Two-stage classification strategy for breast cancer diagnosis using ultrasound-guided diffuse optical tomography and deep learning.

Significance: Ultrasound (US)-guided diffuse optical tomography (DOT) has demonstrated great potential for breast cancer diagnosis in which real-time or near real-time diagnosis with high accuracy is desired. Aim: We aim to use US-guided DOT to achieve an automated, fast, and accurate classification of breast lesions. Approach: We propose a two-stage classification strategy with deep learning. In the first stage, US images and histograms created from DOT perturbation measurements are combined to predict benign lesions. Then the non-benign suspicious lesions are passed through to the second stage, which combine US image features, DOT histogram features, and 3D DOT reconstructed images for final diagnosis. Results: The first stage alone identified 73.0% of benign cases without image reconstruction. In distinguishing between benign and malignant breast lesions in patient data, the two-stage classification approach achieved an area under the receiver operating characteristic curve of 0.946, outperforming the diagnoses of all single-modality models and of a single-stage classification model that combines all US images, DOT histogram, and imaging features. Conclusions: The proposed two-stage classification strategy achieves better classification accuracy than single-modality-only models and a single-stage classification model that combines all features. It can potentially distinguish breast cancers from benign lesions in near real-time.