Abstract

With the increasing daily workload of physicians, computer-aided diagnosis (CAD) systems based on deep learning play an increasingly important role in pattern recognition of diagnostic medical images. In this paper, we propose a framework based on hierarchical convolutional neural networks (CNNs) for automatic detection and classification of focal liver lesions (FLLs) in multi-phasic computed tomography (CT). A total of 616 nodules, composed of three types of malignant lesions (hepatocellular carcinoma, intrahepatic cholangiocarcinoma, and metastasis) and benign lesions (hemangioma, focal nodular hyperplasia, and cyst), were randomly divided into training and test sets at an approximate ratio of 3:1. To evaluate the performance of our model, other commonly adopted CNN models and two physicians were included for comparison. Our model achieved the best results to detect FLLs, with an average test precision of 82.8%, recall of 93.4%, and F1-score of 87.8%. Our model initially classified FLLs into malignant and benign and then classified them into more detailed classes. For the binary and six-class classification, our model achieved average accuracy results of 82.5 and73.4%, respectively, which were better than the other three classification neural networks. Interestingly, the classification performance of the model was placed between a junior physician and a senior physician. Overall, this preliminary study demonstrates that our proposed multi-modality and multi-scale CNN structure can locate and classify FLLs accurately in a limited dataset, and would help inexperienced physicians to reach a diagnosis in clinical practice.

Highlights

  • Liver cancer, which is one of the most malignant types, represents the second-highest leading cause of cancer death in men worldwide, with a 5-year survival rate of less than 18% [1, 2]

  • We developed a strategy based on a multimodality and multi-scale convolutional neural networks (CNNs) structure, composed of three 2.5D Faster R-CNN w/feature pyramid network (FPN) and one 3D ResNet-18, for the automatic detection and classification of focal liver lesions (FLLs) in three-phases of computed tomography (CT) images, respectively

  • We conducted five experiments using the same settings to reduce the variance in the training of the neural networks, and further evaluated the detection performance based on the metrics obtained from the test set

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Summary

Introduction

Liver cancer, which is one of the most malignant types, represents the second-highest leading cause of cancer death in men worldwide, with a 5-year survival rate of less than 18% [1, 2]. Early detection and precise classification of focal liver lesions (FLLs) are important for subsequent effective treatment. Diagnostic radiographic imaging such as dynamic contrastenhanced computed tomography (CT) provides useful information for the differential diagnosis of the aforementioned FLLs [4, 5]. A recent study reported that, in some cases, radiologists have to read CT images at a speed of every 3–4 s per image during an 8 h workday to meet their workload demands [6]. The automatic detection and classification of lesions in diagnostic images using a computer-aided diagnosis (CAD) system has been developed to overcome these issues

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