive screening performance with area-under-the-curve scores of 0.92 and 0.95, respectively. CONCLUSIONS Our model not only allows an overall assessment of lesion types in mammography but also provides intermediate results related to radiological features and potential cancer risk factors, indicating its potential to offer comprehensive workflow support to radiologists.
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Affiliation(s)
- Yutong Zhong
- School of Electronic Information Engineering, Changchun University of Science and Technology, Changchun 130022, PR China
| | - Yan Piao
- School of Electronic Information Engineering, Changchun University of Science and Technology, Changchun 130022, PR China.
| | - Baolin Tan
- Technology Co. LTD, Shenzhen 518000, PR China
| | - Jingxin Liu
- Department of Radiology, China-Japan Union Hospital, Jilin University, Changchun 130033, PR China
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Zhong Y, Piao Y, Zhang G. Multi-view fusion-based local-global dynamic pyramid convolutional cross-tansformer network for density classification in mammography. Phys Med Biol 2023; 68:225012. [PMID: 37827166 DOI: 10.1088/1361-6560/ad02d7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2023] [Accepted: 10/12/2023] [Indexed: 10/14/2023]
Abstract
Object.Breast density is an important indicator of breast cancer risk. However, existing methods for breast density classification do not fully utilise the multi-view information produced by mammography and thus have limited classification accuracy.Method.In this paper, we propose a multi-view fusion network, denoted local-global dynamic pyramidal-convolution transformer network (LG-DPTNet), for breast density classification in mammography. First, for single-view feature extraction, we develop a dynamic pyramid convolutional network to enable the network to adaptively learn global and local features. Second, we address the problem exhibited by traditional multi-view fusion methods, this is based on a cross-transformer that integrates fine-grained information and global contextual information from different views and thereby provides accurate predictions for the network. Finally, we use an asymmetric focal loss function instead of traditional cross-entropy loss during network training to solve the problem of class imbalance in public datasets, thereby further improving the performance of the model.Results.We evaluated the effectiveness of our method on two publicly available mammography datasets, CBIS-DDSM and INbreast, and achieved areas under the curve (AUC) of 96.73% and 91.12%, respectively.Conclusion.Our experiments demonstrated that the devised fusion model can more effectively utilise the information contained in multiple views than existing models and exhibits classification performance that is superior to that of baseline and state-of-the-art methods.
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Affiliation(s)
- Yutong Zhong
- Electronic Information Engineering School, Changchun University of Science and Technology, Changchun, People's Republic of China
| | - Yan Piao
- Electronic Information Engineering School, Changchun University of Science and Technology, Changchun, People's Republic of China
| | - Guohui Zhang
- Department of Pneumoconiosis Diagnosis and Treatment Center, Occupational Preventive and Treatment Hospital in Jilin Province, Changchun, People's Republic of China
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Zhou C, Xie H, Zhu F, Yan W, Yu R, Wang Y. Improving the malignancy prediction of breast cancer based on the integration of radiomics features from dual-view mammography and clinical parameters. Clin Exp Med 2023; 23:2357-2368. [PMID: 36413273 DOI: 10.1007/s10238-022-00944-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Accepted: 11/05/2022] [Indexed: 11/23/2022]
Abstract
Radiomics has been a promising imaging biomarker for many malignant diseases. We developed a novel radiomics strategy that incorporating radiomics features extracted from dual-view mammograms and clinical parameters for identifying benign and malignant breast lesions, and validated whether the radiomics assessment could improve the accurate diagnosis of breast cancer. A total of 380 patients (mean age, 52 ± 7 years) with 621 breast lesions utilizing mammograms on craniocaudal (CC) and mediolateral oblique (MLO) views were randomly allocated into the training (n = 486) and testing (n = 135) sets in this retrospective study. A total of 1184 and 2368 radiomics features were extracted from single-position region of interest (ROI) and position-paired ROI, separately. Clinical parameters were then combined for better prediction. Recursive feature elimination and least absolute shrinkage and selection operator methods were applied to select optimal predictive features. Random forest was used to conduct the predictive model. Intraclass correlation coefficient test was used to assess repeatability and reproducibility of features. After preprocessing, 467 radiomics features and clinical parameters remained in the single-view and dual-view models. The performance and significance of models were quantified by the area under the curve (AUC), sensitivity, specificity, and accuracy. The correlation analysis between variables was evaluated using the correlation ratio and Pearson correlation coefficient. The model using a combination of dual-view radiomics and clinical parameters achieved a favorable performance (AUC: 0.804, 95% CI: 0.668-0.916), outperformed single-view model and model without clinical parameters. Incorporating with radiomics features of dual-view (CC&MLO) mammogram, age, breast density, and type of suspicious lesions can provide a noninvasive approach to evaluate the malignancy of breast lesions and facilitate clinical decision-making.
