Detection Of Microcalcifications Research Articles

"Artificial intelligence Reading Digital Mammogram: Enhancing Detection and Differentiation of Suspicious Microcalcifications".

To investigate the impact of artificial intelligence (AI) on enhancing the sensitivity of digital mammograms in the detection and specification of grouped microcalcifications. The study is a retrospective analysis of grouped microcalcifications for 447 patients. Grouped microcalcifications detected were correlated with AI, which was applied to the initial mammograms. AI provided a heat map, demarcation, and quantitative evaluation for abnormalities according to the degree of suspicion of malignancy. Histopathology was the standard for confirmation of malignancy. AI showed a high correlation percentage of 67.5% between the red color of the color hue bar and malignant microcalcifications (p value <0.001). The scoring of probable cancer was suggested (ie, more than 50% abnormality scoring) in 39.5% of true cancer lesions. The diagnostic performance of mammography for grouped microcalcifications revealed a sensitivity of 94.7% and a negative predictive value of 82.1%. False negatives were only 12 out of 228 that proved malignant calcifications. The agreement of cancer probability between standard mammograms and examinations read by AI presented a Kappa value of -0.094 and a p value of < 0.001. The used AI system enhanced the sensitivity of mammograms in detecting suspicious microcalcifications, yet an expert human reader is required for proper specification. Grouped calcifications could be early breast cancer on a mammogram. The morphology and distribution are correlated with the nature of breast diseases. AI is a potential decision support for the detection and classification of grouped microcalcifications and thus positively affects the control of breast cancer.

Automated assessment of task-based performance of digital mammography and tomosynthesis systems using an anthropomorphic breast phantom and deep learning-based scoring.

Conventional metrics used for assessing digital mammography (DM) and digital breast tomosynthesis (DBT) image quality, including noise, spatial resolution, and detective quantum efficiency, do not necessarily predict how well the system will perform in a clinical task. A number of existing phantom-based methods have their own limitations, such as unrealistic uniform backgrounds, subjective scoring using humans, and regular signal patterns unrepresentative of common clinical findings. We attempted to address this problem with a realistic breast phantom with random hydroxyapatite microcalcifications and semi-automated deep learning-based image scoring. Our goal was to develop a methodology for objective task-based assessment of image quality for tomosynthesis and DM systems, which includes an anthropomorphic phantom, a detection task (microcalcification clusters), and automated performance evaluation using a convolutional neural network. Experimental 2D and pseudo-3D mammograms of an anthropomorphic inkjet-printed breast phantom with inserted microcalcification clusters were collected on clinical mammography systems to train a signal-present/signal-absent image classifier based on Resnet-18 architecture. In a separate validation study using simulations, this Resnet-18 classifier was shown to approach the performance of an ideal observer. Microcalcification detection performance was evaluated as a function of four dose levels using receiver operating characteristic (ROC) analysis [i.e., area under the ROC curve (AUC)]. To demonstrate the use of this evaluation approach for assessing different technologies, the method was applied to two different mammography systems, as well as to mammograms with re-binned pixels emulating a lower-resolution X-ray detector. Microcalcification detectability, as assessed by the deep learning classifier, was observed to vary with the exposure incident on the breast phantom for both DM and tomosynthesis. At full dose, experimental AUC was 0.96 (for DM) and 0.95 (for DBT), whereas at half dose, it dropped to 0.85 and 0.71, respectively. AUC performance on DM was significantly decreased with an effective larger pixel size obtained with re-binning. The task-based assessment approach also showed the superiority of a newer mammography system compared with an older system. An objective task-based methodology for assessing the image quality of mammography and tomosynthesis systems is proposed. Possible uses for this tool could be quality control, acceptance, and constancy testing, assessing the safety and effectiveness of new technology for regulatory submissions, and system optimization. The results from this study showed that the proposed evaluation method using a deep learning model observer can track differences in microcalcification signal detectability with varied exposure conditions.

