Koios DS

by Koios Medical  · Based in United States →Smart Ultrasound™
Endocrinology Oncology Radiology

Subscription
Regulatory Status Disclosed

Overview

Koios DS is an AI-powered clinical decision support software developed by Koios Medical, designed to assist trained interpreting physicians in analyzing breast and thyroid ultrasound images. The software utilizes artificial intelligence and machine learning to provide real-time cancer risk assessments and classify lesions based on image data, aligning with established diagnostic systems like ACR BI-RADS, European U1-U5 Classification System, ACR TI-RADS, and American Thyroid Association (ATA) risk stratification systems. Koios DS aims to improve diagnostic accuracy, reduce interpretation variability, decrease unnecessary biopsies of benign tissue, and streamline clinical workflows. It can also function as an image viewer for multi-modality digital images, including ultrasound and mammography, and integrates seamlessly into most PACS workstations and directly onto ultrasound scanners.

Reviewed by Pouyan Golshani, MD — Interventional Radiologist

Key Features

  • AI-based clinical decision support for ultrasound images
  • Analysis of breast and thyroid ultrasound images
  • Automatic classification of lesions (BI-RADS, TI-RADS, European U1-U5, ATA)
  • AI/ML-derived cancer risk assessment
  • Auto-population of lesion/nodule descriptors
  • Lesion/nodule segmentation
  • Image viewer for multi-modality digital images (ultrasound, mammography)
  • Integrates with PACS workstations
  • Real-time decision making / instantaneous results (in seconds)
  • Exportable findings to reporting systems

Use Cases

  • Early detection and accurate diagnosis of breast cancer
  • Early detection and accurate diagnosis of thyroid cancer
  • Reducing unnecessary biopsies of benign tissue
  • Improving diagnostic accuracy and consistency for physicians
  • Streamlining workflow and reducing interpretation time
  • Prioritizing high-risk patients for backlog assessment

What Physicians Need to Know

Evidence Base
Koios DS utilizes AI/ML algorithms trained on a proprietary dataset of over 2 million ultrasound images, analyzing 17,900 features per image. Its risk assessments align with established guidelines such as ACR BI-RADS for breast lesions and ACR TI-RADS and ATA risk stratification systems for thyroid nodules.
Clinical Validation Studies
Multiple studies demonstrate improved diagnostic accuracy, sensitivity, and specificity, alongside reduced benign biopsy rates. For breast cancer, studies show improved accuracy (sensitivity 92-97% to 97-98%, specificity 38-46% to 45-52%) and a 25-55% reduction in benign biopsies. One study reported 100% cancer identification with a 69% reduction in benign biopsies. A multicenter study found a significantly higher mean AUC with Koios DS (0.88) compared to US alone (0.83), and improved interobserver agreement and decreased intra-observer variability. For thyroid cancer, studies indicate a 14% higher detection rate and over 35% reduction in unnecessary biopsy orders. An increase in AUROC (0.776 vs. 0.817), improved mean sensitivity (82.3% vs. 86.5%) and specificity (38.3% vs. 54.8%), and significant improvement in interobserver agreement were observed with Koios DS. A pilot study suggests a potential 31% reduction in unnecessary fine needle aspirations.
Differential Diagnosis Support
Koios DS provides an AI/ML-derived cancer risk assessment and automatically selects applicable lexicon-based descriptors (ACR BI-RADS for breast, ACR TI-RADS/ATA for thyroid) to enhance diagnostic accuracy and reduce physician variability. This classification of lesions and nodules directly aids in supporting differential diagnosis related to cancer risk.
Guideline Update Frequency
The software's outputs align with established and regularly updated guidelines such as ACR BI-RADS and TI-RADS. While a specific update frequency for the software's guidelines isn't provided, the system continuously 'learns' from an ever-growing database, implying ongoing algorithm improvement.
Clinical Workflow Integration
Koios DS is designed for seamless integration into existing PACS systems and clinical workflows. It can be deployed as a web application, integrated into PACS workstations, or directly on ultrasound scanners (e.g., GE Healthcare LOGIQu2122 E10). The system supports exporting results to third-party reporting software and can save findings to PACS via DICOM Secondary Capture. It aims to reduce interpretation time and manual data entry.
Decision Audit Trail
Koios DS includes audit capabilities, log/event tracking data, and user account creation/modification tracking, which encompasses changes to access privileges, timestamps, and the ID of the creating/modifying user, as well as account activation/inactivation.
Physician Tip

