YOLOv4-Based CNN Model versus Nested Contours Algorithm in the Suspicious Lesion Detection on the Mammography Image: A Direct Comparison in the Real Clinical Settings

Background: We directly compared the mammography image processing results obtained with the help of the YOLOv4 convolutional neural network (CNN) model versus those obtained with the help of the NCA-based nested contours algorithm model. Method: We used 1080 images to train the YOLOv4, plus 100 images with proven breast cancer (BC) and 100 images with proven absence of BC to test both models. Results: the rates of true-positive, false-positive and false-negative outcomes were 60, 10 and 40, respectively, for YOLOv4, and 93, 63 and 7, respectively, for NCA. The sensitivities for the YOLOv4 and the NCA were comparable to each other for star-like lesions, masses with unclear borders, round- or oval-shaped masses with clear borders and partly visualized masses. On the contrary, the NCA was superior to the YOLOv4 in the case of asymmetric density and of changes invisible on the dense parenchyma background. Radiologists changed their earlier decisions in six cases per 100 for NCA. YOLOv4 outputs did not influence the radiologists’ decisions. Conclusions: in our set, NCA clinically significantly surpasses YOLOv4.