Two-stage classification strategy for breast cancer diagnosis using ultrasound-guided diffuse optical tomography and deep learning

SignificanceUltrasound (US)-guided diffuse optical tomography (DOT) has demonstrated great potential for breast cancer diagnosis in which real-time or near real-time diagnosis with high accuracy is desired.AimWe aim to use US-guided DOT to achieve an automated, fast, and accurate classification of breast lesions.ApproachWe propose a two-stage classification strategy with deep learning. In the first stage, US images and histograms created from DOT perturbation measurements are combined to predict benign lesions. Then the non-benign suspicious lesions are passed through to the second stage, which combine US image features, DOT histogram features, and 3D DOT reconstructed images for final diagnosis.ResultsThe first stage alone identified 73.0% of benign cases without image reconstruction. In distinguishing between benign and malignant breast lesions in patient data, the two-stage classification approach achieved an area under the receiver operating characteristic curve of 0.946, outperforming the diagnoses of all single-modality models and of a single-stage classification model that combines all US images, DOT histogram, and imaging features.ConclusionsThe proposed two-stage classification strategy achieves better classification accuracy than single-modality-only models and a single-stage classification model that combines all features. It can potentially distinguish breast cancers from benign lesions in near real-time.