背景:乳腺病变的准确诊断和腋窝淋巴结(ALN)转移的辨别很大程度上取决于放射科医师的经验。
目的:开发一种基于深度学习的全过程系统(DLWPS),用于乳腺病变的分割和诊断以及ALN转移的区分。
方法:回顾性。
方法:1760例乳腺癌患者,他们被分为训练集和验证集(1110名患者),内部(476名患者),和外部(174名患者)测试集。
■3.0T/动态对比增强(DCE)-MRI序列。
结果:DLWPS是使用分割和分类模型开发的。基于DLWPS的分割模型是由U-Net框架开发的,注意模块和边缘特征提取模块相结合。使用三个网络的输出得分的平均得分作为基于DLWPS的分类模型的结果。此外,探讨了无DLWPS辅助和有DLWPS辅助的放射科医师诊断。为了揭示DLWPS的潜在生物学基础,基于RNA测序数据进行遗传分析.
方法:骰子相似系数(DI),接收器工作特性曲线下面积(AUC),准确度,灵敏度,特异性,和Kappa值。
结果:分割模型在内部和外部测试集中达到了0.828和0.813的DI,分别。在乳腺病变诊断中,DLWPS在内部测试组中的AUC为0.973,在外部测试组中的AUC为0.936.对于ALN转移区分,DLWPS在内部测试组中的AUC为0.927,在外部测试组中的AUC为0.917.在乳腺病变诊断和ALN转移辨别方面,放射科医生在DLWPS辅助下的一致性从0.547提高到0.794,从0.848提高到0.892,分别。此外,10例具有ALN转移的乳腺癌与有氧电子传递链和细胞质翻译的途径有关。
结论:DLWPS的表现表明,它可以促进放射科医生对乳腺病变以及ALN转移和非转移的判断。
方法:4技术效率阶段:3.
Accurate diagnosis of breast lesions and discrimination of axillary lymph node (ALN) metastases largely depend on radiologist experience.
To develop a deep learning-based whole-process system (DLWPS) for segmentation and diagnosis of breast lesions and discrimination of ALN metastasis.
Retrospective.
1760 breast patients, who were divided into training and validation sets (1110 patients), internal (476 patients), and external (174 patients) test sets.
3.0T/dynamic contrast-enhanced (DCE)-MRI sequence.
DLWPS was developed using segmentation and classification models. The DLWPS-based segmentation model was developed by the U-Net framework, which combined the attention module and the edge feature extraction module. The average score of the output scores of three networks was used as the result of the DLWPS-based classification model. Moreover, the radiologists\' diagnosis without and with the DLWPS-assistance was explored. To reveal the underlying biological basis of DLWPS, genetic analysis was performed based on RNA-sequencing data.
Dice similarity coefficient (DI), area under receiver operating characteristic curve (AUC), accuracy, sensitivity, specificity, and kappa value.
The segmentation model reached a DI of 0.828 and 0.813 in the internal and external test sets, respectively. Within the breast lesions diagnosis, the DLWPS achieved AUCs of 0.973 in internal test set and 0.936 in external test set. For ALN metastasis discrimination, the DLWPS achieved AUCs of 0.927 in internal test set and 0.917 in external test set. The agreement of radiologists improved with the DLWPS-assistance from 0.547 to 0.794, and from 0.848 to 0.892 in breast lesions diagnosis and ALN metastasis discrimination, respectively. Additionally, 10 breast cancers with ALN metastasis were associated with pathways of aerobic electron transport chain and cytoplasmic translation.
The performance of DLWPS indicates that it can promote radiologists in the judgment of breast lesions and ALN metastasis and nonmetastasis.
4 TECHNICAL EFFICACY STAGE: 3.