Radiology Journal detailed a multimodal AI solution that can classify breast lesion subtypes using mammograms, potentially reducing unnecessary biopsies and improving biopsy interpretations.
Researchers from Israel and IBM/Merative first pretrained a deep learning model with 26k digital mammograms to classify images (malignant, benign, or normal), and used these pretraining weights to develop a lesion subtype classification model trained with mammograms and clinical data. Finally, they trained a pair of lesion classification models using digital mammograms linked to biopsy results from 2,120 women in Israel and 1,642 women in the US.
When the Israel AI model was tested against mammograms from 441 Israeli women it…
- Predicted malignancy with an 0.88 AUC
- Classified ductal carcinoma in situ, invasive carcinomas, or benign lesions with 0.76, 0.85, and 0.82 AUCs
- Correctly interpreted 98.7% of malignant mammographic examinations and 74.6% of invasive carcinomas (matching three radiologists)
- Would have prevented 13% of unnecessary biopsies and missed 1.3% of malignancies (at 99% sensitivity)
When the US AI model was tested against mammograms from 344 US women it…
- Predicted malignancy with a lower 0.80 AUC
- Classified ductal carcinoma in situ, invasive carcinomas, or benign lesions with lower 0.74, 0.83, and 0.72 AUCs
- Correctly interpreted 96.8% of malignant mammographic examinations and 63% of invasive carcinomas (matching three radiologists)
The authors attributed the US model’s lower accuracy to its smaller training dataset, and noted that the two models’ also had worse performance when tested against data from the other country (US model w/Israel data, Israel model w/ US data) or when classifying rare lesion types.
However, they were still bullish about this approach with enough training data, and noted the future potential to add other imaging modalities and genetic information to further enhance multimodal breast cancer assessments.
The Takeaway
We’ve historically relied on biopsy results to classify breast lesion subtypes, and that will remain true for quite a while. However, this study shows that multimodal-trained AI can extract far more information from mammograms, while potentially reducing unnecessary biopsies and improving the accuracy of the biopsies that are performed.
