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. 2022 Aug;35(4):910-922.
doi: 10.1007/s10278-019-00266-4.

Prediction of Short-Term Breast Cancer Risk with Fusion of CC- and MLO-Based Risk Models in Four-View Mammograms

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Prediction of Short-Term Breast Cancer Risk with Fusion of CC- and MLO-Based Risk Models in Four-View Mammograms

Yane Li et al. J Digit Imaging. 2022 Aug.

Abstract

This study performed and assessed a novel program to improve the accuracy of short-term breast cancer risk prediction by using information from craniocaudal (CC) and mediolateral-oblique (MLO) views of two breasts. An age-matched dataset of 556 patients with at least two sequential full-field digital mammography examinations was applied. In the second examination, 278 cases were diagnosed and pathologically verified as cancer, and 278 were negative, while all cases in the first examination were negative (not recalled). Two generalized linear-model-based risk prediction models were established with global- and local-based bilateral asymmetry features for CC and MLO views first. Then, a new fusion risk model was developed by fusing prediction results of the CC- and MLO-based risk models with an adaptive alpha-integration-based fusion method. The AUC of the fusion risk model was 0.72 ± 0.02, which was significantly higher than the AUC of CC- or MLO-based risk model (P < 0.05). The maximum odds ratio for CC- and MLO-based risk models were 8.09 and 5.25, respectively, and increased to 11.99 for the fusion risk model. For subgroups of patients aged 37-49 years, 50-65 years, and 66-87 years, the AUCs of 0.73, 0.71, and 0.75 for the fusion risk model were higher than AUC for CC- and MLO-based risk models. For the BIRADS 2 and 3 subgroups, the AUC values were 0.72 and 0.71 respectively for the fusion risk model which were higher than the AUC for the CC- and MLO-based risk models. This study demonstrated that the fusion risk model we established could effectively derive and integrate supplementary and useful information extracted from both CC and MLO view images and adaptively fuse them to increase the predictive power of the short-term breast cancer risk assessment model.

Keywords: Bilateral asymmetry; Computer-aided detection; Four-view mammography; Fusion risk model; Short-term breast cancer risk.

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Figures

Fig. 1
Fig. 1
Distribution and comparison of case in age and density BIRADS ratings between the two risk groups. a Distribution of cases into the three age-based subgroups. b The two risk group cases categorized into four subgroups
Fig. 2
Fig. 2
Flow chart of the procedure to perform the fusion risk prediction model
Fig. 3
Fig. 3
Examples of original images and regions of interest from one patient. a, b Original CC and MLO views. cf Bilateral strips, g–j rectangular strips. k, l DoG-based element regions and six sub-regions. m, n Global regions
Fig. 4
Fig. 4
Three ROC curves produced from the output of three risk models, the CC-based risk model, MLO-based risk model, and the fusion risk model, with an adaptive alpha-integration-based fusion method
Fig. 5
Fig. 5
Learning α and ω starting from 0 and [0.5, 0.5] respectively. a, b One cycle of the alpha and fusion weighting factor curves
Fig. 6
Fig. 6
Trend lines of increased odds ratios with increases in risk scores for CC-based risk model, MLO-based risk model, and the fusion risk model
Fig. 7
Fig. 7
Comparison of ROC curves generated from CC- and MLO-based risk models and the fusion risk model in the three age-based subgroups
Fig. 8
Fig. 8
Trend lines of odds ratios for the three age-based subgroups for CC-based risk model, MLO-based risk model, and the fusion risk model respectively
Fig. 9
Fig. 9
Comparison of ROC curves for the BIRADS 2 and 3 subgroups for the CC-based risk model, MLO-based risk model, and the fusion risk model

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