UltrasonographyPub Date : 2025-05-01Epub Date: 2024-12-09DOI: 10.14366/usg.24120
Dongsuk Im, Lyo Min Kwon, Sun Young Park, Min Su Park, Won Ju Hong
{"title":"Ultrasound evaluation of clinical mimics of deep vein thrombosis: essential insights for radiologists in interpretation.","authors":"Dongsuk Im, Lyo Min Kwon, Sun Young Park, Min Su Park, Won Ju Hong","doi":"10.14366/usg.24120","DOIUrl":"10.14366/usg.24120","url":null,"abstract":"<p><p>Ultrasonography (US) is a sensitive and radiation-free technique for diagnosing deep vein thrombosis (DVT). Therefore, when DVT is clinically suspected but not detected on US, radiologists should consider a range of alternative differential diagnoses. This review article presents the imaging findings of clinical conditions that mimic DVT, which can be distinguished using a multimodal radiologic approach. Additionally, DVT mimics can be categorized into two groups based on whether a flat or normal waveform is observed on Doppler US. This article details the imaging findings and clinical presentations of DVT mimics, organized by these classifications. This information may help radiologists make more accurate diagnoses, enabling patients to receive appropriate treatment in a timely manner.</p>","PeriodicalId":54227,"journal":{"name":"Ultrasonography","volume":" ","pages":"171-188"},"PeriodicalIF":2.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12081133/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143025758","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
UltrasonographyPub Date : 2025-05-01Epub Date: 2025-04-30DOI: 10.14366/usg.24142
Luciane Alves da Rocha Amorim, Nathalie Jeanne Bravo-Valenzuela, Sophia Livas de Morais Almeida, Alberto Borges Peixoto, Luiz Henrique Soares Nicoloso, Márcia Moura Schmidt, Paulo Zielinsky, Edward Araujo Júnior
{"title":"Development of a Z-score equation for atrioventricular interval measurement by two-dimensional pulsed Doppler echocardiography in normal fetuses between 16 and 33+6 weeks of gestation.","authors":"Luciane Alves da Rocha Amorim, Nathalie Jeanne Bravo-Valenzuela, Sophia Livas de Morais Almeida, Alberto Borges Peixoto, Luiz Henrique Soares Nicoloso, Márcia Moura Schmidt, Paulo Zielinsky, Edward Araujo Júnior","doi":"10.14366/usg.24142","DOIUrl":"10.14366/usg.24142","url":null,"abstract":"<p><strong>Purpose: </strong>Fetal echocardiography is the primary diagnostic tool for assessing the atrioventricular (AV) time interval. Establishing a reference range for this parameter throughout pregnancy is essential for the early detection of potential abnormalities. The aim of this study was to develop a Z-score equation and establish specific percentiles for the AV time interval in normal fetuses between 16 and 33+6 weeks of gestation.</p><p><strong>Methods: </strong>A multicenter, prospective, cross-sectional study was conducted between 2018 and 2022. A large sample of pregnant women meeting specific eligibility criteria was included, while cases with potential confounders were excluded. Two-dimensional echocardiography with pulsed Doppler techniques was employed, focusing on the left ventricular inflow and outflow. Data were rigorously analyzed with careful assessment of measurements and normalization procedures.</p><p><strong>Results: </strong>In total, 1,309 echocardiograms were performed, and 1,183 pregnant women were included after applying the eligibility criteria. Detailed percentiles for each gestational age were determined, and a Z-score equation was formulated. A very weak correlation was observed between AV interval measurement and gestational age (r=0.16, P<0.001). In addition, the correlation between AV interval measurement and fetal heart rate was weak (r=-0.21, P<0.001). The Z-score for the AV interval measurement in milliseconds was derived as follows: Z-score=(AV interval measurement-111.3)/8.6.</p><p><strong>Conclusion: </strong>This study provides a reference range and Z-score equation for the AV interval, which may enhance the accuracy of monitoring fetuses at risk for developing atrioventricular block-especially in pregnant women with specific antibodies-thus facilitating earlier diagnosis and treatment.</p>","PeriodicalId":54227,"journal":{"name":"Ultrasonography","volume":"44 3","pages":"212-219"},"PeriodicalIF":2.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12081140/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144025610","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
