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Objective: This retrospective study aims to assess the role of pre-contrast sequences of an MRI-guided breast biopsy (MRIB) exam in confident and accurate lesion site localization based on tissue landmarks. Methods: The charts of all consecutives MRIB that were performed between January 2018 and December 2020 were reviewed. The images of the eligible exams were analyzed by 3 breast radiologists. Each radiologist independently attempted to identify lesion site on pre-contrast MRIB sequences, while blinded to the post-contrast MRIB images. Confidence levels (I-confident, II-not confident, and III-unknown) were assigned by each reviewer. A fourth radiologist assessed the accuracy (≤5 mm-accurate, >5 mm-inaccurate) in lesion site localization using the actual biopsied lesion site and the post-contrast MRIB images as reference. Descriptive statistics were used to calculate the percentage of confidence and accuracy categories for each reviewer, with Chi-square tests applied to analyze relationships between categorical variables. Results: There were 174 female patients with 181 lesions eligible for the trial. When the lesion site is confidently identified on the pre-contrast MRIB images (level 1 confidence), mean grade 1 accuracy was 93.8% (P < .001). Accuracy decreased with Level II and III confidence (55.3% and 34.2% respectively). Up to 61.4% improved accuracy was demonstrated when combining the performance of 2 reviewers. No correlation was found between breast density, lesion morphology, or biopsy positioning with confidence level or accuracy grade. Conclusion: Careful review of the pre-contrast MRIB images and familiarization with the surrounding tissue landmarks are important steps in confidently and accurately detecting lesion site.

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In recent years, deep learning has been used to develop an automatic breast cancer detection and classification tool to assist doctors. In this paper, we proposed a three-stage deep learning framework based on an anchor-free object detection algorithm, named the Probabilistic Anchor Assignment (PAA) to improve diagnosis performance by automatically detecting breast lesions (i.e., mass and calcification) and further classifying mammograms into benign or malignant. Firstly, a single-stage PAA-based detector roundly finds suspicious breast lesions in mammogram. Secondly, we designed a two-branch ROI detector to further classify and regress these lesions that aim to reduce the number of false positives. Besides, in this stage, we introduced a threshold-adaptive post-processing algorithm with dense breast information. Finally, the benign or malignant lesions would be classified by an ROI classifier which combines local-ROI features and global-image features. In addition, considering the strong correlation between the task of detection head of PAA and the task of whole mammogram classification, we added an image classifier that utilizes the same global-image features to perform image classification. The image classifier and the ROI classifier jointly guide to enhance the feature extraction ability and further improve the performance of classification. We integrated three public datasets of mammograms (CBIS-DDSM, INbreast, MIAS) to train and test our model and compared our framework with recent state-of-the-art methods. The results show that our proposed method can improve the diagnostic efficiency of radiologists by automatically detecting and classifying breast lesions and classifying benign and malignant mammograms.

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Recently, a novel microwave apparatus for breast lesion detection (MammoWave), uniquely able to function in air with 2 antennas rotating in the azimuth plane and operating within the band 1-9 GHz has been developed. Machine learning (ML) has been implemented to understand information from the frequency spectrum collected through MammoWave in response to the stimulus, segregating breasts with and without lesions. The study comprises 61 breasts (from 35 patients), each one with the correspondent output of the radiologist's conclusion (i.e., gold standard) obtained from echography and/or mammography and/or MRI, plus pathology or 1-year clinical follow-up when required. The MammoWave examinations are performed, recording the frequency spectrum, where the magnitudes show substantial discrepancy and reveals dissimilar behaviours when reflected from tissues with/without lesions. Principal component analysis is implemented to extract the unique quantitative response from the frequency response for automated breast lesion identification, engaging the support vector machine (SVM) with a radial basis function kernel. In-vivo feasibility validation (now ended) of MammoWave was approved in 2015 by the Ethical Committee of Umbria, Italy (N. 6845/15/AV/DM of 14 October 2015, N. 10352/17/NCAV of 16 March 2017, N 13203/18/NCAV of 17 April 2018). Here, we used a set of 35 patients. According to the radiologists conclusions, 25 breasts without lesions and 36 breasts with lesions underwent a MammoWave examination. The proposed SVM model achieved the accuracy, sensitivity, and specificity of 91%, 84.40%, and 97.20%. The proposed ML augmented MammoWave can identify breast lesions with high accuracy.