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Affiliation(s)
- Chenyi Zhou
- Department of Radiology, The People's Hospital of Suzhou New District, Suzhou, 215129, Jiangsu, China
| | - Hui Xie
- Department of Radiology, The People's Hospital of Suzhou New District, Suzhou, 215129, Jiangsu, China
| | - Fanglian Zhu
- Department of Radiology, The People's Hospital of Suzhou New District, Suzhou, 215129, Jiangsu, China
| | - Wanying Yan
- Beijing Infervision Technology Co. Ltd., Beijing, 100025, Beijing, China
| | - Ruize Yu
- Beijing Infervision Technology Co. Ltd., Beijing, 100025, Beijing, China
| | - Yanling Wang
- Department of Radiology, The People's Hospital of Suzhou New District, Suzhou, 215129, Jiangsu, China.
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Development of an Artificial Intelligence-Based Breast Cancer Detection Model by Combining Mammograms and Medical Health Records. Diagnostics (Basel) 2023; 13:diagnostics13030346. [PMID: 36766450 PMCID: PMC9913958 DOI: 10.3390/diagnostics13030346] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Revised: 01/10/2023] [Accepted: 01/13/2023] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND Artificial intelligence (AI)-based computational models that analyze breast cancer have been developed for decades. The present study was implemented to investigate the accuracy and efficiency of combined mammography images and clinical records for breast cancer detection using machine learning and deep learning classifiers. METHODS This study was verified using 731 images from 357 women who underwent at least one mammogram and had clinical records for at least six months before mammography. The model was trained on mammograms and clinical variables to discriminate benign and malignant lesions. Multiple pre-trained deep CNN models to detect cancer in mammograms, including X-ception, VGG16, ResNet-v2, ResNet50, and CNN3 were employed. Machine learning models were constructed using k-nearest neighbor (KNN), support vector machine (SVM), random forest (RF), Artificial Neural Network (ANN), and gradient boosting machine (GBM) in the clinical dataset. RESULTS The detection performance obtained an accuracy of 84.5% with a specificity of 78.1% at a sensitivity of 89.7% and an AUC of 0.88. When trained on mammography image data alone, the result achieved a slightly lower score than the combined model (accuracy, 72.5% vs. 84.5%, respectively). CONCLUSIONS A breast cancer-detection model combining machine learning and deep learning models was performed in this study with a satisfactory result, and this model has potential clinical applications.
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Karri M, Annavarapu CSR, Acharya UR. Explainable multi-module semantic guided attention based network for medical image segmentation. Comput Biol Med 2022; 151:106231. [PMID: 36335811 DOI: 10.1016/j.compbiomed.2022.106231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Revised: 10/05/2022] [Accepted: 10/11/2022] [Indexed: 12/27/2022]
Abstract
Automated segmentation of medical images is crucial for disease diagnosis and treatment planning. Medical image segmentation has been improved based on the convolutional neural networks (CNNs) models. Unfortunately, they are still limited by scenarios in which the segmentation objective has large variations in size, boundary, position, and shape. Moreover, current CNNs have low explainability, restricting their use in clinical decisions. In this paper, we involve substantial use of various attentions in a CNN model and present an explainable multi-module semantic guided attention based network (MSGA-Net) for explainable and highly accurate medical image segmentation, which involves considering the most significant spatial regions, boundaries, scales, and channels. Specifically, we present a multi-scale attention module (MSA) to extract the most salient features at various scales from medical images. Then, we propose a semantic region-guided attention mechanism (SRGA) including location attention (LAM), channel-wise attention (CWA), and edge attention (EA) modules to extract the most important spatial, channel-wise, boundary-related features for interested regions. Moreover, we present a sequence of fine-tuning steps with the SRGA module to gradually weight the significance of interesting regions while simultaneously reducing the noise. In this work, we experimented with three different types of medical images such as dermoscopic images (HAM10000 dataset), multi-organ CT images (CHAOS 2019 dataset), and Brain tumor MRI images (BraTS 2020 dataset). Extensive experiments on all types of medical images revealed that our proposed MSGA-Net substantially increased the overall performance of all metrics over the existing models. Moreover, displaying the attention feature maps has more explainability than state-of-the-art models.