Digital breast tomosynthesis for early detection of malignant breast microcalcification: A hospital-based cross-sectional study

Background: Breast cancer is the leading cause of cancer-related deaths in women. Early detection by screening is crucial for improved survival. Digital breast tomosynthesis (DBT) may offer better visibility than conventional screening. This study aims to assess the diagnostic accuracy of DBT in detecting malignant breast microcalcifications compared to histopathological findings. Methods: This cross-sectional study was done at the Department of Radiology and Imaging, Bangabandhu Sheikh Mujib Medical University, Dhaka, from July 2022 to June 2023 and enrolled 35 women suspected of having breast cancer. Each patient underwent DBT and histopathology tests. The diagnostic accuracy of DBT in detecting malignant breast microcalcifications was assessed compared to the gold standard of histopathology. Results: The average age of the participants was 48.6 years. Palpable breast lumps (91.4%) were the most common clinical presentation. Among them, 80% had malignant microcalcifications diagnosed by DBT, primarily with linear (40.0%) and segmental (28.6%) distribution. Histopathology identified 80% of cases as malignant, with ductal carcinoma in situ (34.3%) being the most prevalent type. DBT demonstrated high sensitivity (100%) and specificity (85.7%) in detecting malignant microcalcifications, resulting in an overall accuracy of 97.1%. Conclusions: DBT has high diagnostic accuracy for detecting malignant breast microcalcifications and can be considered a valid tool for the early detection of breast microcalcifications, particularly in the context of diagnosing breast cancer.

Detection of multiple abnormalities of breast cancer in mammograms using a deep dilated fully convolutional neural network

Breast cancer is one of the serious health issues which are quite frequent among women and the mortality rate due to it can be reduced if detected and diagnosed at the early stage. In this paper, a new generalized deep learning architecture, deep dilated fully convolutional neural network (DDFCNN), is designed to detect multiple abnormalities like mass, microcalcification, and architectural distortion in mammograms. The proposed DDFCNN architecture consists of a feature and a dilation module. In feature module, convolutional kernels of various sizes are used to capture information at different scales. Since there is no loss of resolution in the output of the dilation module, it renders more details which helps in localizing the anomaly properly. Several experiments are conducted on a widely used databases — DDSM and mini-MIAS where an accuracy of 95.33%, 91.42%, and 92.67% is measured for detection of mass, microcalcification, and architectural distortion, respectively with a FPs/I of 0.43, 0.50, and 0.46 for DDSM and similar assessment for mini-MIAS database are 96.56%, 89.63%, and 95.07% with a FPs/I of 0.29, 0.51, and 0.31. Moreover, the overall performance in detection of all the abnormalities in combination is 93.14% with 0.46 as FPs/I for DDSM whereas for mini-MIAS is 93.75% with 0.37 as FPs/I. The performance is further compared with the state-of-the-other methods where the proposed approach takes an edge.

Breast cancer characterization using region-based convolutional neural network with screening and diagnostic mammogram

Background: Detection and classification of microcalcifications in breast tissues is crucial for early breast cancer diagnosis and long-term treatment. Objective: This paper aims to propose a robust model capable of detection and classification of breast cancer calcifications in digital mammogram images using Deep Convolutional Neural Networks (DCNN). Materials and methods: An expert breast radiologist annotated the 3,265 clinical mammogram images to create a comprehensive ground truth dataset comprising 2,500 annotations for malignant and benign calcifications. This dataset was utilized to train our model, a two-stage detection system incorporating a Region-based Convolutional Neural Network (RCNN) with AlexNet and support vector machines to enhance the system’s robustness. The proposed model was compared to the one-stage detection, utilizing YOLOv4 combined with the Cross-Stage Partial Darknet53 (CSPDarknet53) architecture. A separate dataset of 504 mammogram images was explicitly set aside for model testing. The efficacy of the proposed model was evaluated based on key performance metrics, including precision, recall, F1 score, and mean average precision (mAP). Results: The results showed that the proposed RCNN-2 model could automatically identify and categorize calcifications as malignant or benign, outperforming the YOLOv4 models. The RCNN-2’s overall effectiveness, as evaluated by precision, recall, F1 score, and mean average precision (mAP), achieved scores of 0.82, 0.85, 0.83, and 0.74, respectively. Conclusion: The proposed RCNN-2 model demonstrates very effective detection and classification of calcification in mammogram images, especially in high-dense breast images. The performance of the proposed model was compared to that of YOLOv4, and it can be concluded that the proposed RCNN model yields outstanding performance. The model can be a helpful tool for radiologists.

