Abstract

PurposeTo compare two methods of automatic breast segmentation with each other and with manual segmentation in a large subject cohort. To discuss the factors involved in selecting the most appropriate algorithm for automatic segmentation and, in particular, to investigate the appropriateness of overlap measures (e.g., Dice and Jaccard coefficients) as the primary determinant in algorithm selection.MethodsTwo methods of breast segmentation were applied to the task of calculating MRI breast density in 200 subjects drawn from the Avon Longitudinal Study of Parents and Children, a large cohort study with an MRI component. A semiautomated, bias‐corrected, fuzzy C‐means (BC‐FCM) method was combined with morphological operations to segment the overall breast volume from in‐phase Dixon images. The method makes use of novel, problem‐specific insights. The resulting segmentation mask was then applied to the corresponding Dixon water and fat images, which were combined to give Dixon MRI density values. Contemporaneously acquired T1‐ and T2‐weighted image datasets were analyzed using a novel and fully automated algorithm involving image filtering, landmark identification, and explicit location of the pectoral muscle boundary. Within the region found, fat‐water discrimination was performed using an Expectation Maximization–Markov Random Field technique, yielding a second independent estimate of MRI density.ResultsImages are presented for two individual women, demonstrating how the difficulty of the problem is highly subject‐specific. Dice and Jaccard coefficients comparing the semiautomated BC‐FCM method, operating on Dixon source data, with expert manual segmentation are presented. The corresponding results for the method based on T1‐ and T2‐weighted data are slightly lower in the individual cases shown, but scatter plots and interclass correlations for the cohort as a whole show that both methods do an excellent job in segmenting and classifying breast tissue.ConclusionsEpidemiological results demonstrate that both methods of automated segmentation are suitable for the chosen application and that it is important to consider a range of factors when choosing a segmentation algorithm, rather than focus narrowly on a single metric such as the Dice coefficient.

Highlights

  • Mammographic density, a quantitative measure of radiodense fibroglandular tissue in the breast, is one of the strongest predictors of breast cancer risk

  • Results are shown for two separate manual segmentations by the same experienced observer; for the bias-corrected fuzzy C-means (BC-fuzzy C-means (FCM)) method from ref. [37]; the BC-FCM method with additional heuristics and default parameters, as described above; and the new method based on T1 and T2 images (VaT12)

  • Note how implementation of guidelines developed during the manual segmentation process supplements the BC-FCM approach in order to cut off the segmentation in both the left-right and superior-inferior directions, where there are no corresponding intensity boundaries seen in the image data themselves

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Summary

Introduction

Mammographic density, a quantitative measure of radiodense fibroglandular tissue in the breast, is one of the strongest predictors of breast cancer risk. Subsequent risk assessment and epidemiological analysis rarely use full 3-D information (normally preferring a single number, i.e., the volume-averaged mean breast density), accurate derivation of such a statistic from the 2-D x-ray data is problematic and subject to error. Automated tools, such as Volpara (VolparaSolutions, Wellington, NZ)[5] and QUANTRA (Hologic Inc., USA), are gaining traction in the mammography community, suggesting that mean breast density can be calculated without inter-reader bias. Such readings may be affected by errors in estimating breast thickness[6] and the relation between the values of breast density reported and those obtained by other techniques remains to be elucidated.[7]

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