3D都卜勒乳房超音波之腫瘤診斷

在所有癌症當中，乳癌一直是女性死亡的主要原因之一。近年來，由於電腦輔助診斷系統快速的發展，現在它們不但可以偵測腫瘤的存在，甚至能夠判斷出腫瘤的良惡性，因此或許可以讓乳房病理切片診斷的必要性大幅下降。自從都卜勒超音波成功地偵測到血液的流動，腫瘤血管型態、腫瘤形狀和腫瘤紋理就變成為主要的研究課題。一般而言，和良性腫瘤相比，惡性腫瘤需要更多的血管來提供生長所需要的養分和氧氣，另外，惡性腫瘤的體積通常較大，表面比較不平整。在過去的研究中，通常只利用腫瘤本身或是腫瘤血管的特徵來診斷腫瘤的良惡性。在本篇論文中，我們提出的電腦輔助診斷系統將利用3D都卜勒超音波，同時獲得腫瘤及血管的資訊，並以此分類腫瘤。為了獲得腫瘤及血管的特徵，必須先將灰階影像利用水平集方法切割出腫瘤的輪廓，再利用三維細線化演算法取得血管骨幹。接著，腫瘤紋理特徵、腫瘤形狀特徵、腫瘤橢球特徵和血管特徵將會被取出。最後再以二元邏輯回歸的方式利用這些特徵來判斷乳房腫瘤的良惡性。實驗共分析82個乳房腫瘤病例，其中包含41個良性及41個惡性腫瘤。根據實驗結果，我們所提出的結合腫瘤及血管兩類特徵的準確率比只使用單一類特徵的好，可達到準確率85.37%、敏感性85.37%、專一性85.37%以及ROC曲線面積0.9104。

關鍵字

都卜勒超音波；乳房；腫瘤；電腦輔助診斷；血管分佈

並列摘要

The breast cancer is always a major cause of death for women among all kind of cancers. In recent years, the computer-aided diagnosis systems have been developed rapidly and they can not only detect the tumors but also distinguish malignant tumors from benign ones. Therefore, the need of the breast biopsy of the detected tumors might be further decreased. Since the blood flow is successfully detected with the conventional US image by the Doppler ultrasound (US), the studies of tumor vascularity, tumor morphology, and texture of tumor have played important roles to diagnose diseases of breast recently. In general, malignant tumors need more complex blood vessels to obtain sufficient nutrients for growing, and the volume and surface of malignant tumors are larger and more irregular than those of benign tumors. In the past, researches about Doppler US only used the characteristics based on the tumor or vascular information for diagnosing tumor. In this paper, we demonstrate a computer-aided diagnosis (CAD) system for three-dimensional (3-D) power Doppler breast US images that can quantify the characteristics of both vascularity and tumor. In order to obtain the features of tumor and vascularity, the level-set method is applied to segment the tumor margin and thinning approach is used to skeletonize the vascularity. Then, the features including the texture information based on co-occurrence matrix, shape information, and ellipsoid fitting information are extracted based on the segmented 3-D tumor contour, and the vascular morphology are quantified from the skeletonized vessels. The features are used to classify the benign and malignant tumors by the binary logistic regression model. In the experiment, 82 biopsy-proved lesions including 41 benign tumors and 41 malignant tumors are used to test the diagnosis performance of the proposed CAD system. From the experimental results, it is found that the features of tumor combined with vascular features has better performance than using single type of features. Moreover, the proposed method could achieve a high performance with the accuracy, sensitivity, specificity and Az value being 85.37% (70/82), 85.37% (35/41), 85.37% (35/41), and 0.9104, respectively.

並列關鍵字

ultrasound ； PDUS ； vascularity ； breast ； tumor ； computer-aided diagnosis

參考文獻

[1] H. Zhi, et al., "Comparison of ultrasound elastography, mammography, and sonography in the diagnosis of solid breast lesions," J Ultrasound Med, vol. 26, pp. 807-15, Jun 2007.

[2] L. L. Humphrey, et al., "Breast cancer screening: a summary of the evidence for the U.S. Preventive Services Task Force," Ann Intern Med, vol. 137, pp. 347-60, Sep 3 2002.

[3] T. M. Kolb, et al., "Occult cancer in women with dense breasts: detection with screening US--diagnostic yield and tumor characteristics," Radiology, vol. 207, pp. 191-9, Apr 1998.

[4] T. M. Kolb, et al., "Comparison of the performance of screening mammography, physical examination, and breast US and evaluation of factors that influence them: an analysis of 27,825 patient evaluations," Radiology, vol. 225, pp. 165-75, Oct 2002.

[5] K. Kalmantis, et al., "The contribution of three-dimensional power Doppler imaging in the preoperative assessment of breast tumors: a preliminary report," Obstet Gynecol Int, vol. 2009, p. 530579, 2009.

國際替代計量

3D都卜勒乳房超音波之腫瘤診斷

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