Abstract

PurposeAccurate and timely diagnosis of breast carcinoma is very crucial because of its high incidence and high morbidity. Screening can improve overall prognosis by detecting the disease early. Biopsy remains as the gold standard for pathological confirmation of malignancy and tumour grading. The development of diagnostic imaging techniques as an alternative for the rapid and accurate characterization of breast masses is necessitated. Quantitative ultrasound (QUS) spectroscopy is a modality well suited for this purpose. This study was carried out to evaluate different texture analysis methods applied on QUS spectral parametric images for the characterization of breast lesions.MethodsParametric images of mid-band-fit (MBF), spectral-slope (SS), spectral-intercept (SI), average scatterer diameter (ASD), and average acoustic concentration (AAC) were determined using QUS spectroscopy from 193 patients with breast lesions. Texture methods were used to quantify heterogeneities of the parametric images. Three statistical-based approaches for texture analysis that include Gray Level Co-occurrence Matrix (GLCM), Gray Level Run-length Matrix (GRLM), and Gray Level Size Zone Matrix (GLSZM) methods were evaluated. QUS and texture-parameters were determined from both tumour core and a 5-mm tumour margin and were used in comparison to histopathological analysis in order to classify breast lesions as either benign or malignant. We developed a diagnostic model using different classification algorithms including linear discriminant analysis (LDA), k-nearest neighbours (KNN), support vector machine with radial basis function kernel (SVM-RBF), and an artificial neural network (ANN). Model performance was evaluated using leave-one-out cross-validation (LOOCV) and hold-out validation.ResultsClassifier performances ranged from 73% to 91% in terms of accuracy dependent on tumour margin inclusion and classifier methodology. Utilizing information from tumour core alone, the ANN achieved the best classification performance of 93% sensitivity, 88% specificity, 91% accuracy, 0.95 AUC using QUS parameters and their GLSZM texture features.ConclusionsA QUS-based framework and texture analysis methods enabled classification of breast lesions with >90% accuracy. The results suggest that optimizing method for extracting discriminative textural features from QUS spectral parametric images can improve classification performance. Evaluation of the proposed technique on a larger cohort of patients with proper validation technique demonstrated the robustness and generalization of the approach.

Highlights

  • Breast cancer demonstrates a high incidence and leads to high morbidity in women [1,2]

  • A Quantitative ultrasound (QUS)-based framework and texture analysis methods enabled classification of breast lesions with >90% accuracy

  • The results suggest that optimizing method for extracting discriminative textural features from QUS spectral parametric images can improve classification performance

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Summary

Introduction

Breast cancer demonstrates a high incidence and leads to high morbidity in women [1,2]. Detection of breast carcinoma through screening can enhance prognosis as appropriate treatments are provided to patients at an earlier stage of the disease [2]. For this purpose, accurate and precise diagnostic techniques are required. The current imaging workflow for breast cancer diagnosis begins with x-ray mammography, followed by standard ultrasound imaging (B-mode US imaging), dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) as needed, followed by core-needle biopsy, as required [2]. The specificity of breast cancer detection may be increased using Dynamic Contrast-Enhanced Magnetic Resonance Imaging (DCE-MRI) [7]. The development of imaging techniques that can perform rapid and accurate characterization of breast lesions is highly beneficial for early detection of breast carcinoma and triaging patients in a screening workflow [8,9]

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