Computer-aided Diagnosis in Breast Ultrasound

Cancer remains a leading cause of death in Taiwan, and the prevalence of breast cancer has increased in recent years. The early detection and diagnosis of breast cancer is the key to ensuring prompt treatment and a reduced death rate. Mammography and ultrasound (US) are the main imaging techniques used in the detection of breast cancer. The heterogeneity of breast cancers leads to an overlap in benign and malignant ultrasonography images, and US examinations are also operator dependent. Recently, computer-aided diagnosis (CAD) has become a major research topic in medical imaging and diagnosis. Technical advances such as tissue harmonic imaging, compound imaging, split screen imaging and extended field-of-view imaging, Doppler US, the use of intravenous contrast agents, elastography, and CAD systems have expanded the clinical application of breast US. Breast US CAD can be an efficient computerized model to provide a second opinion and avoid interobserver variation. Various breast US CAD systems have been developed using techniques which combine image texture extraction and a decision-making algorithm. However, the textural analysis is system dependent and can only be performed well using one specific US system. Recently, several researchers have demonstrated the use of such CAD systems with various US machines mainly for preprocessing techniques designed to homogenize textural features between systems. Morphology-based CAD systems used for the diagnosis of solid breast tumors have the advantage of being nearly independent of either the settings of US systems or different US machines. Future research on CAD systems should include pathologically specific tissue-related and hormonerelated conjecture, which could be applied to picture archiving and communication systems or teleradiology.