Fiona J. Gilbert

Yijun Yang, Shujun Wang, Lihao Liu et al.

Breast cancer is a major cause of cancer death among women, emphasising the importance of early detection for improved treatment outcomes and quality of life. Mammography, the primary diagnostic imaging test, poses challenges due to the high variability and patterns in mammograms. Double reading of mammograms is recommended in many screening programs to improve diagnostic accuracy but increases radiologists' workload. Researchers explore Machine Learning models to support expert decision-making. Stand-alone models have shown comparable or superior performance to radiologists, but some studies note decreased sensitivity with multiple datasets, indicating the need for high generalisation and robustness models. This work devises MammoDG, a novel deep-learning framework for generalisable and reliable analysis of cross-domain multi-center mammography data. MammoDG leverages multi-view mammograms and a novel contrastive mechanism to enhance generalisation capabilities. Extensive validation demonstrates MammoDG's superiority, highlighting the critical importance of domain generalisation for trustworthy mammography analysis in imaging protocol variations.

Shuaiyu Yuan, Tristan Whitmarsh, Dimitri A Kessler et al.

New multinuclear MRI techniques, such as sodium MRI, generally suffer from low image quality due to an inherently low signal. Postprocessing methods, such as image denoising, have been developed for image enhancement. However, the assessment of these enhanced images is challenging especially considering when there is a lack of high resolution and high signal images as reference, such as in sodium MRI. No-reference Image Quality Assessment (NR-IQA) metrics are approaches to solve this problem. Existing learning-based NR-IQA metrics rely on labels derived from subjective human opinions or metrics like Signal-to-Noise Ratio (SNR), which are either time-consuming or lack accurate ground truths, resulting in unreliable assessment. We note that deep learning (DL) models have a unique characteristic in that they are specialized to a characteristic training set, meaning that deviations between the input testing data from the training data will reduce prediction accuracy. Therefore, we propose a novel DL-based NR-IQA metric, the Model Specialization Metric (MSM), which does not depend on ground-truth images or labels. MSM measures the difference between the input image and the model's prediction for evaluating the quality of the input image. Experiments conducted on both simulated distorted proton T1-weighted MR images and denoised sodium MR images demonstrate that MSM exhibits a superior evaluation performance on various simulated noises and distortions. MSM also has a substantial agreement with the expert evaluations, achieving an averaged Cohen's Kappa coefficient of 0.6528, outperforming the existing NR-IQA metrics.

Gustav Müller-Franzes, Lorena Escudero Sánchez, Nicholas Payne et al.

Detecting breast cancer early is of the utmost importance to effectively treat the millions of women afflicted by breast cancer worldwide every year. Although mammography is the primary imaging modality for screening breast cancer, there is an increasing interest in adding magnetic resonance imaging (MRI) to screening programmes, particularly for women at high risk. Recent guidelines by the European Society of Breast Imaging (EUSOBI) recommended breast MRI as a supplemental screening tool for women with dense breast tissue. However, acquiring and reading MRI scans requires significantly more time from expert radiologists. This highlights the need to develop new automated methods to detect cancer accurately using MRI and Artificial Intelligence (AI), which have the potential to support radiologists in breast MRI interpretation and classification and help detect cancer earlier. For this reason, the ODELIA consortium has made this multi-centre dataset publicly available to assist in developing AI tools for the detection of breast cancer on MRI.

Shuaiyu Yuan, Tristan Whitmarsh, Dimitri A Kessler et al.

Sodium MRI is an imaging technique used to visualize and quantify sodium concentrations in vivo, playing a role in many biological processes and potentially aiding in breast cancer characterization. Sodium MRI, however, suffers from inherently low signal-to-noise ratios (SNR) and spatial resolution, compared with conventional proton MRI. A deep-learning method, the Denoising Diffusion Probabilistic Models (DDPM), has demonstrated success across a wide range of denoising tasks, yet struggles with sodium MRI's unique noise profile, as DDPM primarily targets Gaussian noise. DDPM can distort features when applied to sodium MRI. This paper advances the DDPM by introducing the Rician Denoising Diffusion Probabilistic Models (RDDPM) for sodium MRI denoising. RDDPM converts Rician noise to Gaussian noise at each timestep during the denoising process. The model's performance is evaluated using three non-reference image quality assessment metrics, where RDDPM consistently outperforms DDPM and other CNN-based denoising methods.

Tao Wei, Angelica I Aviles-Rivero, Shuo Wang et al.

The task of classifying mammograms is very challenging because the lesion is usually small in the high resolution image. The current state-of-the-art approaches for medical image classification rely on using the de-facto method for ConvNets - fine-tuning. However, there are fundamental differences between natural images and medical images, which based on existing evidence from the literature, limits the overall performance gain when designed with algorithmic approaches. In this paper, we propose to go beyond fine-tuning by introducing a novel framework called MorphHR, in which we highlight a new transfer learning scheme. The idea behind the proposed framework is to integrate function-preserving transformations, for any continuous non-linear activation neurons, to internally regularise the network for improving mammograms classification. The proposed solution offers two major advantages over the existing techniques. Firstly and unlike fine-tuning, the proposed approach allows for modifying not only the last few layers but also several of the first ones on a deep ConvNet. By doing this, we can design the network front to be suitable for learning domain specific features. Secondly, the proposed scheme is scalable to hardware. Therefore, one can fit high resolution images on standard GPU memory. We show that by using high resolution images, one prevents losing relevant information. We demonstrate, through numerical and visual experiments, that the proposed approach yields to a significant improvement in the classification performance over state-of-the-art techniques, and is indeed on a par with radiology experts. Moreover and for generalisation purposes, we show the effectiveness of the proposed learning scheme on another large dataset, the ChestX-ray14, surpassing current state-of-the-art techniques.

Trent Kyono, Fiona J. Gilbert, Mihaela van der Schaar

With an aging and growing population, the number of women requiring either screening or symptomatic mammograms is increasing. To reduce the number of mammograms that need to be read by a radiologist while keeping the diagnostic accuracy the same or better than current clinical practice, we develop Man and Machine Mammography Oracle (MAMMO) - a clinical decision support system capable of triaging mammograms into those that can be confidently classified by a machine and those that cannot be, thus requiring the reading of a radiologist. The first component of MAMMO is a novel multi-view convolutional neural network (CNN) with multi-task learning (MTL). MTL enables the CNN to learn the radiological assessments known to be associated with cancer, such as breast density, conspicuity, suspicion, etc., in addition to learning the primary task of cancer diagnosis. We show that MTL has two advantages: 1) learning refined feature representations associated with cancer improves the classification performance of the diagnosis task and 2) issuing radiological assessments provides an additional layer of model interpretability that a radiologist can use to debug and scrutinize the diagnoses provided by the CNN. The second component of MAMMO is a triage network, which takes as input the radiological assessment and diagnostic predictions of the first network's MTL outputs and determines which mammograms can be correctly and confidently diagnosed by the CNN and which mammograms cannot, thus needing to be read by a radiologist. Results obtained on a private dataset of 8,162 patients show that MAMMO reduced the number of radiologist readings by 42.8% while improving the overall diagnostic accuracy in comparison to readings done by radiologists alone. We analyze the triage of patients decided by MAMMO to gain a better understanding of what unique mammogram characteristics require radiologists' expertise.