UltrasonographyPub Date : 2025-05-01Epub Date: 2025-03-18DOI: 10.14366/usg.24219
Xinrui Jin, Terry Cheuk-Fung Yip, Grace Lai-Hung Wong, Vincent Wai-Sun Wong, Jimmy Che-To Lai
{"title":"The new definition of metabolic dysfunction-associated steatotic liver disease: the role of ultrasound and elastography.","authors":"Xinrui Jin, Terry Cheuk-Fung Yip, Grace Lai-Hung Wong, Vincent Wai-Sun Wong, Jimmy Che-To Lai","doi":"10.14366/usg.24219","DOIUrl":"10.14366/usg.24219","url":null,"abstract":"<p><p>In 2023, nonalcoholic fatty liver disease was renamed metabolic dysfunction-associated steatotic liver disease by the American and European liver associations. This new nomenclature recognizes metabolic dysfunction as the central driver of the disease, and the diagnostic criteria now require the presence of hepatic steatosis plus at least one of five cardiometabolic risk factors. B-mode ultrasonography remains the most common and practical method for detecting hepatic steatosis, although newer ultrasound techniques based on attenuation, backscatter, and speed of sound have gained traction as tools to diagnose and quantify hepatic steatosis. Additionally, ultrasound elastography is increasingly used in routine clinical practice to assess liver fibrosis, diagnose cirrhosis, and identify clinically significant portal hypertension.</p>","PeriodicalId":54227,"journal":{"name":"Ultrasonography","volume":"44 3","pages":"189-201"},"PeriodicalIF":2.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12081130/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144026352","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
UltrasonographyPub Date : 2025-05-01Epub Date: 2025-03-06DOI: 10.14366/usg.24223
Hyeon Ji Jang, Jong Keon Jang, Subin Heo, Boyeon Koo, In Hye Song, Hee Jun Park, Seonghun Yoon, So Yeon Kim
{"title":"A prospective comparison of two ultrasound attenuation imaging modes using different frequencies for assessing hepatic steatosis.","authors":"Hyeon Ji Jang, Jong Keon Jang, Subin Heo, Boyeon Koo, In Hye Song, Hee Jun Park, Seonghun Yoon, So Yeon Kim","doi":"10.14366/usg.24223","DOIUrl":"10.14366/usg.24223","url":null,"abstract":"<p><strong>Purpose: </strong>This study compared the diagnostic performance of two attenuation imaging (ATI) modes-low-frequency (3 MHz) and high-frequency (4 MHz)-for assessing hepatic steatosis, with histopathological hepatic fat fraction (HFF) as the reference standard.</p><p><strong>Methods: </strong>This prospective single-center study enrolled participants with suspected metabolic dysfunction-associated steatotic liver disease (MASLD) scheduled for liver biopsy or surgery between June 2023 and June 2024. Attenuation coefficient (AC) values were consecutively measured using low- and high-frequency ATI modes, while the skin-to-region of interest distance (SRD) was measured simultaneously. Spearman correlation analysis evaluated the relationships of AC with HFF and SRD, and linear regression identified factors affecting AC. Diagnostic performance was evaluated using the area under the receiver operating characteristic curve (AUROC).</p><p><strong>Results: </strong>In total, 119 participants (mean age, 37.2±12.0 years; 87 men) were included, with 73 (61.3%) diagnosed with MASLD. HFF ranged from 0% to 50%. The AC values in the lowfrequency mode were significantly higher than those in the high-frequency mode (0.61 vs. 0.54 dB/cm/MHz, P<0.001). HFF significantly influenced AC in both modes, whereas SRD affected AC only in the high-frequency mode (P<0.001). AC correlated positively with HFF in both modes (rs≥0.514, P<0.001) and negatively with SRD in the high-frequency mode (rs=-0.338, P<0.001). The AUROC for hepatic steatosis did not differ significantly between the two modes (0.751 vs. 0.771, P=0.609).</p><p><strong>Conclusion: </strong>The low-frequency mode produced higher AC values than the high-frequency mode and demonstrated comparable diagnostic accuracy for assessing hepatic steatosis. Unlike the high-frequency mode, the low-frequency mode was not influenced by SRD.</p>","PeriodicalId":54227,"journal":{"name":"Ultrasonography","volume":"44 3","pages":"202-211"},"PeriodicalIF":2.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12081138/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144057543","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
UltrasonographyPub Date : 2025-05-01Epub Date: 2025-03-13DOI: 10.14366/usg.24205
