BRAIxDet: Learning to Detect Malignant Breast Lesion with Incomplete Annotations

Methods to detect malignant lesions from screening mammograms are usually trained with fully annotated datasets, where images are labelled with the localisation and classification of cancerous lesions. However, real-world screening mammogram datasets commonly have a subset that is fully annotated and another subset that is weakly annotated with just the global classification (i.e., without lesion localisation). Given the large size of such datasets, researchers usually face a dilemma with the weakly annotated subset: to not use it or to fully annotate it. The first option will reduce detection accuracy because it does not use the whole dataset, and the second option is too expensive given that the annotation needs to be done by expert radiologists. In this paper, we propose a middle-ground solution for the dilemma, which is to formulate the training as a weakly- and semi-supervised learning problem that we refer to as malignant breast lesion detection with incomplete annotations. To address this problem, our new method comprises two stages, namely: 1) pre-training a multi-view mammogram classifier with weak supervision from the whole dataset, and 2) extending the trained classifier to become a multi-view detector that is trained with semi-supervised student-teacher learning, where the training set contains fully and weakly-annotated mammograms. We provide extensive detection results on two real-world screening mammogram datasets containing incomplete annotations, and show that our proposed approach achieves state-of-the-art results in the detection of malignant breast lesions with incomplete annotations.

Knowledge Distillation to Ensemble Global and Interpretable Prototype-Based Mammogram Classification Models

State-of-the-art (SOTA) deep learning mammogram classifiers, trained with weakly-labelled images, often rely on global models that produce predictions with limited interpretability, which is a key barrier to their successful translation into clinical practice. On the other hand, prototype-based models improve interpretability by associating predictions with training image prototypes, but they are less accurate than global models and their prototypes tend to have poor diversity. We address these two issues with the proposal of BRAIxProtoPNet++, which adds interpretability to a global model by ensembling it with a prototype-based model. BRAIxProtoPNet++ distills the knowledge of the global model when training the prototype-based model with the goal of increasing the classification accuracy of the ensemble. Moreover, we propose an approach to increase prototype diversity by guaranteeing that all prototypes are associated with different training images. Experiments on weakly-labelled private and public datasets show that BRAIxProtoPNet++ has higher classification accuracy than SOTA global and prototype-based models. Using lesion localisation to assess model interpretability, we show BRAIxProtoPNet++ is more effective than other prototype-based models and post-hoc explanation of global models. Finally, we show that the diversity of the prototypes learned by BRAIxProtoPNet++ is superior to SOTA prototype-based approaches.

Multi-view Local Co-occurrence and Global Consistency Learning Improve Mammogram Classification Generalisation

When analysing screening mammograms, radiologists can naturally process information across two ipsilateral views of each breast, namely the cranio-caudal (CC) and mediolateral-oblique (MLO) views. These multiple related images provide complementary diagnostic information and can improve the radiologist's classification accuracy. Unfortunately, most existing deep learning systems, trained with globally-labelled images, lack the ability to jointly analyse and integrate global and local information from these multiple views. By ignoring the potentially valuable information present in multiple images of a screening episode, one limits the potential accuracy of these systems. Here, we propose a new multi-view global-local analysis method that mimics the radiologist's reading procedure, based on a global consistency learning and local co-occurrence learning of ipsilateral views in mammograms. Extensive experiments show that our model outperforms competing methods, in terms of classification accuracy and generalisation, on a large-scale private dataset and two publicly available datasets, where models are exclusively trained and tested with global labels.