Classification of breast mass lesions using model-based analysis of the characteristic kinetic curve derived from fuzzy c-means clustering

Department of Medical Imaging, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan.
Magnetic Resonance Imaging (Impact Factor: 2.09). 04/2012; 30(3):312-22. DOI: 10.1016/j.mri.2011.12.002
Source: PubMed


The purpose of this study is to evaluate the diagnostic efficacy of the representative characteristic kinetic curve of dynamic contrast-enhanced (DCE) magnetic resonance imaging (MRI) extracted by fuzzy c-means (FCM) clustering for the discrimination of benign and malignant breast tumors using a novel computer-aided diagnosis (CAD) system. About the research data set, DCE-MRIs of 132 solid breast masses with definite histopathologic diagnosis (63 benign and 69 malignant) were used in this study. At first, the tumor region was automatically segmented using the region growing method based on the integrated color map formed by the combination of kinetic and area under curve color map. Then, the FCM clustering was used to identify the time-signal curve with the larger initial enhancement inside the segmented region as the representative kinetic curve, and then the parameters of the Tofts pharmacokinetic model for the representative kinetic curve were compared with conventional curve analysis (maximal enhancement, time to peak, uptake rate and washout rate) for each mass. The results were analyzed with a receiver operating characteristic curve and Student's t test to evaluate the classification performance. Accuracy, sensitivity, specificity, positive predictive value and negative predictive value of the combined model-based parameters of the extracted kinetic curve from FCM clustering were 86.36% (114/132), 85.51% (59/69), 87.30% (55/63), 88.06% (59/67) and 84.62% (55/65), better than those from a conventional curve analysis. The A(Z) value was 0.9154 for Tofts model-based parametric features, better than that for conventional curve analysis (0.8673), for discriminating malignant and benign lesions. In conclusion, model-based analysis of the characteristic kinetic curve of breast mass derived from FCM clustering provides effective lesion classification. This approach has potential in the development of a CAD system for DCE breast MRI.

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    • "In the semiquantitative approach, features directly obtained from the signal intensity time curve (e.g. maximum relative enhancement, initial slope, time to peak, area under the curve) are used to get a simple description of curve shapes [32] and for discriminating between benign and malign lesions [8] [33] or combined with diffusion-based multispectral analysis techniques [34]. The purpose of this study is to investigate the ability of a clustering approach on assessing tumor heterogeneity and thereof changes in the evaluation of the response to a DNA-based antiangiogenic treatment employing a blood-pool contrast agent at 1 T. Within the clustering approach, based on a pixel-by-pixel analysis, the whole tumor has been segmented into several sub-regions according to their enhancement/permeability properties . "
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    ABSTRACT: The objective of this study was to compare a clustering approach to conventional analysis methods for assessing changes in pharmacokinetic parameters obtained from dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) during antiangiogenic treatment in a breast cancer model. BALB/c mice bearing established transplantable her2+ tumors were treated with a DNA-based antiangiogenic vaccine or with an empty plasmid (untreated group). DCE-MRI was carried out by administering a dose of 0.05 mmol/kg of Gadocoletic acid trisodium salt, a Gd-based blood pool contrast agent (CA) at 1T. Changes in pharmacokinetic estimates (K(trans) and vp) in a nine-day interval were compared between treated and untreated groups on a voxel-by-voxel analysis. The tumor response to therapy was assessed by a clustering approach and compared with conventional summary statistics, with sub-regions analysis and with histogram analysis. Both the K(trans) and vp estimates, following blood-pool CA injection, showed marked and spatial heterogeneous changes with antiangiogenic treatment. Averaged values for the whole tumor region, as well as from the rim/core sub-regions analysis were unable to assess the antiangiogenic response. Histogram analysis resulted in significant changes only in the vp estimates (p<0.05). The proposed clustering approach depicted marked changes in both the K(trans) and vp estimates, with significant spatial heterogeneity in vp maps in response to treatment (p<0.05), provided that DCE-MRI data are properly clustered in three or four sub-regions. This study demonstrated the value of cluster analysis applied to pharmacokinetic DCE-MRI parametric maps for assessing tumor response to antiangiogenic therapy. Copyright © 2015. Published by Elsevier Inc.
    Full-text · Article · Mar 2015 · Magnetic Resonance Imaging
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    ABSTRACT: Three-dimensional (3-D) dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) consists of a large number of images in different enhancement phases which are used to identify and characterize breast lesions. The purpose of this study was to develop a computer-assisted algorithm for tumor segmentation and characterization using both kinetic information and morphological features of 3-D breast DCE-MRI. An integrated color map created by intersecting kinetic and area under the curve (AUC) color maps was used to detect potential breast lesions, followed by the application of a region growing algorithm to segment the tumor. Modified fuzzy c-means clustering was used to identify the most representative kinetic curve of the whole segmented tumor, which was then characterized by using conventional curve analysis or pharmacokinetic model. The 3-D morphological features including shape features (compactness, margin, and ellipsoid fitting) and texture features (based on the grey level co-occurrence matrix) of the segmented tumor were obtained to characterize the lesion. One hundred and thirty-two biopsy-proven lesions (63 benign and 69 malignant) were used to evaluate the performance of the proposed computer-aided system for breast MRI. Five combined features including rate constant (kep), volume of plasma (vp), energy (G1), entropy (G2), and compactness (C1), had the best performance with an accuracy of 91.67% (121/132), sensitivity of 91.30% (63/69), specificity of 92.06% (58/63), and Az value of 0.9427. Combining the kinetic and morphological features of 3-D breast MRI is a potentially useful and robust algorithm when attempting to differentiate benign and malignant lesions.
    No preview · Article · Jan 2013 · Magnetic Resonance Imaging
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    ABSTRACT: This study aimed to investigate a computer-aided system for detecting breast masses using dynamic contrast-enhanced magnetic resonance imaging for clinical use. Detection performance of the system was analyzed on 61 biopsy-confirmed lesions (21 benign and 40 malignant lesions) in 34 women. The breast region was determined using the demons deformable algorithm. After the suspicious tissues were identified by kinetic feature (area under the curve) and the fuzzy c-means clustering method, all breast masses were detected based on the rotation-invariant and multi-scale blob characteristics. Subsequently, the masses were further distinguished from other detected non-tumor regions (false positives). Free-response operating characteristics (FROC) curve and detection rate were used to evaluate the detection performance. Using the combined features, including blob, enhancement, morphologic, and texture features with 10-fold cross validation, the mass detection rate was 100 % (61/61) with 15.15 false positives per case and 91.80 % (56/61) with 4.56 false positives per case. In conclusion, the proposed computer-aided detection system can help radiologists reduce inter-observer variability and the cost associated with detection of suspicious lesions from a large number of images. Our results illustrated that breast masses can be efficiently detected and that enhancement and morphologic characteristics were useful for reducing non-tumor regions.
    No preview · Article · Apr 2014 · Journal of Digital Imaging
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