Comparison of Artificial Neural Network and Bayesian Belief Network in a
Computer-Assisted Diagnosis Scheme for Mammography
Bin Zheng, Yuan-Hsiang Chang, Xiao-Hui Wang, Walter F. Good
Department of Radiology, University of Pittsburgh, Pittsburgh, PA 15261-0001
Bzheng@radserv.arad.upmc .edu
Abstract
Artificial neural networks (A“)have been widely used in
computer-assisted diagnosis (W) schemes as a
class$mtion tool to identii abnormalities in digitized
mammopams. Because of certain limitations of Ai%%,
some investigators argue that Bqesiun belief network
(BBN may exhibit higherpe$ormance. In this stu& we
compared the pet$ormance of an A” and a BBN used in
the same CAD scheme. The common databares and the
same genetic algorithm (GA) were used to optimize both
network. Ttre experimental results demonstrated that
using GA optimizution, the per$ormance of the two
networks converged to the same level in detecting masses
fiom digitized mammograms. Ther#ore, in this study we
concluded that improving the peq4ormance of CAD
schemes might be more dependent on optimimtion of
feaiure selection and divers@ of training database than on
anyparticular machine chs$cation paradigm.
Key Words: Artificial neural network, Bayesian belief
network, Genetic algorithm,Computer-assisteddiagnosis.
I. Introduction
After intensive investigation for more than a decade by
many research groups, a large number of computer-
assisted diagnosis (CAD) schemes in mammography have
been developed [l-lo]. For mass detection, the CAD
schemes usually adopted three steps to identify positive
and negative mass regions. In the first step, they use
different image segmentation methods to filter out basic
tissue structure and select initial suspicious regions. The
second step is to compute or extract features fiom each
suspicious region. Then, the third step uses a classifier to
identify positive and negative regions based on the set of
extracted features. Although each scheme was
independently developed using databases of limited size,
most current CAD schemes yield similar performance(i.e.,
0-7803-5529-6/99/$10.00 01999 IEEEi
85% to 90% sensitivity with 1 to 2 false-positive regions
per image in mass detection). Unlike many other pattern
recognition problems where the feature domain is
reasonably limited and well defined (e.g., optical character
recognition), the feature space in CAD of mammography
is very complex, due to wide diversity of normal tissue
patterns and variety of abnormalities. To improve CAD
performance, a large number of features are usually
extracted. Most of these features are neither visible nor
understandable by human observers. It is very difficult to
find the correlation and effectiveness of these features in
identifying masses in mammograms. Thus, many machine
learning (classification) methods have been tested to
identify the positive mass regions based on a set of
computed features. Artificial neural networks (ANN) are
the most popular paradigm used as a machine learning
classifier in current CAD schemes.
The ANN uses ‘hill-climbing” approach to learn the
correct response or output for each of the training samples.
After training, the structure of the ANN has been self-
organized to enable extrapolation when faced with new,
yet similar, patterns, on the basis of ‘Bxperience” with the
training set. One attractive feature when using an ANN in
a complex pattern recognition problem is that the required
amount of a priori knowledge of the input features and
internal system operation is minimal [l 13. AlthoughANNs
have the ability to learn complex patterns directly fiom
observations, their reasoning process is inaccessible to
human understanding and observers cannot be certain what
the ANN has learned [12]. Because of this, it may be hard
for physicians to accept and act on a computer systems
advice without knowing the basis for the systems decision
[13]. Furthermore, due to ‘hill-climbing” optimization
process of the A N N s , the possible data over-fitting may
significantly deteriorate the robustness of ANN-based
CAD schemes in real clinical environment [14].
Bayesian belief networks (BBN) use different training
concept. A BBN is a causal probabilistic network that
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compactly represents the joint probability distribution of a
problem domain by exploiting conditional dependencies.
The BBN captures knowledge of a given problem domain
in a natural and efficient way. A BBN can also explain its
reasoning and can avoid the danger of data over-fitting
[15]. Because of these unique characteristics, BBNs have
been widely used in many machine learning applications
[16]. In the area of computer-assisted diagnosis of breast
cancer, some researchers have claimed that BBNs should
perform much better and more reliably than ANNs [17].