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PURPOSE: We propose a deep learning-based computer-aided detection (CADe) method to detect breast lesions in ultrafast DCE-MRI sequences. This method uses both the 3D spatial information and temporal information obtained from the early-phase of the dynamic acquisition. METHODS: The proposed CADe method, based on a modified 3D RetinaNet model, operates on ultrafast T1 weighted sequences, which are preprocessed for motion compensation, temporal normalization, and are cropped before passing into the model. The model is optimized to enable the detection of relatively small breast lesions in a screening setting, focusing on detection of lesions that are harder to differentiate from confounding structures inside the breast. RESULTS: The method was developed based on a dataset consisting of 489 ultrafast MRI studies obtained from 462 patients containing a total of 572 lesions (365 malignant, 207 benign) and achieved a detection rate, sensitivity, and detection rate of benign lesions of 0.90 (0.876-0.934), 0.95 (0.934-0.980), and 0.81 (0.751-0.871) at four false positives per normal breast with 10-fold cross-testing, respectively. CONCLUSIONS: The deep learning architecture used for the proposed CADe application can efficiently detect benign and malignant lesions on ultrafast DCE-MRI. Furthermore, utilizing the less visible hard-to-detect lesions in training improves the learning process and, subsequently, detection of malignant breast lesions.

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BACKGROUND: Computer-aided diagnosis (CAD) in the medical field has received more and more attention in recent years. One important CAD application is to detect and classify breast lesions in ultrasound images. Traditionally, the process of CAD for breast lesions classification is mainly composed of two separated steps: i) locate the lesion region of interests (ROI); ii) classify the located region of interests (ROI) to see if they are benign or not. However, due to the complex structure of breast and the existence of noise in the ultrasound images, traditional handcrafted feature based methods usually can not achieve satisfactory result. METHODS: With the recent advance of deep learning, the performance of object detection and classification has been boosted to a great extent. In this paper, we aim to systematically evaluate the performance of several existing state-of-the-art object detection and classification methods for breast lesions CAD. To achieve that, we have collected a new dataset consisting of 579 benign and 464 malignant lesion cases with the corresponding ultrasound images manually annotated by experienced clinicians. We evaluate different deep learning architectures and conduct comprehensive experiments on our newly collected dataset. RESULTS: For the lesion regions detecting task, Single Shot MultiBox Detector with the input size as 300×300 (SSD300) achieves the best performance in terms of average precision rate (APR), average recall rate (ARR) and F1 score. For the classification task, DenseNet is more suitable for our problems. CONCLUSIONS: Our experiments reveal that better and more efficient detection and convolutional neural network (CNN) frameworks is one important factor for better performance of detecting and classification task of the breast lesion. Another significant factor for improving the performance of detecting and classification task, which is transfer learning from the large-scale annotated ImageNet to classify breast lesion.

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PURPOSE: The purpose of this study was to assess the potential of a deep learning model to discriminate between benign and malignant breast lesions using magnetic resonance imaging (MRI) and characterize different histological subtypes of breast lesions. MATERIALS AND METHODS: We developed a deep learning model that simultaneously learns to detect lesions and characterize them. We created a lesion-characterization model based on a single two-dimensional T1-weighted fat suppressed MR image obtained after intravenous administration of a gadolinium chelate selected by radiologists. The data included 335 MR images from 335 patients, representing 17 different histological subtypes of breast lesions grouped into four categories (mammary gland, benign lesions, invasive ductal carcinoma and other malignant lesions). Algorithm performance was evaluated on an independent test set of 168 MR images using weighted sums of the area under the curve (AUC) scores. RESULTS: We obtained a cross-validation score of 0.817 weighted average receiver operating characteristic (ROC)-AUC on the training set computed as the mean of three-shuffle three-fold cross-validation. Our model reached a weighted mean AUC of 0.816 on the independent challenge test set. CONCLUSION: This study shows good performance of a supervised-attention model with deep learning for breast MRI. This method should be validated on a larger and independent cohort.

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