Systems and methods are provided for projection profile enabled computer aided detection (CAD). Volumetric ultrasound dataset may be generated, based on echo ultrasound signals, and based on the volumetric ultrasound dataset, a three-dimensional (3D) ultrasound volume may generated. Selective structure detection may be applied to the three-dimensional (3D) ultrasound volume. The selective structure detection may include generating based on a projection of the three-dimensional (3D) ultrasound volume in a particular spatial direction, a two-dimensional (2D) image; applying two-dimensional (2D) structure detection to the two-dimensional (2D) image, to identify structure candidates associated with a particular type of structures; selecting for each identified structure candidate, a corresponding local volume within the three-dimensional (3D) ultrasound volume; applying three-dimensional (3D) structure detection to each selected local volume; and identifying based on applying the three-dimensional (3D) structure detection, one or more structure candidates that match the particular type of structures.