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Objective. Breast architectural distortion (AD), a common imaging symptom of breast cancer, is associated with a particularly high rate of missed clinical detection. In clinical practice, atypical ADs that lack an obvious radiating appearance constitute most cases, and detection models based on single-view images often exhibit poor performance in detecting such ADs. Existing multi-view deep learning methods have overlooked the correspondence between anatomical structures across different views. Approach. To develop a computer-aided detection (CADe) model for AD detection that effectively utilizes the craniocaudal (CC) and mediolateral oblique (MLO) views of digital breast tomosynthesis (DBT) images, we proposed an anatomic-structure-based multi-view information fusion approach by leveraging the related anatomical structure information between these ipsilateral views. To obtain a representation that can effectively capture the similarity between ADs in images from ipsilateral views, our approach utilizes a Siamese network architecture to extract and compare information from both views. Additionally, we employed a triplet module that utilizes the anatomical structural relationship between the ipsilateral views as supervision information. Main results. Our method achieved a mean true positive fraction (MTPF) of 0.05-2.0, false positives (FPs) per volume of 64.40%, and a number of FPs at 80% sensitivity (FPs@0.8) of 3.5754; this indicates a 6% improvement in MPTF and 16% reduction in FPs@0.8 compared to the state-of-the-art baseline model. Significance. From our experimental results, it can be observed that the anatomic-structure-based fusion of ipsilateral view information contributes significantly to the improvement of CADe model performance for atypical AD detection based on DBT. The proposed approach has the potential to lead to earlier diagnosis and better patient outcomes., (© 2023 Institute of Physics and Engineering in Medicine.)

Objective . In digital breast tomosynthesis (DBT), architectural distortion (AD) is a breast lesion that is difficult to detect. Compared with typical ADs, which have radial patterns, identifying a typical ADs is more difficult. Most existing computer-aided detection (CADe) models focus on the detection of typical ADs. This study focuses on atypical ADs and develops a deep learning-based CADe model with an adaptive receptive field in DBT. Approach . Our proposed model uses a Gabor filter and convergence measure to depict the distribution of fibroglandular tissues in DBT slices. Subsequently, two-dimensional (2D) detection is implemented using a deformable-convolution-based deep learning framework, in which an adaptive receptive field is introduced to extract global features in slices. Finally, 2D candidates are aggregated to form the three-dimensional AD detection results. The model is trained on 99 positive cases with ADs and evaluated on 120 AD-positive cases and 100 AD-negative cases. Main results . A convergence-measure-based model and deep-learning model without an adaptive receptive field are reproduced as controls. Their mean true positive fractions (MTPF) ranging from 0.05 to 4 false positives per volume are 0.3846 ± 0.0352 and 0.6501 ± 0.0380, respectively. Our proposed model achieves an MTPF of 0.7148 ± 0.0322, which is a significant improvement ( p < 0.05) compared with the other two methods. In particular, our model detects more atypical ADs, primarily contributing to the performance improvement. Significance . The adaptive receptive field helps the model improve the atypical AD detection performance. It can help radiologists identify more ADs in breast cancer screening., (© 2023 Institute of Physics and Engineering in Medicine.)

Computer aided detection (CADe) for breast lesions can provide an important reference for radiologists in breast cancer screening. Architectural distortion (AD) is a type of breast lesion that is difficult to detect. A majority of CADe methods focus on detecting the radial pattern, which is a main characteristic of typical ADs. However, a few atypical ADs do not exhibit such a pattern. To improve the performance of CADe for typical and atypical ADs, we propose a deep-learning-based model that used mammary gland distribution as prior information to detect ADs in digital breast tomosynthesis (DBT). First, information about gland distribution, including the Gabor magnitude, the Gabor orientation field, and a convergence map, were produced using a bank of Gabor filters and convergence measures. Then, this prior information and an original slice were input into a Faster R-CNN detection network to obtain the 2-D candidates for each slice. Finally, a 3-D aggregation scheme was employed to fuse these 2-D candidates as 3-D candidates for each DBT volume. Retrospectively, 64 typical AD volumes, 74 atypical AD volumes, and 127 normal volumes were collected. Six-fold cross-validation and mean true positive fraction (MTPF) were used to evaluate the model. Compared to an existing convergence-based model, our proposed model achieved an MTPF of 0.53 ± 0.04, 0.61 ± 0.05, and 0.45 ± 0.04 for all DBT volumes, typical + normal volumes, and atypical + normal volumes, respectively. These results were significantly better than those of 0.36 ± 0.03, 0.46 ± 0.04, and 0.28 ± 0.04 for a convergence-based model (p ≪ 0.01). These results indicate that employing the prior information of gland distribution and a deep learning method can improve the performance of CADe for AD.