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Affiliation(s)
- Meghana Karri
- Computer Science and Engineering Department, Indian Institute of Technology (ISM), Dhanbad, 826004, Jharkhand, India.
| | | | - U Rajendra Acharya
- Ngee Ann Polytechnic, Department of Electronics and Computer Engineering, 599489, Singapore; Department of Biomedical Engineering, School of science and Technology, SUSS university, Singapore; Department of Biomedical Informatics and Medical Engineering, Asia university, Taichung, Taiwan.
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din NMU, Dar RA, Rasool M, Assad A. Breast cancer detection using deep learning: Datasets, methods, and challenges ahead. Comput Biol Med 2022; 149:106073. [DOI: 10.1016/j.compbiomed.2022.106073] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2022] [Revised: 08/21/2022] [Accepted: 08/27/2022] [Indexed: 12/22/2022]
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Classifying Breast Density from Mammogram with Pretrained CNNs and Weighted Average Ensembles. APPLIED SCIENCES-BASEL 2022. [DOI: 10.3390/app12115599] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/10/2022]
Abstract
We are currently experiencing a revolution in data production and artificial intelligence (AI) applications. Data are produced much faster than they can be consumed. Thus, there is an urgent need to develop AI algorithms for all aspects of modern life. Furthermore, the medical field is a fertile field in which to apply AI techniques. Breast cancer is one of the most common cancers and a leading cause of death around the world. Early detection is critical to treating the disease effectively. Breast density plays a significant role in determining the likelihood and risk of breast cancer. Breast density describes the amount of fibrous and glandular tissue compared with the amount of fatty tissue in the breast. Breast density is categorized using a system called the ACR BI-RADS. The ACR assigns breast density to one of four classes. In class A, breasts are almost entirely fatty. In class B, scattered areas of fibroglandular density appear in the breasts. In class C, the breasts are heterogeneously dense. In class D, the breasts are extremely dense. This paper applies pre-trained Convolutional Neural Network (CNN) on a local mammogram dataset to classify breast density. Several transfer learning models were tested on a dataset consisting of more than 800 mammogram screenings from King Abdulaziz Medical City (KAMC). Inception V3, EfficientNet 2B0, and Xception gave the highest accuracy for both four- and two-class classification. To enhance the accuracy of density classification, we applied weighted average ensembles, and performance was visibly improved. The overall accuracy of ACR classification with weighted average ensembles was 78.11%.
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Li H, Mukundan R, Boyd S. Spatial Distribution Analysis of Novel Texture Feature Descriptors for Accurate Breast Density Classification. SENSORS 2022; 22:s22072672. [PMID: 35408286 PMCID: PMC9002800 DOI: 10.3390/s22072672] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Revised: 03/27/2022] [Accepted: 03/28/2022] [Indexed: 12/10/2022]
Abstract
Breast density has been recognised as an important biomarker that indicates the risk of developing breast cancer. Accurate classification of breast density plays a crucial role in developing a computer-aided detection (CADe) system for mammogram interpretation. This paper proposes a novel texture descriptor, namely, rotation invariant uniform local quinary patterns (RIU4-LQP), to describe texture patterns in mammograms and to improve the robustness of image features. In conventional processing schemes, image features are obtained by computing histograms from texture patterns. However, such processes ignore very important spatial information related to the texture features. This study designs a new feature vector, namely, K-spectrum, by using Baddeley's K-inhom function to characterise the spatial distribution information of feature point sets. Texture features extracted by RIU4-LQP and K-spectrum are utilised to classify mammograms into BI-RADS density categories. Three feature selection methods are employed to optimise the feature set. In our experiment, two mammogram datasets, INbreast and MIAS, are used to test the proposed methods, and comparative analyses and statistical tests between different schemes are conducted. Experimental results show that our proposed method outperforms other approaches described in the literature, with the best classification accuracy of 92.76% (INbreast) and 86.96% (MIAS).
