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Ruitenbeek HC, Oei EHG, Visser JJ, Kijowski R. Artificial intelligence in musculoskeletal imaging: realistic clinical applications in the next decade. Skeletal Radiol 2024; 53:1849-1868. [PMID: 38902420 DOI: 10.1007/s00256-024-04684-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2024] [Revised: 04/06/2024] [Accepted: 04/15/2024] [Indexed: 06/22/2024]
Abstract
This article will provide a perspective review of the most extensively investigated deep learning (DL) applications for musculoskeletal disease detection that have the best potential to translate into routine clinical practice over the next decade. Deep learning methods for detecting fractures, estimating pediatric bone age, calculating bone measurements such as lower extremity alignment and Cobb angle, and grading osteoarthritis on radiographs have been shown to have high diagnostic performance with many of these applications now commercially available for use in clinical practice. Many studies have also documented the feasibility of using DL methods for detecting joint pathology and characterizing bone tumors on magnetic resonance imaging (MRI). However, musculoskeletal disease detection on MRI is difficult as it requires multi-task, multi-class detection of complex abnormalities on multiple image slices with different tissue contrasts. The generalizability of DL methods for musculoskeletal disease detection on MRI is also challenging due to fluctuations in image quality caused by the wide variety of scanners and pulse sequences used in routine MRI protocols. The diagnostic performance of current DL methods for musculoskeletal disease detection must be further evaluated in well-designed prospective studies using large image datasets acquired at different institutions with different imaging parameters and imaging hardware before they can be fully implemented in clinical practice. Future studies must also investigate the true clinical benefits of current DL methods and determine whether they could enhance quality, reduce error rates, improve workflow, and decrease radiologist fatigue and burnout with all of this weighed against the costs.
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Affiliation(s)
- Huibert C Ruitenbeek
- Department of Radiology and Nuclear Medicine, Erasmus MC, University Medical Center, P.O. Box 2040, 3000 CA, Rotterdam, The Netherlands
| | - Edwin H G Oei
- Department of Radiology and Nuclear Medicine, Erasmus MC, University Medical Center, P.O. Box 2040, 3000 CA, Rotterdam, The Netherlands
| | - Jacob J Visser
- Department of Radiology and Nuclear Medicine, Erasmus MC, University Medical Center, P.O. Box 2040, 3000 CA, Rotterdam, The Netherlands
| | - Richard Kijowski
- Department of Radiology, New York University Grossman School of Medicine, 660 First Avenue, 3rd Floor, New York, NY, 10016, USA.
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2
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Chen M, Cai R, Zhang A, Chi X, Qian J. The diagnostic value of artificial intelligence-assisted imaging for developmental dysplasia of the hip: a systematic review and meta-analysis. J Orthop Surg Res 2024; 19:522. [PMID: 39210407 PMCID: PMC11360681 DOI: 10.1186/s13018-024-05003-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2024] [Accepted: 08/16/2024] [Indexed: 09/04/2024] Open
Abstract
OBJECTIVE To clarify the efficacy of artificial intelligence (AI)-assisted imaging in the diagnosis of developmental dysplasia of the hip (DDH) through a meta-analysis. METHODS Relevant literature on AI for early DDH diagnosis was searched in PubMed, Web of Science, Embase, and The Cochrane Library databases until April 4, 2024. The Quality Assessment of Diagnostic Accuracy Studies tool was used to assess the quality of included studies. Revman5.4 and StataSE-64 software were used to calculate the combined sensitivity, specificity, AUC value, and DOC value of AI-assisted imaging for DDH diagnosis. RESULTS The meta-analysis included 13 studies (6 prospective and 7 retrospective) with 28 AI models and a total of 10,673 samples. The summary sensitivity, specificity, AUC value, and DOC value were 99.0% (95% CI: 97.0-100.0%), 94.0% (95% CI: 89.0-96.0%), 99.0% (95% CI: 98.0-100.0%), and 1342 (95% CI: 469-3842), respectively. CONCLUSION AI-assisted imaging demonstrates high diagnostic efficacy for DDH detection, improving the accuracy of early DDH imaging examination. More prospective studies are needed to further confirm the value of AI-assisted imaging for early DDH diagnosis.
