Use of Artificial Intelligence in Breast Ultrasound Imaging: Diagnosis and Clinical Decision Support

AI in Breast Ultrasound: Diagnosis and Decision Support

Authors

  • Muhammad Irshad Ul Haq Office of Research Innovation and Commercialization, Green International University, Lahore, Pakistan
  • Syed Muhammad Yousaf Farooq Department of Radiology and Imaging Technology, Green International University, Lahore, Pakistan
  • Muhammad Moazzam Office of Research Innovation and Commercialization, Green International University, Lahore, Pakistan

DOI:

https://doi.org/10.54393/fbt.v5i4.192

Keywords:

Breast Ultrasound, Medical Imaging, Deep Learning, Computer-Aided Diagnosis

Abstract

Breast ultrasound (US) is a critical non-invasive imaging modality for evaluating breast lesions, particularly in women with dense breast tissue. However, conventional interpretation suffers from inter-observer variability and high false-positive rates due to operator dependence and subjectivity. Objectives: To evaluate the role of Artificial Intelligence (AI), specifically deep learning models, in enhancing diagnostic accuracy, reducing unnecessary interventions, and supporting clinical decision-making in breast ultrasound imaging. Methods: A comprehensive review of recent literature (2000-2025) was conducted, focusing on AI applications in breast ultrasound for lesion detection, classification, segmentation, and clinical workflow integration. Results: AI systems, particularly convolutional neural networks, demonstrate diagnostic accuracy with area under the curve (AUC) values ranging from 0.92 to 0.98, often matching or exceeding expert radiologist performance. These systems achieve sensitivities and specificities typically exceeding 85%, with some studies reporting up to 98% sensitivity. AI integration reduces false-positive rates by up to 37% and unnecessary biopsies by approximately 28%. Beyond diagnosis, AI assists in lesion segmentation, BI-RADS classification consistency, and risk stratification. Portable AI-powered devices have shown promise in resource-limited settings, achieving 96-98% sensitivity. Integration of quantitative ultrasound parameters with AI enhances lesion differentiation and treatment planning. Conclusions: AI in breast ultrasound significantly improves diagnostic precision, workflow efficiency, and accessibility. Despite challenges including dataset diversity, model interpretability, and clinical integration, ongoing developments support AI as a valuable adjunct tool for enhancing breast cancer detection and supporting personalized patient management.

 

References

Reyes M, Meier R, Pereira S, Silva CA, Dahlweid FM, Tengg-Kobligk HV, et al. On the Interpretability of Artificial Intelligence in Radiology: Challenges and Opportunities. Radiology Artificial Intelligence. 2020 May; 2(3): e190043. doi: 10.1148/ryai.2020190043.

London AJ. Artificial Intelligence and Black-Box Medical Decisions: Accuracy versus Explainability. Hastings Center Report. 2019 Jan; 49(1): 15-21. doi: 10.1002/hast.973.

Esteva A, Robicquet A, Ramsundar B, Kuleshov V, DePristo M, Chou K, et al. A Guide to Deep Learning in Healthcare. Nature Medicine. 2019 Jan; 25(1): 24-9. doi: 10.1038/s41591-018-0316-z.

Zhang L, Qiu Y, Shao Z, Zhang Y, Zhang Y, Tong Z, et al. A Portable Ultrasound-Based Clinical Assessment System for Breast Cancer Screening and Diagnosis: A Multicenter Prospective Diagnostic Study. Frontiers in Oncology. 2024 May; 14: 1411261. doi: 10.3389/fonc.2024.1438923.

Tagliafico AS, Piana M, Schenone D, Lai R, Massone AM, Houssami N. Overview of Radiomics in Breast Cancer Diagnosis and Prognostication. Breast. 2020 Feb; 49: 74-80. doi: 10.1016/j.breast.2019.10.018.

Sadoughi F, Kazemy Z, Hamedani F, Owji L, Rahmanikatigari M, Azadboni TT. Artificial Intelligence Methods for the Diagnosis of Breast Cancer by Image Processing: A Review. Breast Cancer (Dove Medical Press). 2018; 10: 219-30. doi: 10.2147/BCTT.S175311.

Shen YT, Chen L, Yue WW, Xu HX. Artificial Intelligence in Ultrasound. European Journal of Radiology. 2021 Jul; 139: 109717. doi: 10.1016/j.ejrad.2021.109717.

Shen Y, Shamout FE, Oliver JR, Witowski J, Kannan K, Jung J, et al. Artificial Intelligence System Reduces False-Positive Findings in the Interpretation of Breast Ultrasound Exams. Nature Communications. 2021 Sep; 12(1): 5645. doi: 10.1038/s41467-021-26023-2.

Berg WA, Blume JD, Cormack JB, Mendelson EB, Lehrer D, Böhm-Vélez M, et al. Combined Screening with Ultrasound and Mammography vs Mammography Alone in Women at Elevated Risk of Breast Cancer. Journal of the American Medical Association. 2008 May; 299(18): 2151-63. doi: 10.1001/jama.299.18.2151.

