Ciurescu Sebastian, Cerbu Simona, Dima Ciprian Nicușor, Borozan Florina, Pârvănescu Raluca, Ilaș Diana-Gabriela, Cîtu Cosmin, Vernic Corina, Sas Ioan
Doctoral School in Medicine, Victor Babeș University of Medicine and Pharmacy, 300041 Timișoara, Romania.
Department of Obstetrics and Gynecology, Victor Babeş University of Medicine and Pharmacy, 300041 Timișoara, Romania.
Medicina (Kaunas). 2025 Apr 26;61(5):809. doi: 10.3390/medicina61050809.
: Breast cancer is a leading global health challenge, where early detection is essential for improving survival outcomes. Two-dimensional (2D) mammography is the established standard for breast cancer screening; however, its diagnostic accuracy is limited by factors such as breast density and inter-reader variability. Recent advances in artificial intelligence (AI) have shown promise in enhancing radiological interpretation. This study aimed to assess the utility of AI in improving lesion detection and classification in 2D mammography. : A retrospective analysis was performed on a dataset of 578 mammographic images obtained from a single radiology center. The dataset consisted of 36% pathologic and 64% normal cases, and was partitioned into training (403 images), validation (87 images), and test (88 images) sets. Image preprocessing involved grayscale conversion, contrast-limited adaptive histogram equalization (CLAHE), noise reduction, and sharpening. A convolutional neural network (CNN) model was developed using transfer learning with ResNet50. Model performance was evaluated using sensitivity, specificity, accuracy, and area under the receiver operating characteristic (AUC-ROC) curve. : The AI model achieved an overall classification accuracy of 88.5% and an AUC-ROC of 0.93, demonstrating strong discriminative capability between normal and pathologic cases. Notably, the model exhibited a high specificity of 92.7%, contributing to a reduction in false positives and improved screening efficiency. : AI-assisted 2D mammography holds potential to enhance breast cancer detection by improving lesion classification and reducing false-positive findings. Although the model achieved high specificity, further optimization is required to minimize false negatives. Future efforts should aim to improve model sensitivity, incorporate multimodal imaging techniques, and validate results across larger, multicenter prospective cohorts to ensure effective integration into clinical radiology workflows.
乳腺癌是一项全球性的重大健康挑战,早期检测对于改善生存结局至关重要。二维(2D)乳腺钼靶摄影是乳腺癌筛查的既定标准;然而,其诊断准确性受到乳腺密度和阅片者间差异等因素的限制。人工智能(AI)的最新进展在增强放射学解释方面显示出了前景。本研究旨在评估AI在改善2D乳腺钼靶摄影中病变检测和分类的效用。
对从单个放射学中心获得的578幅乳腺钼靶图像数据集进行了回顾性分析。该数据集由36%的病理病例和64%的正常病例组成,并被分为训练集(403幅图像)、验证集(87幅图像)和测试集(88幅图像)。图像预处理包括灰度转换、对比度受限自适应直方图均衡化(CLAHE)、降噪和锐化。使用带有ResNet50的迁移学习开发了一个卷积神经网络(CNN)模型。使用灵敏度、特异性、准确性和受试者工作特征曲线下面积(AUC-ROC)评估模型性能。
AI模型的总体分类准确率达到88.5%,AUC-ROC为0.93,表明在正常和病理病例之间具有很强的判别能力。值得注意的是,该模型表现出92.7%的高特异性,有助于减少假阳性并提高筛查效率。
AI辅助的2D乳腺钼靶摄影有潜力通过改善病变分类和减少假阳性结果来增强乳腺癌检测。尽管该模型实现了高特异性,但仍需要进一步优化以尽量减少假阴性。未来的工作应旨在提高模型灵敏度,纳入多模态成像技术,并在更大的多中心前瞻性队列中验证结果,以确保有效整合到临床放射学工作流程中。