Deep Neural Networks Improve Radiologists' Performance in Breast Cancer Screening

We present a deep convolutional neural network for breast cancer screening exam classification, trained and evaluated on over 200,000 exams (over 1,000,000 images). Our network achieves an AUC of 0.895 in predicting whether there is a cancer in the breast, when tested on the screening population. We attribute the high accuracy of our model to a two-stage training procedure, which allows us to use a very high-capacity patch-level network to learn from pixel-level labels alongside a network learning from macroscopic breast-level labels. To validate our model, we conducted a reader study with 14 readers, each reading 720 screening mammogram exams, and find our model to be as accurate as experienced radiologists when presented with the same data. Finally, we show that a hybrid model, averaging probability of malignancy predicted by a radiologist with a prediction of our neural network, is more accurate than either of the two separately. To better understand our results, we conduct a thorough analysis of our network's performance on different subpopulations of the screening population, model design, training procedure, errors, and properties of its internal representations.

High-Resolution Breast Cancer Screening with Multi-View Deep Convolutional Neural Networks

Advances in deep learning for natural images have prompted a surge of interest in applying similar techniques to medical images. The majority of the initial attempts focused on replacing the input of a deep convolutional neural network with a medical image, which does not take into consideration the fundamental differences between these two types of images. Specifically, fine details are necessary for detection in medical images, unlike in natural images where coarse structures matter most. This difference makes it inadequate to use the existing network architectures developed for natural images, because they work on heavily downscaled images to reduce the memory requirements. This hides details necessary to make accurate predictions. Additionally, a single exam in medical imaging often comes with a set of views which must be fused in order to reach a correct conclusion. In our work, we propose to use a multi-view deep convolutional neural network that handles a set of high-resolution medical images. We evaluate it on large-scale mammography-based breast cancer screening (BI-RADS prediction) using 886,000 images. We focus on investigating the impact of the training set size and image size on the prediction accuracy. Our results highlight that performance increases with the size of training set, and that the best performance can only be achieved using the original resolution. In the reader study, performed on a random subset of the test set, we confirmed the efficacy of our model, which achieved performance comparable to a committee of radiologists when presented with the same data.

Breast density classification with deep convolutional neural networks

Breast density classification is an essential part of breast cancer screening. Although a lot of prior work considered this problem as a task for learning algorithms, to our knowledge, all of them used small and not clinically realistic data both for training and evaluation of their models. In this work, we explore the limits of this task with a data set coming from over 200,000 breast cancer screening exams. We use this data to train and evaluate a strong convolutional neural network classifier. In a reader study, we find that our model can perform this task comparably to a human expert.