Abstract

We propose and evaluate a procedure for the explainability of a breast density deep learning based classifier. A total of 1662 mammography exams labeled according to the BI-RADS categories of breast density was used. We built a residual Convolutional Neural Network, trained it and studied the responses of the model to input changes, such as different distributions of class labels in training and test sets and suitable image pre-processing. The aim was to identify the steps of the analysis with a relevant impact on the classifier performance and on the model explainability. We used the grad-CAM algorithm for CNN to produce saliency maps and computed the Spearman’s rank correlation between input images and saliency maps as a measure of explanation accuracy. We found that pre-processing is critical not only for accuracy, precision and recall of a model but also to have a reasonable explanation of the model itself. Our CNN reaches good performances compared to the state-of-art and it considers the dense pattern to make the classification. Saliency maps strongly correlate with the dense pattern. This work is a starting point towards the implementation of a standard framework to evaluate both CNN performances and the explainability of their predictions in medical image classification problems.

Highlights

  • Breast cancer is the most frequently diagnosed cancer among women worldwide and it is the second leading cause of death [1]

  • Full Field Digital Mammography (FFDM) is a non-invasive highly sensitive method for early stage breast cancer detection and diagnosis, and represents the reference imaging technique to explore the breast in a complete way [3,4]

  • Due to the lack of public research databases populated with digital mammograms to use in AI applications devoted to density class identification [20,22], we analyzed FullField Digital Mammograms (FFDM) collected within the RADIOMA project and described in [23]

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Summary

Introduction

Breast cancer is the most frequently diagnosed cancer among women worldwide and it is the second leading cause of death [1]. It has been shown that one woman in eight is going to develop breast cancer in her life and early diagnosis is one of the most powerful instruments we have in fighting the disease [2]. Full Field Digital Mammography (FFDM) is a non-invasive highly sensitive method for early stage breast cancer detection and diagnosis, and represents the reference imaging technique to explore the breast in a complete way [3,4]. One of the major issues in cancer detection is due to the presence of breast dense tissue. Breast density is defined as the amount of fibroglandular parenchyma or dense tissue with respect to the fat one as seen on a mammographic exam [5]. In order to have a sufficient sensitivity in denser breasts, a higher radiation dose has to be delivered to the patient [6]

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