Showing papers on "Mammography published in 2021"

Robust breast cancer detection in mammography and digital breast tomosynthesis using an annotation-efficient deep learning approach.

Abstract: Breast cancer remains a global challenge, causing over 600,000 deaths in 2018 (ref. 1). To achieve earlier cancer detection, health organizations worldwide recommend screening mammography, which is estimated to decrease breast cancer mortality by 20–40% (refs. 2,3). Despite the clear value of screening mammography, significant false positive and false negative rates along with non-uniformities in expert reader availability leave opportunities for improving quality and access4,5. To address these limitations, there has been much recent interest in applying deep learning to mammography6–18, and these efforts have highlighted two key difficulties: obtaining large amounts of annotated training data and ensuring generalization across populations, acquisition equipment and modalities. 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 patients with cancer, (4) generalizes well to a population with low screening rates and (5) outperforms five out of five full-time breast-imaging specialists with an average increase in sensitivity of 14%. By creating new ‘maximum suspicion projection’ (MSP) images from DBT data, our progressively trained, multiple-instance learning approach effectively trains on DBT exams using only breast-level labels while maintaining localization-based interpretability. Altogether, our results demonstrate promise towards software that can improve the accuracy of and access to screening mammography worldwide. A generalizable and interpretable artificial-intelligence system achieves clinical accuracy for screening and early breast-cancer detection on 2D and 3D mammograms.

Deep learning in mammography images segmentation and classification: Automated CNN approach

Abstract: In this work, a new framework for breast cancer image segmentation and classification is proposed. Different models including InceptionV3, DenseNet121, ResNet50, VGG16 and MobileNetV2 models, are applied to classify Mammographic Image Analysis Society (MIAS), Digital Database for Screening Mammography (DDSM) and the Curated Breast Imaging Subset of DDSM (CBIS-DDSM) into benign and malignant. Moreover, the trained modified U-Net model is utilized to segment breast area from the mammogram images. This method will aid as a radiologist's assistant in early detection and improve the efficiency of our system. The Cranio Caudal (CC) vision and Mediolateral Oblique (MLO) view are widely used for the identification and diagnosis of breast cancer. The accuracy of breast cancer diagnosis will be improved as the number of views is increased. Our proposed frame work is based on MLO view and CC view to enhance the system performance. In addition, the lack of tagged data is a big challenge. Transfer learning and data augmentation are applied to overcome this problem. Three mammographic datasets; MIAS, DDSM and CBIS-DDSM, are utilized in our evaluation. End-to-end fully convolutional neural networks (CNNs) are introduced in this paper. The proposed technique of applying data augmentation with modified U-Net model and InceptionV3 achieves the best result, specifically with the DDSM dataset. This achieves 98.87% accuracy, 98.88% area under the curve (AUC), 98.98% sensitivity, 98.79% precision, 97.99% F1 score, and a computational time of 1.2134 s on DDSM datasets.

Contrast-enhanced Mammography: State of the Art.

Abstract: Contrast-enhanced mammography (CEM) has emerged as a viable alternative to contrast-enhanced breast MRI, and it may increase access to vascular imaging while reducing examination cost. Intravenous iodinated contrast materials are used in CEM to enhance the visualization of tumor neovascularity. After injection, imaging is performed with dual-energy digital mammography, which helps provide a low-energy image and a recombined or iodine image that depict enhancing lesions in the breast. CEM has been demonstrated to help improve accuracy compared with digital mammography and US in women with abnormal screening mammographic findings or symptoms of breast cancer. It has also been demonstrated to approach the accuracy of breast MRI in preoperative staging of patients with breast cancer and in monitoring response after neoadjuvant chemotherapy. There are early encouraging results from trials evaluating CEM in the screening of women who are at an increased risk of breast cancer. Although CEM is a promising tool, it slightly increases radiation dose and carries a small risk of adverse reactions to contrast materials. This review details the CEM technique, diagnostic and screening uses, and future applications, including artificial intelligence and radiomics.

Toward robust mammography-based models for breast cancer risk.