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Affiliation(s)
- Min Chen
- Department of the Child Health Department, Women's Hospital of Nanjing Medical University, (Nanjing Women and Children's Healthcare Hospital), Nanjing, Jiangsu, 21000, China
| | - Ruyi Cai
- Department of the Child Health Department, Women's Hospital of Nanjing Medical University, (Nanjing Women and Children's Healthcare Hospital), Nanjing, Jiangsu, 21000, China
| | - Aixia Zhang
- Department of the Child Health Department, Women's Hospital of Nanjing Medical University, (Nanjing Women and Children's Healthcare Hospital), Nanjing, Jiangsu, 21000, China
| | - Xia Chi
- Department of the Child Health Department, Women's Hospital of Nanjing Medical University, (Nanjing Women and Children's Healthcare Hospital), Nanjing, Jiangsu, 21000, China
- School of Pediatrics, Nanjing Medical University, Nanjing, Jiangsu, 211166, China
| | - Jun Qian
- Department of the Child Health Department, Women's Hospital of Nanjing Medical University, (Nanjing Women and Children's Healthcare Hospital), Nanjing, Jiangsu, 21000, China.
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Jang SJ, Driscoll DA, Anderson CG, Sokrab R, Flevas DA, Mayman DJ, Vigdorchik JM, Jerabek SA, Sculco PK. Radiographic Findings Associated With Mild Hip Dysplasia in 3869 Patients Using a Deep Learning Measurement Tool. Arthroplast Today 2024; 28:101398. [PMID: 38993836 PMCID: PMC11237356 DOI: 10.1016/j.artd.2024.101398] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Revised: 03/10/2024] [Accepted: 04/02/2024] [Indexed: 07/13/2024] Open
Abstract
Background Hip dysplasia is considered one of the leading etiologies contributing to hip degeneration and the eventual need for total hip arthroplasty (THA). We validated a deep learning (DL) algorithm to measure angles relevant to hip dysplasia and applied this algorithm to determine the prevalence of dysplasia in a large population based on incremental radiographic cutoffs. Methods Patients from the Osteoarthritis Initiative with anteroposterior pelvis radiographs and without previous THAs were included. A DL algorithm automated 3 angles associated with hip dysplasia: modified lateral center-edge angle (LCEA), Tönnis angle, and modified Sharp angle. The algorithm was validated against manual measurements, and all angles were measured in a cohort of 3869 patients (61.2 ± 9.2 years, 57.1% female). The percentile distributions and prevalence of dysplastic hips were analyzed using each angle. Results The algorithm had no significant difference (P > .05) in measurements (paired difference: 0.3°-0.7°) against readers and had excellent agreement for dysplasia classification (kappa = 0.78-0.88). In 140 minutes, 23,214 measurements were automated for 3869 patients. LCEA and Sharp angles were higher and the Tönnis angle was lower (P < .01) in females. The dysplastic hip prevalence varied from 2.5% to 20% utilizing the following cutoffs: 17.3°-25.5° (LCEA), 9.4°-15.6° (Tönnis), and 41.3°-45.9° (Sharp). Conclusions A DL algorithm was developed to measure and classify hips with mild hip dysplasia. The reported prevalence of dysplasia in a large patient cohort was dependent on both the measurement and threshold, with 12.4% of patients having dysplasia radiographic indices indicative of higher THA risk.