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Affiliation(s)
- Haipeng Li
- Department of Computer Science and Software Engineering, University of Canterbury, Christchurch 8140, New Zealand;
- Correspondence:
| | - Ramakrishnan Mukundan
- Department of Computer Science and Software Engineering, University of Canterbury, Christchurch 8140, New Zealand;
| | - Shelley Boyd
- Canterbury Breastcare, St. George’s Medical Centre, Christchurch 8014, New Zealand;
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Yang J, Wang L, Qin J, Du J, Ding M, Niu T, Li R. Multi-view learning for lymph node metastasis prediction using tumor and nodal radiomics in gastric cancer. Phys Med Biol 2022; 67. [DOI: 10.1088/1361-6560/ac515b] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2021] [Accepted: 02/02/2022] [Indexed: 11/11/2022]
Abstract
Abstract
Purpose. This study aims to develop and validate a multi-view learning method by the combination of primary tumor radiomics and lymph node (LN) radiomics for the preoperative prediction of LN status in gastric cancer (GC). Methods. A total of 170 contrast-enhanced abdominal CT images from GC patients were enrolled in this retrospective study. After data preprocessing, two-step feature selection approach including Pearson correlation analysis and supervised feature selection method based on test-time budget (FSBudget) was performed to remove redundance of tumor and LN radiomics features respectively. Two types of discriminative features were then learned by an unsupervised multi-view partial least squares (UMvPLS) for a latent common space on which a logistic regression classifier is trained. Five repeated random hold-out experiments were employed. Results. On 20-dimensional latent common space, area under receiver operating characteristic curve (AUC), precision, accuracy, recall and F1-score are 0.9531 ± 0.0183, 0.9260 ± 0.0184, 0.9136 ± 0.0174, 0.9468 ± 0.0106 and 0.9362 ± 0.0125 for the training cohort respectively, and 0.8984 ± 0.0536, 0.8671 ± 0.0489, 0.8500 ± 0.0599, 0.9118 ± 0.0550 and 0.8882 ± 0.0440 for the validation cohort respectively (reported as mean ± standard deviation). It shows a better discrimination capability than single-view methods, our previous method, and eight baseline methods. When the dimension was reduced to 2, the model not only has effective prediction performance, but also is convenient for data visualization. Conclusions. Our proposed method by integrating radiomics features of primary tumor and LN can be helpful in predicting lymph node metastasis in patients of GC. It shows multi-view learning has great potential for guiding the prognosis and treatment decision-making in GC.
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Zhang X, Zhang Y, Zhang G, Qiu X, Tan W, Yin X, Liao L. Deep Learning With Radiomics for Disease Diagnosis and Treatment: Challenges and Potential. Front Oncol 2022; 12:773840. [PMID: 35251962 PMCID: PMC8891653 DOI: 10.3389/fonc.2022.773840] [Citation(s) in RCA: 46] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Accepted: 01/17/2022] [Indexed: 12/12/2022] Open
Abstract
The high-throughput extraction of quantitative imaging features from medical images for the purpose of radiomic analysis, i.e., radiomics in a broad sense, is a rapidly developing and emerging research field that has been attracting increasing interest, particularly in multimodality and multi-omics studies. In this context, the quantitative analysis of multidimensional data plays an essential role in assessing the spatio-temporal characteristics of different tissues and organs and their microenvironment. Herein, recent developments in this method, including manually defined features, data acquisition and preprocessing, lesion segmentation, feature extraction, feature selection and dimension reduction, statistical analysis, and model construction, are reviewed. In addition, deep learning-based techniques for automatic segmentation and radiomic analysis are being analyzed to address limitations such as rigorous workflow, manual/semi-automatic lesion annotation, and inadequate feature criteria, and multicenter validation. Furthermore, a summary of the current state-of-the-art applications of this technology in disease diagnosis, treatment response, and prognosis prediction from the perspective of radiology images, multimodality images, histopathology images, and three-dimensional dose distribution data, particularly in oncology, is presented. The potential and value of radiomics in diagnostic and therapeutic strategies are also further analyzed, and for the first time, the advances and challenges associated with dosiomics in radiotherapy are summarized, highlighting the latest progress in radiomics. Finally, a robust framework for radiomic analysis is presented and challenges and recommendations for future development are discussed, including but not limited to the factors that affect model stability (medical big data and multitype data and expert knowledge in medical), limitations of data-driven processes (reproducibility and interpretability of studies, different treatment alternatives for various institutions, and prospective researches and clinical trials), and thoughts on future directions (the capability to achieve clinical applications and open platform for radiomics analysis).