Abstract: Improved breast cancer risk models enable targeted screening strategies that achieve earlier detection and less screening harm than existing guidelines. To bring deep learning risk models to clinical practice, we need to further refine their accuracy, validate them across diverse populations, and demonstrate their potential to improve clinical workflows. We developed Mirai, a mammography-based deep learning model designed to predict risk at multiple timepoints, leverage potentially missing risk factor information, and produce predictions that are consistent across mammography machines. Mirai was trained on a large dataset from Massachusetts General Hospital (MGH) in the United States and tested on held-out test sets from MGH, Karolinska University Hospital in Sweden, and Chang Gung Memorial Hospital (CGMH) in Taiwan, obtaining C-indices of 0.76 (95% confidence interval, 0.74 to 0.80), 0.81 (0.79 to 0.82), and 0.79 (0.79 to 0.83), respectively. Mirai obtained significantly higher 5-year ROC AUCs than the Tyrer-Cuzick model ( P < 0.001) and prior deep learning models Hybrid DL ( P < 0.001) and Image-Only DL ( P < 0.001), trained on the same dataset. Mirai more accurately identified high-risk patients than prior methods across all datasets. On the MGH test set, 41.5% (34.4 to 48.5) of patients who would develop cancer within 5 years were identified as high risk, compared with 36.1% (29.1 to 42.9) by Hybrid DL ( P = 0.02) and 22.9% (15.9 to 29.6) by the Tyrer-Cuzick model ( P < 0.001).

Impact of the COVID-19 Pandemic on Breast Cancer Mortality in the US: Estimates From Collaborative Simulation Modeling.

Abstract: Background The coronavirus disease 2019 (COVID-19) pandemic has disrupted breast cancer control through short-term declines in screening and delays in diagnosis and treatments. We projected the impact of COVID-19 on future breast cancer mortality between 2020 and 2030. Methods Three established Cancer Intervention and Surveillance Modeling Network breast cancer models modeled reductions in mammography screening use, delays in symptomatic cancer diagnosis, and reduced use of chemotherapy for women with early-stage disease for the first 6 months of the pandemic with return to prepandemic patterns after that time. Sensitivity analyses were performed to determine the effect of key model parameters, including the duration of the pandemic impact. Results By 2030, the models project 950 (model range = 860-1297) cumulative excess breast cancer deaths related to reduced screening, 1314 (model range = 266-1325) associated with delayed diagnosis of symptomatic cases, and 151 (model range = 146-207) associated with reduced chemotherapy use in women with hormone positive, early-stage cancer. Jointly, 2487 (model range = 1713-2575) excess breast cancer deaths were estimated, representing a 0.52% (model range = 0.36%-0.56%) cumulative increase over breast cancer deaths expected by 2030 in the absence of the pandemic's disruptions. Sensitivity analyses indicated that the breast cancer mortality impact would be approximately double if the modeled pandemic effects on screening, symptomatic diagnosis, and chemotherapy extended for 12 months. Conclusions Initial pandemic-related disruptions in breast cancer care will have a small long-term cumulative impact on breast cancer mortality. Continued efforts to ensure prompt return to screening and minimize delays in evaluation of symptomatic women can largely mitigate the effects of the initial pandemic-associated disruptions.

Identifying normal mammograms in a large screening population using artificial intelligence