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Affiliation(s)
- Seong Jun Jang
- Weill Cornell College of Medicine, New York, NY, USA
- Department of Orthopedic Surgery, Hospital for Special Surgery, New York, NY, USA
| | - Daniel A Driscoll
- Department of Orthopedic Surgery, Hospital for Special Surgery, New York, NY, USA
- Adult Reconstruction and Joint Replacement Service, Hospital for Special Surgery, New York, NY, USA
| | - Christopher G Anderson
- Stavros Niarchos Foundation Complex Joint Reconstruction Center, Hospital for Special Surgery, New York, NY, USA
| | - Ruba Sokrab
- Stavros Niarchos Foundation Complex Joint Reconstruction Center, Hospital for Special Surgery, New York, NY, USA
| | - Dimitrios A Flevas
- Stavros Niarchos Foundation Complex Joint Reconstruction Center, Hospital for Special Surgery, New York, NY, USA
| | - David J Mayman
- Adult Reconstruction and Joint Replacement Service, Hospital for Special Surgery, New York, NY, USA
| | - Jonathan M Vigdorchik
- Adult Reconstruction and Joint Replacement Service, Hospital for Special Surgery, New York, NY, USA
| | - Seth A Jerabek
- Adult Reconstruction and Joint Replacement Service, Hospital for Special Surgery, New York, NY, USA
| | - Peter K Sculco
- Adult Reconstruction and Joint Replacement Service, Hospital for Special Surgery, New York, NY, USA
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Jhang H, Park SJ, Sul AR, Jang HY, Park SH. Survey on Value Elements Provided by Artificial Intelligence and Their Eligibility for Insurance Coverage With an Emphasis on Patient-Centered Outcomes. Korean J Radiol 2024; 25:414-425. [PMID: 38627874 PMCID: PMC11058425 DOI: 10.3348/kjr.2023.1281] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2023] [Revised: 01/27/2024] [Accepted: 02/04/2024] [Indexed: 05/01/2024] Open
Abstract
OBJECTIVE This study aims to explore the opinions on the insurance coverage of artificial intelligence (AI), as categorized based on the distinct value elements offered by AI, with a specific focus on patient-centered outcomes (PCOs). PCOs are distinguished from traditional clinical outcomes and focus on patient-reported experiences and values such as quality of life, functionality, well-being, physical or emotional status, and convenience. MATERIALS AND METHODS We classified the value elements provided by AI into four dimensions: clinical outcomes, economic aspects, organizational aspects, and non-clinical PCOs. The survey comprised three sections: 1) experiences with PCOs in evaluating AI, 2) opinions on the coverage of AI by the National Health Insurance of the Republic of Korea when AI demonstrated benefits across the four value elements, and 3) respondent characteristics. The opinions regarding AI insurance coverage were assessed dichotomously and semi-quantitatively: non-approval (0) vs. approval (on a 1-10 weight scale, with 10 indicating the strongest approval). The survey was conducted from July 4 to 26, 2023, using a web-based method. Responses to PCOs and other value elements were compared. RESULTS Among 200 respondents, 44 (22%) were patients/patient representatives, 64 (32%) were industry/developers, 60 (30%) were medical practitioners/doctors, and 32 (16%) were government health personnel. The level of experience with PCOs regarding AI was low, with only 7% (14/200) having direct experience and 10% (20/200) having any experience (either direct or indirect). The approval rate for insurance coverage for PCOs was 74% (148/200), significantly lower than the corresponding rates for other value elements (82.5%-93.5%; P ≤ 0.034). The approval strength was significantly lower for PCOs, with a mean weight ± standard deviation of 5.1 ± 3.5, compared to other value elements (P ≤ 0.036). CONCLUSION There is currently limited demand for insurance coverage for AI that demonstrates benefits in terms of non-clinical PCOs.
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Affiliation(s)
- Hoyol Jhang
- Division of Healthcare Research, National Evidence-Based Healthcare Collaborating Agency, Seoul, Republic of Korea
| | - So Jin Park
- Division of Healthcare Research, National Evidence-Based Healthcare Collaborating Agency, Seoul, Republic of Korea
| | - Ah-Ram Sul
- Division of Healthcare Research, National Evidence-Based Healthcare Collaborating Agency, Seoul, Republic of Korea.
| | - Hye Young Jang
- Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Seong Ho Park
- Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.
