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Can an Artificial Intelligence Decision Aid Decrease False-Positive Breast Biopsies?

Samantha L Heller1, Melanie Wegener, James S Babb

  • 1Department of Radiology, New York University Grossman School of Medicine, New York, NY.

Ultrasound Quarterly
|January 4, 2021
PubMed
Summary
This summary is machine-generated.

Artificial intelligence (AI) decision support improved breast ultrasound diagnostic accuracy, especially for lesions with low reader confidence. This AI tool shows potential in reducing false-positive biopsy rates.

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Area of Science:

  • Radiology
  • Medical Imaging
  • Artificial Intelligence in Healthcare

Background:

  • Breast ultrasound is crucial for lesion detection and characterization.
  • Diagnostic accuracy can be limited by reader experience and lesion complexity.
  • Artificial intelligence (AI) offers potential for enhancing diagnostic performance.

Purpose of the Study:

  • To evaluate the impact of an AI support system on breast ultrasound diagnostic accuracy.
  • To assess AI's effect on diagnostic metrics including accuracy, sensitivity, specificity, and predictive values.
  • To determine AI's influence on reader confidence and false-positive rates.

Main Methods:

  • Retrospective analysis of 200 breast lesions (155 benign, 45 malignant) from ultrasound-guided biopsies.
  • Two blinded readers evaluated lesions with and without FDA-approved AI software.
  • Data collected included lesion features, BI-RADS ratings, reader confidence, and AI BI-RADS equivalents.

Main Results:

  • Overall diagnostic accuracy showed no significant difference between AI-assisted readers and unassisted readers (73% vs 69.8%).
  • AI demonstrated superior accuracy for irregular-shaped lesions (74.1% vs 57.4%) but lower accuracy for round shapes (26.5% vs 50.0%).
  • AI significantly improved diagnostic accuracy for low-confidence lesions, increasing positive predictive value (24.7% vs 19.3%) and specificity (57.8% vs 44.6%).

Conclusions:

  • AI decision support can enhance sonographic diagnostic accuracy, particularly in challenging cases with low reader confidence.
  • The AI system has the potential to decrease unnecessary false-positive biopsies.
  • Further integration of AI in breast ultrasound workflows may improve patient outcomes.