Koios DS serves as an 'expert on-demand second opinion' to significantly enhance diagnostic accuracy and consistency in breast and thyroid ultrasound interpretation. It can substantially reduce interpretation time and the rate of unnecessary benign biopsies, while potentially increasing cancer detection rates. The tool provides AI-derived risk assessments aligned with established lexicon-based descriptors (BI-RADS, TI-RADS, ATA), which aids in standardizing reporting and reducing inter- and intra-operator variability. Physicians should undergo training for its use and understand that patient management decisions should not be made *solely* on Koios DS results, as it is intended as an adjunct tool.

Koios DS is designed for seamless integration within existing radiology ecosystems. It connects with all major PACS systems via DICOM interfaces and can export results to third-party reporting software. The software can also be deployed directly on ultrasound scanners, such as the GE Healthcare LOGIQu2122 E10. It supports enterprise directory services like Active Directory (AD) and Lightweight Directory Access Protocol (LDAP) for user authentication and can accommodate Single Sign-On (SSO) requirements.

Details

Category Oncology AI, Radiology & Imaging AI
Pricing Subscription
  • Annual subscription pricing tailored to customer size; based on number of analyses and number of users
DeploymentLocally virtualized (virtual machine, Docker); web application deployed to Microsoft IIS web server; integrates with PACS workstations; available directly on ultrasound scanners.
Compliance
BAA AvailableUnknown AI-estimated
HIPAA CompliantUnknown AI-estimated
FDA Status 1 AI-estimated

Koios DS received initial FDA clearance for thyroid and breast cancer diagnosis in December 2021. An earlier version, Koios DS Breast 2.0, was cleared in July 2019. The latest 510(k) premarket notification (K242130) for Koios DS Version 3.6 had a summary date of October 18, 2024, and a decision date of November 15, 2024.

Integrations
EHR Not specified
Specialties Endocrinology, Oncology, Radiology

What the Web Says

Koios DS is an AI-powered ultrasound decision support system designed to help radiologists characterize thyroid and breast nodules. Reviews highlight its ability to improve diagnostic accuracy, standardize reporting, and enhance workflow efficiency, particularly for less experienced physicians. While generally well-received, some discussions touch upon the integration challenges with existing PACS and the learning curve for new users.

Overall: Positive

Strengths

  • Improved diagnostic accuracy and reduced false positives/negatives for thyroid and breast nodules.
  • Standardizes reporting using guidelines like ACR TI-RADS and BI-RADS, leading to consistent diagnoses.
  • Enhances workflow efficiency by automating measurements and risk stratification.
  • Provides decision support, potentially reducing unnecessary biopsies and follow-ups.
  • User-friendly interface with intuitive features for radiologists.
  • Beneficial for training and supporting less experienced physicians in nodule characterization.

Limitations

  • Potential integration challenges with existing PACS and EMR systems.
  • Initial learning curve for radiologists to fully utilize all features.
  • Reliance on high-quality ultrasound images for optimal AI performance.
  • Cost of implementation and ongoing maintenance could be a factor for smaller practices.
  • Some users report occasional minor software glitches or performance issues.
  • Limited information available on long-term impact on patient outcomes beyond diagnostic accuracy.

Based on reviews from: Koios Medical Website, Healthcare IT News, Radiology Today, G2, Capterra, Reddit (r/radiology, r/healthcareit)

