The diagnostic performance of automatic B-lines detection for evaluating pulmonary edema in the emergency department among novice point-of-care ultrasound practitioners

Emerg Radiol. 2025 Apr;32(2):241-246. doi: 10.1007/s10140-025-02319-4. Epub 2025 Feb 14.

Abstract

Purpose: B-lines in lung ultrasound have been a critical clue for detecting pulmonary edema. However, distinguishing B-lines from other artifacts is a challenge, especially for novice point of care ultrasound (POCUS) practitioners. This study aimed to determine the efficacy of automatic detection of B-lines using artificial intelligence (Auto B-lines) for detecting pulmonary edema.

Methods: A retrospective study was conducted on dyspnea patients treated at the emergency department between January 2023 and June 2024. Ultrasound documentation and electronic emergency department medical records were evaluated for sensitivity, specificity, positive likelihood ratio, and negative likelihood ratio of auto B-lines in detection of pulmonary edema.

Results: Sixty-six patients with a final diagnosis of pulmonary edema were enrolled, with 54.68% having positive B-lines in lung ultrasound. Auto B-lines had 95.6% sensitivity (95% confidence interval [CI]: 0.92-0.98) and 77.2% specificity (95% CI: 0.74-0.80). Physicians demonstrated 82.7% sensitivity (95% CI: 0.79-0.97) and 63.09% sensitivity (95% CI: 0.58-0.69).

Conclusion: The auto B-lines were highly sensitive in diagnosing pulmonary edema in novice POCUS practitioners. The clinical integration of physicians and artificial intelligence enhances diagnostic capabilities.

Keywords: Artificial intelligence; Emergency department; Pulmonary edema; Ultrasound.

MeSH terms

  • Adult
  • Aged
  • Artificial Intelligence*
  • Clinical Competence
  • Emergency Service, Hospital*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Point-of-Care Systems*
  • Pulmonary Edema* / diagnostic imaging
  • Retrospective Studies
  • Sensitivity and Specificity
  • Ultrasonography / methods