Corsetti V, Houssami N, Ghirardi M, Ferrari A, Speziani M, Bellarosa S, et al. Evidence of the Effect of Adjunct Ultrasound Screening in Women with Mammography-Negative Dense Breasts: Interval Breast Cancers at 1 Year Follow-Up. European Journal of Cancer. 2011 May; 47(7): 1021-6. doi: 10.1016/j.ejca.2010.12.002.

Topol EJ. High-Performance Medicine: The Convergence of Human and Artificial Intelligence. Nature Medicine. 2019 Jan; 25(1): 44-56. doi: 10.1038/s41591-018-0300-7.

Byra M, Styczynski G, Szmigielski C, Kalinowski P, Michałowski Ł, Paluszkiewicz R, et al. Transfer Learning with Deep Convolutional Neural Network for Liver Steatosis Assessment in Ultrasound Images. International Journal of Computer Assisted Radiology and Surgery. 2018 Dec; 13(12): 1895-903. doi: 10.1007/s11548-018-1843-2.

Xiao Y, Wu J, Lin Z, Zhao X. A Deep Learning-Based Multi-Model Ensemble Method for Cancer Prediction. Computer Methods and Programs in Biomedicine. 2018 Aug; 153: 1-9. doi: 10.1016/j.cmpb.2017.09.005.

Gu J, Li H, Yang L, Liu C, Jiang X. Automated 3D Segmentation of Breast Ultrasound Images for Tumor Boundary Detection. Ultrasound in Medicine and Biology. 2017 Jul; 43(7): 1439-52.

Kim HE, Kim HH, Han BK, Kim KH, Han K, Nam H, et al. Changes in Cancer Detection and False-Positive Recall in Mammography Using Artificial Intelligence: A Retrospective, Multireader Study. The Lancet Digital Health. 2020 Mar; 2(3): e138-48. doi: 10.1016/S2589-7500(20)30003-0.

Mendelson EB, Böhm-Vélez M, Berg WA, Whitman GJ, Feldman MI, Madjar H. ACR BI-RADS® Ultrasound. In: D'Orsi CJ, Sickles EA, Mendelson EB, Morris EA, editors. ACR BI-RADS® Atlas, Breast Imaging Reporting and Data System. 5th ed. Reston, VA: American College of Radiology; 2013. p. 54-65.

Liu S, Wang Y, Yang X, Lei B, Liu L, Li SX, et al. Deep Learning in Medical Ultrasound Analysis: A Review. Engineering. 2019 Apr; 5(2): 261-75. doi: 10.1016/j.eng.2018.11.020.

Drukker K, Giger ML, Horsch K, Kupinski MA, Vyborny CJ, Mendelson EB. Computerized Analysis of Breast Lesions on Ultrasound Using a Rule-Based Classification System. In: Medical Imaging 2002: Image Processing. Bellingham, WA: Society of Photo-Optical Instrumentation Engineers; 2002. p. 54-65.

Li Z, Liu F, Yang W, Peng S, Zhou J. A Survey of Convolutional Neural Networks: Analysis, Applications, and Prospects. IEEE Transactions on Neural Networks and Learning Systems. 2022 Dec; 33(12): 6999-7019. doi: 10.1109/TNNLS.2021.3084827.

Yang J, Zheng Y, Pu J, Wang C, Wang Y. Automatic Classification of Breast Tumors in Ultrasound Images Using Deep Neural Networks. Journal of Zhejiang University Science B. 2017 Nov; 18(11): 965-72.

Lee JH, Kim EK, Kim HE, Choi YJ, Lee YJ, Kang HJ. Application of Artificial Intelligence in Breast Ultrasound: A Diagnostic Study for Differentiation of Benign from Malignant Masses. Korean Journal of Radiology. 2020 Mar; 21(3): 369-76.

Tagliafico AS, Bignotti B, Rossi F, Valdora F, Signori A, Sormani MP, et al. Breast Cancer Ki-67 Expression Prediction by Digital Breast Tomosynthesis Radiomics Features. European Radiology Experimental. 2022 Jul; 6(1): 36.

Zhao C, Xiao M, Jiang Y, Sun W, Sun M, Li Y, et al. Diagnostic Performance of an Artificial Intelligence System in Breast Ultrasound. Ultrasound in Medicine and Biology. 2021 Dec; 47(12): 3323-3331.

Matsuhashi T, Yamada T, Yamada K, Suzuki M, Wu J, He Y, et al. Smartphone-Based AI System for Breast Ultrasound Image Diagnosis: YOLOv3 Implementation. World Journal of Surgical Oncology. 2024 Jan; 22(1): 2.

Mango VL, Brot N. Artificial Intelligence in Breast Imaging: Current Applications and Future Directions. Seminars in Roentgenology. 2023 Jan; 58(1): 35-43.

