Intelligent Lesion Selection: A Novel Method for Longitudinal Assessment of Breast Cancer Lung Metastases

Abstract

Breast cancer, the second most common cancer globally, often metastasizes to the lungs, requiring frequent computed tomography (CT) scans to monitor disease progression. Manual analysis by radiologists is time-consuming and prone to variability, underscoring the need for automated systems to enhance accuracy and efficiency. The goal of such systems is to optimize processes like RECIST score calculation for tumor response assessment. This study presents a pipeline for the automated temporal analysis of breast cancer lung metastases. Existing lung nodule detection and segmentation models were adapted for detecting and segmenting breast cancer metastases. Registration-based lesion tracking was incorporated, and a novel Temporal Lesion Pair Classifier was developed to identify significant lesions and estimate tumor load evolution by summing their diameters, following an adaptation of the RECIST guidelines. Evaluated on a unique dataset of breast cancer patients, each with multiple annotated CT scans at different disease stages, the proposed pipeline demonstrated a 42\% reduction in median tumor size progression discrepancy for consecutive study pairs and improved tumor response classification accuracy by 22\% at the patient level.