Diagnostic performance of ultrasound S-Detect technology in evaluating BI-RADS-4 breast nodules ≤ 20 mm and > 20 mm

Abstract Background This study aimed to explore the diagnostic performance of ultrasound S-Detect in differentiating Breast Imaging-Reporting and Data System (BI-RADS) 4 breast nodules ≤ 20 mm and > 20 mm. Methods Between November 2020 and November 2022, a total of 382 breast nodules in 312 patie...

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Main Authors: Boyuan Xing, Chen Gu, Chenghui Fu, Bingyi Zhang, Yandi Tan
Format: Article
Language:English
Published: BMC 2025-08-01
Series:BMC Cancer
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Online Access:https://doi.org/10.1186/s12885-025-14760-2
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author Boyuan Xing
Chen Gu
Chenghui Fu
Bingyi Zhang
Yandi Tan
author_facet Boyuan Xing
Chen Gu
Chenghui Fu
Bingyi Zhang
Yandi Tan
author_sort Boyuan Xing
collection DOAJ
description Abstract Background This study aimed to explore the diagnostic performance of ultrasound S-Detect in differentiating Breast Imaging-Reporting and Data System (BI-RADS) 4 breast nodules ≤ 20 mm and > 20 mm. Methods Between November 2020 and November 2022, a total of 382 breast nodules in 312 patients were classified as BI-RADS-4 by conventional ultrasound. Using pathology results as the gold standard, we applied receiver operator characteristics (ROC), sensitivity (SE), specificity (SP), accuracy (ACC), positive predictive value (PPV), and negative predictive value (NPV) to analyze the diagnostic value of BI-RADS, S-Detect, and the two techniques in combination (Co-Detect) in the diagnosis of BI-RADS 4 breast nodules ≤ 20 mm and > 20 mm. Results There were 382 BI-RADS-4 nodules, of which 151 were pathologically confirmed as malignant, and 231 as benign. In lesions ≤ 20 mm, the SE, SP, ACC, PPV, NPV, and area under the curve (AUC) of the BI-RADS group were 77.27%, 89.73%, 85.71%, 78.16%, 89.24%, 0.835, respectively. SE, SP, ACC, PPV, NPV, and AUC of the S-Detect group were 92.05%, 78.92%, 83.15%, 67.50%, 95.43%, 0.855, respectively. SE, SP, ACC, PPV, NPV, and AUC of the Co-Detect group were 89.77%, 93.51%, 92.31%, 86.81%, 95.05%, 0.916, respectively. The differences of SE, ACC, NPV, and AUC between the BI-RADS group and the Co-Detect group were statistically significant (P < 0.05). In lesions > 20 mm, SE, SP, ACC, PPV, NPV, and AUC of the BI-RADS group were 88.99%, 89.13%, 88.99%, 91.80%, 85.42%, 0.890, respectively. SE, SP, ACC, PPV, NPV, and AUC of the S-Detect group were 98.41%, 69.57%, 86.24%, 81.58%, 96.97%, 0.840, respectively. SE, SP, ACC, PPV, NPV, and AUC of the Co-Detect group were 98.41%, 91.30%, 95.41%, 93.94%, 97.67%, 0.949, respectively. A total of 166 BI-RADS 4 A nodules were downgraded to category 3 by Co-Detect, with 160 (96.4%) confirmed as benign and 6 (all ≤ 20 mm) as false negatives. Conversely, 25 nodules were upgraded to 4B, of which 19 (76.0%) were malignant. The difference in AUC between the BI-RADS group and the Co-Detect group was statistically significant (P < 0.05). Conclusions S-Detect combined with BI-RADS is effective in the differential diagnosis of BI-RADS 4 breast nodules ≤ 20 mm and > 20 mm. However, its performance is particularly pronounced in lesions ≤ 20 mm, where it contributes to a significant reduction in unnecessary biopsies.
