Energy sustainability of breast ultrasound: comparison of automated and handheld ultrasound systems.

PURPOSE: This study evaluated and compared energy consumption between automated breast ultrasound (ABUS) and handheld ultrasound (HHUS) systems during routine whole-breast ultrasound (US) examinations in clinical practice. METHODS: This prospective observational study included 320 consecutive patients who underwent breast US between July and October 2025. Four systems were used: two ABUS systems, designated ABUS-1 and ABUS-2, and two HHUS systems, designated HHUS-1 and HHUS-2. HHUS examinations were performed by four radiologists. Energy consumption was measured using a real-time power meter synchronized with system log files. Power consumption was analyzed in active, idle, and off modes. Average power in each mode, examination duration, and energy consumption during active scanning were calculated. Data were analyzed using the independent-samples t-test or Mann-Whitney U test with Bonferroni correction. RESULTS: In idle mode, ABUS systems consumed significantly less average power than HHUS systems (P<0.001). In off mode, both ABUS systems consumed 0 W, whereas HHUS systems continued to consume residual power. During active scanning, ABUS systems had shorter examination durations than HHUS systems, with ABUS-1 showing the shortest duration. Energy consumption during active scanning was lowest for ABUS-1, which consumed approximately 47% less energy than HHUS-1 (P<0.001). Across all radiologists, both ABUS systems consistently showed lower energy consumption than HHUS-1. CONCLUSION: Compared with HHUS, ABUS showed lower power use in idle and off modes and similar or lower energy consumption during active scanning. When clinically appropriate, preferential use of ABUS may improve energy sustainability while preserving clinical utility.