title: Breast mass lesions: computer-aided diagnosis models with mammographic and sonographic descriptors.
abstract: OBJECTIVE
  To retrospectively develop and evaluate computer-aided diagnosis (CAD) models that include both mammographic and sonographic descriptors.
  
  
  METHODS
  Institutional review board approval was obtained for this HIPAA-compliant study. A waiver of informed consent was obtained. Mammographic and sonographic examinations were performed in 737 patients (age range, 17-87 years), which yielded 803 breast mass lesions (296 malignant, 507 benign). Radiologist-interpreted features from mammograms and sonograms were used as input features for linear discriminant analysis (LDA) and artificial neural network (ANN) models to differentiate benign from malignant lesions. An LDA with all the features was compared with an LDA with only stepwise-selected features. Classification performances were quantified by using receiver operating characteristic (ROC) analysis and were evaluated in a train, validate, and retest scheme. On the retest set, both LDAs were compared with radiologist assessment score of malignancy.
  
  
  RESULTS
  Both the LDA and ANN achieved high classification performance with cross validation (area under the ROC curve [A(z)] = 0.92 +/- 0.01 [standard deviation] and (0.90)A(z) = 0.54 +/- 0.08 for LDA, A(z) = 0.92 +/- 0.01 and (0.90)A(z) = 0.55 +/- 0.08 for ANN). Results of both models generalized well to the retest set, with no significant performance differences between the validate and retest sets (P > .1). On the retest set, there were no significant performance differences between LDA with all features and LDA with only the stepwise-selected features (P > .3) and between either LDA and radiologist assessment score (P > .2).
  
  
  CONCLUSIONS
  Results showed that combining mammographic and sonographic descriptors in a CAD model can result in high classification and generalization performance. On the retest set, LDA performance matched radiologist classification performance.
authors.affiliation: Department of Biomedical Engineering, Duke University Medical Center, 2424 Erwin Rd, Suite 302, Durham, NC 27705, USA. jonathan.jesneck@duke.edu
authors.forename: Jonathan L
authors.initials: JL
authors.lastname: Jesneck
authors.forename: Joseph Y
authors.initials: JY
authors.lastname: Lo
authors.forename: Jay A
authors.initials: JA
authors.lastname: Baker
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000000981:diagnostic imaging*; D016002:Discriminant Analysis; D005260:Female; D006801:Humans; D007089:Image Enhancement / Q000379:methods; D007090:Image Interpretation, Computer-Assisted / Q000379:methods*; D008327:Mammography; D008875:Middle Aged; D016571:Neural Networks, Computer; D011237:Predictive Value of Tests; D012372:ROC Curve; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D016217:Ultrasonography, Mammary