Tumor segmentation in automated whole breast ultrasound using bidirectional LSTM neural network and attention mechanism

Accurate breast mass segmentation of automated breast ultrasound (ABUS) is a great help to breast cancer diagnosis and treatment. However, the lack of clear boundary and significant variation in mass shapes make the automatic segmentation very challenging. In this paper, a novel automatic tumor segmentation method SC-FCN-BLSTM is proposed by incorporating bi-directional long short-term memory (BLSTM) and spatial-channel attention (SC-attention) module into fully convolutional network (FCN). In order to decrease performance degradation caused by ambiguous boundaries and varying tumor sizes, an SC-attention module is designed to integrate both finer-grained spatial information and rich semantic information. Since ABUS is three-dimensional data, utilizing inter-slice context can improve segmentation performance. A BLSTM module with SC-attention is constructed to model the correlation between slices, which employs inter-slice context to assist segmentation for false positive elimination. The proposed method is verified on our private ABUS dataset of 124 patients with 170 volumes, including 3636 2D labeled slices. The Dice similarity coefficient (DSC), Recall, Precision and Hausdorff distance (HD) of the proposed method are 0.8178, 0.8067, 0.8292 and 11.1367. Experimental results demonstrate that the proposed method offered improved segmentation results compared with existing deep learning-based methods.