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Chen J, Fan X, Chen Z, Peng Y, Liang L, Su C, Chen Y, Yao J. Enhancing YOLO5 for the Assessment of Irregular Pelvic Radiographs with Multimodal Information. JOURNAL OF IMAGING INFORMATICS IN MEDICINE 2024; 37:744-755. [PMID: 38315343 PMCID: PMC11031542 DOI: 10.1007/s10278-024-00986-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Revised: 12/09/2023] [Accepted: 12/12/2023] [Indexed: 02/07/2024]
Abstract
Developmental dysplasia of the hip (DDH) is one of the most common orthopedic disorders in infants and young children. Accurate identification and localization of anatomical landmarks are prerequisites for the diagnosis of DDH. In recent years, various works have employed deep learning algorithms on radiography images for DDH diagnosis. However, none of these works have considered the incorporation of multimodal information. The pelvis exhibits distinct structures at different developmental stages, and there are also gender-based differences. In light of this, this study proposes a method to enhance the performance of deep learning models in diagnosing DDH by incorporating age and gender information into the channels. The study utilizes YOLO5 to construct a deep learning network for detecting hip joint landmarks. Moreover, a comprehensive dataset of 7750 pelvic X-ray images is established, covering ages from 4 months to 16 years and encompassing various conditions, such as deformities and post-operative cases, which authentically capture the temporal diversity and pathological complexities of DDH. Experimental results show that the YOLO5 model with integrated multimodal information achieves a mAP0.5-0.95 of 83.1% and a diagnostic accuracy of 86.7% in test dataset. The F1 scores for diagnosing cases of normal (NM), suspected dislocation (SD), mild dislocation (MD), and heavily dislocation (HD) are 90.9%, 79.8%, 63.5%, and 97.4%, respectively. Furthermore, experiments conducted on datasets of different sizes and networks of different sizes demonstrate the beneficial impact of multimodal information in improving the effectiveness of deep learning in diagnosing DDH.
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Affiliation(s)
- Jing Chen
- School of Physics and Optoelectronic Engineering, Guangdong University of Technology, Guangzhou, 510006, Guangdong, China
| | - Xiaoyou Fan
- School of Physics and Optoelectronic Engineering, Guangdong University of Technology, Guangzhou, 510006, Guangdong, China
| | - Zhen Chen
- School of Physics and Optoelectronic Engineering, Guangdong University of Technology, Guangzhou, 510006, Guangdong, China
| | - Yichao Peng
- Department of Pediatric Orthopedics, Center for Orthopaedic Surgery, Hospital of Guangdong Province, The Third School of Clinical Medicine, Southern Medical University, The Third Affiliated Hospital of Southern Medical University, Guangzhou, 510630, Guangdong, China
- Department of Orthopedics, Academy of Orthopedics Guangdong Province, Guangdong Provincial Key Laboratory of Bone and Joint Degeneration Diseases, Guangzhou, 510630, Guangdong, China
| | - Lichong Liang
- School of Physics and Optoelectronic Engineering, Guangdong University of Technology, Guangzhou, 510006, Guangdong, China
| | - Chengyue Su
- School of Physics and Optoelectronic Engineering, Guangdong University of Technology, Guangzhou, 510006, Guangdong, China
| | - Yun Chen
- Department of Pediatric Orthopedics, Center for Orthopaedic Surgery, Hospital of Guangdong Province, The Third School of Clinical Medicine, Southern Medical University, The Third Affiliated Hospital of Southern Medical University, Guangzhou, 510630, Guangdong, China.
- School of Nursing, Southern Medical University, The Third Affiliated Hospital of Southern Medical University, Guangzhou, 510630, Guangdong, China.
| | - Jinghui Yao
- Department of Pediatric Orthopedics, Center for Orthopaedic Surgery, Hospital of Guangdong Province, The Third School of Clinical Medicine, Southern Medical University, The Third Affiliated Hospital of Southern Medical University, Guangzhou, 510630, Guangdong, China.
- Department of Orthopedics, Academy of Orthopedics Guangdong Province, Guangdong Provincial Key Laboratory of Bone and Joint Degeneration Diseases, Guangzhou, 510630, Guangdong, China.