Abstract: To evaluate the potential of artificial intelligence (AI) to identify normal mammograms in a screening population. In this retrospective study, 9581 double-read mammography screening exams including 68 screen-detected cancers and 187 false positives, a subcohort of the prospective population-based Malmo Breast Tomosynthesis Screening Trial, were analysed with a deep learning–based AI system. The AI system categorises mammograms with a cancer risk score increasing from 1 to 10. The effect on cancer detection and false positives of excluding mammograms below different AI risk thresholds from reading by radiologists was investigated. A panel of three breast radiologists assessed the radiographic appearance, type, and visibility of screen-detected cancers assigned low-risk scores (≤ 5). The reduction of normal exams, cancers, and false positives for the different thresholds was presented with 95% confidence intervals (CI). If mammograms scored 1 and 2 were excluded from screen-reading, 1829 (19.1%; 95% CI 18.3–19.9) exams could be removed, including 10 (5.3%; 95% CI 2.1–8.6) false positives but no cancers. In total, 5082 (53.0%; 95% CI 52.0–54.0) exams, including 7 (10.3%; 95% CI 3.1–17.5) cancers and 52 (27.8%; 95% CI 21.4–34.2) false positives, had low-risk scores. All, except one, of the seven screen-detected cancers with low-risk scores were judged to be clearly visible. The evaluated AI system can correctly identify a proportion of a screening population as cancer-free and also reduce false positives. Thus, AI has the potential to improve mammography screening efficiency. • Retrospective study showed that AI can identify a proportion of mammograms as normal in a screening population. • Excluding normal exams from screening using AI can reduce false positives.

Breast Cancer Screening Recommendations Inclusive of All Women at Average Risk: Update from the ACR and Society of Breast Imaging

Abstract: Breast cancer remains the most common nonskin cancer, the second leading cause of cancer deaths, and the leading cause of premature death in US women. Mammography screening has been proven effective in reducing breast cancer deaths in women age 40 years and older. A mortality reduction of 40% is possible with regular screening. Treatment advances cannot overcome the disadvantage of being diagnosed with an advanced-stage tumor. The ACR and Society of Breast Imaging recommend annual mammography screening beginning at age 40, which provides the greatest mortality reduction, diagnosis at earlier stage, better surgical options, and more effective chemotherapy. Annual screening results in more screening-detected tumors, tumors of smaller sizes, and fewer interval cancers than longer screening intervals. Screened women in their 40s are more likely to have early-stage disease, negative lymph nodes, and smaller tumors than unscreened women. Delaying screening until age 45 or 50 will result in an unnecessary loss of life to breast cancer and adversely affects minority women in particular. Screening should continue past age 74 years, without an upper age limit unless severe comorbidities limit life expectancy. Benefits of screening should be considered along with the possibilities of recall for additional imaging and benign biopsy and the less tangible risks of anxiety and overdiagnosis. Although recall and biopsy recommendations are higher with more frequent screening, so are life-years gained and breast cancer deaths averted. Women who wish to maximize benefit will choose annual screening starting at age 40 years and will not stop screening prematurely.

Changes in Mammography Use by Women's Characteristics During the First 5 Months of the COVID-19 Pandemic.

Abstract: BACKGROUND: The coronavirus disease 2019 (COVID-19) pandemic led to a near-total cessation of mammography services in the United States in mid-March 2020. It is unclear if screening and diagnostic mammography volumes have recovered to pre-pandemic levels and whether utilization has varied by women's characteristics. METHODS: We collected data on 461,083 screening mammograms and 112,207 diagnostic mammograms conducted during January 2019 through July 2020 at 62 radiology facilities in the Breast Cancer Surveillance Consortium. We compared monthly screening and diagnostic mammography volumes before and during the pandemic, stratified by age, race/ethnicity, breast density, and family history of breast cancer. RESULTS: Screening and diagnostic mammography volumes in April 2020 were 1.1% (95% confidence interval [CI] = 0.5% to 2.4%) and 21.4% (95% CI = 18.7% to 24.4%) of April 2019 pre-pandemic volumes, respectively, but by July 2020 rebounded to 89.7% (95% CI = 79.6% to 101.1%) and 101.6% (95% CI = 93.8% to 110.1%) of July 2019 pre-pandemic volumes, respectively. The year-to-date cumulative volume of screening and diagnostic mammograms performed through July 2020 was 66.2% (95% CI = 60.3% to 72.6%) and 79.9% (95% CI = 75.4% to 84.6%), respectively, of year-to-date volume through July 2019. Screening mammography rebound was similar across age groups and by family history of breast cancer. Monthly screening mammography volume in July 2020 for Black, White, Hispanic, and Asian women reached 96.7% (95% CI = 88.1% to 106.1%), 92.9% (95% CI = 82.9% to 104.0%), 72.7% (95% CI = 56.5% to 93.6%), and 51.3% (95% CI = 39.7% to 66.2%) of July 2019 pre-pandemic volume, respectively. CONCLUSION: Despite a strong overall rebound in mammography volume by July 2020, the rebound lagged among Asian and Hispanic women and a substantial cumulative deficit in missed mammograms accumulated, which may have important health consequences.