Yi Dong, Juan Cheng, Yun-Lin Huang, Yi-Jie Qiu, Jia-Ying Cao, Xiu-Yun Lu, Wen-Ping Wang, Kathleen Möller, Christoph F Dietrich
{"title":"Characterization of non-alcoholic fatty liver disease-related hepatocellular carcinoma on contrast-enhanced ultrasound with Sonazoid.","authors":"Yi Dong, Juan Cheng, Yun-Lin Huang, Yi-Jie Qiu, Jia-Ying Cao, Xiu-Yun Lu, Wen-Ping Wang, Kathleen Möller, Christoph F Dietrich","doi":"10.14366/usg.24205","DOIUrl":"10.14366/usg.24205","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to evaluate the contrast-enhanced ultrasound with Sonazoid (Sonazoid-CEUS) features of hepatocellular carcinoma (HCC) in patients with non-alcoholic fatty liver disease (NAFLD).</p><p><strong>Methods: </strong>In this retrospective study, patients who underwent surgical resection and were histopathologically diagnosed with NAFLD or cirrhosis-related HCC were included. All patients received Sonazoid-CEUS examinations within 1 week prior to hepatic surgery. The enhancement patterns of HCC lesions were evaluated and compared between the two groups according to the current World Federation for Ultrasound in Medicine and Biology guidelines. Multivariate logistic regression analysis was used to assess the correlations between Sonazoid-CEUS enhancement patterns and clinicopathologic characteristics.</p><p><strong>Results: </strong>From March 2022 to April 2023, a total of 151 patients with HCC were included, comprising 72 with NAFLD-related HCC and 79 with hepatitis B virus (HBV) cirrhosis-related HCC. On Sonazoid-CEUS, more than half of the NAFLD-related HCCs exhibited relatively early and mild washout within 60 seconds (54.2%, 39/72), whereas most HBV cirrhosis-related HCCs displayed washout between 60 and 120 seconds (46.8%, 37/79) or after 120 seconds (39.2%, 31/79) (P<0.001). In the patients with NAFLD-related HCC, multivariate analysis revealed that international normalized ratio (odds ratio [OR], 0.002; 95% confidence interval [CI], 0.000 to 0.899; P=0.046) and poor tumor differentiation (OR, 21.930; 95% CI, 1.960 to 245.319; P=0.012) were significantly associated with washout occurring within 60 seconds.</p><p><strong>Conclusion: </strong>Characteristic Sonazoid-CEUS features are useful for diagnosing HCC in patients with NAFLD.</p>","PeriodicalId":54227,"journal":{"name":"Ultrasonography","volume":" ","pages":"232-242"},"PeriodicalIF":2.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12081131/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143813091","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
UltrasonographyPub Date : 2025-05-01Epub Date: 2025-03-11DOI: 10.14366/usg.25012
Taewon Han, Woo Kyoung Jeong, Jaeseung Shin
{"title":"Diagnostic performance of multimodal large language models in radiological quiz cases: the effects of prompt engineering and input conditions.","authors":"Taewon Han, Woo Kyoung Jeong, Jaeseung Shin","doi":"10.14366/usg.25012","DOIUrl":"10.14366/usg.25012","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to evaluate the diagnostic accuracy of three multimodal large language models (LLMs) in radiological image interpretation and to assess the impact of prompt engineering strategies and input conditions.</p><p><strong>Methods: </strong>This study analyzed 67 radiological quiz cases from the Korean Society of Ultrasound in Medicine. Three multimodal LLMs (Claude 3.5 Sonnet, GPT-4o, and Gemini-1.5-Pro-002) were evaluated using six types of prompts (basic [without system prompt], original [specific instructions], chain-of-thought, reflection, multiagent, and artificial intelligence [AI]-generated). Performance was assessed across various factors, including tumor versus non-tumor status, case rarity, difficulty, and knowledge cutoff dates. A subgroup analysis compared diagnostic accuracy between imaging-only inputs and combined imaging-descriptive text inputs.</p><p><strong>Results: </strong>With imaging-only inputs, Claude 3.5 Sonnet achieved the highest overall accuracy (46.3%, 186/402), followed by GPT-4o (43.5%, 175/402) and Gemini-1.5-Pro-002 (39.8%, 160/402). AI-generated prompts yielded superior combined accuracy across all three models, with improvements over the basic (5.5%, P=0.035), chain-of-thought (4.0%, P=0.169), and multiagent prompts (3.5%, P=0.248). The integration of descriptive text significantly enhanced diagnostic accuracy for Claude 3.5 Sonnet (46.3% to 66.2%, P<0.001), GPT-4o (43.5% to 57.5%, P<0.001), and Gemini-1.5-Pro-002 (39.8% to 60.4%, P<0.001). Model performance was significantly influenced by case rarity for GPT-4o (rare: 6.7% vs. non-rare: 53.9%, P=0.001) and by knowledge cutoff dates for Claude 3.5 Sonnet (post-cutoff: 23.5% vs. pre-cutoff: 64.0%, P=0.005).