Lars J. Grimm

Nicholas Konz, Richard Osuala, Preeti Verma et al.

Determining whether two sets of images belong to the same or different distributions or domains is a crucial task in modern medical image analysis and deep learning; for example, to evaluate the output quality of image generative models. Currently, metrics used for this task either rely on the (potentially biased) choice of some downstream task, such as segmentation, or adopt task-independent perceptual metrics (e.g., Fréchet Inception Distance/FID) from natural imaging, which we show insufficiently capture anatomical features. To this end, we introduce a new perceptual metric tailored for medical images, FRD (Fréchet Radiomic Distance), which utilizes standardized, clinically meaningful, and interpretable image features. We show that FRD is superior to other image distribution metrics for a range of medical imaging applications, including out-of-domain (OOD) detection, the evaluation of image-to-image translation (by correlating more with downstream task performance as well as anatomical consistency and realism), and the evaluation of unconditional image generation. Moreover, FRD offers additional benefits such as stability and computational efficiency at low sample sizes, sensitivity to image corruptions and adversarial attacks, feature interpretability, and correlation with radiologist-perceived image quality. Additionally, we address key gaps in the literature by presenting an extensive framework for the multifaceted evaluation of image similarity metrics in medical imaging -- including the first large-scale comparative study of generative models for medical image translation -- and release an accessible codebase to facilitate future research. Our results are supported by thorough experiments spanning a variety of datasets, modalities, and downstream tasks, highlighting the broad potential of FRD for medical image analysis.

Qihang Li, Jichen Yang, Yaqian Chen et al.

Breast MRI provides high-resolution imaging critical for breast cancer screening and preoperative staging. However, existing segmentation methods for breast MRI remain limited in scope, often focusing on only a few anatomical structures, such as fibroglandular tissue or tumors, and do not cover the full range of tissues seen in scans. This narrows their utility for quantitative analysis. In this study, we present BreastSegNet, a multi-label segmentation algorithm for breast MRI that covers nine anatomical labels: fibroglandular tissue (FGT), vessel, muscle, bone, lesion, lymph node, heart, liver, and implant. We manually annotated a large set of 1123 MRI slices capturing these structures with detailed review and correction from an expert radiologist. Additionally, we benchmark nine segmentation models, including U-Net, SwinUNet, UNet++, SAM, MedSAM, and nnU-Net with multiple ResNet-based encoders. Among them, nnU-Net ResEncM achieves the highest average Dice scores of 0.694 across all labels. It performs especially well on heart, liver, muscle, FGT, and bone, with Dice scores exceeding 0.73, and approaching 0.90 for heart and liver. All model code and weights are publicly available, and we plan to release the data at a later date.

Xuan Liu, Yinhao Ren, Marc D. Ryser et al.

Accurate lesion tracking in temporal mammograms is essential for monitoring breast cancer progression and facilitating early diagnosis. However, automated lesion correspondence across exams remains a challenges in computer-aided diagnosis (CAD) systems, limiting their effectiveness. We propose MammoTracker, a mask-guided lesion tracking framework that automates lesion localization across consecutively exams. Our approach follows a coarse-to-fine strategy incorporating three key modules: global search, local search, and score refinement. To support large-scale training and evaluation, we introduce a new dataset with curated prior-exam annotations for 730 mass and calcification cases from the public EMBED mammogram dataset, yielding over 20000 lesion pairs, making it the largest known resource for temporal lesion tracking in mammograms. Experimental results demonstrate that MammoTracker achieves 0.455 average overlap and 0.509 accuracy, surpassing baseline models by 8%, highlighting its potential to enhance CAD-based lesion progression analysis. Our dataset will be available at https://gitlab.oit.duke.edu/railabs/LoGroup/mammotracker.

Zhe Zhu, Michael Harowicz, Jun Zhang et al.

Purpose: To determine whether deep learning-based algorithms applied to breast MR images can aid in the prediction of occult invasive disease following the di- agnosis of ductal carcinoma in situ (DCIS) by core needle biopsy. Material and Methods: In this institutional review board-approved study, we analyzed dynamic contrast-enhanced fat-saturated T1-weighted MRI sequences of 131 patients at our institution with a core needle biopsy-confirmed diagnosis of DCIS. The patients had no preoperative therapy before breast MRI and no prior history of breast cancer. We explored two different deep learning approaches to predict whether there was a hidden (occult) invasive component in the analyzed tumors that was ultimately detected at surgical excision. In the first approach, we adopted the transfer learning strategy, in which a network pre-trained on a large dataset of natural images is fine-tuned with our DCIS images. Specifically, we used the GoogleNet model pre-trained on the ImageNet dataset. In the second approach, we used a pre-trained network to extract deep features, and a support vector machine (SVM) that utilizes these features to predict the upstaging of the DCIS. We used 10-fold cross validation and the area under the ROC curve (AUC) to estimate the performance of the predictive models. Results: The best classification performance was obtained using the deep features approach with GoogleNet model pre-trained on ImageNet as the feature extractor and a polynomial kernel SVM used as the classifier (AUC = 0.70, 95% CI: 0.58- 0.79). For the transfer learning based approach, the highest AUC obtained was 0.53 (95% CI: 0.41-0.62). Conclusion: Convolutional neural networks could potentially be used to identify occult invasive disease in patients diagnosed with DCIS at the initial core needle biopsy.