Comparative Analysis of the Diagnostic Value of S-Detect Technology in Different Planes Versus the BI-RADS Classification for Breast Lesions.

ABSTRACT

RATIONALE AND OBJECTIVES: S-Detect, a deep learning-based Computer-Aided Detection system, is recognized as an important tool for diagnosing breast lesions using ultrasound imaging. However, it may exhibit inconsistent findings across multiple imaging planes. This study aims to evaluate the diagnostic performance of S-Detect in different planes and identify factors contributing to these inconsistencies. MATERIALS AND METHODS: A retrospective cohort study was conducted on 711 patients with 756 breast lesions between January 2019 and January 2022. S-Detect was utilized to assess lesions in radial and anti-radial planes. BI-RADS classifications were employed for comparative analysis. The diagnostic performance was compared within each group, and p-values were computed for intergroup comparisons. Univariable and multivariable analyses were conducted to identify factors contributing to diagnostic inconsistency in S-Detect across planes. RESULTS: Among 756 breast lesions, 668 (88.4%) exhibited consistent S-Detect outcomes across planes while 88 (11.6%) were inconsistent. In the consistent group, the diagnostic accuracy and area under the curve (AUC) of S-Detect were significantly higher than those of BI-RADS (accuracy 91.2% vs. 84.9%, p = 0.045; AUC 0.916 vs. 0.859, p = 0.036). In the inconsistent group, the diagnostic accuracy and AUC of S-Detect in radial and anti-radial planes were lower than those of BI-RADS (accuracy 47.7% for radial, 52.2% for anti-radial vs. 69.3% for BI-RADS, p = 0.014, p-anti = 0.039; AUC 0.503 for radial, 0.497 for anti-radial vs. 0.739 for BI-RADS, p = 0.042, p-anti <0.001). Diagnostic inconsistency in S-Detect across planes was significantly associated with lesion size, indistinct or angular margins, and enhancement posterior acoustic features (p < 0.05). CONCLUSION: S-Detect has outperformed BI-RADS in diagnostic precision under conditions of inter-planar concordance. However, its diagnostic efficacy is compromised in scenarios of inter-planar discordance. Under these circumstances, the results of S-Detect should be carefully referenced.