</p><p><strong>Conclusion: </strong>Claude 3.5 Sonnet achieved the highest diagnostic accuracy in radiological quiz cases, followed by GPT-4o and Gemini-1.5-Pro-002. The use of AI-generated prompts and the integration of descriptive text inputs enhanced model performance.</p>","PeriodicalId":54227,"journal":{"name":"Ultrasonography","volume":"44 3","pages":"220-231"},"PeriodicalIF":2.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12081132/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144041182","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Erratum: Thrombus stiffness as an independent predictor of endovascular treatment success in hemodialysis fistulas: a study using ultrasound elastography.","authors":"Sarhun Zirek, Gökhan Mert Özyurt, Alptuğ Özen, Refik Olmaz, Kaan Esen","doi":"10.14366/usg.24175.ER","DOIUrl":"10.14366/usg.24175.ER","url":null,"abstract":"","PeriodicalId":54227,"journal":{"name":"Ultrasonography","volume":"44 3","pages":"243"},"PeriodicalIF":2.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12094714/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144028474","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Intelligent handheld ultrasound improving the ability of non-expert general practitioners in carotid examinations for community populations: a prospective and parallel controlled trial.","authors":"Pei Sun, Hong Han, Yi-Kang Sun, Xi Wang, Xiao-Chuan Liu, Bo-Yang Zhou, Li-Fan Wang, Ya-Qin Zhang, Zhi-Gang Pan, Bei-Jian Huang, Hui-Xiong Xu, Chong-Ke Zhao","doi":"10.14366/usg.24172","DOIUrl":"10.14366/usg.24172","url":null,"abstract":"<p><strong>Purpose: </strong>The aim of this study was to investigate the feasibility of an intelligent handheld ultrasound (US) device for assisting non-expert general practitioners (GPs) in detecting carotid plaques (CPs) in community populations.</p><p><strong>Methods: </strong>This prospective parallel controlled trial recruited 111 consecutive community residents. All of them underwent examinations by non-expert GPs and specialist doctors using handheld US devices (setting A, setting B, and setting C). The results of setting C with specialist doctors were considered the gold standard. Carotid intima-media thickness (CIMT) and the features of CPs were measured and recorded. The diagnostic performance of GPs in distinguishing CPs was evaluated using a receiver operating characteristic curve. Inter-observer agreement was compared using the intragroup correlation coefficient (ICC). Questionnaires were completed to evaluate clinical benefits.</p><p><strong>Results: </strong>Among the 111 community residents, 80, 96, and 112 CPs were detected in settings A, B, and C, respectively. Setting B exhibited better diagnostic performance than setting A for detecting CPs (area under the curve, 0.856 vs. 0.749; P<0.01). Setting B had better consistency with setting C than setting A in CIMT measurement and the assessment of CPs (ICC, 0.731 to 0.923). Moreover, measurements in setting B required less time than the other two settings (44.59 seconds vs. 108.87 seconds vs. 126.13 seconds, both P<0.01).</p><p><strong>Conclusion: </strong>Using an intelligent handheld US device, GPs can perform CP screening and achieve a diagnostic capability comparable to that of specialist doctors.</p>","PeriodicalId":54227,"journal":{"name":"Ultrasonography","volume":" ","pages":"112-123"},"PeriodicalIF":2.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11938801/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143384081","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Thrombus stiffness as an independent predictor of endovascular treatment success in hemodialysis fistulas: a study using ultrasound elastography.","authors":"Sarhun Zirek, Gökhan Mert Özyurt, Alptuğ Özen, Refik Olmaz, Kaan Esen","doi":"10.14366/usg.24175","DOIUrl":"10.14366/usg.24175","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to evaluate the prognostic value of thrombus stiffness, measured by strain elastography, in independently predicting the success of endovascular treatment for thrombosed hemodialysis fistulas.