Darbandi A, Fouladi S, Afrash MR, Ghalandari M, As'adi K, Kiani F, et al. Artificial Intelligence and Deep Learning in Breast Ultrasound: Diagnosis and Treatment. Diagnostics. 2024 Feb; 14(4): 428.

Deng J, Zhang Y, Zhao X. Artificial Intelligence in Breast Ultrasound: Current Status and Future Perspectives. Insights into Imaging. 2019 Dec; 10(1): 109.

Yuan WH, Hsu HC, Chen YY, Wu CH. Supplemental Breast Cancer Screening in Women with Dense Breasts and Average Risk. Seminars in Roentgenology. 2023 Apr; 58(2): 162-175.

Love RR, Shing J, Salvado OR, Kirschner MB, Tapia C, Esquivel AK, et al. Palpable Breast Lump Triage by Minimally Trained Operators in Mexico Using Computer-Assisted Diagnosis and Low-Cost Ultrasound. Journal of Global Oncology. 2018 Oct; 4: 1-9. doi: 10.1200/JGO.17.00222.

Fleury EFC, Alvares BR, Piato S, Fleury JC, Roveda D Jr. Computer-Aided Diagnosis (CAD) in the Classification of Breast Lesions on Ultrasonography and Its Agreement with the Breast Imaging Reporting and Data System (BI-RADS). Technology in Cancer Research and Treatment. 2018 Jan; 17: 1533033818768334. doi: 10.1177/1533033818763461.

Zhang Q, Xiao Y, Dai W, Suo T, Liu Z, Zhang Q, et al. Deep Learning-Based Classification of Breast Tumors with Shear-Wave Elastography. Ultrasonics. 2016 Sep; 72: 150-7. doi: 10.1016/j.ultras.2016.08.004.

Yu L, Chen H, Dou Q, Qin J, Heng PA. Automated Melanoma Recognition in Dermoscopy Images via Very Deep Residual Networks. IEEE Transactions on Medical Imaging. 2017 Apr; 36(4): 994-1004. doi: 10.1109/TMI.2016.2642839.

Mo H, Zhang H, Huang W, Dou Y, Xu R, Wang J, et al. HoVer-Trans: Anatomy-Aware HoVer-Transformer for ROI-Free Breast Cancer Diagnosis in Ultrasound Images. IEEE Transactions on Medical Imaging. 2024 Jan; 43(1): 595-606.

Wang Y, Zhou Z, Li Y, Li P, Chen K, Sun M, et al. Deep Learning-Assisted Diagnosis of Breast Lesions on US Images: A Prospective Multicenter Study. Radiology Artificial Intelligence. 2023 May; 5(3): e220185. doi: 10.1148/ryai.220185.

McKinney SM, Sieniek M, Godbole V, Godwin J, Antropova N, Ashrafian H, et al. International Evaluation of an AI System for Breast Cancer Screening. Nature. 2020 Jan; 577(7788): 89-94. doi: 10.1038/s41586-019-1799-6.

Yin L, Li J, Zhang H, Wang H, Sun M, Li Y, et al. Optimizing Breast Cancer Ultrasound Diagnosis Using Deep Learning Models and Resolution Parameters: A Multicenter Study. Frontiers in Oncology. 2025 Jan; 14: 1336365.

Wang ZL, Li JL, Li M, Huang Y, Wan WB, Li J, et al. Study of Quantitative Elastography with Supersonic Shear Imaging in the Diagnosis of Breast Tumours. Radiologia Medica. 2013 Apr; 118(4): 583-90. doi: 10.1007/s11547-012-0903-x.

Wojcinski S, Farrokh A, Weber S, Thomas A, Fischer T, Slowinski T, et al. Multicenter Study of Ultrasound Real-Time Tissue Elastography in 779 Cases for the Assessment of Breast Lesions: Improved Diagnostic Performance by Combining the BI-RADS®-US Classification System with Sonoelastography. Ultraschall in der Medizin. 2010 Oct; 31(5): 484-91. doi: 10.1055/s-0029-1245282.

Park HJ, Kim SM, La Yun B, Jang M, Kim B, Jang JY, et al. A Computer-Aided Diagnosis System Using Artificial Intelligence for the Diagnosis and Characterization of Breast Masses on Ultrasound: Added Value for the Inexperienced Breast Radiologist. Medicine. 2019 Jan; 98(3): e14146. doi: 10.1097/MD.0000000000014146.

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Published

2025-12-31
CITATION
DOI: 10.54393/fbt.v5i4.192
Published: 2025-12-31

How to Cite

Haq, M. I. U., Farooq, S. M. Y., & Moazzam, M. (2025). Use of Artificial Intelligence in Breast Ultrasound Imaging: Diagnosis and Clinical Decision Support: AI in Breast Ultrasound: Diagnosis and Decision Support. Futuristic Biotechnology, 5(4), 18–26. https://doi.org/10.54393/fbt.v5i4.192

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