A Multi-Source Ultrasound Benchmark Revealing the Limits of Contemporary Self-Supervised Anomaly Detection Methods

Marco Riedenauer, Daniel Kienzle, Pratik Mayekar, Rainer Lienhart

Self-supervised anomaly detection is a promising paradigm for medical ultrasound, as normal images are often easier to obtain than exhaustive annotations of all possible pathologies. However, most existing evaluations are limited to a single anatomy or task, making it unclear whether models learn a robust notion of normal ultrasound appearance or only a source-specific representation. We introduce the SADUSI benchmark, a multi-source ultrasound dataset designed to train and evaluate anomaly detection methods across a broad range of anatomical regions, views, and acquisition protocols. The goal of SADUSI is to provide a diverse normal ultrasound distribution and a benchmark for visible structural anomalies that can be assessed from single images. We evaluate representative self-supervised anomaly detection methods and find that current approaches struggle in this setting. In particular, reconstruction-based diffusion methods such as AnoDDPM and DeCo-Diff achieve pixel-level AUROC values of 0.56-0.72 and maximum F1 scores of 0.10-0.26, indicating limited separation of pathology from normal image regions. Feature-based PatchCore variants perform better, reaching pixel-level AUROC…