Value of Ultrasonography in Assessment of Screen-Detected Calcified Ductal Carcinoma In Situ: A Clinical Audit

Abstract Background: Approximately 80% of ductal carcinoma in situ (DCIS) cases are asymptomatic and manifest as microcalcifications, usually detected on screening mammograms. Stereotactic biopsy is used as the primary modality for histopathologic diagnosis. Ultrasonography has been relied upon as a potentially viable alternative for early breast cancer detection, especially in low- and medium-income countries. Aim: Determine the role and reliability of breast ultrasonography in the evaluation of screen-detected microcalcifications using histologically proven calcified DCIS as a case study. Materials and Methods: Cross-sectional evaluation of records of patients recalled for M3–M5 (indeterminate to malignant) type microcalcifications on screening mammograms, with a histological diagnosis of pure DCIS, in an NHS Trust Hospital, Kent, England, from March 2021 to April 2023. Results: Eighty women included were within the age range of 46–79 years, with mean age of 60 years. Background breast density was predominantly fatty in 51/80 (63.8%), without any correlation with mammographic abnormalities. Microcalcifications were classified as indeterminate (M3) in 42/80 (52.5%), while suspicious (M4) and malignant (M5) types were seen in 38/80 (47.5%). No targeted sonographic abnormalities were noted in 69 (86.2%) of the patients, while 11 (13.8%) had sonographic abnormalities. The predominant sonographic feature was non-mass hypoechogenicity in 6/11(55%). There was a correlation between mammographic code, lesion size, and ultrasonic abnormality, with 9/11 (81.8%) patients with sonographic lesions having suspicious and malignant type calcifications. The mean mammographic lesion size was significantly greater in women with abnormal ultrasound findings, 42 vs. 20 mm. Histological tumour grade was high grade in 10/11 (90.9%) lesions. Conclusion: The accuracy of breast ultrasonography as an adjunct in the detection of screen-detected microcalcifications and subsequent guided biopsy is higher when dealing with malignant type microcalcifications &gt;15 mm in size.

Hybrid Feature Mammogram Analysis: Detecting and Localizing Microcalcifications Combining Gabor, Prewitt, GLCM Features, and Top Hat Filtering Enhanced with CNN Architecture.

Breast cancer is a prevalent malignancy characterized by the uncontrolled growth of glandular epithelial cells, which can metastasize through the blood and lymphatic systems. Microcalcifications, small calcium deposits within breast tissue, are critical markers for early detection of breast cancer, especially in non-palpable carcinomas. These microcalcifications, appearing as small white spots on mammograms, are challenging to identify due to potential confusion with other tissues. This study hypothesizes that a hybrid feature extraction approach combined with Convolutional Neural Networks (CNNs) can significantly enhance the detection and localization of microcalcifications in mammograms. The proposed algorithm employs Gabor, Prewitt, and Gray Level Co-occurrence Matrix (GLCM) kernels for feature extraction. These features are input to a CNN architecture designed with maxpooling layers, Rectified Linear Unit (ReLU) activation functions, and a sigmoid response for binary classification. Additionally, the Top Hat filter is used for precise localization of microcalcifications. The preprocessing stage includes enhancing contrast using the Volume of Interest Look-Up Table (VOI LUT) technique and segmenting regions of interest. The CNN architecture comprises three convolutional layers, three ReLU layers, and three maxpooling layers. The training was conducted using a balanced dataset of digital mammograms, with the Adam optimizer and binary cross-entropy loss function. Our method achieved an accuracy of 89.56%, a sensitivity of 82.14%, and a specificity of 91.47%, outperforming related works, which typically report accuracies around 85-87% and sensitivities between 76 and 81%. These results underscore the potential of combining traditional feature extraction techniques with deep learning models to improve the detection and localization of microcalcifications. This system may serve as an auxiliary tool for radiologists, enhancing early detection capabilities and potentially reducing diagnostic errors in mass screening programs.