Because in current CAD studies, different schemes have
been trained and tested using different databases,
performance of these schemes can not be compared [181.
In this study, we used the same database to train both an
ANN and a BBN. After optimizing the topologies of these
networks using a genetic algorithm (GA), an independent
database was used to test the performance and robustness
of the ANN and the BBN. In this way, we can objectively
compare the performance and robustness of the ANN and
the BBN based CAD schemes developed in this
experiment. A description of the approach, along with the
preliminary experimental results derived fkom three
independent databases involving total of 1,557 images, is
presented here.
II. Materials and Methods
2.1. Three independent databases
Three independently acquired image databases were used
in this study. The first one was used for training the
networks. The second was used to evaluate a fitness
function in the GA, and the third was used to assess the
perfinmace and robustness of the optimized networks.
Three databases, which were acquired from three different
medical centers, included 545,579, and 433 images. All of
these 1,557 images were digitized in our laboratory using
the same laser film digitizer Cumisys 150) with a pixel
size of 100 pm x 100 pm and 12-bit gray-level resolution.
The digitized images were then sub-sampled by a factor of
four in both directions to generate new images with sizes
of approximately600 x 450 pixels. In each database there
is a mixture of images with and without mass regions. All
masses were pathology verified. The locations of these
verified mass regions in the original film mammograms
were identified by expert radiologists in the different
medical centers where the mammograms were acquired.
Most of the ‘hegative” images in these databases were
considered to be difficult controls because they had dense
breast parenchyma with highly fluctuated image features.
It should be noted that because in this study we were only
interested in mass detection, an image without a positive
mass was considered as a ‘hegative” image even though it
might contain other abnormalities (i.e., microcalcification
clusters).
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The 1,557 images were individually processed by our
multi-layer topographic based CAD scheme which has
been described elsewhere [3]. In brief, this scheme has
three distinct stages for the identification of suspicious
regions. The first stage of dual kernel filtering, subtraction,
thresholding, and labeling resulted in the selection of a
large number of suspicious regions (approximately 18
regions per image when applied to these image databases).
Based on local contrast measurements, the second stage
used an adaptive region growth algorithm to define three
topographic layers for each suspicious region. In each
growth layer, a set of simple intra-layer boundary
conditions on the growth ratio and change of shape factor
of the region was applied to eliminate a large number of
initial suspicious regions (> 80%), which may included
both positive and negative regions. Only the regions that
successllly pass through three topographic growths were
retained as suspicious regions for further classification.
After the second stage, the number of suspicious regions
(including both positive and negative regions) decreased to
5,560 (approximately 3.6 per image) in these 1,557
images. For each of these remaining regions, a set of
image features was automatically computed by our CAD
scheme. Using these features, in the third stage of the
scheme, different classification tools based on nonlinear
multi-layer feature analysis were incorporated to identify
positive and negative mass regions. The classification tools
that have been tested in our previous studies include a rule-
based expert classifier [3], set enumeration trees [8], an
ANN [19], and a BBN [20]. In this study, both an ANN
and a BBN were used as classification tools. All suspicious
regions identified by the second stage of the CAD scheme
were included in the experimentaldatabases.
772 of these 5,560 regions depicted verified masses, while
4,788 suspicious regions were actually negative. With the
exception of the suspicious regions that matched the
verified masses, all other regions that had been identified
by our CAD scheme in the second stage as suspicious were
determined to be negative. No pathologic verification was
available for the negative regions. In summary, there are
288, 172, 312 positive mass regions in these three image
databases, respectively. The CAD scheme detected 1,65 1,
1,876,1,261 negative (false-positive) regions in these three
image databases. A feature vector extracted by the CAD
scheme was used to represent each suspiciousmass region.
This feature vector contains 38 features. Within these
features, 32 were computed from the interior of the region
and its sumounding background, which were considered to
be local features, while the other six were global features
that represent the global tissue patterns of the breast.
Definitions of these features and related computational
methods using our CAD scheme have been described
elsewhere [8,19,20].
22. Topology of networks and GA initialization
In these experiments, all 38 features were used to train and
test the classifiers. The topologies of the ANN and the
BBN are different. The ANN has 38 input neurons, 16
hidden neurons, and one output neuron. The topology of
the BBN was similar to the BBN that we have developed
and tested for mass detection in our previous studies [20].
