Privacy-Preserving Federated Foundation Model for Generalist Ultrasound Artificial Intelligence

Ultrasound imaging is widely used in clinical diagnosis due to its non-invasive nature and real-time capabilities. However, conventional ultrasound diagnostics face several limitations, including high dependence on physician expertise and suboptimal image quality, which complicates interpretation and increases the likelihood of diagnostic errors. Artificial intelligence (AI) has emerged as a promising solution to enhance clinical diagnosis, particularly in detecting abnormalities across various biomedical imaging modalities. Nonetheless, current AI models for ultrasound imaging face critical challenges. First, these models often require large volumes of labeled medical data, raising concerns over patient privacy breaches. Second, most existing models are task-specific, which restricts their broader clinical utility. To overcome these challenges, we present UltraFedFM, an innovative privacy-preserving ultrasound foundation model. UltraFedFM is collaboratively pre-trained using federated learning across 16 distributed medical institutions in 9 countries, leveraging a dataset of over 1 million ultrasound images covering 19 organs and 10 ultrasound modalities. This extensive and diverse data, combined with a secure training framework, enables UltraFedFM to exhibit strong generalization and diagnostic capabilities. It achieves an average area under the receiver operating characteristic curve of 0.927 for disease diagnosis and a dice similarity coefficient of 0.878 for lesion segmentation. Notably, UltraFedFM surpasses the diagnostic accuracy of mid-level ultrasonographers and matches the performance of expert-level sonographers in the joint diagnosis of 8 common systemic diseases. These findings indicate that UltraFedFM can significantly enhance clinical diagnostics while safeguarding patient privacy, marking an advancement in AI-driven ultrasound imaging for future clinical applications.

Less is More: Simultaneous View Classification and Landmark Detection for Abdominal Ultrasound Images

An abdominal ultrasound examination, which is the most common ultrasound examination, requires substantial manual efforts to acquire standard abdominal organ views, annotate the views in texts, and record clinically relevant organ measurements. Hence, automatic view classification and landmark detection of the organs can be instrumental to streamline the examination workflow. However, this is a challenging problem given not only the inherent difficulties from the ultrasound modality, e.g., low contrast and large variations, but also the heterogeneity across tasks, i.e., one classification task for all views, and then one landmark detection task for each relevant view. While convolutional neural networks (CNN) have demonstrated more promising outcomes on ultrasound image analytics than traditional machine learning approaches, it becomes impractical to deploy multiple networks (one for each task) due to the limited computational and memory resources on most existing ultrasound scanners. To overcome such limits, we propose a multi-task learning framework to handle all the tasks by a single network. This network is integrated to perform view classification and landmark detection simultaneously; it is also equipped with global convolutional kernels, coordinate constraints, and a conditional adversarial module to leverage the performances. In an experimental study based on 187,219 ultrasound images, with the proposed simplified approach we achieve (1) view classification accuracy better than the agreement between two clinical experts and (2) landmark-based measurement errors on par with inter-user variability. The multi-task approach also benefits from sharing the feature extraction during the training process across all tasks and, as a result, outperforms the approaches that address each task individually.