In-silico study of the impact of system design parameters on microcalcification detection in wide-angle digital breast tomosynthesis.

Accurate detection of microcalcifications ( ) is crucial for the early detection of breast cancer. Some clinical studies have indicated that digital breast tomosynthesis (DBT) systems with a wide angular range have inferior detectability compared with those with a narrow angular range. This study aims to (1)provide guidance for optimizing wide-angle (WA) DBT for improving detectability and (2)prioritize key optimization factors. An in-silico DBT pipeline was constructed to evaluate detectability of a WA DBT system under various imaging conditions: focal spot motion (FSM), angular dose distribution (ADS), detector pixel pitch, and detector electronic noise (EN). Images were simulated using a digital anthropomorphic breast phantom inserted with clusters. Evaluation metrics included the signal-to-noise ratio (SNR) of the filtered channel observer and the area under the receiver operator curve (AUC) of multiple-reader multiple-case analysis. Results showed that FSM degraded sharpness and decreased the SNR and AUC by 5.2% and 1.8%, respectively. Non-uniform ADS increased the SNR by 62.8% and the AUC by 10.2% for filtered backprojection reconstruction with a typical clinical filter setting. When EN decreased from 2000 to 200 electrons, the SNR and AUC increased by 21.6% and 5.0%, respectively. Decreasing the detector pixel pitch from 85 to improved the SNR and AUC by 55.6% and 7.5%, respectively. The combined improvement of a pixel pitch and EN200 was 89.2% in the SNR and 12.8% in the AUC. Based on the magnitude of impact, the priority for enhancing detectability in WA DBT is as follows: (1)utilizing detectors with a small pixel pitch and low EN level, (2)allocating a higher dose to central projections, and (3)reducing FSM. The results from this study can potentially provide guidance for DBT system optimization in the future.

Finding Missing Calcifications.

Mammographic identification of microcalcifications may result in biopsy because many calcifications serve as markers for breast pathology. Absence of these calcifications in histologic sections may indicate that an area of concern has not been adequately sampled. To determine the optimal cutting protocols to identify mammary calcifications. Our standard protocol for breast biopsies with suspected mircocalcifications is to cut 2 levels separated by 30 µm and if no microcalcifications are detected, an additional 10 levels are obtained. An electronic search of surgical pathology records was performed for cases with microcalcifications identified between January 1, 2022, and March 30, 2023. For each case, slides designated by the radiologist as containing microcalcifications were retrieved. The level at which microcalcifications were first detected was recorded. The search revealed 431 specimens meeting the search criteria, of which 415 contained microcalcifications. Probability of finding microcalcifications in the initial level was 0.629 and the probability of detecting microcalcifications in the first 4 levels was 0.905. Four hundred three of 415 microcalcifications documented by mammographic imaging (97%) were detected histologically in the first 6 levels. A 6-level approach appears optimal for the detection of microcalcifications. This study may have implications for other specimen types where a strong suspicion exists for a pathologic lesion, but examination reveals no lesions in the initial sections. Protocols using 6-level-deep cuts may represent optimal sampling.

Dedicated Photon-Counting CT for Detection and Classification of Microcalcifications: An Intraindividual Comparison With Digital Breast Tomosynthesis.