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Kim DY, Oh HW, Suh CH. Reporting Quality of Research Studies on AI Applications in Medical Images According to the CLAIM Guidelines in a Radiology Journal With a Strong Prominence in Asia. Korean J Radiol 2023; 24:1179-1189. [PMID: 38016678 PMCID: PMC10701000 DOI: 10.3348/kjr.2023.1027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2023] [Revised: 10/25/2023] [Accepted: 10/26/2023] [Indexed: 11/30/2023] Open
Abstract
OBJECTIVE We aimed to evaluate the reporting quality of research articles that applied deep learning to medical imaging. Using the Checklist for Artificial Intelligence in Medical Imaging (CLAIM) guidelines and a journal with prominence in Asia as a sample, we intended to provide an insight into reporting quality in the Asian region and establish a journal-specific audit. MATERIALS AND METHODS A total of 38 articles published in the Korean Journal of Radiology between June 2018 and January 2023 were analyzed. The analysis included calculating the percentage of studies that adhered to each CLAIM item and identifying items that were met by ≤ 50% of the studies. The article review was initially conducted independently by two reviewers, and the consensus results were used for the final analysis. We also compared adherence rates to CLAIM before and after December 2020. RESULTS Of the 42 items in the CLAIM guidelines, 12 items (29%) were satisfied by ≤ 50% of the included articles. None of the studies reported handling missing data (item #13). Only one study respectively presented the use of de-identification methods (#12), intended sample size (#19), robustness or sensitivity analysis (#30), and full study protocol (#41). Of the studies, 35% reported the selection of data subsets (#10), 40% reported registration information (#40), and 50% measured inter and intrarater variability (#18). No significant changes were observed in the rates of adherence to these 12 items before and after December 2020. CONCLUSION The reporting quality of artificial intelligence studies according to CLAIM guidelines, in our study sample, showed room for improvement. We recommend that the authors and reviewers have a solid understanding of the relevant reporting guidelines and ensure that the essential elements are adequately reported when writing and reviewing the manuscripts for publication.
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Affiliation(s)
- Dong Yeong Kim
- Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | | | - Chong Hyun Suh
- Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.
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Jan F, Rahman A, Busaleh R, Alwarthan H, Aljaser S, Al-Towailib S, Alshammari S, Alhindi KR, Almogbil A, Bubshait DA, Ahmed MIB. Assessing Acetabular Index Angle in Infants: A Deep Learning-Based Novel Approach. J Imaging 2023; 9:242. [PMID: 37998088 PMCID: PMC10672484 DOI: 10.3390/jimaging9110242] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2023] [Revised: 10/25/2023] [Accepted: 11/02/2023] [Indexed: 11/25/2023] Open
Abstract
Developmental dysplasia of the hip (DDH) is a disorder characterized by abnormal hip development that frequently manifests in infancy and early childhood. Preventing DDH from occurring relies on a timely and accurate diagnosis, which requires careful assessment by medical specialists during early X-ray scans. However, this process can be challenging for medical personnel to achieve without proper training. To address this challenge, we propose a computational framework to detect DDH in pelvic X-ray imaging of infants that utilizes a pipelined deep learning-based technique consisting of two stages: instance segmentation and keypoint detection models to measure acetabular index angle and assess DDH affliction in the presented case. The main aim of this process is to provide an objective and unified approach to DDH diagnosis. The model achieved an average pixel error of 2.862 ± 2.392 and an error range of 2.402 ± 1.963° for the acetabular angle measurement relative to the ground truth annotation. Ultimately, the deep-learning model will be integrated into the fully developed mobile application to make it easily accessible for medical specialists to test and evaluate. This will reduce the burden on medical specialists while providing an accurate and explainable DDH diagnosis for infants, thereby increasing their chances of successful treatment and recovery.
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Affiliation(s)
- Farmanullah Jan
- Department of Computer Science, College of Computer Science and Information Technology, Imam Abdulrahman Bin Faisal University, P.O. Box 1982, Dammam 31441, Saudi Arabia (K.R.A.)
| | - Atta Rahman
- Department of Computer Science, College of Computer Science and Information Technology, Imam Abdulrahman Bin Faisal University, P.O. Box 1982, Dammam 31441, Saudi Arabia (K.R.A.)
| | - Roaa Busaleh
- Department of Computer Science, College of Computer Science and Information Technology, Imam Abdulrahman Bin Faisal University, P.O. Box 1982, Dammam 31441, Saudi Arabia (K.R.A.)
