Hybrid Mass Detection in Breast MRI Combining Unsupervised Saliency Analysis and Deep Learning

To interpret a breast MRI study, a radiologist has to examine over 1000 images, and integrate spatial and temporal information from multiple sequences. The automated detection and classification of suspicious lesions can help reduce the workload and improve accuracy. We describe a hybrid mass-detection algorithm that combines unsupervised candidate detection with deep learning-based classification. The detection algorithm first identifies image-salient regions, as well as regions that are cross-salient with respect to the contralateral breast image. We then use a convolutional neural network (CNN) to classify the detected candidates into true-positive and false-positive masses. The network uses a novel multi-channel image representation; this representation encompasses information from the anatomical and kinetic image features, as well as saliency maps. We evaluated our algorithm on a dataset of MRI studies from 171 patients, with 1957 annotated slices of malignant (59%) and benign (41%) masses. Unsupervised saliency-based detection provided a sensitivity of 0.96 with 9.7 false-positive detections per slice. Combined with CNN classification, the number of false positive detections dropped to 0.7 per slice, with 0.85 sensitivity. The multi-channel representation achieved higher classification performance compared to single-channel images. The combination of domain-specific unsupervised methods and general-purpose supervised learning offers advantages for medical imaging applications, and may improve the ability of automated algorithms to assist radiologists.