A deep learning model integrating mammography and clinical factors facilitates the malignancy prediction of BI-RADS 4 microcalcifications in breast cancer screening
Abstract
Objectives To investigate the value of full-field digital mammography-based deep learning (DL) in predicting malignancy of Breast Imaging Reporting and Data System (BI-RADS) 4 microcalcifications. Methods A total of 384 patients with 414 pathologically confirmed microcalcifications (221 malignant and 193 benign) were randomly allocated into the training, validation, and testing datasets (272/71/71 lesions) in this retrospective study. A combined DL model was developed incorporating mammography and clinical variables. Model performance was evaluated by using areas under the receiver operating characteristic curve (AUC) and compared with the clinical model, stand-alone DL image model, and BI-RADS approach. The predictive performance for malignancy was also compared between the combined model and human readers (2 juniors and 2 seniors). Results The combined DL model demonstrated favorable AUC, sensitivity, and specificity of 0.910, 85.3%, and 91.9% in predicting BI-RADS 4 malignant microcalcifications in the testing dataset, which outperformed the clinical model, DL image model, and BI-RADS with AUCs of 0.799, 0.841, and 0.804, respectively. The combined model achieved non-inferior performance as senior radiologists (p = 0.860, p = 0.800) and outperformed junior radiologists (p = 0.155, p = 0.029). The diagnostic performance of two junior radiologists was improved after artificial intelligence assistance with AUCs increased to 0.854 and 0.901 from 0.816 (p = 0.556) and 0.773 (p…
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AI is rapidly reshaping healthcare and the competencies expected of graduating medical students.
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AI has enabled novel digital solutions in diagnostics, imaging, and clinical decision support and patient management.
“AI has enabled novel digital solutions in diagnostics1–4, imaging5,6, and clinical decision support and patient management7–9.”
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- Authors
- Liu, H., Chen, Y., Zhang, Y., Wang, L., Luo, R., Wu, H., Wu, C., Zhang, H., Tan, W., Yin, H., & Wang, D.
- Affiliations
- Shanghai Jiao Tong University (CN)
- InferVision (China) (CN)
- Corresponding author
- Wang, Dengbin
- Venue
- European Radiology
- Published
- 2021-01-26
- Volume
- 31
- Issue
- 8
- Pages
- 5902-5912
- ISSN
- 0938-7994 (ISSN-L)
- 1432-1084
- OpenAlex
- W3122649642
- Cited by
- 88
- References
- 26
- Citations by year
- 2026: 14 · 2025: 18 · 2024: 27 · 2023: 14 · 2022: 13 · 2021: 2
- FWCI
- 4.95
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- European Radiology (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Shanghai Municipal Commission (No. 2018ZHYL0108)
- National Key Research and Development Program of China (No. 2017YFC0109003)
- National Natural Science Foundation of China (No. 81901695)
- Shanghai Sailing Program (No.19YF1433100)
- Research Fund of Hospital Project (No. 18YJ16)
- Topics
- Physical Sciences › Computer Science › Artificial Intelligence › AI in cancer detection
- Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Radiomics and Machine Learning in Medical Imaging
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Digital Radiography and Breast Imaging
- Keywords
- breast cancer screening, full-field digital mammography, deep learning, malignancy prediction, clinical factors, BI-RADS, radiologist performance, interobserver agreement, computer-aided diagnosis, breast microcalcifications, artificial intelligence in radiology, clinical decision support, junior radiologists, breast cancer risk stratification
- MeSH terms
- Deep Learning, Artificial Intelligence, Breast Neoplasms, Calcinosis, Female, Humans, Mammography, Retrospective Studies, Early Detection of Cancer
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