Computerized Segmentation Method for Nonmasses on Breast DCE-MRI Images Using ResUNet++ with Slice Sequence Learning and Cross-Phase Convolution.

The purpose of this study was to develop a computerized segmentation method for nonmasses using ResUNet++ with a slice sequence learning and cross-phase convolution to analyze temporal information in breast dynamic contrast material-enhanced magnetic resonance imaging (DCE-MRI) images. The dataset consisted of a series of DCE-MRI examinations from 54 patients, each containing three-phase images, which included one image that was acquired before contrast injection and two images that were acquired after contrast injection. In the proposed method, the region of interest (ROI) slice images are first extracted from each phase image. The slice images at the same position in each ROI are stacked to generate a three-dimensional (3D) tensor. A cross-phase convolution generates feature maps with the 3D tensor to incorporate the temporal information. Subsequently, the feature maps are used as the input layers for ResUNet++. New feature maps are extracted from the input data using the ResUNet++ encoders, following which the nonmass regions are segmented by a decoder. A convolutional long short-term memory layer is introduced into the decoder to analyze a sequence of slice images. When using the proposed method, the average detection accuracy of nonmasses, number of false positives, Jaccard coefficient, Dice similarity coefficient, positive predictive value, and sensitivity were 90.5%, 1.91, 0.563, 0.712, 0.714, and 0.727, respectively, larger than those obtained using 3D U-Net, V-Net, and nnFormer. The proposed method achieves high detection and shape accuracies and will be useful in differential diagnoses of nonmasses.