Regular examination of breasts may prevent and help to cure because breast cancer is treatable when it is detected early. Therefore, a breast cancer screening modality being sensitivity and cost-effective like ultrasonic imaging modality (US), is strongly required. In addition, the combination of a conventional US and its adjunct, Color Doppler has been proved for decreasing the rate of false-positive in breast cancer diagnosis. Thus, combination of these imaging modalities in a breast cancer segmentation would provide some benefits as well. An effective method for feature segmentation, active contour model has been widely utilized for decades. A crucial stage that affects the performance of active contour model is the initialization. This paper proposes a novel method for an automatic initialization of active contour model designed specifically for US-based imaging modalities. The method estimates an initial contour by utilizing the fusion of conventional US and Color Doppler. Examples and comparisons with three state-of-the-art automatic initialization methods are demonstrated to present the advantages of the proposed method. The evaluation results show high accuracy of initialization as well as fast convergence to features of interest.

Background Phyllodes tumor is a rare fibroepithelial neoplasm of the breast, which is classified histologically as benign, borderline, or malignant. Accurate preoperative diagnosis allows the correct surgical planning and reoperation avoidance. Objective To describe the clinical presentation and radiologic features of phyllodes tumors and differentiate between benign and non-benign (borderline and malignant) groups. Methods A retrospective study of 57 patients with a diagnosis of phyllodes tumor who had preoperative imaging (mammography, ultrasound, or CT chest) and histological confirmation. The data was collected from 1 June 2011 to 30 September 2021. The imaging features of the phyllodes tumors were described according to the 5th edition of the ACR BI-RADS lexicon. For comparing between two groups, the student t-test, Wilcoxon rank sum test, Chi-square test, and Fisher’s exact test were used for statistical analyses. The logistic regression analysis was calculated for non-benign phyllodes tumor prediction. Results From 57 patients, the pathologic results were benign for 43 cases and non-benign phyllodes tumors for 14 cases. There was no differentiation of mammographic and CT features between benign and non-benign groups. Non-benign phyllodes tumors had the statistical significance of menopausal status, entire breast involvement, tumor size larger than 10 cm, and heterogeneous echo on univariable analysis. After multivariable analysis, menopausal status (odd ratios=13.79, p=0.04) and presence of vessels in the rim (odd ratios=16.51, p=0.019) or absent vascularity (odd ratios=8.45, p=0.047) on doppler ultrasound were significantly increased possibility of non-benign phyllodes tumor. Conclusions Menopausal status and presence of vessels in the rim or absent vascularity on Doppler ultrasound were important predictors for the diagnosis of non-benign phyllodes tumor.