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Affiliation(s)
- Xingping Zhang
- Institute of Advanced Cyberspace Technology, Guangzhou University, Guangzhou, China
- Department of New Networks, Peng Cheng Laboratory, Shenzhen, China
| | - Yanchun Zhang
- Institute of Advanced Cyberspace Technology, Guangzhou University, Guangzhou, China
- Department of New Networks, Peng Cheng Laboratory, Shenzhen, China
| | - Guijuan Zhang
- Department of Respiratory Medicine, First Affiliated Hospital of Gannan Medical University, Ganzhou, China
| | - Xingting Qiu
- Department of Radiology, First Affiliated Hospital of Gannan Medical University, Ganzhou, China
| | - Wenjun Tan
- Key Laboratory of Intelligent Computing in Medical Image, Ministry of Education, Shenyang, China
| | - Xiaoxia Yin
- Institute of Advanced Cyberspace Technology, Guangzhou University, Guangzhou, China
| | - Liefa Liao
- School of Information Engineering, Jiangxi University of Science and Technology, Ganzhou, China
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Tardy M, Mateus D. Leveraging Multi-Task Learning to Cope With Poor and Missing Labels of Mammograms. FRONTIERS IN RADIOLOGY 2022; 1:796078. [PMID: 37492176 PMCID: PMC10365086 DOI: 10.3389/fradi.2021.796078] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/15/2021] [Accepted: 12/06/2021] [Indexed: 07/27/2023]
Abstract
In breast cancer screening, binary classification of mammograms is a common task aiming to determine whether a case is malignant or benign. A Computer-Aided Diagnosis (CADx) system based on a trainable classifier requires clean data and labels coming from a confirmed diagnosis. Unfortunately, such labels are not easy to obtain in clinical practice, since the histopathological reports of biopsy may not be available alongside mammograms, while normal cases may not have an explicit follow-up confirmation. Such ambiguities result either in reducing the number of samples eligible for training or in a label uncertainty that may decrease the performances. In this work, we maximize the number of samples for training relying on multi-task learning. We design a deep-neural-network-based classifier yielding multiple outputs in one forward pass. The predicted classes include binary malignancy, cancer probability estimation, breast density, and image laterality. Since few samples have all classes available and confirmed, we propose to introduce the uncertainty related to the classes as a per-sample weight during training. Such weighting prevents updating the network's parameters when training on uncertain or missing labels. We evaluate our approach on the public INBreast and private datasets, showing statistically significant improvements compared to baseline and independent state-of-the-art approaches. Moreover, we use mammograms from Susan G. Komen Tissue Bank for fine-tuning, further demonstrating the ability to improve the performances in our multi-task learning setup from raw clinical data. We achieved the binary classification performance of AUC = 80.46 on our private dataset and AUC = 85.23 on the INBreast dataset.
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Affiliation(s)
- Mickael Tardy
- Ecole Centrale de Nantes, LS2N, UMR CNRS 6004, Nantes, France
- Hera-MI SAS, Saint-Herblain, France
| | - Diana Mateus
- Ecole Centrale de Nantes, LS2N, UMR CNRS 6004, Nantes, France
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17
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Mridha MF, Hamid MA, Monowar MM, Keya AJ, Ohi AQ, Islam MR, Kim JM. A Comprehensive Survey on Deep-Learning-Based Breast Cancer Diagnosis. Cancers (Basel) 2021; 13:6116. [PMID: 34885225 PMCID: PMC8656730 DOI: 10.3390/cancers13236116] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Revised: 11/25/2021] [Accepted: 12/01/2021] [Indexed: 12/11/2022] Open
Abstract
Breast cancer is now the most frequently diagnosed cancer in women, and its percentage is gradually increasing. Optimistically, there is a good chance of recovery from breast cancer if identified and treated at an early stage. Therefore, several researchers have established deep-learning-based automated methods for their efficiency and accuracy in predicting the growth of cancer cells utilizing medical imaging modalities. As of yet, few review studies on breast cancer diagnosis are available that summarize some existing studies. However, these studies were unable to address emerging architectures and modalities in breast cancer diagnosis. This review focuses on the evolving architectures of deep learning for breast cancer detection. In what follows, this survey presents existing deep-learning-based architectures, analyzes the strengths and limitations of the existing studies, examines the used datasets, and reviews image pre-processing techniques. Furthermore, a concrete review of diverse imaging modalities, performance metrics and results, challenges, and research directions for future researchers is presented.