Basically, the six global features are located in the top
layer of the network and comprise the ‘barent” nodes to
detection node (output for the mass identification). The 32
local features are ‘Wild nodes” located in a layer below
the detection node. Unlike the ANN where the input
features are continuous data (e.g., from 0 to l), in a BBN,
each node must be quantified to a fixed number of
exclusive states. The continuous data for these features
must be converted to discrete data. In this study, each
feature was divided into five discrete states. The methods
to convert these features into discrete states have been
reported elsewhere [20]. Although each feature vector
contains 38 features, many of them might be redundant.
The redundant features used in the input nodes of an ANN
or a BBN make very little contribution to information but
add a lot of noise, which result in poor generalization for
the networks. Evan though the topology of a BBN can be
interpreted, manual selection of independent and effective
features is a difficult task. To find a small number of
independent features and eliminate the redundant ones in
this feature vector, a genetic algorithm (GA) was used to
optimize feature set and topologies of the ANN and the
BBN. The GA sohare, GENESIS, was acquired from
Prime Time Freeware for AI [21] and used in this study.
A GA solves a complex optimization problem by
emulating evolutionary concepts that on& the strongest
stvyiyes.A population of possible chromosomesis created,
evaluated, recombined, and mutated to generate more and
different chromosomes. The best are kept as a basis for
evolving better chromosomes. In general, a GA involves
the steps of initialization, evaluation, selection, search, and
termination [22]. Although the software, GENESIS,
provides a basic program structure for optimization, users
need to determine m y detailed parameters and functions,
such as encoding, fitness function, and evaluation
criterion.
Based on their distributions in our databases, each of the
38 features was normalized to a range between 0 and 1. In
the GA, a binary coded chromosome was used. Each
feature corresponded to a gene in a chmosome (or a bit
of the structure defined in GEAESIS). In this binary coded
chromosome, I indicates the presence of a gene (the
feature is used as an input node) and 0 indicates its absence
(the feature is rejected). In our experiments, all
chromosomes have fixedlength of 38 (including six global
features and 32 local features). The initial population size
4183
of the chromosomes was set as 50. In order to incorporate
our experience in the feature selection and also to achieve
a diverse initial population, about one third of the initial
chromosomes were manually selected with a small number
of bits of I (S IO), while the rest of initial population was
randomly assigned by GA sohare. Meanwhile, the
crossover rate, the mutation rate, and the generation gap
used in the GA were set at 0.6, 0.001, and 1.0,
respectively.
2.3. Optimization of feature selection
From initial 38 features, we used GA to select sub-sets of
features, xi,i = 1,2,... n , where n I38 . The selected
features were then connected to the input neurons in the
ANN and the probability nodes in the BBN. The number
..
of hidden neurons (hj j = 1,2,. rn) in the ANN was
determined as half of the input neurons, or
+
m = (int)(0.5 n / 2 ) . There is one neuron in the
output layer to represent the result of mass detection. The
detailed description of the ANN structure used in our CAD
scheme was previously reported [19]. In this study, the
number of training iterations was fixed at 1,000. The
momentum and learning rate were set as 0.8 and 0.01,
respectively. In the BBN, the features selected by the GA
were located in the different nodes. If the selected feature
was a global feature, it was placed in the top layq
otherwise the feature was connected to one of the ‘Wild”
nodes in the BBN.
Because a GA is a task independent optimizer, users must
provide or define a fitness function and an evaluation
criterion, so that the GA has an optimization goal. In the
experiments, the fitness function was the receiver
operating characteristic (ROC) curve, and the evaluation
criterion was the maximum area under the ROC curve
( A , value). ROC curves were generated by the ROCFIT
program [23], based on output data fiom the networks.
