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Purpose The aim of this study was to develop and test a post-processing technique for detection and classification of lesions according to the BI-RADS atlas in automated breast ultrasound (ABUS) based on deep convolutional neural networks (dCNNs). Methods and materials In this retrospective study, 645 ABUS datasets from 113 patients were included; 55 patients had lesions classified as high malignancy probability. Lesions were categorized in BI-RADS 2 (no suspicion of malignancy), BI-RADS 3 (probability of malignancy   3%). A deep convolutional neural network was trained after data augmentation with images of lesions and normal breast tissue, and a sliding-window approach for lesion detection was implemented. The algorithm was applied to a test dataset containing 128 images and performance was compared with readings of 2 experienced radiologists. Results Results of calculations performed on single images showed accuracy of 79.7% and AUC of 0.91 [95% CI: 0.85–0.96] in categorization according to BI-RADS. Moderate agreement between dCNN and ground truth has been achieved ( κ : 0.57 [95% CI: 0.50–0.64]) what is comparable with human readers. Analysis of whole dataset improved categorization accuracy to 90.9% and AUC of 0.91 [95% CI: 0.77–1.00], while achieving almost perfect agreement with ground truth ( κ : 0.82 [95% CI: 0.69–0.95]), performing on par with human readers. Furthermore, the object localization technique allowed the detection of lesion position slice-wise. Conclusions Our results show that a dCNN can be trained to detect and distinguish lesions in ABUS according to the BI-RADS classification with similar accuracy as experienced radiologists. Key Points •  A deep convolutional neural network (dCNN) was trained for classification of ABUS lesions according to the BI-RADS atlas . •  A sliding-window approach allows accurate automatic detection and classification of lesions in ABUS examinations .

Fully automatic classification of automated breast ultrasound (ABUS) imaging according to BI-RADS using a deep convolutional neural network