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Affiliation(s)
- Muhammad Firoz Mridha
- Department of Computer Science and Engineering, Bangladesh University of Business and Technology, Dhaka 1216, Bangladesh; (M.F.M.); (A.J.K.); (A.Q.O.)
| | - Md. Abdul Hamid
- Department of Information Technology, Faculty of Computing & Information Technology, King Abdulaziz University, Jeddah 21589, Saudi Arabia; (M.A.H.); (M.M.M.)
| | - Muhammad Mostafa Monowar
- Department of Information Technology, Faculty of Computing & Information Technology, King Abdulaziz University, Jeddah 21589, Saudi Arabia; (M.A.H.); (M.M.M.)
| | - Ashfia Jannat Keya
- Department of Computer Science and Engineering, Bangladesh University of Business and Technology, Dhaka 1216, Bangladesh; (M.F.M.); (A.J.K.); (A.Q.O.)
| | - Abu Quwsar Ohi
- Department of Computer Science and Engineering, Bangladesh University of Business and Technology, Dhaka 1216, Bangladesh; (M.F.M.); (A.J.K.); (A.Q.O.)
| | - Md. Rashedul Islam
- Department of Computer Science and Engineering, University of Asia Pacific, Dhaka 1216, Bangladesh;
| | - Jong-Myon Kim
- Department of Electrical, Electronics, and Computer Engineering, University of Ulsan, Ulsan 680-749, Korea
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He X, Deng Y, Fang L, Peng Q. Multi-Modal Retinal Image Classification With Modality-Specific Attention Network. IEEE TRANSACTIONS ON MEDICAL IMAGING 2021; 40:1591-1602. [PMID: 33625978 DOI: 10.1109/tmi.2021.3059956] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Recently, automatic diagnostic approaches have been widely used to classify ocular diseases. Most of these approaches are based on a single imaging modality (e.g., fundus photography or optical coherence tomography (OCT)), which usually only reflect the oculopathy to a certain extent, and neglect the modality-specific information among different imaging modalities. This paper proposes a novel modality-specific attention network (MSAN) for multi-modal retinal image classification, which can effectively utilize the modality-specific diagnostic features from fundus and OCT images. The MSAN comprises two attention modules to extract the modality-specific features from fundus and OCT images, respectively. Specifically, for the fundus image, ophthalmologists need to observe local and global pathologies at multiple scales (e.g., from microaneurysms at the micrometer level, optic disc at millimeter level to blood vessels through the whole eye). Therefore, we propose a multi-scale attention module to extract both the local and global features from fundus images. Moreover, large background regions exist in the OCT image, which is meaningless for diagnosis. Thus, a region-guided attention module is proposed to encode the retinal layer-related features and ignore the background in OCT images. Finally, we fuse the modality-specific features to form a multi-modal feature and train the multi-modal retinal image classification network. The fusion of modality-specific features allows the model to combine the advantages of fundus and OCT modality for a more accurate diagnosis. Experimental results on a clinically acquired multi-modal retinal image (fundus and OCT) dataset demonstrate that our MSAN outperforms other well-known single-modal and multi-modal retinal image classification methods.
