RESUMEN
Purpose: Evaluation of the performance of a computer-aided diagnosis (CAD) system based on the quantified color distribution in strain elastography imaging to evaluate the malignancy of breast tumors. Methods: The database consisted of 31 malignant and 52 benign lesions. A radiologist who was blinded to the diagnosis performed the visual analysis of the lesions. After six months with no eye contact on the breast images, the same radiologist and other two radiologists manually drew the contour of the lesions in B-mode ultrasound, which was masked in the elastography image. In order to measure the amount of hard tissue in a lesion, we developed a CAD system able to identify the amount of hard tissue, represented by red color, and quantify its predominance in a lesion, allowing classification as soft, intermediate, or hard. The data obtained with the CAD system were compared with the visual analysis. We calculated the sensitivity, specificity, and area under the curve (AUC) for the classification using the CAD system from the manual delineation of the contour by each radiologist. Results: The performance of the CAD system for the most experienced radiologist achieved sensitivity of 70.97%, specificity of 88.46%, and AUC of 0.853. The system presented better performance compared with his visual diagnosis, whose sensitivity, specificity, and AUC were 61.29%, 88.46%, and 0.829, respectively. The system obtained sensitivity, specificity, and AUC of 67.70%, 84.60%, and 0.783, respectively, for images segmented by Radiologist 2, and 51.60%, 92.30%, and 0.771, respectively, for those segmented by the Resident. The intra-class correlation coefficient was 0.748. The inter-observer agreement of the CAD system with the different contours was good in all comparisons. Conclusions: The proposed CAD system can improve the radiologist performance for classifying breast masses, with excellent inter-observer agreement. It could be a promising tool for clinical use.
RESUMEN
This research presents a methodology for the automatic detection and characterization of breast sonographic findings. We performed the tests in ultrasound images obtained from breast phantoms made of tissue mimicking material. When the results were considerable, we applied the same techniques to clinical examinations. The process was started employing preprocessing (Wiener filter, equalization, and median filter) to minimize noise. Then, five segmentation techniques were investigated to determine the most concise representation of the lesion contour, enabling us to consider the neural network SOM as the most relevant. After the delimitation of the object, the most expressive features were defined to the morphological description of the finding, generating the input data to the neural Multilayer Perceptron (MLP) classifier. The accuracy achieved during training with simulated images was 94.2%, producing an AUC of 0.92. To evaluating the data generalization, the classification was performed with a group of unknown images to the system, both to simulators and to clinical trials, resulting in an accuracy of 90% and 81%, respectively. The proposed classifier proved to be an important tool for the diagnosis in breast ultrasound.