AI-based Strategies to Reduce Workload in Breast Cancer Screening with Mammography and Tomosynthesis: A Retrospective Evaluation.

Abstract: Digital mammography and digital breast tomosynthesis screening strategies based on artificial intelligence systems could reduce workload up to 70% without reducing sensitivity by 5% or more.

A CNN-based methodology for breast cancer diagnosis using thermal images

Abstract: A recent study from GLOBOCAN disclosed that during 2018 two million women worldwide had been diagnosed with breast cancer. Currently, mammography, magnetic resonance imaging, ultrasound, and biopsi...

Multi-Institutional Validation of a Mammography-Based Breast Cancer Risk Model.

Abstract: PURPOSEAccurate risk assessment is essential for the success of population screening programs in breast cancer. Models with high sensitivity and specificity would enable programs to target more ela...

Automatic Detection and Classification of Mammograms Using Improved Extreme Learning Machine with Deep Learning

Abstract: Background and objective Breast cancer, the most intrusive form of cancer affecting women globally. Next to lung cancer, breast cancer is the one that provides a greater number of cancer deaths among women. In recent times, several intelligent methodologies were come into existence for building an effective detection and classification of such noxious type of cancer. For further improving the rate of early diagnosis and for increasing the life span of victims, optimistic light of research is essential in breast cancer classification. Accordingly, a new customized method of integrating the concept of deep learning with the extreme learning machine (ELM), which is optimized using a simple crow-search algorithm (ICS-ELM). Thus, to enhance the state-of-the-art workings, an improved deep feature-based crow-search optimized extreme learning machine is proposed for addressing the health-care problem. The paper pours a light-of-research on detecting the input mammograms as either normal or abnormal. Subsequently, it focuses on further classifying the type of abnormal severities i.e., benign type or malignant. Materials and methods The digital mammograms for this work are taken from the Curated Breast Imaging Subset of DDSM (CBIS-DDSM), Mammographic Image Analysis Society (MIAS), and INbreast datasets. Herein, the work employs 570 digital mammograms (250 normal, 200 benign and 120 malignant cases) from CBIS-DDSM dataset, 322 digital mammograms (207 normal, 64 benign and 51 malignant cases) from MIAS database and 179 full-field digital mammograms (66 normal, 56 benign and 57 malignant cases) from INbreast dataset for its evaluation. The work utilizes ResNet-18 based deep extracted features with proposed Improved Crow-Search Optimized Extreme Learning Machine (ICS-ELM) algorithm. Results The proposed work is finally compared with the existing Support Vector Machines (RBF kernel), ELM, particle swarm optimization (PSO) optimized ELM, and crow-search optimized ELM, where the maximum overall classification accuracy is obtained for the proposed method with 97.193% for DDSM, 98.137% for MIAS and 98.266% for INbreast datasets, respectively. Conclusion The obtained results reveal that the proposed Computer-Aided-Diagnosis (CAD) tool is robust for the automatic detection and classification of breast cancer.

Population-level impact of coronavirus disease 2019 on breast cancer screening and diagnostic procedures.

