Efficient Axillary Lymph Node Detection Via Two-stage Spatial-information-fusion-based CNN.

BACKGROUND AND OBJECTIVE: Preoperative imaging diagnosis of axillary lymph node (ALN) metastasis is particularly important for breast cancer patients. This paper focuses on developing non-invasive and automatic schemes for accurate localization and classification (metastasis prediction) of ALN via contrast-enhanced computed tomography (CECT) image and deep learning models. METHODS: Based on a two-stage strategy, a novel detection neural network is proposed, where the convolutional block attention module is utilized to extract spacial information and the bottleneck feature fusion module is designed for feature fusion in different scales. RESULTS: Owing to the two embedded modules, the proposed convolutional neural network (CNN) model outperforms Faster R-CNN, YOLOv3, and EfficientDet in the sense that the achieved mAP is 0.454, higher than 0.247, 0.335, and 0.329, respectively. In particular, considering the function of classification only, the proposed model reaches the best performance on most indices (accuracy of 0.968, positive predictive value of 0.972, negative predictive value of 0.966, specificity of 0.983), compared with the methods that have been frequently adopted to predict ALN. In addition, the proposed CNN model has the function of locating ALN, which is lacking in existing models. CONCLUSIONS: In this paper, a supervised deep learning method is proposed to detect ALN in CECT images. The positive effect of new added modules are verified, and the benefits of spatial information in ALN detection are confirmed. Further, the two subtasks called localization and classification are evaluated separately, where the proposed model achieves the best performance on most indices. The source code mentioned in this article will be released later.

Axillary lymph node metastasis prediction by contrast-enhanced computed tomography images for breast cancer patients based on deep learning.

When doctors use contrast-enhanced computed tomography (CECT) images to predict the metastasis of axillary lymph nodes (ALN) for breast cancer patients, the prediction performance could be degraded by subjective factors such as experience, psychological factors, and degree of fatigue. This study aims to exploit efficient deep learning schemes to predict the metastasis of ALN automatically via CECT images. A new construction called deformable sampling module (DSM) was meticulously designed as a plug-and-play sampling module in the proposed deformable attention VGG19 (DA-VGG19). A dataset of 800 samples labeled from 800 CECT images of 401 breast cancer patients retrospectively enrolled in the last three years was adopted to train, validate, and test the deep convolutional neural network models. By comparing the accuracy, positive predictive value, negative predictive value, sensitivity and specificity indices, the performance of the proposed model is analyzed in detail. The best-performing DA-VGG19 model achieved an accuracy of 0.9088, which is higher than that of other classification neural networks. As such, the proposed intelligent diagnosis algorithm can provide doctors with daily diagnostic assistance and advice and reduce the workload of doctors. The source code mentioned in this article will be released later.