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.