Swarm learning with weak supervision enables automatic breast cancer detection in magnetic resonance imaging
Communications Medicine, vol. 5, pp. 38
Abstract
BACKGROUND: Over the next 5 years, new breast cancer screening guidelines recommending magnetic resonance imaging (MRI) for certain patients will significantly increase the volume of imaging data to be analyzed. While this increase poses challenges for radiologists, artificial intelligence (AI) offers potential solutions to manage this workload. However, the development of AI models is often hindered by manual annotation requirements and strict data-sharing regulations between institutions. METHODS: In this study, we present an integrated pipeline combining weakly supervised learning-reducing the need for detailed annotations-with local AI model training via swarm learning (SL), which circumvents centralized data sharing. We utilized three datasets comprising 1372 female bilateral breast MRI exams from institutions in three countries: the United States (US), Switzerland, and the United Kingdom (UK) to train models. These models were then validated on two external datasets consisting of 649 bilateral breast MRI exams from Germany and Greece. RESULTS: Upon systematically benchmarking various weakly supervised two-dimensional (2D) and three-dimensional (3D) deep learning (DL) methods, we find that the 3D-ResNet-101 demonstrates superior performance. By implementing a real-world SL setup across three international centers, we observe that these collaboratively trained models outperform those trained locally. Even with a smaller dataset, we demonstrate the practical feasibility of deploying SL internationally with on-site data processing, addressing challenges such as data privacy and annotation variability. CONCLUSIONS: Combining weakly supervised learning with SL enhances inter-institutional collaboration, improving the utility of distributed datasets for medical AI training without requiring detailed annotations or centralized data sharing.
Authors 30
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Universitätsklinikum Aachen · Else Kröner Fresenius Center for Digital Health · Technische Universität Dresden · RWTH Aachen University
Affiliation as printed
Department of Diagnostic and Interventional Radiology, University Hospital RWTH Aachen, Aachen, Germany
Else Kroener Fresenius Center for Digital Health, Medical Faculty Carl Gustav Carus, Technical University Dresden, Dresden, Germany
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Universitätsklinikum Aachen · RWTH Aachen University
Affiliation as printed
Department of Diagnostic and Interventional Radiology, University Hospital RWTH Aachen, Aachen, Germany
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Universitätsklinikum Aachen · RWTH Aachen University
Affiliation as printed
Department of Diagnostic and Interventional Radiology, University Hospital RWTH Aachen, Aachen, Germany
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University of Cambridge · NIHR Cambridge Biomedical Research Centre
Affiliation as printed
Department of Radiology, Clinical School, Cambridge Biomedical Research Centre, University of Cambridge, Cambridge, UK
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University of Cambridge · Cancer Research UK · Cancer Research UK Cambridge Center · NIHR Cambridge Biomedical Research Centre
Affiliation as printed
Cancer Research UK Cambridge Centre, Cambridge, UK
Department of Radiology, Clinical School, Cambridge Biomedical Research Centre, University of Cambridge, Cambridge, UK
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Affiliation as printed
Breast Imaging Department, Mitera Hospital Athens, Athens, Greece
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University of Zurich · University Hospital Zurich
Affiliation as printed
Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, Zurich, Switzerland
b-rayZ AG, Schlieren, Switzerland
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Else Kröner Fresenius Center for Digital Health · Technische Universität Dresden
Affiliation as printed
Else Kroener Fresenius Center for Digital Health, Medical Faculty Carl Gustav Carus, Technical University Dresden, Dresden, Germany
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Else Kröner Fresenius Center for Digital Health · Technische Universität Dresden
Affiliation as printed
Else Kroener Fresenius Center for Digital Health, Medical Faculty Carl Gustav Carus, Technical University Dresden, Dresden, Germany
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Else Kröner Fresenius Center for Digital Health · Technische Universität Dresden
Affiliation as printed
Else Kroener Fresenius Center for Digital Health, Medical Faculty Carl Gustav Carus, Technical University Dresden, Dresden, Germany
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University of Cambridge · NIHR Cambridge Biomedical Research Centre · Sultan Zainal Abidin University