Abstract: Background To understand how health care delays may affect breast cancer detection, the authors quantified changes in breast-related preventive and diagnostic care during the coronavirus disease 2019 (COVID-19) pandemic. Methods Eligible women (N = 39,444) were aged ≥18 years and received a screening mammogram, diagnostic mammogram, or breast biopsy between January 1, 2019 and September 30, 2020, at 7 academic and community breast imaging facilities in North Carolina. Changes in the number of mammography or breast biopsy examinations after March 3, 2020 (the first COVID-19 diagnosis in North Carolina) were evaluated and compared with the expected numbers based on trends between January 1, 2019 and March 2, 2020. Changes in the predicted mean monthly number of examinations were estimated using interrupted time series models. Differences in patient characteristics were tested using least squares means regression. Results Fewer examinations than expected were received after the pandemic's onset. Maximum reductions occurred in March 2020 for screening mammography (-85.1%; 95% CI, -100.0%, -70.0%) and diagnostic mammography (-48.9%; 95% CI, -71.7%, -26.2%) and in May 2020 for biopsies (-40.9%; 95% CI, -57.6%, -24.3%). The deficit decreased gradually, with no significant difference between observed and expected numbers by July 2020 (diagnostic mammography) and August 2020 (screening mammography and biopsy). Several months after the pandemic's onset, women who were receiving care had higher predicted breast cancer risk (screening mammography, P Conclusions Pandemic-associated deficits in the number of breast examinations decreased over time. Utilization differed by breast cancer risk and insurance status, but not by age or race/ethnicity. Long-term studies are needed to clarify the contribution of these trends to breast cancer disparities.

ResNet-SCDA-50 for Breast Abnormality Classification

Abstract: (Aim) Breast cancer is the most common cancer in women and the second most common cancer worldwide. With the rapid advancement of deep learning, the early stages of breast cancer development can be accurately detected by radiologists with the help of artificial intelligence systems. (Method) Based on mammographic imaging, a mainstream clinical breast screening technique, we present a diagnostic system for accurate classification of breast abnormalities based on ResNet-50. To improve the proposed model, we created a new data augmentation framework called SCDA (Scaling and Contrast limited adaptive histogram equalization Data Augmentation). In its procedure, we first conduct the scaling operation to the original training set, followed by applying contrast limited adaptive histogram equalisation (CLAHE) to the scaled training set. By stacking the training set after SCDA with the original training set, we formed a new training set. The network trained by the augmented training set, was coined as ResNet-SCDA-50. Our system, which aims at a binary classification on mammographic images acquired from INbreast and MINI-MIAS, classifies masses, microcalcification as “abnormal”, while normal regions are classified as “normal”. (Results) We present the first attempt to use the image contrast enhancement method as the data augmentation method, resulting in an averaged 98.55 percent specificity and 92.83 percent sensitivity, which gives our best model an overall accuracy of 95.74 percent. (Conclusion) Our proposed method is effective in classifying breast abnormality.

OPTIMAM Mammography Image Database: A Large-Scale Resource of Mammography Images and Clinical Data.

Abstract: The OPTIMAM Mammography Image Database is a sharable resource with processed and unprocessed mammography images from United Kingdom breast screening centers, with annotated cancers and clinical det...

Multi- class classification of breast cancer abnormalities using Deep Convolutional Neural Network (CNN).

Abstract: The real cause of breast cancer is very challenging to determine and therefore early detection of the disease is necessary for reducing the death rate due to risks of breast cancer. Early detection of cancer boosts increasing the survival chance up to 8%. Primarily, breast images emanating from mammograms, X-Rays or MRI are analyzed by radiologists to detect abnormalities. However, even experienced radiologists face problems in identifying features like micro-calcifications, lumps and masses, leading to high false positive and high false negative. Recent advancement in image processing and deep learning create some hopes in devising more enhanced applications that can be used for the early detection of breast cancer. In this work, we have developed a Deep Convolutional Neural Network (CNN) to segment and classify the various types of breast abnormalities, such as calcifications, masses, asymmetry and carcinomas, unlike existing research work, which mainly classified the cancer into benign and malignant, leading to improved disease management. Firstly, a transfer learning was carried out on our dataset using the pre-trained model ResNet50. Along similar lines, we have developed an enhanced deep learning model, in which learning rate is considered as one of the most important attributes while training the neural network. The learning rate is set adaptively in our proposed model based on changes in error curves during the learning process involved. The proposed deep learning model has achieved a performance of 88% in the classification of these four types of breast cancer abnormalities such as, masses, calcifications, carcinomas and asymmetry mammograms.