Objectives To investigate the imaging characteristics and clinicopathological features of rim enhancement of breast masses demonstrated on contrast-enhanced mammography (CEM). Methods 67 cases of breast lesions confirmed by pathology and showing rim enhancement on CEM examinations were analyzed. The lesions were divided into benign and malignant groups, and the morphological and enhanced features were described. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were calculated separately for each morphology descriptor to evaluate the diagnostic ability of each indicator. Results There were 35 (52.2%) malignant and 32 (47.8%) benign lesions. There are significant differences in the morphological and enhanced features between benign and malignant lesions. 29/35 (82.9%) malignant lesions exhibited irregular shapes, and 31/35 (88.6%) showed indistinct margins. 28/35 (80%) malignant lesions displayed strong enhancement on CEM, while 12/32 (37.5%) benign lesions exhibited weak enhancement (P  = 0.001). Malignant lesions showed a higher incidence of unsmooth inner walls than benign lesions (28/35 vs 7/32; P  <.001). Lesion margins showed high sensitivity of 88.57% and NPV of 81.8%. The presence of suspicious calcifications had the highest specificity of 100% and PPV of 100%. The diagnostic sensitivity, specificity, PPV, and NPV of the combined parameters were 97.14%, 93.15%, 94.44%, and 96.77%, respectively. Conclusions The assessment of morphological and enhanced features of breast lesions exhibiting rim enhancement on CEM can improve the differentiation between benign and malignant breast lesions. Advances in knowledge This article provides a reference for the differential diagnosis of ring enhanced lesions on CEM. [ABSTRACT FROM AUTHOR]

Background: In 2020, breast cancer becomes the most leading diagnosed cancer all over the world. The burden is increasing in the prevention and treatment of breast cancer. Accurately detecting breast lesions in screening images is important for early detection of cancer. Architectural distortion (AD) is one of the breast lesions that need to be detected. Purpose: To develop a deep‐learning‐based computer‐aided detection (CADe) model for AD in digital breast tomosynthesis (DBT). This model uses the superior–inferior directional context of DBT and anatomic prior knowledge to reduce false positive (FP). It can identify some negative samples that cannot be distinguished by deep learning features. Methods: The proposed CADe model consists of three steps. In the first step, a deep learning detection network detects two‐dimensional (2D) candidates of ADs in DBT slices with the inputs preprocessed by Gabor filters and convergence measure. In the second step, three‐dimensional (3D) candidates are obtained by stacking 2D candidates along superior–inferior direction. In the last step, FP reduction for 3D candidates is implemented based on superior–inferior directional context and anatomic prior knowledge of breast. DBT data from 99 cases with AD were used as the training set to train the CADe model, and data from 208 cases were used as an independent test set (including 108 cases with AD and 100 cases without AD as the control group). The free‐response receiver operating characteristic and mean true positive fraction (MTPF) in the range of 0.05–2.0 FPs per volume are used to evaluate the model. Results: Compared with the baseline model based on convergence measure, our proposed method demonstrates significant improvement (MTPF: 0.2826 ± 0.0321 vs. 0.6640 ± 0.0399). Results of an ablation study show that our proposed context‐ and anatomy‐based FP reduction methods improve the detection performance. The number of FPs per DBT volume reduces from 2.47 to 1.66 at 80% sensitivity after employing these two schemes. Conclusions: The deep learning model demonstrates practical value for AD detection. The results indicate that introducing superior–inferior directional context and anatomic prior knowledge into model can indeed reduce FPs and improve the performance of CADe model. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the mammographic features, clinicopathological characteristics, treatments, and prognosis of pure and mixed tubular carcinomas of the breast. Materials and methods: Twenty-five tubular carcinomas were pathologically confirmed at our hospital from January 2011 to May 2019. Twenty-one patients underwent preoperative mammography. A retrospective analysis of mammographic features, clinicopathological characteristics, treatment, and outcomes was performed. Results: Altogether, 95% of the pure tubular carcinomas (PTCs) and mixed tubular carcinomas (MTCs) showed the presence of a mass or structural distortions on mammography and the difference was not statistically significant (P =.373). MTCs exhibited a larger tumor size than PTCs (P =.033). Lymph node metastasis was more common (P =.005) in MTCs. Patients in our study showed high estrogen receptor and progesterone receptor positivity rates, but low human epidermal growth factor receptor 2 positivity rate. The overall survival rate was 100% in both PTC and MTC groups and the 5-year disease-free survival rates were 100% and 75%, respectively with no significant difference between the groups (P =.264). Conclusion: Tubular carcinoma of the breast is potentially malignant and has a favorable prognosis. Digital breast tomosynthesis may improve its detection. For patients with PTC, breast-conserving surgery and sentinel lymph node biopsy are recommended based on the low rate of lymph node metastasis and good prognosis. MTC has a relatively high rate of lymph node metastasis and a particular risk of metastasis. Axillary lymph node dissection should be performed for MTC even if the tumor is smaller than 2 cm. [ABSTRACT FROM AUTHOR]

