Evidence mapPaperPMID 41682007Full record

ArticleCancers2026

Effect of a Real-Time Artificial Intelligence-Assisted Ultrasound System on BI-RADS C4 Breast Lesions Based on Breast Density.

Jeeyeon Lee, Won Hwa Kim, Jaeil Kim, Byeongju Kang, Joon Suk Moon, Hye Jung Kim, Soo Jung Lee, In Hee Lee, Ho Yong Park

Abstract read
In one paragraph

Article in Cancers, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

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2 · The registry

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3 · Its place in the literature

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4 · The record

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5 · Who and what money

Authors and funding

9 authors.

Jeeyeon LeeDepartment of Surgery, School of Medicine, Kyungpook National University, Daegu 41566, Republic of Korea.ORCID 0000-0003-1826-1690
Won Hwa KimKyungpook National University Chilgok Hospital, Daegu 41404, Republic of Korea.
Jaeil KimBeamWorks Inc., Daegu 41404, Republic of Korea.ORCID 0000-0002-9799-1773
Byeongju KangDepartment of Surgery, School of Medicine, Kyungpook National University, Daegu 41566, Republic of Korea.
Joon Suk MoonDepartment of Surgery, School of Medicine, Kyungpook National University, Daegu 41566, Republic of Korea.ORCID 0009-0009-2880-6472
Hye Jung KimKyungpook National University Chilgok Hospital, Daegu 41404, Republic of Korea.ORCID 0000-0002-0263-0941
Soo Jung LeeKyungpook National University Chilgok Hospital, Daegu 41404, Republic of Korea.ORCID 0000-0003-0066-4109
In Hee LeeKyungpook National University Chilgok Hospital, Daegu 41404, Republic of Korea.
Ho Yong ParkDepartment of Surgery, School of Medicine, Kyungpook National University, Daegu 41566, Republic of Korea.

Funding

Korea Health Technology R&D Project through the Korea Health Industry Development Institute (KHIDI), funded by the Ministry of Health & Welfare, Republic of Korea HR-2022-KH130591Ministry of Health and Welfare (MOHW), Daegu Metropolitan City, and the Korea Health Industry Development Institute (KHIDI) Digital Healthcare Medical Device Demonstration Support Project
6 · The paper itself

Abstract

backgroundArtificial intelligence-based computer-aided diagnosis (AI-CAD) systems are increasingly used in breast ultrasonography; however, their diagnostic performance may vary with breast density. Given that dense breasts are highly prevalent among Asian women, understanding this relationship is essential for optimizing AI-assisted imaging strategies. Therefore, this study aims to evaluate the effect of breast density on the diagnostic accuracy of an AI-CAD ultrasound system in BI-RADS category 4 (C4) breast lesions.

methodsOverall, 110 consecutive BI-RADS C4 lesions were reviewed between January and December 2023. An AI-CAD ultrasound system automatically assigned BI-RADS categories and calculated the probability of malignancy (POM) using static ultrasound images. Histopathology served as the reference standard, with atypia and malignancy combined into a non-benign category. Diagnostic performance-including sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and overall accuracy-was analyzed based on breast density (BI-RADS B-D), determined using AI-assisted mammography.

resultsOverall, the sensitivity and NPV were 81.3% and 87.5%, respectively, while the specificity and PPV were lower at 53.8% and 41.9%. All diagnostic performance metrics improved with increasing breast density. In the density D category, sensitivity (92.3%), specificity (61.5%), NPV (96.0%), and accuracy (69.2%) were highest. Additionally, concordance between AI-assigned BI-RADS categories and histopathologic diagnoses increased with density (B: 50.0%, C: 57.5%, D: 67.3%). Across all density groups, non-benign lesions consistently demonstrated higher POM values.

conclusionsBreast density significantly affects the diagnostic performance of AI-CAD ultrasound in BI-RADS C4 lesions. The AI system demonstrates higher accuracy and concordance in dense breasts, suggesting more consistent lesion interpretation in high-density environments. These findings highlight the potential utility of AI-assisted ultrasound as a diagnostic adjunct, particularly for Asian women, who commonly have dense breast composition. Further multicenter, real-time validation studies are warranted to validate these findings.

Indexed as

artificial intelligenceBI-RADS C4breastultrasound

Identifiers

PMID41682007
PMCPMC12897095

What Socratic holds

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.