Robust breast cancer detection in mammography and digital breast tomosynthesis using an annotation-efficient deep learning approach
Authors
Lotter, WilliamDiab, Abdul Rahman
Haslam, Bryan
Kim, Jiye G.
Grisot, Giorgia
Wu, Eric
Wu, Kevin
Onieva, Jorge Onieva
Boyer, Yun
Boxerman, Jerrold L.
Wang, Meiyun
Bandler, Mack
Vijayaraghavan, Gopal
Gregory Sorensen, A.
UMass Chan Affiliations
Department of RadiologyDocument Type
Journal ArticlePublication Date
2021-02-01Keywords
Breast cancerMachine learning
Artificial Intelligence and Robotics
Diagnosis
Neoplasms
Radiology
Metadata
Show full item recordAbstract
Breast cancer remains a global challenge, causing over 600,000 deaths in 2018 (ref. (1)). To achieve earlier cancer detection, health organizations worldwide recommend screening mammography, which is estimated to decrease breast cancer mortality by 20-40% (refs. (2,3)). Despite the clear value of screening mammography, significant false positive and false negative rates along with non-uniformities in expert reader availability leave opportunities for improving quality and access(4,5). To address these limitations, there has been much recent interest in applying deep learning to mammography(6-18), and these efforts have highlighted two key difficulties: obtaining large amounts of annotated training data and ensuring generalization across populations, acquisition equipment and modalities. Here we present an annotation-efficient deep learning approach that (1) achieves state-of-the-art performance in mammogram classification, (2) successfully extends to digital breast tomosynthesis (DBT; '3D mammography'), (3) detects cancers in clinically negative prior mammograms of patients with cancer, (4) generalizes well to a population with low screening rates and (5) outperforms five out of five full-time breast-imaging specialists with an average increase in sensitivity of 14%. By creating new 'maximum suspicion projection' (MSP) images from DBT data, our progressively trained, multiple-instance learning approach effectively trains on DBT exams using only breast-level labels while maintaining localization-based interpretability. Altogether, our results demonstrate promise towards software that can improve the accuracy of and access to screening mammography worldwide.Source
Lotter W, Diab AR, Haslam B, Kim JG, Grisot G, Wu E, Wu K, Onieva JO, Boyer Y, Boxerman JL, Wang M, Bandler M, Vijayaraghavan GR, Gregory Sorensen A. Robust breast cancer detection in mammography and digital breast tomosynthesis using an annotation-efficient deep learning approach. Nat Med. 2021 Feb;27(2):244-249. doi: 10.1038/s41591-020-01174-9. Epub 2021 Jan 11. PMID: 33432172. Link to article on publisher's site
DOI
10.1038/s41591-020-01174-9Permanent Link to this Item
http://hdl.handle.net/20.500.14038/48490PubMed ID
33432172Related Resources
ae974a485f413a2113503eed53cd6c53
10.1038/s41591-020-01174-9