Artificial Intelligence advances mammography triaging

NETHERLANDS – Radiologists can use artificial intelligence technology to quickly and accurately sort through breast MRIs in patients with dense breast tissue to eliminate those who do not have cancer, freeing up radiologists to focus on more complex cases.

Mammography has aided in the reduction of breast cancer-related deaths by detecting the disease early, when it is still treatable. It is, however, less sensitive in women with extremely dense breast tissue than in women with fatty breast tissue.

Furthermore, women with extremely dense breasts are three to six times more likely to develop breast cancer than women with almost entirely fatty breasts, and two times more likely than the average woman.

Supplemental screening in women with extremely dense breasts improves cancer detection sensitivity. The Dense Tissue and Early Breast Neoplasm Screening (DENSE) Trial, a large study based in the Netherlands, supported the use of MRI supplemental screening.

The DENSE trial showed that additional MRI screening for women with extremely dense breasts was beneficial,” said study lead author Erik Verburg, M.Sc., from the Image Sciences Institute at the University Medical Center Utrecht in the Netherlands.

On the other hand, the DENSE trial confirmed that the vast majority of screened women do not have any suspicious findings on MRI.”

Because adding supplemental MRI to standard screening has been shown to benefit this population, researchers used this imaging data to develop a deep learning tool.

Verburg and colleagues created their AI tool using 4,500 MRI datasets from a Dutch study that demonstrated the benefits of supplemental MRI screening for women with dense breasts. This included scans from seven hospitals as well as testing data from an eighth.

Because of its higher sensitivity, MRI screening is a preferred method for imaging women with dense breasts.

In the Netherlands, approximately 8 percent of women enrolled in screening programs have extremely dense breasts. In the Netherlands alone, nearly 82,000 women are eligible for MRI biennial breast screening.

More than half of women, particularly those with dense breasts, are willing to pay at least US$250-US$500 for a screening MRI.

The Dutch authors noted that having an automated system sort through the MRI scans could greatly assist busy radiographers.

Because most MRIs show normal anatomical and physiological variation that may not necessitate radiological review, methods to triage these normal MRIs are required to reduce radiologist workload.

Despite its clinical benefits, breast MRI faces a number of challenges, including workflow, reimbursement, quality, and safety concerns.

In the United States, federally certified physicians are required to interpret such exams, according to Bonnie N. Joe, a radiologist at the University of California, San Francisco.

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