Affiliation as printed
Department of Radiology, Clinical School, Cambridge Biomedical Research Centre, University of Cambridge, Cambridge, UK
Universiti Sultan Zainal Abidin, Kuala Nerus, Terengganu, Malaysia
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Affiliation as printed
Breast Imaging Department, Mitera Hospital Athens, Athens, Greece
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Affiliation as printed
Breast Imaging Department, Mitera Hospital Athens, Athens, Greece
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Affiliation as printed
Breast Imaging Department, Mitera Hospital Athens, Athens, Greece
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Affiliation as printed
Breast Imaging Department, Mitera Hospital Athens, Athens, Greece
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University of Zurich · University Hospital Zurich
Affiliation as printed
Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, Zurich, Switzerland
b-rayZ AG, Schlieren, Switzerland
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University of Zurich · University Hospital Zurich
Affiliation as printed
Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, Zurich, Switzerland
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Affiliation as printed
Breast Imaging Department, Mitera Hospital Athens, Athens, Greece
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Vall d'Hebron Institute of Oncology
Affiliation as printed
Radiomics Group, Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain
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Radboud University Nijmegen · Radboud University Medical Center · The Netherlands Cancer Institute
Affiliation as printed
Department of Diagnostic Imaging, Radboud University Medical Center, Nijmegen, The Netherlands
Department of radiology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
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University Medical Center Utrecht
Affiliation as printed
Imaging Division, University Medical Center Utrecht, Utrecht, The Netherlands
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Affiliation as printed
Breast Cancer Unit, Ribera Salud Hospitals, Valencia, Spain
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Fraunhofer Institute for Digital Medicine · RWTH Aachen University
Affiliation as printed
Fraunhofer Institute for Digital Medicine MEVIS, Bremen, Germany
Imaging and Computer Vision, RWTH Aachen University, Aachen, Germany
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Constructor University · Fraunhofer Institute for Digital Medicine
Affiliation as printed
Constructor University Bremen GmbH, Bremen, Germany
Fraunhofer Institute for Digital Medicine MEVIS, Bremen, Germany
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Affiliation as printed
The European Society of Medical Imaging Informatics (EuSoMII), Vienna, Austria
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University of Zurich · University Hospital Zurich
Affiliation as printed
Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, Zurich, Switzerland
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Universitätsklinikum Aachen · RWTH Aachen University
Affiliation as printed
Department of Diagnostic and Interventional Radiology, University Hospital RWTH Aachen, Aachen, Germany
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University of Cambridge · NIHR Cambridge Biomedical Research Centre
Affiliation as printed
Department of Radiology, Clinical School, Cambridge Biomedical Research Centre, University of Cambridge, Cambridge, UK
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Universitätsklinikum Aachen · RWTH Aachen University
Affiliation as printed
Department of Diagnostic and Interventional Radiology, University Hospital RWTH Aachen, Aachen, Germany
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Jakob Nikolas Kather corresponding
Heidelberg University · University Hospital Heidelberg · National Center for Tumor Diseases · University Hospital Carl Gustav Carus · Else Kröner Fresenius Center for Digital Health · Technische Universität Dresden
Affiliation as printed
Department of Medicine 1, University Hospital and Faculty of Medicine Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany. jakob-nikolas.kather@alumni.dkfz.de
Else Kroener Fresenius Center for Digital Health, Medical Faculty Carl Gustav Carus, Technical University Dresden, Dresden, Germany. jakob-nikolas.kather@alumni.dkfz.de
Medical Oncology, National Center for Tumor Diseases (NCT), University Hospital Heidelberg, Heidelberg, Germany. jakob-nikolas.kather@alumni.dkfz.de
Department of Medicine 1, University Hospital and Faculty of Medicine Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
Medical Oncology, National Center for Tumor Diseases (NCT), University Hospital Heidelberg, Heidelberg, Germany
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