Last updated: 2026-07-18

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Press & Coverage

iCAD
Koios Medical and iCAD Partner to Expand AI-Powered, Multi-Modality Breast Cancer Detection Solutions at ECR 2025
Koios Medical and iCAD announced a strategic reseller partnership to deliver a comprehensive, multi-modality AI suite for breast cancer detection, integrating iCAD's ProFound AIu00ae with Koios SmartUltrasoundu2122.
2025-02
Imaging Technology News
RamSoft, Koios Medical Team Up to Provide Integrated AI-Powered Software for Breast and Thyroid Cancer Diagnosis
RamSoft Inc. and Koios Medical have partnered to integrate Koios's AI-powered clinical decision support solution for breast and thyroid cancer detection into RamSoft's cloud-native RIS/PACS platforms.
2025-09
Ultrasonography
Utilization of artificial intelligence to triage patients with delayed follow-up of probably benign breast ultrasound findings - Ultrasonography
A study evaluated Koios DS software's performance in triaging patients with delayed follow-up of probably benign breast ultrasound findings, demonstrating a sensitivity and NPV of 100%.
2025-01
PMC (PubMed Central)
Investigation of artificial intelligenceu2013based clinical decision support system's performance in reducing the fine needle aspiration rate of thyroid nodules: A pilot study - PMC
This pilot study investigated the performance of Koios DSu2122 Thyroid software in reducing fine needle aspiration rates for thyroid nodules, showing its potential to improve patient care and efficiency.
2024-12
AJR Online
Should We Ignore, Follow, or Biopsy? Impact of Artificial Intelligence Decision Support on Breast Ultrasound Lesion Assessment - AJR Online
A multicenter retrospective review assessed the impact of Koios DS for Breast on breast ultrasound lesion assessment, finding that the AI system improved diagnostic accuracy for physicians.
2024-02
AuntMinnie.com
Koios ultrasound AI software gets FDA clearance - AuntMinnie
The U.S. Food and Drug Administration (FDA) has cleared Koios Medical's Koios DS, an AI-based software platform for diagnosing thyroid and breast cancer, developed using ultrasound data from 48 global sites.
2021-12
FirstWord HealthTech (via EIN Presswire)
FDA Clears Koios Medical Smart Ultrasound AI Software for Thyroid and Breast Cancer Diagnosis.
Koios Medical announced FDA clearance for Koios DS, an AI-based software platform for thyroid and breast cancer diagnosis, designed to aid physicians in accurate diagnosis and reduce avoidable surgical procedures.
2021-12
EIN Presswire
Koios Medical Announces FDA Breakthrough Device Designation for Early Cancer Detection AI Software.
Koios Medical received FDA Breakthrough Device designation for its Koios DS decision support software platform, recognizing its potential for accurately interpreting breast and thyroid ultrasound images for early cancer detection.
2021-04

Videos

Product demos, reviews, and walkthroughs for Koios DS.

View all on YouTube

Frequently Asked Questions

Koios DS is an AI/ML-based clinical decision support software designed to assist trained physicians in analyzing breast and thyroid ultrasound images for cancer diagnosis. It integrates seamlessly with most PACS workstations and can be available directly on some ultrasound scanners, allowing users to select a region of interest for rapid AI-driven analysis and reporting.
Koios DS has been shown to improve diagnostic accuracy by increasing sensitivity and specificity in cancer detection, while also reducing benign biopsy rates. Studies indicate it can reduce interpreting physician variability and streamline reporting, ultimately saving time and enhancing patient outcomes.
Yes, Koios DS is FDA-cleared in the United States and holds CE Mark certification in Europe, indicating its compliance with established regulatory standards for medical devices. This allows for its widespread use in clinical settings within these regions.
Patient management decisions should not be made solely based on Koios DS analysis, as it is intended as an adjunct to diagnostic examinations. It is not for evaluating normal tissue, post-surgical excision sites, or images with certain overlays like Doppler or elastography, nor is it intended for use on portable handheld devices or as a primary mammography viewer.
Koios DS pricing is generally based on the annual diagnostic exam volume of a facility. This model provides a software license for unlimited use by the entire physician and technologist staff, aiming to ensure broad accessibility without restricting usage.
While Koios DS is a prominent AI solution for breast and thyroid ultrasound, other companies offer AI-powered diagnostic platforms and advanced visualization tools in the broader medical imaging space. Examples include Samsung's S-Detect for breast ultrasound, and platforms like TeraRecon or Viz.ai which offer AI-driven insights across various specialties, though not always directly comparable in scope.

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Suggest an Edit → | Last Verified: 2026-04-18 | First Added: 2026-04-18
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