title: Semi-automatic region-of-interest segmentation based computer-aided diagnosis of mass lesions from dynamic contrast-enhanced magnetic resonance imaging based breast cancer screening.
abstract: Cancer screening with magnetic resonance imaging (MRI) is currently recommended for very high risk women. The high variability in the diagnostic accuracy of radiologists analyzing screening MRI examinations of the breast is due, at least in part, to the large amounts of data acquired. This has motivated substantial research towards the development of computer-aided diagnosis (CAD) systems for breast MRI which can assist in the diagnostic process by acting as a second reader of the examinations. This retrospective study was performed on 184 benign and 49 malignant lesions detected in a prospective MRI screening study of high risk women at Sunnybrook Health Sciences Centre. A method for performing semi-automatic lesion segmentation based on a supervised learning formulation was compared with the enhancement threshold based segmentation method in the context of a computer-aided diagnostic system. The results demonstrate that the proposed method can assist in providing increased separation between malignant and radiologically suspicious benign lesions. Separation between malignant and benign lesions based on margin measures improved from a receiver operating characteristic (ROC) curve area of 0.63 to 0.73 when the proposed segmentation method was compared with the enhancement threshold, representing a statistically significant improvement. Separation between malignant and benign lesions based on dynamic measures improved from a ROC curve area of 0.75 to 0.79 when the proposed segmentation method was compared to the enhancement threshold, also representing a statistically significant improvement. The proposed method has potential as a component of a computer-aided diagnostic system.
authors.affiliation: Institute of Biomedical Engineering, University of Oxford, Parks Road, Oxford, OX1 3PJ, UK, jacob.levman@eng.ox.ac.uk.
authors.forename: Jacob
authors.initials: J
authors.lastname: Levman
authors.forename: Ellen
authors.initials: E
authors.lastname: Warner
authors.forename: Petrina
authors.initials: P
authors.lastname: Causer
authors.forename: Anne
authors.initials: A
authors.lastname: Martel
mesh_terms: D001940:Breast / Q000473:pathology; D001943:Breast Neoplasms / Q000175:diagnosis*; D003287:Contrast Media; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007089:Image Enhancement / Q000379:methods*; D007090:Image Interpretation, Computer-Assisted / Q000379:methods*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D010363:Pattern Recognition, Automated / Q000379:methods*; D012372:ROC Curve; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012680:Sensitivity and Specificity
chemical_list: D003287:Contrast Media
references.citation: Magn Reson Imaging. 2006 Sep;24(7):917-29
references.pmid: 16916709
references.citation: Med Phys. 2006 Aug;33(8):2878-87
references.pmid: 16964864
references.citation: J Magn Reson Imaging. 2007 Mar;25(3):495-501
references.pmid: 17279534
references.citation: Phys Med Biol. 2007 Jul 7;52(13):3803-16
references.pmid: 17664578
references.citation: IEEE Trans Med Imaging. 2008 May;27(5):688-96
references.pmid: 18450541
references.citation: CA Cancer J Clin. 2007 Mar-Apr;57(2):75-89
references.pmid: 17392385
references.citation: Acad Radiol. 2009 Sep;16(9):1064-9
references.pmid: 19515584
references.citation: Inf Process Med Imaging. 2005;19:126-37
references.pmid: 17354690
references.citation: JAMA. 2004 Sep 15;292(11):1317-25
references.pmid: 15367553
references.citation: JAMA. 2012 Apr 4;307(13):1394-404
references.pmid: 22474203
references.citation: J Digit Imaging. 2014 Feb;27(1):145-51
references.pmid: 23836079
references.citation: Acad Radiol. 2006 Jan;13(1):63-72
references.pmid: 16399033
references.citation: Am J Hum Genet. 1998 Mar;62(3):676-89
references.pmid: 9497246
references.citation: Acad Radiol. 2011 Dec;18(12):1577-81
references.pmid: 21958601
references.citation: Ann Intern Med. 2008 May 6;148(9):671-9
references.pmid: 18458280
references.citation: Acad Radiol. 2008 Dec;15(12):1513-25
references.pmid: 19000868
references.citation: Magn Reson Med. 1998 Jan;39(1):108-15
references.pmid: 9438444