Application Value of Deep Learning-Based AI Model in the Classification of Breast Nodules

Abstract

Aims/Background Breast nodules are highly prevalent among women, and ultrasound is a widely used screening tool. However, single ultrasound examinations often result in high false-positive rates, leading to unnecessary biopsies. Artificial intelligence (AI) has demonstrated the potential to improve diagnostic accuracy, reducing misdiagnosis and minimising inter-observer variability. This study developed a deep learning-based AI model to evaluate its clinical utility in assisting sonographers with the Breast Imaging Reporting and Data System (BI-RADS) classification of breast nodules. Methods A retrospective analysis was conducted on 558 patients with breast nodules classified as BI-RADS categories 3 to 5, confirmed through pathological examination at The People's Hospital of Pingyang County between December 2019 and December 2023. The image dataset was divided into a training set, validation set, and test set, and a convolutional neural network (CNN) was used to construct a deep learning-based AI model. Patients underwent ultrasound examination and AI-assisted diagnosis. The receiver operating characteristic (ROC) curve was used to analyse the performance of the AI model, physician adjudication results, and the diagnostic efficacy of physicians before and after AI model assistance. Cohen's weighted Kappa coefficient was used to assess the consistency of BI-RADS classification among five ultrasound physicians before and after AI model assistance. Additionally, statistical analyses were performed to evaluate changes in BI-RADS classification results before and after AI model assistance for each physician. Results According to pathological examination, 765 of the 1026 breast nodules were benign, while 261 were malignant. The sensitivity, specificity, and accuracy of routine ultrasonography in diagnosing benign and malignant nodules were 80.85%, 91.59%, and 88.31%, respectively. In comparison, the AI system achieved a sensitivity of 89.36%, specificity of 92.52%, and accuracy of 91.56%. Furthermore, AI model assistance significantly improved the consistency of physicians' BI-RADS classification (p < 0.001). Conclusion A deep learning-based AI model constructed using ultrasound images can enhance the differentiation between benign and malignant breast nodules and improve classification accuracy, thereby reducing the incidence of missed and misdiagnoses.

Keywords: artificial intelligence; breast; breast ultrasound; deep learning; diagnosis; nodule.