title: On the interplay of machine learning and background knowledge in image interpretation by Bayesian networks.
abstract: OBJECTIVE
  To obtain a balanced view on the role and place of expert knowledge and learning methods in building Bayesian networks for medical image interpretation.
  
  
  METHODS
  The interpretation of mammograms was selected as the example medical image interpretation problem. Medical image interpretation has its own common standards and procedures. The impact of these on two complementary methods for Bayesian network construction was explored. Firstly, methods for the discretisation of continuous features were investigated, yielding multinomial distributions that were compared to the original Gaussian probabilistic parameters of the network. Secondly, the structure of a manually constructed Bayesian network was tested by structure learning from image data. The image data used for the research came from screening mammographic examinations of 795 patients, of whom 344 were cancerous.
  
  
  RESULTS
  The experimental results show that there is an interesting interplay of machine learning results and background knowledge in medical image interpretation. Networks with discretised data lead to better classification performance (increase in the detected cancers of up to 11.7%), easier interpretation, and a better fit to the data in comparison to the expert-based Bayesian network with Gaussian probabilistic parameters. Gaussian probability distributions are often used in medical image interpretation because of the continuous nature of many of the image features. The structures learnt supported many of the expert-originated relationships but also revealed some novel relationships between the mammographic features. Using discretised features and performing structure learning on the mammographic data has further improved the cancer detection performance of up to 17% compared to the manually constructed Bayesian network model.
  
  
  CONCLUSIONS
  Finding the right balance between expert knowledge and data-derived knowledge, both at the level of network structure and parameters, is key to using Bayesian networks for medical image interpretation. A balanced approach to building Bayesian networks for image interpretation yields more accurate and understandable Bayesian network models.
authors: Institute for Computing and Information Sciences, Radboud University Nijmegen, Heyendaalseweg 135, 6525 AJ Nijmegen, The Netherlands. marinav@cs.ru.nl
authors: Marina
authors: M
authors: Velikova
authors: Peter J F
authors: PJ
authors: Lucas
authors: Maurice
authors: M
authors: Samulski
authors: Nico
authors: N
authors: Karssemeijer
mesh_terms: D001499:Bayes Theorem; D001943:Breast Neoplasms / Q000000981:diagnostic imaging*; D020000:Decision Support Systems, Clinical; D003661:Decision Support Techniques; D003936:Diagnosis, Computer-Assisted / Q000379:methods*; D005260:Female; D006801:Humans; D051188:Knowledge Bases; D008327:Mammography; D008962:Models, Theoretical; D016571:Neural Networks, Computer; D011237:Predictive Value of Tests; D011379:Prognosis; D011857:Radiographic Image Interpretation, Computer-Assisted / Q000379:methods*