Для корреспонденции Рожкова Надежда Ивановна, д.м.н., профессор, заслуженный деятель науки РФ, лауреат премии Совета министров СССР, руководитель Национального центра онкологии репродуктивных органов Московского научно-исследовательского онкологического института им. П.А.Герцена-филиал ФГБУ «Национальный медицинский исследовательский центр радиологии» Министерства здравоохранения Российской Федерации, профессор кафедры клинической маммологии, лучевой диагностики и лучевой терапии факультета повышения квалификации медицинских работников ФГАОУ ВО «Российский университет дружбы народов», член Международного Комитета Европейской ассоциации радиологов, президент Российской ассоциации маммологов Адрес: 125284, Российская Федерация, г. Москва, 2-й Боткинский проезд, д. 3
Comparison of the sensitivity of cytological and molecular genetic methods (19 specimens of lymph nodes from 8 patients with breast cancer and suspected metastases obtained by transcutaneous fine-needle aspiration biopsy under ultrasound guidance) showed that molecular genetic and cytological studies produced true results in 95 and 84% specimens, respectively. True-positive and true-negative results were obtained in 8 and 7 patients, respectively. Expression of cytokeratin 19 was detected in 3 specimens with negative cytological results and confirmed metastases in lymph nodes. Our results indicate that molecular genetic diagnostic study for lymph node metastases should be used in small amounts of biopsy specimens, presence of marginal metastases in lymph nodes, and negative results of repeated cytological examination.
Diagnostic efficiency of breast cancer screening remains one of the most important issues in oncology and radiology. Artificial intelligence technologies are widely used in clinical medicine to effectively solve a number of technological and diagnostic problems. The aim. To develop segmentation neural network model for breast plain radiographs analysis with subsequent study of its clinical effectiveness. Materials and methods. The artificial intelligence-based system was developed to analyze X-ray mammography, аnd included a segmentation neural network with the U-Net architecture, a classification neural architecture ResNet50 with outputting the result using gradient boosting. 15486 X-ray cases were used for training, estimation of diagnostic accuracy and validation of the developed segmental model. All cases were labeled in specially developed software environment LabelCMAITech. The segmentation accuracy was determined by Intersection over Union (IoU) similarity coefficient, the probability of malignancy was calculated using the binary classification metrics. Results. The developed system is represented by a segmentation model based on neural network architecture. The model allows, with high accuracy of 0.8176 and higher, at threshold values on the output neurons of the network of 0.1 and 0.15, to localize X-ray findings that have diagnostic value for determining the likelihood of the presence of breast cancer signs in an X-ray mammographic study — focus, architecture distortion, local asymmetry, calcifications. When comparing the results of machine segmentation and marking of images by a radiologist, it was found that the model is not inferior to the doctor in the accuracy of determining the formations, extra-focal calcifications and intraglandular lymph nodes. Conclusion. The results of this study allow considering the model as an intelligent assistant to a radiologist in the analysis of screening mammographic cases.
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