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spelling doaj-art-d9bff2a8f11941d68a9a09a10b020d1f2025-08-20T04:03:06ZengBMCBMC Cancer1471-24072025-08-012511910.1186/s12885-025-14760-2Diagnostic performance of ultrasound S-Detect technology in evaluating BI-RADS-4 breast nodules ≤ 20 mm and > 20 mmBoyuan Xing0Chen Gu1Chenghui Fu2Bingyi Zhang3Yandi Tan4Department of Ultrasound, The First College of Clinical Medical Science, Yichang Central People’s Hospital, China Three Gorges UniversityDepartment of Ultrasound, The First College of Clinical Medical Science, Yichang Central People’s Hospital, China Three Gorges UniversityDepartment of Ultrasound, The First College of Clinical Medical Science, Yichang Central People’s Hospital, China Three Gorges UniversityDepartment of Ultrasound, The First College of Clinical Medical Science, Yichang Central People’s Hospital, China Three Gorges UniversityDepartment of Medical Ultrasound, Tongji Hospital, Tongji Medical College, Huazhong University of Science and TechnologyAbstract Background This study aimed to explore the diagnostic performance of ultrasound S-Detect in differentiating Breast Imaging-Reporting and Data System (BI-RADS) 4 breast nodules ≤ 20 mm and > 20 mm. Methods Between November 2020 and November 2022, a total of 382 breast nodules in 312 patients were classified as BI-RADS-4 by conventional ultrasound. Using pathology results as the gold standard, we applied receiver operator characteristics (ROC), sensitivity (SE), specificity (SP), accuracy (ACC), positive predictive value (PPV), and negative predictive value (NPV) to analyze the diagnostic value of BI-RADS, S-Detect, and the two techniques in combination (Co-Detect) in the diagnosis of BI-RADS 4 breast nodules ≤ 20 mm and > 20 mm. Results There were 382 BI-RADS-4 nodules, of which 151 were pathologically confirmed as malignant, and 231 as benign. In lesions ≤ 20 mm, the SE, SP, ACC, PPV, NPV, and area under the curve (AUC) of the BI-RADS group were 77.27%, 89.73%, 85.71%, 78.16%, 89.24%, 0.835, respectively. SE, SP, ACC, PPV, NPV, and AUC of the S-Detect group were 92.05%, 78.92%, 83.15%, 67.50%, 95.43%, 0.855, respectively. SE, SP, ACC, PPV, NPV, and AUC of the Co-Detect group were 89.77%, 93.51%, 92.31%, 86.81%, 95.05%, 0.916, respectively. The differences of SE, ACC, NPV, and AUC between the BI-RADS group and the Co-Detect group were statistically significant (P < 0.05). In lesions > 20 mm, SE, SP, ACC, PPV, NPV, and AUC of the BI-RADS group were 88.99%, 89.13%, 88.99%, 91.80%, 85.42%, 0.890, respectively. SE, SP, ACC, PPV, NPV, and AUC of the S-Detect group were 98.41%, 69.57%, 86.24%, 81.58%, 96.97%, 0.840, respectively. SE, SP, ACC, PPV, NPV, and AUC of the Co-Detect group were 98.41%, 91.30%, 95.41%, 93.94%, 97.67%, 0.949, respectively. A total of 166 BI-RADS 4 A nodules were downgraded to category 3 by Co-Detect, with 160 (96.4%) confirmed as benign and 6 (all ≤ 20 mm) as false negatives. Conversely, 25 nodules were upgraded to 4B, of which 19 (76.0%) were malignant. The difference in AUC between the BI-RADS group and the Co-Detect group was statistically significant (P < 0.05). Conclusions S-Detect combined with BI-RADS is effective in the differential diagnosis of BI-RADS 4 breast nodules ≤ 20 mm and > 20 mm. However, its performance is particularly pronounced in lesions ≤ 20 mm, where it contributes to a significant reduction in unnecessary biopsies.https://doi.org/10.1186/s12885-025-14760-2UltrasoundArtificial intelligenceS-DetectBreast massBreast imaging reporting and data system
spellingShingle Boyuan Xing
Chen Gu
Chenghui Fu
Bingyi Zhang
Yandi Tan
Diagnostic performance of ultrasound S-Detect technology in evaluating BI-RADS-4 breast nodules ≤ 20 mm and > 20 mm
BMC Cancer
Ultrasound
Artificial intelligence
S-Detect
Breast mass
Breast imaging reporting and data system
title Diagnostic performance of ultrasound S-Detect technology in evaluating BI-RADS-4 breast nodules ≤ 20 mm and > 20 mm
title_full Diagnostic performance of ultrasound S-Detect technology in evaluating BI-RADS-4 breast nodules ≤ 20 mm and > 20 mm
title_fullStr Diagnostic performance of ultrasound S-Detect technology in evaluating BI-RADS-4 breast nodules ≤ 20 mm and > 20 mm
title_full_unstemmed Diagnostic performance of ultrasound S-Detect technology in evaluating BI-RADS-4 breast nodules ≤ 20 mm and > 20 mm
title_short Diagnostic performance of ultrasound S-Detect technology in evaluating BI-RADS-4 breast nodules ≤ 20 mm and > 20 mm
title_sort diagnostic performance of ultrasound s detect technology in evaluating bi rads 4 breast nodules ≤ 20 mm and 20 mm
topic Ultrasound
Artificial intelligence
S-Detect
Breast mass
Breast imaging reporting and data system
url https://doi.org/10.1186/s12885-025-14760-2
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