{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,6]],"date-time":"2026-09-06T04:10:35Z","timestamp":1788667835381,"version":"build-2803163510"},"reference-count":18,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T00:00:00Z","timestamp":1788393600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Ultrasound"],"abstract":"<jats:sec>\n                    <jats:title>Introduction:<\/jats:title>\n                    <jats:p>Thyroid nodules affect more than 60% of the population, approximately 5% being malignant. The British Thyroid Association U-classification guides ultrasound risk stratification across the United Kingdom but is subject to inter-observer variability. Artificial intelligence decision support tools may offer more standardised assessment, yet no peer-reviewed study has validated S-Detect, a computer-aided diagnosis tool integrated into Samsung ultrasound systems, against the British Thyroid Association framework. This study compares S-Detect with experienced ultrasound operators using histology as the reference standard.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>This retrospective pilot diagnostic accuracy study assessed 32 thyroid nodules (September 2023 to August 2024). S-Detect served as the index test applied retrospectively on a Samsung RS85 Prestige platform; prospectively assigned U-scores were the comparator and surgical histology the reference standard. A secondary analysis varied Doppler input across all four options in the 11 malignancies misclassified by S-Detect to test whether Doppler selection contributed to misclassification.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Operators achieved superior balanced performance (sensitivity: 78.9%, specificity: 84.6%, accuracy: 81.3%, and area under the curve: 0.870) compared with S-Detect (42.1%, 100%, 65.6%, area under the curve: 0.729), which under-classified 58% of malignancies. Inter-method agreement was slight (\n                      <jats:italic toggle=\"yes\">\u03ba<\/jats:italic>\n                      = 0.175), with significant directional discordance (McNemar\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      = 0.008). Doppler manipulation produced substantial variability: 81.8% of misclassified cases showed U-score change attributable solely to Doppler selection, with peripheral patterns yielding zero correct malignancy classifications.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Operators achieved superior diagnostic performance. S-Detect\u2019s high false-negative rate appears largely driven by over-reliance on Doppler. Its clinical utility is limited within this single-centre study. Future iterations excluding Doppler would likely achieve substantially improved sensitivity.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/1742271x261479402","type":"journal-article","created":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T07:50:49Z","timestamp":1788421849000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Investigation of S-Detect AI (a computer-aided diagnosis tool) versus ultrasound operators for thyroid nodule classification using British Thyroid Association guidelines: A pilot diagnostic accuracy study"],"prefix":"10.1177","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-4839-2121","authenticated-orcid":false,"given":"Kieran","family":"Walker","sequence":"first","affiliation":[{"name":"University Hospitals Birmingham NHS Foundation Trust, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-2376-7572","authenticated-orcid":false,"given":"James","family":"Michael","sequence":"additional","affiliation":[{"name":"Birmingham City University, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark","family":"Ballard","sequence":"additional","affiliation":[{"name":"University Hospitals Birmingham NHS Foundation Trust, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Geoffrey","family":"Chilvers","sequence":"additional","affiliation":[{"name":"University Hospitals Birmingham NHS Foundation Trust, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steve","family":"Colley","sequence":"additional","affiliation":[{"name":"University Hospitals Birmingham NHS Foundation Trust, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Khalid","family":"Hussain","sequence":"additional","affiliation":[{"name":"University Hospitals Birmingham NHS Foundation Trust, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lloyd","family":"Rickard","sequence":"additional","affiliation":[{"name":"University Hospitals Birmingham NHS Foundation Trust, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,9,3]]},"reference":[{"key":"e_1_3_3_2_2","article-title":"Thyroid nodules: diagnostic evaluation based on thyroid cancer risk assessment","volume":"368","author":"Singh Ospina N","year":"2020","unstructured":"Singh Ospina N, I\u00f1iguez-Ariza NM, Castro MR. Thyroid nodules: diagnostic evaluation based on thyroid cancer risk assessment. BMJ 2020; 368: l6670.","journal-title":"BMJ"},{"key":"e_1_3_3_3_2","unstructured":"Cancer Research UK. Thyroid cancer statistics [Internet] https:\/\/www.cancerresearchuk.org\/health-professional\/cancer-statistics\/statistics-by-cancer-type\/thyroid-cancer (2025 accessed 7 February 2025)."