Jesneck Jonathan L, Lo Joseph Y, Baker Jay A
Department of Biomedical Engineering, Duke University Medical Center, 2424 Erwin Rd, Suite 302, Durham, NC 27705, USA.
Radiology. 2007 Aug;244(2):390-8. doi: 10.1148/radiol.2442060712. Epub 2007 Jun 11.
To retrospectively develop and evaluate computer-aided diagnosis (CAD) models that include both mammographic and sonographic descriptors.
Institutional review board approval was obtained for this HIPAA-compliant study. A waiver of informed consent was obtained. Mammographic and sonographic examinations were performed in 737 patients (age range, 17-87 years), which yielded 803 breast mass lesions (296 malignant, 507 benign). Radiologist-interpreted features from mammograms and sonograms were used as input features for linear discriminant analysis (LDA) and artificial neural network (ANN) models to differentiate benign from malignant lesions. An LDA with all the features was compared with an LDA with only stepwise-selected features. Classification performances were quantified by using receiver operating characteristic (ROC) analysis and were evaluated in a train, validate, and retest scheme. On the retest set, both LDAs were compared with radiologist assessment score of malignancy.
Both the LDA and ANN achieved high classification performance with cross validation (area under the ROC curve [A(z)] = 0.92 +/- 0.01 [standard deviation] and (0.90)A(z) = 0.54 +/- 0.08 for LDA, A(z) = 0.92 +/- 0.01 and (0.90)A(z) = 0.55 +/- 0.08 for ANN). Results of both models generalized well to the retest set, with no significant performance differences between the validate and retest sets (P > .1). On the retest set, there were no significant performance differences between LDA with all features and LDA with only the stepwise-selected features (P > .3) and between either LDA and radiologist assessment score (P > .2).
Results showed that combining mammographic and sonographic descriptors in a CAD model can result in high classification and generalization performance. On the retest set, LDA performance matched radiologist classification performance.
回顾性开发并评估包含乳腺X线摄影和超声描述符的计算机辅助诊断(CAD)模型。
本符合健康保险流通与责任法案(HIPAA)的研究获得了机构审查委员会的批准。已获得知情同意书的豁免。对737例患者(年龄范围17 - 87岁)进行了乳腺X线摄影和超声检查,共产生803个乳腺肿块病变(296个恶性,507个良性)。将放射科医生解读的乳腺X线摄影和超声图像特征用作线性判别分析(LDA)和人工神经网络(ANN)模型的输入特征,以区分良性和恶性病变。将具有所有特征的LDA与仅具有逐步选择特征的LDA进行比较。通过使用受试者操作特征(ROC)分析对分类性能进行量化,并在训练、验证和重新测试方案中进行评估。在重新测试集上,将两种LDA与放射科医生的恶性评估评分进行比较。
LDA和ANN在交叉验证中均取得了较高的分类性能(LDA的ROC曲线下面积[A(z)] = 0.92±0.01[标准差]且(0.90)A(z) = 0.54±0.08,ANN的A(z) = 0.92±0.01且(0.90)A(z) = 0.55±0.08)。两种模型的结果在重新测试集中都能很好地推广,验证集和重新测试集之间的性能无显著差异(P>.1)。在重新测试集上,具有所有特征的LDA与仅具有逐步选择特征的LDA之间(P>.3)以及任何一种LDA与放射科医生评估评分之间(P>.2)的性能均无显著差异。
结果表明在CAD模型中结合乳腺X线摄影和超声描述符可获得较高的分类和推广性能。在重新测试集上,LDA的性能与放射科医生的分类性能相当。