Small Lesions Evaluation Based on Unsupervised Cluster Analysis of Signal-Intensity Time Courses in Dynamic Breast MRI

An application of an unsupervised neural network-based computer-aided diagnosis (CAD) system is reported for the detection and characterization of small indeterminate breast lesions, average size 1.1 mm, in dynamic contrast-enhanced MRI. This system enables the extraction of spatial and temporal features of dynamic MRI data and additionally provides a segmentation with regard to identification and regional subclassification of pathological breast tissue lesions. Lesions with an initial contrast enhancement ≥50% were selected with semiautomatic segmentation. This conventional segmentation analysis is based on the mean initial signal increase and postinitial course of all voxels included in the lesion. In this paper, we compare the conventional segmentation analysis with unsupervised classification for the evaluation of signal intensity time courses for the differential diagnosis of enhancing lesions in breast MRI. The results suggest that the computerized analysis system based on unsupervised clustering has the potential to increase the diagnostic accuracy of MRI mammography for small lesions and can be used as a basis for computer-aided diagnosis of breast cancer with MR mammography.