arXiv:2510.14340eess.IVcs.AI2025-10被引 3

根据乳腺密度动态选择影像模态,提升癌症检测率

A Density-Informed Multimodal Artificial Intelligence Framework for Improving Breast Cancer Detection Across All Breast Densities

  • 按乳腺密度智能切换哺乳检查或热成像AI,融合功能与结构信息
  • 整体敏感度达94.55%,在致密型乳腺中仍保持92.86%高检出率
  • 框架可解释、低成本,适合医疗资源丰富与匮乏地区推广

目前乳腺癌筛查的标准手段——乳腺钼靶,在致密型乳腺组织中灵敏度下降,易导致漏诊或延误。热成像技术Thermalytix可捕捉血管和代谢功能信息,或可补充钼靶的结构数据。本研究探索基于乳腺密度的多模态AI框架能否通过动态选择成像方式来提升癌症检出能力。共纳入324名女性,同时进行钼靶与热成像检查。钼靶图像由多视角深度学习模型分析,Thermalytix通过血管与热辐射组学评估热成像。该框架对脂肪型乳腺采用钼靶AI,对致密型乳腺则使用Thermalytix AI,依据组织类型优化预测。多模态框架实现敏感度94.55%(95% CI: 88.54–100),特异度79.93%(95% CI: 75.14–84.71),优于单独使用钼靶AI(敏感度81.82%,特异度86.25%)和Thermalytix AI(敏感度92.73%,特异度75.46%)。值得注意的是,钼靶在致密型乳腺中敏感度显著下降至67.86%,而在脂肪型乳腺中为96.30%;而Thermalytix AI在两类乳腺中均保持稳定高敏感度(分别为92.59%和92.86%)。结果表明,基于密度的多模态AI框架能克服单模态筛查局限,实现跨乳腺组成的高性能检测。该框架具备可解释性、低成本、易部署优势,为高资源与低资源环境下的乳腺癌筛查提供可行路径。

原文摘要 · Abstract (English)

Mammography, the current standard for breast cancer screening, has reduced sensitivity in women with dense breast tissue, contributing to missed or delayed diagnoses. Thermalytix, an AI-based thermal imaging modality, captures functional vascular and metabolic cues that may complement mammographic structural data. This study investigates whether a breast density-informed multi-modal AI framework can improve cancer detection by dynamically selecting the appropriate imaging modality based on breast tissue composition. A total of 324 women underwent both mammography and thermal imaging. Mammography images were analyzed using a multi-view deep learning model, while Thermalytix assessed thermal images through vascular and thermal radiomics. The proposed framework utilized Mammography AI for fatty breasts and Thermalytix AI for dense breasts, optimizing predictions based on tissue type. This multi-modal AI framework achieved a sensitivity of 94.55% (95% CI: 88.54-100) and specificity of 79.93% (95% CI: 75.14-84.71), outperforming standalone mammography AI (sensitivity 81.82%, specificity 86.25%) and Thermalytix AI (sensitivity 92.73%, specificity 75.46%). Importantly, the sensitivity of Mammography dropped significantly in dense breasts (67.86%) versus fatty breasts (96.30%), whereas Thermalytix AI maintained high and consistent sensitivity in both (92.59% and 92.86%, respectively). This demonstrates that a density-informed multi-modal AI framework can overcome key limitations of unimodal screening and deliver high performance across diverse breast compositions. The proposed framework is interpretable, low-cost, and easily deployable, offering a practical path to improving breast cancer screening outcomes in both high-resource and resource-limited settings.

乳腺癌筛查多模态AI密度感知热成像

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