Automated Breast Mass Classification System Using Deep Learning and Ensemble Learning in Digital Mammogram

Abstract: In recent years, deep learning techniques are employed in the mammography processing field to reduce radiologists’ costs Existing breast mass classification systems are implemented using deep learning technologies such as a Convolutional Neural Network (CNN) CNN based systems have attained higher performance than the machine learning-based systems in the classification task of mammography images, but a few issues still exist Some of these issues are; ignorance of semantic features, analysis limitation to the current patch of images, lost patches in less contrast mammography images, and ambiguity in segmentation These issues lead to increased false information about patches of mammography image, computational cost, decisions based on current patches, and not recovering the variance of patches intensity In turn, breast mass classification systems based on convolutional neural networks produced unsatisfactory classification accuracy To resolve these issues and improve the accuracy of classification on low contrast images, we propose a novel Breast Mass Classification system named BMC It has improved architecture based on a combination of k- mean clustering, Long Short-Term Memory network of Recurrent Neural Network (RNN), CNN, random forest, boosting techniques to classify the breast mass into benign, malignant, and normal Further, the proposed BMC system is compared with existing classification systems using two publicly available datasets of mammographic images Proposed BMC system achieves the sensitivity, specificity, F-measure, and accuracy for the DDSM dataset is 097%, 098%,097%, 096% and for the MIAS dataset is 097%, 097%,098%, and 095% respectively Further Area Under Curve (AUC) rate of the proposed BMC system lies between 094% - 097% for DDSM and 094%-098% for the MIAS dataset The BMC method worked comparably better than other mammography classification schemes that have previously been invented Moreover, the Confidence interval statistical test is also employed to determine the classification accuracy of the BMC system using different configurations and neural network parameters

Assessing Risk of Breast Cancer: A Review of Risk Prediction Models

Abstract: Accurate and individualized breast cancer risk assessment can be used to guide personalized screening and prevention recommendations. Existing risk prediction models use genetic and nongenetic risk factors to provide an estimate of a woman's breast cancer risk and/or the likelihood that she has a BRCA1 or BRCA2 mutation. Each model is best suited for specific clinical scenarios and may have limited applicability in certain types of patients. For example, the Breast Cancer Risk Assessment Tool, which identifies women who would benefit from chemoprevention, is readily accessible and user-friendly but cannot be used in women under 35 years of age or those with prior breast cancer or lobular carcinoma in situ. Emerging research on deep learning-based artificial intelligence (AI) models suggests that mammographic images contain risk indicators that could be used to strengthen existing risk prediction models. This article reviews breast cancer risk factors, describes the appropriate use, strengths, and limitations of each risk prediction model, and discusses the emerging role of AI for risk assessment.

The current status of risk-stratified breast screening

Abstract: Apart from high-risk scenarios such as the presence of highly penetrant genetic mutations, breast screening typically comprises mammography or tomosynthesis strategies defined by age. However, age-based screening ignores the range of breast cancer risks that individual women may possess and is antithetical to the ambitions of personalised early detection. Whilst screening mammography reduces breast cancer mortality, this is at the risk of potentially significant harms including overdiagnosis with overtreatment, and psychological morbidity associated with false positives. In risk-stratified screening, individualised risk assessment may inform screening intensity/interval, starting age, imaging modality used, or even decisions not to screen. However, clear evidence for its benefits and harms needs to be established. In this scoping review, the authors summarise the established and emerging evidence regarding several critical dependencies for successful risk-stratified breast screening: risk prediction model performance, epidemiological studies, retrospective clinical evaluations, health economic evaluations and qualitative research on feasibility and acceptability. Family history, breast density or reproductive factors are not on their own suitable for precisely estimating risk and risk prediction models increasingly incorporate combinations of demographic, clinical, genetic and imaging-related parameters. Clinical evaluations of risk-stratified screening are currently limited. Epidemiological evidence is sparse, and randomised trials only began in recent years.