Synthetic digital mammography (SDM), a 2D image generated from digital breast tomosynthesis (DBT), is used as a potential substitute for full-field digital mammography (FFDM) in clinic to reduce the radiation dose for breast cancer screening. Previous studies exploited projection geometry and fused projection data and DBT volume, with different post-processing techniques applied on re-projection data which may generate different image appearance compared to FFDM. To alleviate this issue, one possible solution to generate an SDM image is using a learning-based method to model the transformation from the DBT volume to the FFDM image using current DBT/FFDM combo images. In this study, we proposed to use a deep convolutional neural network (DCNN) to learn the transformation to generate SDM using current DBT/FFDM combo images. Gradient guided conditional generative adversarial networks (GGGAN) objective function was designed to preserve subtle MCs and the perceptual loss was exploited to improve the performance of the proposed DCNN on perceptual quality. We used various image quality criteria for evaluation, including preserving masses and MCs which are important in mammogram. Experiment results demonstrated progressive performance improvement of network using different objective functions in terms of those image quality criteria. The methodology we exploited in the SDM generation task to analyze and progressively improve image quality by designing objective functions may be helpful to other image generation tasks. [ABSTRACT FROM AUTHOR]

• The malignant group had greater kVp, mAs, CBT, and MGD compared to benign group. • Breast thickness, density and lesion size were associated with the difference in MGD. • Breast lesion type clearly influenced exposure parameters when using AEC. • Our result can be helpful in distinguishing malignancies from benign lesions. To explore lesion-specific exposure parameters on digital breast tomosynthesis (DBT) and full-field digital mammography (FFDM) and evaluate their efficiency for breast cancer diagnosis. We reviewed the DBT and FFDM images of 492 women with unilateral breast lesions and compared the findings with a healthy group comprising the contralateral breasts of all patients. The tube voltage (kVp), tube load (mAs), compressed breast thickness (CBT), and mean glandular dose (MGD) for each image were retrieved from the DICOM metadata, and the difference in MGD between DBT and FFDM images (△MGD) was calculated. Three models were developed to discriminate breast cancer: logistic model, comprising traditional risk factors alone; FFDM model, comprising exposure parameters from FFDM images alone, and a hybrid model, comprising traditional risk factors and exposure parameters from DBT and FFDM images. Model performance was assessed in an independent dataset of 189 women by determining the area under the receiver operating characteristic curve (AUC). The malignant group showed greater kVp, mAs, CBT, and MGD values than the benign and healthy groups on both FFDM and DBT. Breast thickness, density, and lesion size were independently associated with △MGD. The hybrid model showed a significantly higher AUC value (0.78 ± 0.04) than the logistic (0.68 ± 0.05) and FFDM models (0.56 ± 0.05). The breast lesion type has an influence on exposure parameters when using automatic exposure control. Our results provide evidence for lesion-specific exposure parameters, which can be helpful in distinguishing benign lesions from malignancies. [ABSTRACT FROM AUTHOR]