| | - Haya Alwarthan
- Department of Computer Science, College of Computer Science and Information Technology, Imam Abdulrahman Bin Faisal University, P.O. Box 1982, Dammam 31441, Saudi Arabia (K.R.A.)
| | - Samar Aljaser
- Department of Computer Science, College of Computer Science and Information Technology, Imam Abdulrahman Bin Faisal University, P.O. Box 1982, Dammam 31441, Saudi Arabia (K.R.A.)
| | - Sukainah Al-Towailib
- Department of Computer Science, College of Computer Science and Information Technology, Imam Abdulrahman Bin Faisal University, P.O. Box 1982, Dammam 31441, Saudi Arabia (K.R.A.)
| | - Safiyah Alshammari
- Department of Computer Science, College of Computer Science and Information Technology, Imam Abdulrahman Bin Faisal University, P.O. Box 1982, Dammam 31441, Saudi Arabia (K.R.A.)
| | - Khadeejah Rasheed Alhindi
- Department of Computer Science, College of Computer Science and Information Technology, Imam Abdulrahman Bin Faisal University, P.O. Box 1982, Dammam 31441, Saudi Arabia (K.R.A.)
| | - Asrar Almogbil
- Department of Computer Science, College of Computer Science and Information Technology, Imam Abdulrahman Bin Faisal University, P.O. Box 1982, Dammam 31441, Saudi Arabia (K.R.A.)
| | - Dalal A. Bubshait
- Department of Orthopedics, College of Medicine, Imam Abdulrahman Bin Faisal University, P.O. Box 1982, Dammam 31441, Saudi Arabia
| | - Mohammed Imran Basheer Ahmed
- Department of Computer Engineering, College of Computer Science and Information Technology, Imam Abdulrahman Bin Faisal University, P.O. Box 1982, Dammam 31441, Saudi Arabia
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Shen X, He Z, Shi Y, Yang Y, Luo J, Tang X, Chen B, Liu T, Xu S, Xiao J, Zhou Y, Qin Y. Automatic detection of early osteonecrosis of the femoral head from various hip pathologies using deep convolutional neural network: a multi-centre study. INTERNATIONAL ORTHOPAEDICS 2023; 47:2235-2244. [PMID: 37115222 DOI: 10.1007/s00264-023-05813-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/05/2023] [Accepted: 04/11/2023] [Indexed: 04/29/2023]
Abstract
PURPOSE The aim of this study was to develop a deep convolutional neural network (DCNN) for detecting early osteonecrosis of the femoral head (ONFH) from various hip pathologies and evaluate the feasibility of its application. METHODS We retrospectively reviewed and annotated hip magnetic resonance imaging (MRI) of ONFH patients from four participated institutions and constructed a multi-centre dataset to develop the DCNN system. The diagnostic performance of the DCNN in the internal and external test datasets was calculated, including area under the receiver operating characteristic curve (AUROC), accuracy, precision, recall, and F1 score, and gradient-weighted class activation mapping (Grad-CAM) technique was used to visualize its decision-making process. In addition, a human-machine comparison trial was performed. RESULTS Overall, 11,730 hip MRI segments from 794 participants were used to develop and optimize the DCNN system. The AUROC, accuracy, and precision of the DCNN in internal test dataset were 0.97 (95% CI, 0.93-1.00), 96.6% (95% CI: 93.0-100%), and 97.6% (95% CI: 94.6-100%), and in external test dataset, they were 0.95 (95% CI, 0.91- 0.99), 95.2% (95% CI, 91.1-99.4%), and 95.7% (95% CI, 91.7-99.7%). Compared with attending orthopaedic surgeons, the DCNN showed superior diagnostic performance. The Grad-CAM demonstrated that the DCNN placed focus on the necrotic region. CONCLUSION Compared with clinician-led diagnoses, the developed DCNN system is more accurate in diagnosing early ONFH, avoiding empirical dependence and inter-reader variability. Our findings support the integration of deep learning systems into real clinical settings to assist orthopaedic surgeons in diagnosing early ONFH.
