Efficient Bone Metastasis Diagnosis in Bone Scintigraphy Using a Fast Convolutional Neural Network Architecture.

(1) Background: Bone metastasis is among diseases that frequently appear in breast, lung and prostate cancer; the most popular imaging method of screening in metastasis is bone scintigraphy and presents very high sensitivity (95%). In the context of image recognition, this work investigates convolutional neural networks (CNNs), which are an efficient type of deep neural networks, to sort out the diagnosis problem of bone metastasis on prostate cancer patients; (2) Methods: As a deep learning model, CNN is able to extract the feature of an image and use this feature to classify images. It is widely applied in medical image classification. This study is devoted to developing a robust CNN model that efficiently and fast classifies bone scintigraphy images of patients suffering from prostate cancer, by determining whether or not they develop metastasis of prostate cancer. The retrospective study included 778 sequential male patients who underwent whole-body bone scans. A nuclear medicine physician classified all the cases into three categories: (a) benign, (b) malignant and (c) degenerative, which were used as gold standard; (3) Results: An efficient and fast CNN architecture was built, based on CNN exploration performance, using whole body scintigraphy images for bone metastasis diagnosis, achieving a high prediction accuracy. The results showed that the method is sufficiently precise when it comes to differentiate a bone metastasis case from other either degenerative changes or normal tissue cases (overall classification accuracy = 91.61% ± 2.46%). The accuracy of prostate patient cases identification regarding normal, malignant and degenerative changes was 91.3%, 94.7% and 88.6%, respectively. To strengthen the outcomes of this study the authors further compared the best performing CNN method to other popular CNN architectures for medical imaging, like ResNet50, VGG16, GoogleNet and MobileNet, as clearly reported in the literature; and (4) Conclusions: The remarkable outcome of this study is the ability of the method for an easier and more precise interpretation of whole-body images, with effects on the diagnosis accuracy and decision making on the treatment to be applied.