Despina Kontos

Ramya Muthukrishnan, Angelina Heyler, Keshava Katti et al.

In this study, we automate quantitative mammographic breast density estimation with neural networks and show that this tool is a strong use case for federated learning on multi-institutional datasets. Our dataset included bilateral CC-view and MLO-view mammographic images from two separate institutions. Two U-Nets were separately trained on algorithm-generated labels to perform segmentation of the breast and dense tissue from these images and subsequently calculate breast percent density (PD). The networks were trained with federated learning and compared to three non-federated baselines, one trained on each single-institution dataset and one trained on the aggregated multi-institution dataset. We demonstrate that training on multi-institution datasets is critical to algorithm generalizability. We further show that federated learning on multi-institutional datasets improves model generalization to unseen data at nearly the same level as centralized training on multi-institutional datasets, indicating that federated learning can be applied to our method to improve algorithm generalizability while maintaining patient privacy.

Babak Haghighi, Warren B. Gefter, Lauren Pantalone et al.

Purpose: To utilize high-resolution quantitative CT (QCT) imaging features for prediction of diagnosis and prognosis in fibrosing interstitial lung diseases (ILD). Approach: 40 ILD patients (20 usual interstitial pneumonia (UIP), 20 non-UIP pattern ILD) were classified by expert consensus of 2 radiologists and followed for 7 years. Clinical variables were recorded. Following segmentation of the lung field, a total of 26 texture features were extracted using a lattice-based approach (TM model). The TM model was compared with previously histogram-based model (HM) for their abilities to classify UIP vs non-UIP. For prognostic assessment, survival analysis was performed comparing the expert diagnostic labels versus TM metrics. Results: In the classification analysis, the TM model outperformed the HM method with AUC of 0.70. While survival curves of UIP vs non-UIP expert labels in Cox regression analysis were not statistically different, TM QCT features allowed statistically significant partition of the cohort. Conclusions: TM model outperformed HM model in distinguishing UIP from non-UIP patterns. Most importantly, TM allows for partitioning of the cohort into distinct survival groups, whereas expert UIP vs non-UIP labeling does not. QCT TM models may improve diagnosis of ILD and offer more accurate prognostication, better guiding patient management.

Omid Haji Maghsoudi, Aimilia Gastounioti, Christopher Scott et al.

Breast density is an important risk factor for breast cancer that also affects the specificity and sensitivity of screening mammography. Current federal legislation mandates reporting of breast density for all women undergoing breast screening. Clinically, breast density is assessed visually using the American College of Radiology Breast Imaging Reporting And Data System (BI-RADS) scale. Here, we introduce an artificial intelligence (AI) method to estimate breast percentage density (PD) from digital mammograms. Our method leverages deep learning (DL) using two convolutional neural network architectures to accurately segment the breast area. A machine-learning algorithm combining superpixel generation, texture feature analysis, and support vector machine is then applied to differentiate dense from non-dense tissue regions, from which PD is estimated. Our method has been trained and validated on a multi-ethnic, multi-institutional dataset of 15,661 images (4,437 women), and then tested on an independent dataset of 6,368 digital mammograms (1,702 women; cases=414) for both PD estimation and discrimination of breast cancer. On the independent dataset, PD estimates from Deep-LIBRA and an expert reader were strongly correlated (Spearman correlation coefficient = 0.90). Moreover, Deep-LIBRA yielded a higher breast cancer discrimination performance (area under the ROC curve, AUC = 0.611 [95% confidence interval (CI): 0.583, 0.639]) compared to four other widely-used research and commercial PD assessment methods (AUCs = 0.528 to 0.588). Our results suggest a strong agreement of PD estimates between Deep-LIBRA and gold-standard assessment by an expert reader, as well as improved performance in breast cancer risk assessment over state-of-the-art open-source and commercial methods.

Sarthak Pati, Siddhesh P. Thakur, İbrahim Ethem Hamamcı et al.

Deep Learning (DL) has the potential to optimize machine learning in both the scientific and clinical communities. However, greater expertise is required to develop DL algorithms, and the variability of implementations hinders their reproducibility, translation, and deployment. Here we present the community-driven Generally Nuanced Deep Learning Framework (GaNDLF), with the goal of lowering these barriers. GaNDLF makes the mechanism of DL development, training, and inference more stable, reproducible, interpretable, and scalable, without requiring an extensive technical background. GaNDLF aims to provide an end-to-end solution for all DL-related tasks in computational precision medicine. We demonstrate the ability of GaNDLF to analyze both radiology and histology images, with built-in support for k-fold cross-validation, data augmentation, multiple modalities and output classes. Our quantitative performance evaluation on numerous use cases, anatomies, and computational tasks supports GaNDLF as a robust application framework for deployment in clinical workflows.