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      3D Breast Cancer Segmentation in DCE‐MRI Using Deep Learning With Weak Annotation

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          Abstract

          Background

          Deep learning models require large‐scale training to perform confidently, but obtaining annotated datasets in medical imaging is challenging. Weak annotation has emerged as a way to save time and effort.

          Purpose

          To develop a deep learning model for 3D breast cancer segmentation in dynamic contrast‐enhanced magnetic resonance imaging (DCE‐MRI) using weak annotation with reliable performance.

          Study Type

          Retrospective.

          Population

          Seven hundred and thirty‐six women with breast cancer from a single institution, divided into the development ( N = 544) and test dataset ( N = 192).

          Field Strength/Sequence

          3.0‐T, 3D fat‐saturated gradient‐echo axial T1‐weighted flash 3D volumetric interpolated brain examination (VIBE) sequences.

          Assessment

          Two radiologists performed a weak annotation of the ground truth using bounding boxes. Based on this, the ground truth annotation was completed through autonomic and manual correction. The deep learning model using 3D U‐Net transformer (UNETR) was trained with this annotated dataset. The segmentation results of the test set were analyzed by quantitative and qualitative methods, and the regions were divided into whole breast and region of interest (ROI) within the bounding box.

          Statistical Tests

          As a quantitative method, we used the Dice similarity coefficient to evaluate the segmentation result. The volume correlation with the ground truth was evaluated with the Spearman correlation coefficient. Qualitatively, three readers independently evaluated the visual score in four scales. A P‐value <0.05 was considered statistically significant.

          Results

          The deep learning model we developed achieved a median Dice similarity score of 0.75 and 0.89 for the whole breast and ROI, respectively. The volume correlation coefficient with respect to the ground truth volume was 0.82 and 0.86 for the whole breast and ROI, respectively. The mean visual score, as evaluated by three readers, was 3.4.

          Data Conclusion

          The proposed deep learning model with weak annotation may show good performance for 3D segmentations of breast cancer using DCE‐MRI.

          Level of Evidence

          3

          Technical Efficacy

          Stage 2

          Related collections

          Most cited references32

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          Image analysis using mathematical morphology.

          For the purposes of object or defect identification required in industrial vision applications, the operations of mathematical morphology are more useful than the convolution operations employed in signal processing because the morphological operators relate directly to shape. The tutorial provided in this paper reviews both binary morphology and gray scale morphology, covering the operations of dilation, erosion, opening, and closing and their relations. Examples are given for each morphological concept and explanations are given for many of their interrelationships.
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            Generalised Dice Overlap as a Deep Learning Loss Function for Highly Unbalanced Segmentations

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              Breast MRI: State of the Art

              MRI of the breast has the highest sensitivity for breast cancer detection among current clinical imaging modalities and is indispensable for breast imaging practice. While the basis of breast MRI consists of T1-weighted contrast-enhanced imaging, T2-weighted, ultrafast, and diffusion-weighted imaging may be used to improve lesion characterization. Such multiparametric assessment of breast lesions allows for excellent discrimination between benign and malignant breast lesions. Indications for breast MRI are expanding. In preoperative staging, multiple studies confirm the superiority of MRI to other imaging modalities for tumor size estimation and detection of additional tumor foci in the ipsilateral and contralateral breast. Ongoing studies show that in experienced hands this can be used to improve breast cancer surgery, although there is no evidence of improved long-term outcomes. Screening indications are likewise growing as evidence is accumulating that OncologicRI depicts cancers at an earlier stage than mammography in all women. To manage the associated costs for screening, the use of abbreviated protocols may be beneficial. In patients treated with neoadjuvant chemotherapy, MRI is used to document response. It is essential to realize that oncologic and surgical response are different, and evaluation should be adapted to the underlying question.
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                Author and article information

                Contributors
                Journal
                Journal of Magnetic Resonance Imaging
                Magnetic Resonance Imaging
                Wiley
                1053-1807
                1522-2586
                June 2024
                August 19 2023
                June 2024
                : 59
                : 6
                : 2252-2262
                Affiliations
                [1 ] Department of Radiology, Seoul St. Mary's Hospital, College of Medicine The Catholic University of Korea Seoul Republic of Korea
                [2 ] Division of Biomedical Engineering Hankuk University of Foreign Studies Yongin Republic of Korea
                Article
                10.1002/jmri.28960
                b7d0070a-34dd-45e9-867d-78062c0f6922
                © 2024

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