Multifaceted features decoded from mammographic images may describe various perspectives of the breast mass heterogeneity, in this study, we aimed to explore a methodology to effectively integrate multifaceted mass representations extracted from the digital breast tomosynthesis (DBT) and full-field digital mammography (FFDM) to enhance breast cancer discrimination. A novel multi-criterion decision making-based multi-channel fusion (MDMF) framework was proposed to fuse different breast mass representations processed in multi-channels built on the deep convolutional neural network (DCNN) and the multilayer perceptron (MLP) at the decision level. A hierarchical framework (HFMM) was also developed for multi-modality images and multi-channel fusion to integrate multimodality information from DBT and FFDM. We retrospectively collected 441 patients with both DBT and FFDM, and the regions of interest (ROIs) covering the malignant, benign, and normal tissues were extracted for validation. The MDMF achieved the area under the receiver operating characteristic curve (AUC) of 93.14%, 91.30%, 97.35% (FFDM) and 93.79%, 95.16%, 99.31% (DBT) respectively for the malignant, benign and normal mass. While the HFMM further boosted the performance to AUC of malignant 94.14%, benign 95.42% and normal mass 99.56% The matthews correlation coefficient (MCC) were 73.15% and 81.02% for FFDM and DBT accomplished by MDMF, and enhanced to 81.72% when integrating the multimodality information from DBT and FFDM via the proposed HFMM. The experimental results suggested that the proposed HFMM achieved superior discriminative performance when compared with the benchmark classification algorithms and fusion architectures, rendering it a practical tool for breast mass discrimination in breast cancer screening. • A decision making-based multi-channel fusion (MDMF) framework is proposed. • Proposed framework is based on deep convolutional network and multilayer perception. • Hierarchical fusion framework (HFMM) is designed to integrate multimodality DBT and FFDM images. • The proposed methods will aid in computer aided breast cancer screening. [ABSTRACT FROM AUTHOR]

• We propose a novel framework for breast mass segmentation associated with small labeled datasets based on ACP-based parallel medical imaging framework. • We introduce a cGAN-based model to generate X-ray breast mass images with pixel-wise masks in the step of designing artificial medical imaging system. • We introduce an improved U-net model for mass segmentation in the step of computational experiments. • Thorough computational experiments on a public mammogram database of INbreast and a private database show that our proposed method can generate realistic lesion images with precise masks and further enhance the performance of deep segmentation network. Simulation of diverse lesions in images is proposed and applied to overcome the scarcity of labeled data, which has hindered the application of deep learning in medical imaging. However, most of current studies focus on generating samples with class labels for classification and detection rather than segmentation, because generating images with precise masks remains a challenge. Therefore, we aim to generate realistic medical images with precise masks for improving lesion segmentation in mammagrams. In this paper, we propose a new framework for improving X-ray breast mass segmentation performance aided by generated adversarial lesion images with precise masks. Firstly, we introduce a conditional generative adversarial network (cGAN) to learn the distribution of real mass images as well as a mapping between images and corresponding segmentation masks. Subsequently, a number of lesion images are generated from various binary input masks using the generator in the trained cGAN. Then the generated adversarial samples are concatenated with original samples to produce a dataset with increased diversity. Furthermore, we introduce an improved U-net and train it on the previous augmented dataset for breast mass segmentation. To demonstrate the effectiveness of our proposed method, we conduct experiments on publicly available mammogram database of INbreast and a private database provided by Nanfang Hospital in China. Experimental results show that an improvement up to 7% in Jaccard index can be achieved over the same model trained on original real lesion images. Our proposed method can be viewed as one of the first steps toward generating realistic X-ray breast mass images with masks for precise segmentation. [ABSTRACT FROM AUTHOR]