Once GA selected a chromosome, a set of features was
also extracted to be used in the networks. The training
database was used to train the ANN by setting its weights
or to train the BBN by computing the conditional
probability table. After training the networks, the second
database (or evaluation database) was used to examine the
performance of the networks. The output values of
evaluation were directly used as input data to compute a
ROC curve. The ROCFIT program produced an A, value
for each selected chromosome. Chromosomes with higher
A,values have higher priority to be selected to generate
new chromosomes in next generation by the GA using the
techniques of crossover and mutation. The GA was
terminated when it had converged to a maximum A, value
 or the searching generation has reached to 50. Two
chromosomes that produced highest A,values for the
ANN and the BNN were selected to build an optimal ANN
and an optimal BBN, respectively. The performance and
robustness of these networks were compared using another
independent testing database containing 312 true-positive
mass regions and 1,261 false-positive regions. This test
database was never involved in any of the optimization
processes. Finally, we tested a hybrid classifier, in which
feature vectors passed through two networks separately,
and the ultimate output was the average score from the
outputs of the two networks.
III. Results
Using the same training database and all 38 features to
train and test the ANN and BBN, we achieved A, values
of 0.791 f 0.012 and 0.783 f 0.011 on the evaluation
database involving 172 positive mass regions and 1,876
negative regions for the ANN and BBN, respectively.
Table 1 demonstrates that after GA o p t i d o n , the
number of features selected in both ANN and the BBN
have been significantly reduced. Less than half of the
original 38 features were retained for these two networks.
Although the features selected in two networks were not
exactly the same, the perfonnance levels of the two
networks converged to the same level.
Table 1:Optimization results for the ANN and the BBN.
I Network I Numberof I Number of I La A I
local features global features
A” 12 2 0.866
BBN 14 3 0.868
In an independent test of these optimal networks, the
results for the ANN and the BBN remained at the same
level. For the ANN, A, value was 0.847 f 0.014, and for
the BBN, A, value was 0.845 f 0.01 1. Finally, using a
hybrid classifier containing both the ANN and the BBN,
the A, value on the test database was increased to 0.859 f
0.01.
IV.Discussion
Objectively evaluating CAD performance and robustness
is a very complicated and difficult task [18]. The
performance of a scheme depends on many factors, such as
case difficulty in the training and testing databases [24],
the size of training database [19], validation methods [25],
and the ground truth for the comparison [26]. Basically,
the CAD schemes that developed at different institutions
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and optimized using different databases are not
comparable [24]. In this study, we used the same database
and the same optimization protocol to train and test two
machine learning classifiers, an ANN and a BBN. Hence,
the performance of these two networks can be objectively
compared. When applied to a new independent database,
the perfiormance deterioration of a CAD scheme may be
caused by two factors. The fist is bias in the training
samples due to the Iimited size of the training set
compared to the diverse feature distributions in real
clinical testing populations. The second is data over-fitting
in certain learning algorithms, which makes classifiers
much more sensitive to the noise patterns in the testing
samples. The ANN and BBN represent two very typical
and popular classifiers used in CAD. The ANN uses a
black box ‘hill-climbing” method to search for the
relationship between training samples and classification
results. Both the sample bias and the data over-fitting have
impact in the robustness of the ANN. The BBN uses
Bayesian probability theory to find the optimal relationship
between the input features and output results. Although
there is no data over-fitting problem in the BBN, bias in
the learning samples generates incorrect probability tables
that reduce the robustness of the BBN. As a result, the
ANN usually outperforms the BBN in training results, but
falls behind in testing new cases. In our experiments,
several methods have been used to minimize over-fitting
during ANN training, which include limiting the number
of training iterations and maintaining a large ratio between
momentum and learning rate [ll]. The training iteration
number was limited to 1,000 and the ratio between
momentum and learning rate was set at 80.
Although data over-fitting is a potential danger to testing
an ANN, by using a GA and setting an appropriate fitness
criterion, the impact of over-fitting can be significantly
reduced, as shown in this study. In both optimization and
independent testing, the ANN and the BBN achieved the
same performance level (A, value), which clearly
indicates that, in this experiment, the performance
‘tletmioration” in independent testing is mainly caused by
the bias in the training database. There is no significant
difference between using an ANN and a BBN in our CAD
scheme for mass detection, as long as each network has
been properly optimized or trained. This study
demonstrated that improving performance and robustness
of CAD schemes might be more dependent on feature
selection and database diversity than on any particular
machine learning or classification algorithm.
V. Acknowledgements
This work is supported in part by the National Cancer
Institute under the grants of CA77850 and CA79587, and
US Army under mt DAMD17-98-1-8018.

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