Artificial intelligence for ultrasound microflow imaging in breast cancer diagnosis

• Published in: Ultraschall in der Medizin Vol. 45; no. 4; p. 412
• Main Authors: Eun, Na Lae, Lee, Eunjung, Park, Ah Young, Son, Eun Ju, Kim, Jeong-Ah, Youk, Ji Hyun
• Format: Journal Article
• Language: English
• Published: Germany 01.08.2024
• Subjects: Adult; Aged; Algorithms; Artificial Intelligence; Breast - diagnostic imaging; Breast Neoplasms - diagnostic imaging; Female; Humans; Middle Aged; Neural Networks, Computer; Retrospective Studies; ROC Curve; Sensitivity and Specificity; Ultrasonography, Mammary - methods
• ISSN: 1438-8782
• DOI: 10.1055/a-2230-2455

To develop and evaluate artificial intelligence (AI) algorithms for ultrasound (US) microflow imaging (MFI) in breast cancer diagnosis. We retrospectively collected a dataset consisting of 516 breast lesions (364 benign and 152 malignant) in 471 women who underwent B-mode US and MFI. The internal dataset was split into training (n = 410) and test datasets (n = 106) for developing AI algorithms from deep convolutional neural networks from MFI. AI algorithms were trained to provide malignancy risk (0-100%). The developed AI algorithms were further validated with an independent external dataset of 264 lesions (229 benign and 35 malignant). The diagnostic performance of B-mode US, AI algorithms, or their combinations was evaluated by calculating the area under the receiver operating characteristic curve (AUROC). The AUROC of the developed three AI algorithms (0.955-0.966) was higher than that of B-mode US (0.842, P < 0.0001). The AUROC of the AI algorithms on the external validation dataset (0.892-0.920) was similar to that of the test dataset. Among the AI algorithms, no significant difference was found in all performance metrics combined with or without B-mode US. Combined B-mode US and AI algorithms had a higher AUROC (0.963-0.972) than that of B-mode US (P < 0.0001). Combining B-mode US and AI algorithms significantly decreased the false-positive rate of BI-RADS category 4A lesions from 87% to 13% (P < 0.0001). AI-based MFI diagnosed breast cancers with better performance than B-mode US, eliminating 74% of false-positive diagnoses in BI-RADS category 4A lesions.