</p><p><strong>Methods: </strong>The study employed a retrospective observational design. Forty-nine patients with chronic kidney disease undergoing hemodialysis and experiencing fistula dysfunction were included. Various factors were evaluated, including patient age, sex, comorbidities, arteriovenous fistula (AVF) type, use of antiplatelet agents, duration of thrombosed AVF dysfunction, thrombus length, thrombus stiffness, and thrombus strain ratio (SR). Thrombus stiffness was measured using strain ultrasound elastography.</p><p><strong>Results: </strong>The presence of comorbidities (P=0.018), duration of AVF dysfunction due to thrombosis (P=0.005), thrombus stiffness (P<0.001), and thrombus SR (P<0.001) were statistically significant predictors of treatment success, while other factors were not. Thrombus stiffness and SR, assessed by two independent radiologists with excellent inter-reader agreement, demonstrated high reliability. The optimal SR cut-off for treatment success was 1.4 (sensitivity, 0.947; specificity, 0.901; area under the curve, 0.935). Multivariable logistic regression analysis revealed that both thrombus SR and thrombus stiffness significantly influenced treatment outcomes (P=0.003 and P=0.007, respectively). A 0.1-unit increase in thrombus SR was associated with 9.37% reduction in the likelihood of treatment success, while a smilar increase in thrombus stiffness exhibited an 8.06% reduction, underscoring their importance as prognostic factors in clinical setting.</p><p><strong>Conclusion: </strong>This study demonstrates the utility of strain ultrasound elastography in assessing thrombus stiffness in thrombosed hemodialysis AVFs and its correlation with treatment success.</p>","PeriodicalId":54227,"journal":{"name":"Ultrasonography","volume":"44 2","pages":"153-159"},"PeriodicalIF":2.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11938795/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143607031","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
UltrasonographyPub Date : 2025-03-01Epub Date: 2025-01-21DOI: 10.14366/usg.24206
Tali Amir, Kristen Coffey, Jeffrey S Reiner, Varadan Sevilimedu, Victoria L Mango
{"title":"Utilization of artificial intelligence to triage patients with delayed follow-up of probably benign breast ultrasound findings.","authors":"Tali Amir, Kristen Coffey, Jeffrey S Reiner, Varadan Sevilimedu, Victoria L Mango","doi":"10.14366/usg.24206","DOIUrl":"10.14366/usg.24206","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to evaluate our institution's experience in using artificial intelligence (AI) decision support (DS) as part of the clinical workflow to triage patients with Breast Imaging Reporting and Data System (BI-RADS) 3 sonographic lesions whose follow-up was delayed during the coronavirus disease 2019 (COVID-19) pandemic, against subsequent imaging and/or pathologic follow-up results.</p><p><strong>Methods: </strong>This retrospective study included patients with a BI-RADS category 3 (i.e., probably benign) breast ultrasound assessment from August 2019-December 2019 whose follow-up was delayed during the COVID-19 pandemic and whose breast ultrasounds were re-reviewed using Koios DS Breast AI as part of the clinical workflow for triaging these patients. The output of Koios DS was compared with the true outcome of a presence or absence of breast cancer defined by resolution/stability on imaging follow-up for at least 2 years or pathology results.</p><p><strong>Results: </strong>The study included 161 women (mean age, 52 years) with 221 BI-RADS category 3 sonographic lesions. Of the 221 lesions, there were two confirmed cancers (0.9% malignancy rate). Koios DS assessed 112/221 lesions (50.7%) as benign, 42/221 lesions (19.0%) as probably benign, 64/221 lesions (29.0%) as suspicious, and 3/221 lesions (1.4%) as probably malignant. Koios DS had a sensitivity of 100% (2/2; 95% confidence interval [CI], 16% to 100%), specificity of 70% (154/219; 95% CI, 64% to 76%), negative predictive value of 100% (154/154; 95% CI, 98% to 100%), and false-positive rate of 30% (65/219; 95% CI, 24% to 36%).</p><p><strong>Conclusion: </strong>When many follow-up appointments are delayed, e.g., natural disaster, or scenarios where resources are limited, breast ultrasound AI DS can help triage patients with probably benign breast ultrasounds.</p>","PeriodicalId":54227,"journal":{"name":"Ultrasonography","volume":" ","pages":"145-152"},"PeriodicalIF":2.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11938796/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143451043","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}