Clinical experience regarding the use of dedicated photon-counting breast CT (PC-BCT) for diagnosis of breast microcalcifications is scarce. This study systematically compares the detection and classification of breast microcalcifications using a dedicated breast photon-counting CT, especially designed for examining the breast, in comparison with digital breast tomosynthesis (DBT). This is a prospective intraindividual study on women with DBT screening-detected BI-RADS-4/-5 microcalcifications who underwent PC-BCT before biopsy. PC-BCT images were reconstructed with a noninterpolated spatial resolution of 0.15 × 0.15 × 0.15 mm (reconstruction mode 1 [RM-1]) and with 0.3 × 0.3 × 0.3 mm (reconstruction mode 2 [RM-2]), plus thin-slab maximum intensity projection (MIP) reconstructions. Two radiologists independently rated the detection of microcalcifications in direct comparison with DBT on a 5-point scale. The distribution and morphology of microcalcifications were then rated according to BI-RADS. The size of the smallest discernible microcalcification particle was measured. For PC-BCT, the average glandular dose was determined by Monte Carlo simulations; for DBT, the information provided by the DBT system was used. Between September 2022 and July 2023, 22 participants (mean age, 61; range, 42-85 years) with microcalcifications (16 malignant; 6 benign) were included. In 2/22 with microcalcifications in the posterior region, microcalcifications were not detectable on PC-BCT, likely because they were not included in the PC-BCT volume. In the remaining 20 participants, microcalcifications were detectable. With high between-reader agreement (κ > 0.8), conspicuity of microcalcifications was rated similar for DBT and MIPs of RM-1 (mean, 4.83 ± 0.38 vs 4.86 ± 0.35) (P = 0.66), but was significantly lower (P < 0.05) for the remaining PC-BCT reconstructions: 2.11 ± 0.92 (RM-2), 2.64 ± 0.80 (MIPs of RM-2), and 3.50 ± 1.23 (RM-1). Identical distribution qualifiers were assigned for PC-BCT and DBT in 18/20 participants, with excellent agreement (κ = 0.91), whereas identical morphologic qualifiers were assigned in only 5/20, with poor agreement (κ = 0.44). The median size of smallest discernible microcalcification particle was 0.2 versus 0.6 versus 1.1 mm in DBT versus RM-1 versus RM-2 (P < 0.001), likely due to blooming effects. Average glandular dose was 7.04 mGy (PC-BCT) versus 6.88 mGy (DBT) (P = 0.67). PC-BCT allows reliable detection of in-breast microcalcifications as long as they are not located in the posterior part of the breast and allows assessment of their distribution, but not of their individual morphology.

Implementation of Improved U-Net and Optimized XGBoost-SVM Classifier for Early Detection of Masses and Microcalcifications in Breast

Purpose: In contemporary time, breast cancer has been extensively found among women at a global rate of 24.2% as of 2018. This exposes the significant and imperative need for detecting masses and micro calcifications in the breast to avoid death rates. The existing histopathological images have gained a golden standard considering they would afford reliable results. However, these images have been entangled with various complexities including insufficient image contrast, noise, and misdiagnosis. These pitfalls might negatively impact the detection rate for which automatic recognition has become vital. With the momentous evolvement of Machine Learning (ML) and Deep Learning (DL), various researchers have endeavoured to consider ML and DL for accomplishing this prediction. However, they need to improve in accuracy rate due to ineffective feature extraction, and most studies averted to consider segmentation. Hence, this study regards accomplishing a high classification and segmentation process. Materials and Methods: The study proposes Modified Weight Updated Convolutional Block-U-Net (MWu-Conv-U-Net) to handle the image dimensions optimally. In this case, U-Net based model is regarded by improvising it with the inclusion of an additional convolutional layer in individual encoder-decoder. Further, the study proposes an Optimized Weight Updated eXtreme Gradient Boosting-Support Vector Machine (OWu-XGBoost-SVM) for determining the optimal gradient, which would eventually enhance the prediction rate. Results: The overall performance is assessed through performance metrics to confirm its effectiveness in classifying and segmenting the Breast Cancer Histopathological (BACH) image dataset. Comparison is undertaken with conventional systems in accordance with metrics (recall, F1-score, precision, and accuracy). The results revealed the efficacy of the proposed system with 99% accuracy, 99% F1-score, 99% precision, and 99% recall. Conclusion: High accuracy procured through the analysis reveals its efficacy and hence it could be applicable for real-time execution for assisting medical experts in early breast cancer prognosis.