},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1111\/cen.12515"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.2214\/AJR.17.19192"},{"issue":"1","key":"e_1_3_3_6_2","first-page":"150","article-title":"Diagnostic performance of S-Detect for thyroid cancer classification: a systematic review and meta-analysis","volume":"41","author":"Jeong EY","year":"2022","unstructured":"Jeong EY, Kim HL, Ha EJ, et al. Diagnostic performance of S-Detect for thyroid cancer classification: a systematic review and meta-analysis. Ultrasonography 2022; 41(1): 150\u2013162.","journal-title":"Ultrasonography"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0272149"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.3389\/fendo.2023.1227339"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.1177\/1742271X241299220"},{"key":"e_1_3_3_10_2","unstructured":"Southam M Foster W. A comparison as to the advocacy and inter-observer agreement of using S-Detect\u2122 against sonographers classifying thyroid lesions using the British Thyroid Association (BTA) guidelines [White paper]. Samsung Medison 29 August 2024 https:\/\/global.samsungsuite.com\/courses\/a-comparison-as-to-the-advocacy-and-inter-observer-agreement-of-using-s-detect-against-sonographers-classifying-thyroid-lesions-using-the-british-thyroid-association-bta-guidelines\/"},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-155-8-201110180-00009"},{"key":"e_1_3_3_12_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41591-025-03953-8"},{"key":"e_1_3_3_13_2","doi-asserted-by":"publisher","DOI":"10.2307\/2529310"},{"key":"e_1_3_3_14_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00405-025-09236-9"},{"key":"e_1_3_3_15_2","doi-asserted-by":"publisher","DOI":"10.1159\/000509325"},{"issue":"8","key":"e_1_3_3_16_2","first-page":"1","article-title":"Colour Doppler ultrasound for differential diagnosis of benign and malignant thyroid nodules: a meta-analysis","volume":"49","author":"Zhao Z","year":"2021","unstructured":"Zhao Z, Luo X, Li Q, et al. Colour Doppler ultrasound for differential diagnosis of benign and malignant thyroid nodules: a meta-analysis. J Int Med Res 2021; 49(8): 1\u201313.","journal-title":"J Int Med Res"},{"key":"e_1_3_3_17_2","doi-asserted-by":"crossref","unstructured":"Moorthy R Balasubramanian SP Farnell K et al. Evaluation and management of thyroid nodules: a joint consensus statement from the British Thyroid Association (BTA) British Association of Endocrine and Thyroid Surgeons (BAETS) and collaborating bodies. Clin Endocrinol 2026; 104: 682\u2013692. https:\/\/doi.org\/10.1111\/cen.70116","DOI":"10.1111\/cen.70116"},{"key":"e_1_3_3_18_2","volume-title":"Guidelines for professional ultrasound practice","author":"Society and College of Radiographers and British Medical Ultrasound Society","year":"2023","unstructured":"Society and College of Radiographers and British Medical Ultrasound Society. Guidelines for professional ultrasound practice. 5th ed. 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Artificial intelligence (AI): position statement [Internet] https:\/\/www.nice.org.uk\/corporate\/ecd11 (2024 accessed May 2025)."}],"container-title":["Ultrasound"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/1742271X261479402","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/1742271X261479402","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/1742271X261479402","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,6]],"date-time":"2026-09-06T03:28:58Z","timestamp":1788665338000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/1742271X261479402"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,3]]},"references-count":18,"alternative-id":["10.1177\/1742271X261479402"],"URL":"https:\/\/doi.org\/10.1177\/1742271x261479402","relation":{},"ISSN":["1742-271X","1743-1344"],"issn-type":[{"value":"1742-271X","type":"print"},{"value":"1743-1344","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,3]]},"article-number":"1742271X261479402"}}