SU-C-207B-04: Automated Segmentation of Pectoral Muscle in MR Images of Dense Breasts

Purpose: To develop and evaluate a fully automated method for segmentation of the pectoral muscle boundary in Magnetic Resonance Imaging (MRI) of dense breasts. Methods: Segmentation of the pectoral muscle is an important part of automatic breast image analysis methods. Current methods for segmenting the pectoral muscle in breast MRI have difficulties delineating the muscle border correctly in breasts with a large proportion of fibroglandular tissue (i.e., dense breasts). Hence, an automated method based on dynamic programming was developed, incorporating heuristics aimed at shape, location and gradient features.To assess the method, the pectoral muscle was segmented in 91 randomly selected participants (mean age 56.6 years, range 49.5–75.2 years) from a large MRI screening trial in women with dense breasts (ACR BI-RADS category 4). Each MR dataset consisted of 178 or 179 T1-weighted images with voxel size 0.64 × 0.64 × 1.00 mm3. All images (n=16,287) were reviewed and scored by a radiologist. In contrast to volume overlap coefficients, such as DICE, the radiologist detected deviations in the segmented muscle border and determined whether the result would impact the ability to accurately determine the volume of fibroglandular tissue and detection of breast lesions. Results: According to the radiologist's scores, 95.5% of the slices did not mask breast tissue in such way that it could affect detection of breast lesions or volume measurements. In 13.1% of the slices a deviation in the segmented muscle border was present which would not impact breast lesion detection. In 70 datasets (78%) at least 95% of the slices were segmented in such a way it would not affect detection of breast lesions, and in 60 (66%) datasets this was 100%. Conclusion: Dynamic programming with dedicated heuristics shows promising potential to segment the pectoral muscle in women with dense breasts.