Impact of artificial intelligence support on accuracy and reading time in breast tomosynthesis image interpretation: a multi-reader multi-case study

Abstract: Digital breast tomosynthesis (DBT) increases sensitivity of mammography and is increasingly implemented in breast cancer screening. However, the large volume of images increases the risk of reading errors and reading time. This study aims to investigate whether the accuracy of breast radiologists reading wide-angle DBT increases with the aid of an artificial intelligence (AI) support system. Also, the impact on reading time was assessed and the stand-alone performance of the AI system in the detection of malignancies was compared to the average radiologist. A multi-reader multi-case study was performed with 240 bilateral DBT exams (71 breasts with cancer lesions, 70 breasts with benign findings, 339 normal breasts). Exams were interpreted by 18 radiologists, with and without AI support, providing cancer suspicion scores per breast. Using AI support, radiologists were shown examination-based and region-based cancer likelihood scores. Area under the receiver operating characteristic curve (AUC) and reading time per exam were compared between reading conditions using mixed-models analysis of variance. On average, the AUC was higher using AI support (0.863 vs 0.833; p = 0.0025). Using AI support, reading time per DBT exam was reduced (p < 0.001) from 41 (95% CI = 39–42 s) to 36 s (95% CI = 35– 37 s). The AUC of the stand-alone AI system was non-inferior to the AUC of the average radiologist (+0.007, p = 0.8115). Radiologists improved their cancer detection and reduced reading time when evaluating DBT examinations using an AI reading support system. • Radiologists improved their cancer detection accuracy in digital breast tomosynthesis (DBT) when using an AI system for support, while simultaneously reducing reading time. • The stand-alone breast cancer detection performance of an AI system is non-inferior to the average performance of radiologists for reading digital breast tomosynthesis exams. • The use of an AI support system could make advanced and more reliable imaging techniques more accessible and could allow for more cost-effective breast screening programs with DBT.

Automatic computer-aided diagnosis system for mass detection and classification in mammography

Abstract: Mammography is currently the most powerful technique for early detection of breast cancer. To assist radiologists to better interpret mammogram images, computer-aided detection and diagnosis (CAD) systems have been proposed. This paper proposes a complete CAD system for mass detection and diagnosis, which consists of four steps. The first step consists of the preprocessing where the image is enhanced and the noise removed. In the second step, the abnormalities are segmented using the proposed HRAK algorithm. In the third step, the false positives are reduced using texture and shape features and the bagged trees classifier. Finally, the support vector machine (SVM) is used to classify the abnormalities as malignant or benign. The proposed CAD system is verified with both the MIAS and CBIS-DDSM databases. The experimental results proved to be successful. The accuracy detection rate achieves 93,15% for sensitivity and 0,467 FPPI for MIAS and 90,85% for sensitivity and 0,65 FPPI for CBIS-DDSM. The accuracy classification rate achieves 94,2% and the AUC 0,95 for MIAS and 90,44% and 0,9 for CBIS-DDSM.

Screening Algorithms in Dense Breasts: AJR Expert Panel Narrative Review.

Abstract: Screening mammography reduces breast cancer mortality; however, when used to examine women with dense breasts, its performance and resulting benefits are reduced. Increased breast density is an independent risk factor for breast cancer. Digital breast tomosynthesis (DBT), ultrasound (US), molecular breast imaging (MBI), MRI, and contrast-enhanced mammography (CEM) each have shown improved cancer detection in dense breasts when compared with 2D digital mammography (DM). DBT is the preferred mammographic technique for producing a simultaneous reduction in recalls (i.e., additional imaging). US further increases cancer detection after DM or DBT and reduces interval cancers (cancers detected in the interval between recommended screening examinations), but it also produces substantial additional false-positive findings. MBI improves cancer detection with an effective radiation dose that is approximately fourfold that of DM or DBT but is still within accepted limits. MRI provides the greatest increase in cancer detection and reduces interval cancers and late-stage disease; abbreviated techniques will reduce cost and improve availability. CEM appears to offer performance similar to that of MRI, but further validation is needed. Dense breast notification will soon be a national standard; therefore, understanding the performance of mammography and supplemental modalities is necessary to optimize screening for women with dense breasts.