Comparative Study of AI Modes in Ultrasound Diagnosis of Breast Lesions

<b>Objectives:</b> This study evaluated the diagnostic performance of the S-Detect ultrasound system's three selectable AI modes-high-sensitivity (HSe), high-accuracy (HAc), and high-specificity (HSp)-for breast lesion diagnosis, comparing their performance in a clinical setting. <b>Methods:</b> This retrospective analysis evaluated 260 breast lesions from ultrasound images of 232 women (mean age: 50.2 years) using the S-Detect system. Each lesion was analyzed under the HSe, HAc, and HSp modes. The study employed ROC curve analysis to comprehensively compare the diagnostic performance of the AI modes against radiologist diagnoses. Subgroup analyses focused on the age (<45, 45-55, >55 years) and lesion size (<1 cm, 1-2 cm, >2 cm). <b>Results:</b> Among the 260 lesions, 73% were identified as benign and 27% as malignant. Radiologists achieved a sensitivity of 98.6%, specificity of 64.2%, and accuracy of 73.5%. The HSe mode exhibited the highest sensitivity at 95.7%. The HAc mode excelled with the highest accuracy (86.2%) and positive predictive value (71.3%), while the HSp mode had the highest specificity at 95.8%. In the age-based subgroup analyses, the HAc mode consistently showed the highest area under the curve (AUC) across all categories. The HSe mode achieved the highest AUC (0.726) for lesions smaller than 1 cm. In the case of lesions sized 1-2 cm and larger than 2 cm, the HAc mode showed the highest AUCs of 0.906 and 0.776, respectively. <b>Conclusions:</b> The S-Detect HSe mode matches radiologists' performance. Alternative modes provide sensitivity and specificity adjustments. The patient age and lesion size influence the diagnostic performance across all S-Detect modes.