Enhancing early breast cancer diagnosis through automated microcalcification detection using an optimized ensemble deep learning framework

Background Breast cancer remains a pressing global health concern, necessitating accurate diagnostics for effective interventions. Deep learning models (AlexNet, ResNet-50, VGG16, GoogLeNet) show remarkable microcalcification identification (&gt;90%). However, distinct architectures and methodologies pose challenges. We propose an ensemble model, merging unique perspectives, enhancing precision, and understanding critical factors for breast cancer intervention. Evaluation favors GoogleNet and ResNet-50, driving their selection for combined functionalities, ensuring improved precision, and dependability in microcalcification detection in clinical settings. Methods This study presents a comprehensive mammogram preprocessing framework using an optimized deep learning ensemble approach. The proposed framework begins with artifact removal using Otsu Segmentation and morphological operation. Subsequent steps include image resizing, adaptive median filtering, and deep convolutional neural network (D-CNN) development via transfer learning with ResNet-50 model. Hyperparameters are optimized, and ensemble optimization (AlexNet, GoogLeNet, VGG16, ResNet-50) are constructed to identify the localized area of microcalcification. Rigorous evaluation protocol validates the efficacy of individual models, culminating in the ensemble model demonstrating superior predictive accuracy. Results Based on our analysis, the proposed ensemble model exhibited exceptional performance in the classification of microcalcifications. This was evidenced by the model’s average confidence score, which indicated a high degree of dependability and certainty in differentiating these critical characteristics. The proposed model demonstrated a noteworthy average confidence level of 0.9305 in the classification of microcalcification, outperforming alternative models and providing substantial insights into the dependability of the model. The average confidence of the ensemble model in classifying normal cases was 0.8859, which strengthened the model’s consistent and dependable predictions. In addition, the ensemble models attained remarkably high performances in terms of accuracy, precision, recall, F1-score, and area under the curve (AUC). Conclusion The proposed model’s thorough dataset integration and focus on average confidence ratings within classes improve clinical diagnosis accuracy and effectiveness for breast cancer. This study introduces a novel methodology that takes advantage of an ensemble model and rigorous evaluation standards to substantially improve the accuracy and dependability of breast cancer diagnostics, specifically in the detection of microcalcifications.

Maximizing microcalcification detectability in low-dose dedicated cone-beam breast CT: parallel cascades-based theoretical analysis.

We aim to determine the combination of X-ray spectrum and detector scintillator thickness that maximizes the detectability of microcalcification clusters in dedicated cone-beam breast CT. A cascaded linear system analysis was implemented in the spatial frequency domain and was used to determine the detectability index using numerical observers for the imaging task of detecting a microcalcification cluster with 0.17mm diameter calcium carbonate spheres. The analysis considered a thallium-doped cesium iodide scintillator coupled to a complementary metal-oxide semiconductor detector and an analytical filtered-back-projection reconstruction algorithm. Independent system parameters considered were the scintillator thickness, applied X-ray tube voltage, and X-ray beam filtration. The combination of these parameters that maximized the detectability index was considered optimal. Prewhitening, nonprewhitening, and nonprewhitening with eye filter numerical observers indicate that the combination of 0.525 to 0.6mm thick scintillator, 70kV, and 0.25 to 0.4mm added copper filtration maximized the detectability index at a mean glandular dose (MGD) of 4.5mGy. Using parallel cascade systems' analysis, the combination of parameters that could maximize the detection of microcalcifications was identified. The analysis indicates that a harder beam than that used in current practice may be beneficial for the task of detecting microcalcifications at an MGD suitable for breast cancer screening.

A comparison of full-field digital mammography (FFDM) with digital breast tomosynthesis (DBT) in the detection of microcalcifications by correlating mammographic and pathologic findings

A comparison of full-field digital mammography (FFDM) with digital breast tomosynthesis (DBT) in the detection of microcalcifications by correlating mammographic and pathologic findings

A novel approach for segmentation and quantitative analysis of breast calcification in mammograms.

