Discrimination of benign and malignant breast lesions on dynamic contrast-enhanced magnetic resonance imaging using deep learning.

Purpose: To evaluate the capability of deep transfer learning (DTL) and fine-tuning methods in differentiating malignant from benign lesions in breast dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI). Methods: The diagnostic efficiencies of the VGG19, ResNet50, and DenseNet201 models were tested under the same dataset. The model with the highest performance was selected and modified utilizing three fine-tuning strategies (S1-3). Fifty additional lesions were selected to form the validation set to verify the generalization abilities of these models. The accuracy (Ac) of the different models in the training and test sets, as well as the precision (Pr), recall rate (Rc), F1 score (), and area under the receiver operating characteristic curve (AUC), were primary performance indicators. Finally, the kappa test was used to compare the degree of agreement between the DTL models and pathological diagnosis in differentiating malignant from benign breast lesions. Results: The Pr, Rc, f1, and AUC of VGG19 (86.0%, 0.81, 0.81, and 0.81, respectively) were higher than those of DenseNet201 (70.0%, 0.61, 0.63, and 0.61, respectively) and ResNet50 (61.0%, 0.59, 0.59, and 0.59). After fine-tuning, the Pr, Rc, f1, and AUC of S1 (87.0%, 0.86, 0.86, and 0.86, respectively) were higher than those of VGG19. Notably, the degree of agreement between S1 and pathological diagnosis in differentiating malignant from benign breast lesions was 0.720 (κ = 0.720), which was higher than that of DenseNet201 (κ = 0.440), VGG19 (κ = 0.640), and ResNet50 (κ = 0.280). Conclusion: The VGG19 model is an effective method for identifying benign and malignant breast lesions on DCE-MRI, and its performance can be further improved via fine-tuning. Overall, our findings insinuate that this technique holds potential clinical application value. [ABSTRACT FROM AUTHOR]