Bruno Barufaldi

Tamerlan Mustafaev, Oleg Kruglov, Margarita Zuley et al.

Digital breast tomosynthesis (DBT) is now the standard of care for breast cancer screening in the USA. Accurate segmentation of fibroglandular tissue in DBT images is essential for personalized risk estimation, but algorithm development is limited by scarce human-delineated training data. In this study we introduce a time- and labor-saving framework to generate a human-annotated binary segmentation mask for dense tissue in DBT. Our framework enables a user to outline a rough region of interest (ROI) enclosing dense tissue on the central reconstructed slice of a DBT volume and select a segmentation threshold to generate the dense tissue mask. The algorithm then projects the ROI to the remaining slices and iteratively adjusts slice-specific thresholds to maintain consistent dense tissue delineation across the DBT volume. By requiring annotation only on the central slice, the framework substantially reduces annotation time and labor. We used 44 DBT volumes from the DBTex dataset for evaluation. Inter-reader agreement was assessed by computing patient-wise Dice similarity coefficients between segmentation masks produced by two radiologists, yielding a median of 0.84. Accuracy of the proposed method was evaluated by having a radiologist manually segment the 20th and 80th percentile slices from each volume (CC and MLO views; 176 slices total) and calculate Dice scores between the manual and proposed segmentations, yielding a median of 0.83.

Gabriel A. B. do Nascimento, Vincent Dong, Guilherme J. Cavalcante et al.

Accurate breast MRI lesion detection is critical for early cancer diagnosis, especially in high-risk populations. We present a classification pipeline that adapts a pretrained foundation model, the Medical Slice Transformer (MST), for breast lesion classification using dynamic contrast-enhanced MRI (DCE-MRI). Leveraging DINOv2-based self-supervised pretraining, MST generates robust per-slice feature embeddings, which are then used to train a Kolmogorov--Arnold Network (KAN) classifier. The KAN provides a flexible and interpretable alternative to conventional convolutional networks by enabling localized nonlinear transformations via adaptive B-spline activations. This enhances the model's ability to differentiate benign from malignant lesions in imbalanced and heterogeneous clinical datasets. Experimental results demonstrate that the MST+KAN pipeline outperforms the baseline MST classifier, achieving AUC = 0.80 \pm 0.02 while preserving interpretability through attention-based heatmaps. Our findings highlight the effectiveness of combining foundation model embeddings with advanced classification strategies for building robust and generalizable breast MRI analysis tools.

Aditya Jonnalagadda, Bruno B. Barufaldi, Andrew D. A. Maidment et al.

Model observers are computational tools to evaluate and optimize task-based medical image quality. Linear model observers, such as the Channelized Hotelling Observer (CHO), predict human accuracy in detection tasks with a few possible signal locations in clinical phantoms or real anatomic backgrounds. In recent years, Convolutional Neural Networks (CNNs) have been proposed as a new type of model observer. What is not well understood is what CNNs add over the more common linear model observer approaches. We compare the CHO and CNN detection accuracy to the radiologist's accuracy in searching for two types of signals (mass and microcalcification) embedded in 2D/3D breast tomosynthesis phantoms (DBT). We show that the CHO model's accuracy is comparable to the CNN's performance for a location-known-exactly detection task. However, for the search task with 2D/3D DBT phantoms, the CHO's detection accuracy was significantly lower than the CNN accuracy. A comparison to the radiologist's accuracy showed that the CNN but not the CHO could match or exceed the radiologist's accuracy in the 2D microcalcification and 3D mass search conditions. An analysis of the eye position showed that radiologists fixated more often and longer at the locations corresponding to CNN false positives. Most CHO false positives were the phantom's normal anatomy and were not fixated by radiologists. In conclusion, we show that CNNs can be used as an anthropomorphic model observer for the search task for which traditional linear model observers fail due to their inability to discount false positives arising from the anatomical backgrounds.