Breast cancer is a major threat to women's health globally. Early detection of breast cancer is crucial for saving lives. One important early sign is the appearance of breast calcification in mammograms. Accurate segmentation and analysis of calcification can improve diagnosis and prognosis. However, small size and diffuse distribution make calcification prone to oversight. This study aims to develop an efficient approach for segmenting and quantitatively analyzing breast calcification from mammograms. The goal is to assist radiologists in discerning benign versus malignant lesions to guide patient management. This study develops a framework for breast calcification segmentation and analysis using mammograms. A Pro_UNeXt algorithm is proposed to accurately segment calcification lesions by enhancing the UNeXt architecture with a microcalcification detection block, fused-MBConv modules, multiple-loss-function training, and data augmentation. Quantitative features are then extracted from the segmented calcification, including morphology, size, density, and spatial distribution. These features are used to train machine learning classifiers to categorize lesions as malignant or benign. The proposed Pro_UNeXt algorithm achieved superior segmentation performance versus UNet and UNeXt models on both public and private mammogram datasets. It attained a Dice score of 0.823 for microcalcification detection on the public dataset, demonstrating its accuracy for small lesions. For quantitative analysis, the extracted calcification features enabled high malignant/benign classification, with AdaBoost reaching an AUC of 0.97 on the private dataset. The consistent results across datasets validate the representative and discerning capabilities of the proposed features. This study develops an efficient framework integrating customized segmentation and quantitative analysis of breast calcification. Pro_UNeXt offers precise localization of calcification lesions. Subsequent feature quantification and machine learning classification provide comprehensive malignant/benign assessment. This end-to-end solution can assist clinicians in early diagnosis, treatment planning, and follow-up for breast cancer patients.

Adaptive fuzzy weighted median filter for microcalcifications detection in digital breast tomosynthesis images

Breast cancer is a global leading cause of female mortality. Digital breast tomosynthesis (DBT) is pivotal for early breast cancer detection, with microcalcifications serving as crucial indicators. However, the movement of the DBT machine introduces blurry artefacts, potentially impacting accurate diagnosis. This study addresses this challenge by proposing an adaptive fuzzy weighted median filter (AFWMF) to enhance DBT images and aid microcalcification diagnosis. AFWMF automatically determines optimal parameters based on input images, outperforming conventional methods with a threshold range (C) from peak to end of switching. Quantitative assessment reveals peak signal to noise ratio (PSNR), and mean absolute error (MAE) values of 96.2267 and 0.0000636, respectively, demonstrating a significant improvement in microcalcification detection. This study contributes an effective and adaptive enhancement technique for DBT images, promising better breast cancer diagnosis, particularly in microcalcification scenarios.

Optimized signal of calcifications in wide-angle digital breast tomosynthesis: a virtual imaging trial.

Evaluate microcalcification detectability in digital breast tomosynthesis (DBT) and synthetic 2D mammography (SM) for different acquisition setups using a virtual imaging trial (VIT) approach. Medio-lateral oblique (MLO) DBT acquisitions on eight patients were performed at twice the automatic exposure controlled (AEC) dose. The noise was added to the projections to simulate a given dose trajectory. Virtual microcalcification models were added to a given projection set using an in-house VIT framework. Three setups were evaluated: (1) standard acquisition with 25 projections at AEC dose, (2) 25 projections with a convex dose distribution, and (3) sparse setup with 13 projections, every second one over the angular range. The total scan dose and angular range remained constant. DBT volume reconstruction and synthetic mammography image generation were performed using a Siemens prototype algorithm. Lesion detectability was assessed through a Jackknife-alternative free-response receiver operating characteristic (JAFROC) study with six observers. For DBT, the area under the curve (AUC) was 0.97 ± 0.01 for the standard, 0.95 ± 0.02 for the convex, and 0.89 ± 0.03 for the sparse setup. There was no significant difference between standard and convex dose distributions (p = 0.309). Sparse projections significantly reduced detectability (p = 0.001). Synthetic images had a higher AUC with the convex setup, though not significantly (p = 0.435). DBT required four times more reading time than synthetic mammography. A convex setup did not significantly improve detectability in DBT compared to the standard setup. Synthetic images exhibited a non-significant increase in detectability with the convex setup. Sparse setup significantly reduced detectability in both DBT and synthetic mammography. This virtual imaging trial study allowed the design and efficient testing of different dose distribution trajectories with real mammography images, using a dose-neutral protocol. • In DBT, a convex dose distribution did not increase the detectability of microcalcifications compared to the current standard setup but increased detectability for the SM images. • A sparse setup decreased microcalcification detectability in both DBT and SM images compared to the convex and current clinical setups. • Optimal microcalcification cluster detection in the system studied was achieved using either the standard or convex dose setting, with the default number of projections.

