Technology trends and applications of deep learning in ultrasonography: image quality enhancement, diagnostic support, and improving workflow efficiency.

In this review of the most recent applications of deep learning to ultrasound imaging, the architectures of deep learning networks are briefly explained for the medical imaging applications of classification, detection, segmentation, and generation. Ultrasonography applications for image processing and diagnosis are then reviewed and summarized, along with some representative imaging studies of the breast, thyroid, heart, kidney, liver, and fetal head. Efforts towards workflow enhancement are also reviewed, with an emphasis on view recognition, scanning guide, image quality assessment, and quantification and measurement. Finally some future prospects are presented regarding image quality enhancement, diagnostic support, and improvements in workflow efficiency, along with remarks on hurdles, benefits, and necessary collaborations.

Diagnosis of Thyroid Nodules: Performance of a Deep Learning Convolutional Neural Network Model vs. Radiologists.

Computer-aided diagnosis (CAD) systems hold potential to improve the diagnostic accuracy of thyroid ultrasound (US). We aimed to develop a deep learning-based US CAD system (dCAD) for the diagnosis of thyroid nodules and compare its performance with those of a support vector machine (SVM)-based US CAD system (sCAD) and radiologists. dCAD was developed by using US images of 4919 thyroid nodules from three institutions. Its diagnostic performance was prospectively evaluated between June 2016 and February 2017 in 286 nodules, and was compared with those of sCAD and radiologists, using logistic regression with the generalized estimating equation. Subgroup analyses were performed according to experience level and separately for small thyroid nodules 1-2 cm. There was no difference in overall sensitivity, specificity, positive predictive value (PPV), negative predictive value and accuracy (all p > 0.05) between radiologists and dCAD. Radiologists and dCAD showed higher specificity, PPV, and accuracy than sCAD (all p < 0.001). In small nodules, experienced radiologists showed higher specificity, PPV and accuracy than sCAD (all p < 0.05). In conclusion, dCAD showed overall comparable diagnostic performance with radiologists and assessed thyroid nodules more effectively than sCAD, without loss of sensitivity.

A deep learning framework for supporting the classification of breast lesions in ultrasound images.

In this research, we exploited the deep learning framework to differentiate the distinctive types of lesions and nodules in breast acquired with ultrasound imaging. A biopsy-proven benchmarking dataset was built from 5151 patients cases containing a total of 7408 ultrasound breast images, representative of semi-automatically segmented lesions associated with masses. The dataset comprised 4254 benign and 3154 malignant lesions. The developed method includes histogram equalization, image cropping and margin augmentation. The GoogLeNet convolutionary neural network was trained to the database to differentiate benign and malignant tumors. The networks were trained on the data with augmentation and the data without augmentation. Both of them showed an area under the curve of over 0.9. The networks showed an accuracy of about 0.9 (90%), a sensitivity of 0.86 and a specificity of 0.96. Although target regions of interest (ROIs) were selected by radiologists, meaning that radiologists still have to point out the location of the ROI, the classification of malignant lesions showed promising results. If this method is used by radiologists in clinical situations it can classify malignant lesions in a short time and support the diagnosis of radiologists in discriminating malignant lesions. Therefore, the proposed method can work in tandem with human radiologists to improve performance, which is a fundamental purpose of computer-aided diagnosis.

Multiobjective evolutionary optimization for tumor segmentation of breast ultrasound images.

This paper proposes a robust multiobjective evolutionary algorithm (MOEA) to optimize parameters of tumor segmentation for ultrasound breast images. The proposed algorithm employs efficient schemes for reinforcing proximity to Pareto-optimal and diversity of solutions. They are designed to solve multiobjective problems for segmentation accuracy and speed. First objective is evaluated by difference between the segmented outline and ground truth. Second objective is evaluated by elapsed time during segmentation process. The experimental results show the effectiveness of the proposed algorithm compared with conventional MOEA from the viewpoint of proximity to the Pareto-optimal front (improved by 16.4% and 12.4%). Moreover, segmentation results of proposed algorithm describe faster segmentation speed (1.97 second) and higher accuracy (8% Jaccard).

Combining CRF and multi-hypothesis detection for accurate lesion segmentation in breast sonograms.

The implementation of lesion segmentation for breast ultrasound image relies on several diagnostic rules on intensity, texture, etc. In this paper, we propose a novel algorithm to achieve a comprehensive decision upon these rules by incorporating image over-segmentation and lesion detection in a pairwise CRF model, rather than a term-by-term translation. Multiple detection hypotheses are used to propagate object-level cues to segments and a unified classifier is trained based on the concatenated features. The experimental results show that our algorithm can avoid the drawbacks of separate detection or bottom-up segmentation, and can deal with very complicated cases.

Fourier-based shape feature extraction technique for computer-aided B-Mode ultrasound diagnosis of breast tumor.

Early detection of breast tumor is critical in determining the best possible treatment approach. Due to its superiority compared with mammography in its possibility to detect lesions in dense breast tissue, ultrasound imaging has become an important modality in breast tumor detection and classification. This paper discusses the novel Fourier-based shape feature extraction techniques that provide enhanced classification accuracy for breast tumor in the computer-aided B-mode ultrasound diagnosis system. To demonstrate the effectiveness of the proposed method, experiments were performed using 4,107 ultrasound images with 2,508 malignancy cases. Experimental results show that the breast tumor classification accuracy of the proposed technique was 15.8%, 5.43%, 17.32%, and 13.86% higher than the previous shape features such as number of protuberances, number of depressions, lobulation index, and dissimilarity, respectively.