Advanced Ultrasound in Diagnosis and Therapy ›› 2022, Vol. 6 ›› Issue (4): 180-187.doi: 10.37015/AUDT.2022.220007

• Original Research • Previous Articles     Next Articles

Using S-Detect to Improve Breast Ultrasound: The Different Combined Strategies Based on Radiologist Experience

Ying Zhu, MDa,1, Xiaohong Jia, MDa,1, Yijie Dong, MDa, Juan Liu, MDa, Yilai Chen, MDa, Congcong Yuan, MDa, Weiwei Zhan, MDa, Jianqiao Zhou, MDa,*()   

  1. a Department of Ultrasound, Shanghai Ruijin Hospital affiliated to Medical School of Shanghai Jiaotong University, Shanghai, China
  • Received:2022-02-23 Revised:2022-03-16 Accepted:2022-04-09 Online:2022-12-30 Published:2022-10-25
  • Contact: Jianqiao Zhou, MD,
  • About author:First author contact:1 Ying Zhu and Xiaohong Jia contributed equally to this study.


Objective: To investigate the best combined method of S-Detect, a computer-aided diagnosis (CAD) system, with breast ultrasound (US) according to radiologists’ experience.

Methods: From March 2019 to June 2019, 259 breast masses in 255 women were included in this study. Ultrasonographic images of the target masses were prospectively analyzed by radiologists and CAD. Three combined methods, including method 1 [selective downgrading combination for Breast Imaging Reporting and Data System (BI-RADS) 4a lesions], method 2 (selective upgrading combination for BI-RADS 3 lesions) and method 3 (selective upgrading or downgrading combination for BI-RADS 3 or 4a lesions), were applied to interpret the CAD results. The sensitivity, specificity, the area under the receiver operating characteristic curve (AUC) of experienced or inexperienced radiologists before and after adding CAD results were compared using the histopathological results as a reference standard.

Results: In identifying breast malignancy, the AUC for CAD was similar to that of experienced radiologists (P= 0.410), but higher than that of inexperienced radiologists (P= 0.003). When combining CAD with experienced radiologists based on method 1 and combining CAD results with inexperienced radiologists based on method 3, the AUCs were significantly improved (P= 0.024 and 0.003, respectively) compared to US alone, with significantly increased specificity (P< 0.001 for both) and no significantly decreased sensitivity (P> 0.05 for both).

Conclusion: The combination of CAD system and conventional ultrasound can improve ultrasound diagnostic performance in determining breast malignancy. The method 1 and method 3 combinations are respectively recommended for experienced and inexperienced radiologists when CAD is combined with conventional breast ultrasound.

Key words: Ultrasound; Breast; Computer-assisted diagnosis; Neoplasms; BI-RAD classification