GravityNet for end-to-end small lesion detection

This paper introduces a novel one-stage end-to-end detector specifically designed to detect small lesions in medical images. Precise localization of small lesions presents challenges due to their appearance and the diverse contextual backgrounds in which they are found. To address this, our approach introduces a new type of pixel-based anchor that dynamically moves towards the targeted lesion for detection. We refer to this new architecture as GravityNet, and the novel anchors as gravity points since they appear to be “attracted” by the lesions. We conducted experiments on two well-established medical problems involving small lesions to evaluate the performance of the proposed approach: microcalcifications detection in digital mammograms and microaneurysms detection in digital fundus images. Our method demonstrates promising results in effectively detecting small lesions in these medical imaging tasks.

Evaluating the Role of Breast Ultrasound in Early Detection of Breast Cancer in Low- and Middle-Income Countries: A Comprehensive Narrative Review.

Breast cancer, affecting both genders, but mostly females, exhibits shifting demographic patterns, with an increasing incidence in younger age groups. Early identification through mammography, clinical examinations, and breast self-exams enhances treatment efficacy, but challenges persist in low- and medium-income countries due to limited imaging resources. This review assesses the feasibility of employing breast ultrasound as the primary breast cancer screening method, particularly in resource-constrained regions. Following the PRISMA guidelines, this study examines 52 publications from the last five years. Breast ultrasound, distinct from mammography, offers advantages like radiation-free imaging, suitability for repeated screenings, and preference for younger populations. Real-time imaging and dense breast tissue evaluation enhance sensitivity, accessibility, and cost-effectiveness. However, limitations include reduced specificity, operator dependence, and challenges in detecting microcalcifications. Automatic breast ultrasound (ABUS) addresses some issues but faces constraints like potential inaccuracies and limited microcalcification detection. The analysis underscores the need for a comprehensive approach to breast cancer screening, emphasizing international collaboration and addressing limitations, especially in resource-constrained settings. Despite advancements, notably with ABUS, the primary goal is to contribute insights for optimizing breast cancer screening globally, improving outcomes, and mitigating the impact of this debilitating disease.

Interpretable Radiomic Signature for Breast Microcalcification Detection and Classification

Breast microcalcifications are observed in 80% of mammograms, and a notable proportion can lead to invasive tumors. However, diagnosing microcalcifications is a highly complicated and error-prone process due to their diverse sizes, shapes, and subtle variations. In this study, we propose a radiomic signature that effectively differentiates between healthy tissue, benign microcalcifications, and malignant microcalcifications. Radiomic features were extracted from a proprietary dataset, composed of 380 healthy tissue, 136 benign, and 242 malignant microcalcifications ROIs. Subsequently, two distinct signatures were selected to differentiate between healthy tissue and microcalcifications (detection task) and between benign and malignant microcalcifications (classification task). Machine learning models, namely Support Vector Machine, Random Forest, and XGBoost, were employed as classifiers. The shared signature selected for both tasks was then used to train a multi-class model capable of simultaneously classifying healthy, benign, and malignant ROIs. A significant overlap was discovered between the detection and classification signatures. The performance of the models was highly promising, with XGBoost exhibiting an AUC-ROC of 0.830, 0.856, and 0.876 for healthy, benign, and malignant microcalcifications classification, respectively. The intrinsic interpretability of radiomic features, and the use of the Mean Score Decrease method for model introspection, enabled models’ clinical validation. In fact, the most important features, namely GLCM Contrast, FO Minimum and FO Entropy, were compared and found important in other studies on breast cancer.