This study proposes a clinically driven hybrid segmentation framework for dense breast tissue analysis in mammographic images, addressing persistent challenges associated with intensity inhomogeneity, low-contrast, and complex tumor morphology. The framework integrates Multiplicative Intrinsic Component Optimization (MICO₂D) for bias field correction, followed by a distance-regularized multiphase Vese–Chan level-set model for coarse global tumor segmentation. To achieve precise boundary delineation, a localized refinement stage is employed using Localized Active Contours (LAC) with Local Image Fitting (LIF) energy, supported by Gaussian regularization to ensure smooth and coherent boundaries in regions with ambiguous tissue transitions. Building upon the refined semantic tumor mask, the framework further incorporates a panoptic-style tumor instance segmentation stage, enabling the decomposition of connected tumor regions into distinct anatomical instances, which were evaluated on both MIAS and INBreast mammography datasets to demonstrate generalizability. This extension facilitates detailed structural analysis of tumor multiplicity and spatial organization, enhancing interpretability beyond conventional pixel wise segmentation. Experiments conducted on Cranio-Caudal (CC) and Medio-Lateral Oblique (MLO) mammographic views demonstrate competitive performance relative to baseline U-Net and advanced deep learning fusion architectures, including multi-scale and multi-view networks, while offering improved interpretability and robustness. Quantitative evaluation using overlap-related metrics shows strong spatial agreement between predicted and reference segmentations, with per-image Dice Similarity Coefficient (DSC) and Intersection over Union (IoU) distributions reported to ensure reproducibility. Descriptive per-image analysis, supported by bootstrap-based confidence intervals and paired comparisons, indicates consistent performance improvements across images. Robustness analysis under realistic perturbations, including noise, contrast degradation, blur, and rotation, demonstrates stable performance across varying imaging conditions. Furthermore, feature space visualizations using t-SNE and UMAP reveal clear separability between cancerous and non-cancerous tissue regions, highlighting the discriminative capability of the proposed framework. Overall, the results demonstrate the effectiveness, robustness, and clinical motivation of this hybrid panoptic framework for comprehensive dense breast tumor analysis in mammography, while emphasizing reproducibility and conservative statistical assessment.
坂東 et al. (2026) studied this question.