AI-based Prediction of Lesion Occurrence in High-Risk Women based on Anomalies detected in Follow-up Examinations

摘要

Breast Magnetic Resonance Imaging (MRI) is recognized as the most sensitive imaging method for the early detection of breast cancer in women who carry a lifetime risk for breast cancer higher than or equal to 20%. Given the aggressive biology of cancers in this population, early detection is crucial for a favorable prognosis. This study aimed to use artificial intelligence for the detection of lesions at the earliest stage in high-risk women. A Generative Adversarial Network (GAN) detected lesions in breast MR data by quantifying anomaly as divergence from healthy breast tissue appearance. First, follow-up images of patients were aligned and the breast was segmented automatically. Then, the GAN created a model of healthy variability of appearance change during follow-up in 64x64-sized image patches sampled only at healthy tissue locations in follow-up image sequences. During the assessment of new data, each image position was compared with the model yielding an anomaly score. On a image patch level, we evaluated if this anomaly score identifies confirmed lesions, as well as lesion-free regions, where lesions appear during later follow-up studies. In the first experiment of lesion detection, a mean sensitivity of 99.55c and a mean specificity of 84% was achieved. When applying the model to studies denoted as lesion-free, subsequently occurring lesions were predicted with a mean sensitivity of 92.7% and a mean specificity of 78.8%.