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Jiang M, Han L, Sun H, Li J, Bao N, Li H, Zhou S, Yu T. Cross-modality image feature fusion diagnosis in breast cancer. Phys Med Biol 2021; 66. [PMID: 33784653 DOI: 10.1088/1361-6560/abf38b] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Accepted: 03/30/2021] [Indexed: 01/22/2023]
Abstract
Considering the complementarity of mammography and breast MRI, the research of feature fusion diagnosis based on cross-modality images was explored to improve the accuracy of breast cancer diagnosis. 201 patients with both mammography and breast MRI were collected retrospectively, including 117 cases of benign lesions and 84 cases of malignant ones. Two feature optimization strategies of sequential floating forward selection (SFFS), SFFS-1 and SFFS-2, were defined based on the sequential floating forward selection method. Each strategy was used to analyze the diagnostic performance of single-modality images and then to study the feature fusion diagnosis of cross-modality images. Three feature fusion approaches were compared: optimizing MRI features and then fusing those of mammography; optimizing mammography features and then fusing those of MRI; selecting the effective features from the whole feature set (mammography and MRI). Support vector machine, Naive Bayes, and K-nearest neighbor were employed as the classifiers and were finally integrated to get better performance. The average accuracy and area under the ROC curve (AUC) of MRI (88.56%, 0.9 for SFFS-1, 88.39%, 0.89 for SFFS-2) were better than mammography (84.25%, 0.84 for SFFS-1, 80.43%, 0.80 for SFFS-2). Furthermore, compared with a single modality, the average accuracy and AUC of cross-modality feature fusion can improve from 85.40% and 0.86 to 89.66% and 0.91. Classifier integration improved the accuracy and AUC from 90.49%, 0.92 to 92.37%, and 0.97. Cross-modality image feature fusion can achieve better diagnosis performance than a single modality. Feature selection strategy SFFS-1 has better efficiency than SFFS-2. Classifier integration can further improve diagnostic accuracy.
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Affiliation(s)
- Mingkuan Jiang
- College of Medicine and Biological Information Engineering, Northeastern University, Shenyang, People's Republic of China
| | - Lu Han
- Department of Radiology, Cancer Hospital of China Medical University, Liaoning Cancer Hospital & Institute, Shenyang, People's Republic of China
| | - Hang Sun
- College of Medicine and Biological Information Engineering, Northeastern University, Shenyang, People's Republic of China
| | - Jing Li
- Department of Radiology, Affiliated Hospital of Guizhou Medical University, Guiyang, People's Republic of China
| | - Nan Bao
- College of Medicine and Biological Information Engineering, Northeastern University, Shenyang, People's Republic of China
| | - Hong Li
- College of Medicine and Biological Information Engineering, Northeastern University, Shenyang, People's Republic of China
| | - Shi Zhou
- Department of Radiology, Affiliated Hospital of Guizhou Medical University, Guiyang, People's Republic of China
| | - Tao Yu
- Department of Radiology, Cancer Hospital of China Medical University, Liaoning Cancer Hospital & Institute, Shenyang, People's Republic of China
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Hou X, Bai Y, Xie Y, Li Y. Mass segmentation for whole mammograms via attentive multi-task learning framework. Phys Med Biol 2021; 66. [PMID: 33882475 DOI: 10.1088/1361-6560/abfa35] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2020] [Accepted: 04/21/2021] [Indexed: 01/19/2023]
Abstract
Mass segmentation in the mammogram is a necessary and challenging task in the computer-aided diagnosis of breast cancer. Most of the existing methods tended to segment the mass by manually or automatically extracting mass-centered image patches. However, manual patch extraction is time-consuming, and automatic patch extraction can introduce errors that will affect the performance of subsequent segmentation.In order to improve the efficiency of mass segmentation and reduce segmentation errors, we proposed a novel mass segmentation method based on an attentive multi-task learning network (MTLNet), which is an end-to-end model to accurately segment mass in the whole mammogram directly, without the need for extraction in advance with the center of mass image patch. In MTLNet, we applied group convolution to the feature extraction network, which not only reduced the redundancy of the network but also improved the capacity of feature learning. Secondly, an attention mechanism is added to the backbone to highlight the feature channels that contain rich information. Eventually, the multi-task learning framework is employed in the model, which reduces the risk of model overfitting and enables the model not only to segment the mass but also to classify and locate the mass. We \hl{used five-fold cross validation to evaluate the performance of the proposed method under detection and segmentation tasks respectively on the two public mammographic datasets INbreast and CBIS-DDSM, and our method achieved the Dice index of 0.826 on INbreast and 0.863 on CBIS-DDSM.
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Affiliation(s)
- Xuan Hou
- Northwestern Polytechnical University, Xi'an, 710072, CHINA
| | - Yunpeng Bai
- Northwestern Polytechnical University, Xi'an, CHINA
| | - Yefan Xie
- Northwestern Polytechnical University, Xi'an, CHINA
| | - Ying Li
- Northwestern Polytechnical University, Xi'an, CHINA
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