Deep learning in breast imaging.

BJR open Pub Date : 2022-05-13 eCollection Date: 2022-01-01 DOI:10.1259/bjro.20210060
Arka Bhowmik, Sarah Eskreis-Winkler
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Abstract

Millions of breast imaging exams are performed each year in an effort to reduce the morbidity and mortality of breast cancer. Breast imaging exams are performed for cancer screening, diagnostic work-up of suspicious findings, evaluating extent of disease in recently diagnosed breast cancer patients, and determining treatment response. Yet, the interpretation of breast imaging can be subjective, tedious, time-consuming, and prone to human error. Retrospective and small reader studies suggest that deep learning (DL) has great potential to perform medical imaging tasks at or above human-level performance, and may be used to automate aspects of the breast cancer screening process, improve cancer detection rates, decrease unnecessary callbacks and biopsies, optimize patient risk assessment, and open up new possibilities for disease prognostication. Prospective trials are urgently needed to validate these proposed tools, paving the way for real-world clinical use. New regulatory frameworks must also be developed to address the unique ethical, medicolegal, and quality control issues that DL algorithms present. In this article, we review the basics of DL, describe recent DL breast imaging applications including cancer detection and risk prediction, and discuss the challenges and future directions of artificial intelligence-based systems in the field of breast cancer.

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乳腺成像中的深度学习
为了降低乳腺癌的发病率和死亡率,每年都要进行数百万次乳腺成像检查。乳腺成像检查用于癌症筛查、可疑结果的诊断、评估新近确诊的乳腺癌患者的疾病程度以及确定治疗反应。然而,乳腺成像的解读可能是主观的、繁琐的、耗时的,而且容易出现人为错误。回顾性研究和小型读者研究表明,深度学习(DL)在执行医学影像任务方面具有巨大潜力,可以达到或超过人类水平,可用于实现乳腺癌筛查过程的自动化,提高癌症检出率,减少不必要的回访和活检,优化患者风险评估,并为疾病预后开辟新的可能性。目前迫切需要进行前瞻性试验来验证这些拟议的工具,为实际临床应用铺平道路。此外,还必须制定新的监管框架,以解决 DL 算法所带来的独特的伦理、医疗法律和质量控制问题。在本文中,我们回顾了 DL 的基础知识,介绍了最近的 DL 乳腺成像应用,包括癌症检测和风险预测,并讨论了基于人工智能的系统在乳腺癌领域面临的挑战和未来发展方向。
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