PurposeGiven the dependence of radiomic-based computer-aided diagnosis artificial intelligence on accurate lesion segmentation, we assessed the performances of 2D and 3D U-Nets in breast lesion segmentation on dynamic contrast-enhanced (DCE) magnetic resonance imaging (MRI) relative to fuzzy c-means (FCM) and radiologist segmentations. ApproachUsing 994 unique breast lesions imaged with DCE-MRI, three segmentation algorithms (FCM clustering, 2D and 3D U-Net convolutional neural networks) were investigated. Center slice segmentations produced by FCM, 2D U-Net, and 3D U-Net were evaluated using radiologist segmentations as truth, and volumetric segmentations produced by 2D U-Net slices and 3D U-Net were compared using FCM as a surrogate reference standard. Fivefold cross-validation by lesion was conducted on the U-Nets; Dice similarity coefficient (DSC) and Hausdorff distance (HD) served as performance metrics. Segmentation performances were compared across different input image and lesion types. Results2D U-Net outperformed 3D U-Net for center slice (DSC, HD p < 0.001) and volume segmentations (DSC, HD p < 0.001). 2D U-Net outperformed FCM in center slice segmentation (DSC p < 0.001). The use of second postcontrast subtraction images showed greater performance than first postcontrast subtraction images using the 2D and 3D U-Net (DSC p < 0.05). Additionally, mass segmentation outperformed nonmass segmentation from first and second postcontrast subtraction images using 2D and 3D U-Nets (DSC, HD p < 0.001). ConclusionsResults suggest that 2D U-Net is promising in segmenting mass and nonmass enhancing breast lesions from first and second postcontrast subtraction MRIs and thus could be an effective alternative to FCM or 3D U-Net.
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