Impact of Input Resolution in Mammographic Mass Detection: A Controlled Multi-Architecture Study

Joint exam-level prediction and candidate-region localization may improve the usefulness of AI support in mammography. We study this setting using a multi-task DETR framework, where shared representations support both image-level malignancy prediction and lesion localization, and evaluate its performance on OPTIMAM and a biopsy-confirmed SGM1k cohort. Across both datasets, modern backbones consistently outperformed older ResNet-style features, with ConvNeXtV2 and DINOv3 giving the strongest overall results, whereas MambaVision was less competitive. On OPTIMAM, ConvNeXtV2 achieved the best overall performance, reaching 97.96% AUC, 99.89% sensitivity, 25.08% [email protected], and 74.38% [email protected]. On SGM1k, DINOv3 gave the strongest overall results, with 90.97% AUC, 86.28% sensitivity, 82.00% specificity, 27.04% [email protected], and 77.32% [email protected]. These findings suggest that backbone quality is a critical factor in effective multi-task mammography, with ConvNeXtV2 emerging as a particularly strong and well-matched CNN backbone for mammography in this framework.

Purpose: To evaluate the performance-feasibility tradeoffs of foundation models (FMs) and task-specific convolutional neural networks (CNNs) trained from scratch for breast implant classification in 2D mammography, with emphasis on suitability for near real-time clinical deployment. Methods: We evaluated four models: two FMs (RAD-DINO and MammoCLIP) and two CNNs trained from scratch for implant prediction (ResNet18 and our lightweight ResNetLite). Using the Emory Breast Imaging Dataset, 5,000 unilateral screening mammograms were used for training/validation and 1,000 manually reviewed unilateral images were held out for testing. For the FMs, global image embeddings from the pretrained encoder were classified using a support vector machine (SVM). The CNNs were trained end-to-end on 2D mammograms, with ResNetLite optimized via grid search over depth and width to balance accuracy and efficiency. Performance was evaluated using AUROC, sensitivity, specificity, accuracy, embedding visualization, and inference-latency. Results: All models demonstrated strong performance on held-out test data (n = 1,000). MammoCLIP achieved the highest AUROC (0.999) with the quickest training time of 493 seconds. RAD-DINO achieved the highest sensitivity (0.980; accuracy 0.989) but had the slowest inference and training times. ResNet18 and MammoCLIP achieved comparable accuracy (0.985). ResNetLite showed no statistically significant difference from ResNet18 (AUROC 0.993; accuracy 0.976) despite using only 1.4% of ResNet18's parameters, and had the fastest inference time. Conclusion: FMs and task-specific CNN models reliably detect breast implants on 2D mammography. Model selection is best guided by deployment context: MammoCLIP for GPU-equipped hospital settings requiring scalable integration, and lightweight CNNs such as ResNetLite for resource-constrained or edge deployments.

Diabetic Retinopathy (DR) is a leading cause of preventable blindness worldwide, requiring automated lesion segmentation using deep learning models for early detection and monitoring. However, DR lesions vary dramatically in size from tiny microaneurysms to large hemorrhages and exudates. This variability creates conflicting demands on the model architecture and input resolution, posing a challenge for effective design. This work investigates the impact of input resolution on different lesion types. Through systematic experimentation with multiple architectures (U-Net, UNet++, Vision Transformers, DeepLabV3+) at $512 \times 512$ and $1024 \times 1024$ resolutions, we identify a critical, counter-intuitive phenomenon where increasing input resolution has opposing effects on different lesion types. We demonstrate that while higher resolution is essential for resolving fine-grained microaneurysms, it can unexpectedly degrade performance on larger hemorrhages. This finding challenges the common assumption that higher resolution is uniformly beneficial. To address this, we propose a novel Multi-Resolution Feature Stem, an input-level pyramid integrated with a UNet++ backbone. This architecture processes multiple scales in parallel, capturing fine-grained details without sacrificing contextual information. This work contributes crucial empirical evidence of this complex, resolution-dependent behavior and a practical, parameter-efficient architecture that successfully resolves this trade-off.