Preoperative Prediction of Lymph Node Metastasis from Clinical DCE MRI of the Primary Breast Tumor Using a 4D CNN

Son Nguyen, Dogan Polat, Paniz Karbasi, Daniel Moser, Liqiang Wang, Keith Hulsey, Murat Can Çobanoğlu, Basak Dogan, Albert Montillo

Research output: Chapter in Book/Report/Conference proceedingConference contribution

Abstract

In breast cancer, undetected lymph node metastases can spread to distal parts of the body for which the 5-year survival rate is only 27%, making accurate nodal metastases diagnosis fundamental to reducing the burden of breast cancer, when it is still early enough to intervene with surgery and adjuvant therapies. Currently, breast cancer management entails a time consuming and costly sequence of steps to clinically diagnose axillary nodal metastases status. The purpose of this study is to determine whether preoperative, clinical DCE MRI of the primary tumor alone may be used to predict clinical node status with a deep learning model. If possible then many costly steps could be eliminated or reserved for only those with uncertain or probable nodal metastases. This research develops a data-driven approach that predicts lymph node metastasis through the judicious integration of clinical and imaging features from preoperative 4D dynamic contrast enhanced (DCE) MRI of 357 patients from 2 hospitals. Innovative deep learning classifiers are trained from scratch, including 2D, 3D, 4D and 4D deep convolutional neural networks (CNNs) that integrate multiple data types and predict the nodal metastasis differentiating nodal stage N0 (non metastatic) against stages N1, N2 and N3. Appropriate methodologies for data preprocessing and network interpretation are presented, the later of which bolster radiologist confidence that the model has learned relevant features from the primary tumor. Rigorous nested 10-fold cross-validation provides an unbiased estimate of model performance. The best model achieves a high sensitivity of 72% and an AUROC of 71% on held out test data. Results are strongly supportive of the potential of the combination of DCE MRI and machine learning to inform diagnostics that could substantially reduce breast cancer burden.

Original languageEnglish (US)
Title of host publicationMedical Image Computing and Computer Assisted Intervention – MICCAI 2020 - 23rd International Conference, Proceedings
EditorsAnne L. Martel, Purang Abolmaesumi, Danail Stoyanov, Diana Mateus, Maria A. Zuluaga, S. Kevin Zhou, Daniel Racoceanu, Leo Joskowicz
PublisherSpringer Science and Business Media Deutschland GmbH
Pages326-334
Number of pages9
ISBN (Print)9783030597122
DOIs
StatePublished - 2020
Event23rd International Conference on Medical Image Computing and Computer-Assisted Intervention, MICCAI 2020 - Lima, Peru
Duration: Oct 4 2020Oct 8 2020

Publication series

NameLecture Notes in Computer Science (including subseries Lecture Notes in Artificial Intelligence and Lecture Notes in Bioinformatics)
Volume12262 LNCS
ISSN (Print)0302-9743
ISSN (Electronic)1611-3349

Conference

Conference23rd International Conference on Medical Image Computing and Computer-Assisted Intervention, MICCAI 2020
CountryPeru
CityLima
Period10/4/2010/8/20

Keywords

  • Breast cancer
  • DCE MRI
  • Deep learning
  • Nodal metastases

ASJC Scopus subject areas

  • Theoretical Computer Science
  • Computer Science(all)

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