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Affiliation(s)
- Xianyue Shen
- Department of Orthopedics, The Second Hospital of Jilin University, Changchun, Jilin Province, People's Republic of China
| | - Ziling He
- College of Computer Science and Technology, Jilin University, Changchun, Jilin Province, People's Republic of China
| | - Yi Shi
- Department of Orthopedics, The Second Affiliated Hospital of Anhui Medical University, Hefei, Anhui Province, People's Republic of China
| | - Yuhui Yang
- Department of Orthopedics, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong Province, People's Republic of China
| | - Jia Luo
- College of Computer Science and Technology, Jilin University, Changchun, Jilin Province, People's Republic of China
| | - Xiongfeng Tang
- Department of Orthopedics, The Second Hospital of Jilin University, Changchun, Jilin Province, People's Republic of China
| | - Bo Chen
- Department of Orthopedics, The Second Hospital of Jilin University, Changchun, Jilin Province, People's Republic of China
| | - Tong Liu
- Department of Orthopedics, China-Japan Union Hospital of Jilin University, Changchun, Jilin Province, People's Republic of China
| | - Shenghao Xu
- Department of Orthopedics, China-Japan Union Hospital of Jilin University, Changchun, Jilin Province, People's Republic of China
| | - Jianlin Xiao
- Department of Orthopedics, China-Japan Union Hospital of Jilin University, Changchun, Jilin Province, People's Republic of China.
| | - You Zhou
- College of Software, Jilin University, Changchun, Jilin Province, People's Republic of China.
| | - Yanguo Qin
- Department of Orthopedics, The Second Hospital of Jilin University, Changchun, Jilin Province, People's Republic of China.
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9
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Den H, Ito J, Kokaze A. Diagnostic accuracy of a deep learning model using YOLOv5 for detecting developmental dysplasia of the hip on radiography images. Sci Rep 2023; 13:6693. [PMID: 37095189 PMCID: PMC10126130 DOI: 10.1038/s41598-023-33860-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Accepted: 04/20/2023] [Indexed: 04/26/2023] Open
Abstract
Developmental dysplasia of the hip (DDH) is a cluster of hip development disorders and one of the most common hip diseases in infants. Hip radiography is a convenient diagnostic tool for DDH, but its diagnostic accuracy is dependent on the interpreter's level of experience. The aim of this study was to develop a deep learning model for detecting DDH. Patients younger than 12 months who underwent hip radiography between June 2009 and November 2021 were selected. Using their radiography images, transfer learning was performed to develop a deep learning model using the "You Only Look Once" v5 (YOLOv5) and single shot multi-box detector (SSD). A total of 305 anteroposterior hip radiography images (205 normal and 100 DDH hip images) were collected. Of these, 30 normal and 17 DDH hip images were used as the test dataset. The sensitivity and the specificity of our best YOLOv5 model (YOLOv5l) were 0.94 (95% confidence interval [CI] 0.73-1.00) and 0.96 (95% CI 0.89-0.99), respectively. This model also outperformed the SSD model. This is the first study to establish a model for detecting DDH using YOLOv5. Our deep learning model provides good diagnostic performance for DDH. We believe our model is a useful diagnostic assistant tool.
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Affiliation(s)
- Hiroki Den
- Department of Orthopaedic Surgery, National Rehabilitation Center for Children with Disabilities, 1-1-10 Komone, Itabashi-ku, Tokyo, 173-0037, Japan.
- Department of Hygiene, Public Health, and Preventative Medicine, Showa University School of Medicine, 1-5-8 Hatanodai, Shinagawa-ku, Tokyo, 142-8555, Japan.
| | - Junichi Ito
- Department of Orthopaedic Surgery, National Rehabilitation Center for Children with Disabilities, 1-1-10 Komone, Itabashi-ku, Tokyo, 173-0037, Japan
| | - Akatsuki Kokaze
- Department of Hygiene, Public Health, and Preventative Medicine, Showa University School of Medicine, 1-5-8 Hatanodai, Shinagawa-ku, Tokyo, 142-8555, Japan
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10
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Sha J, Huang L, Chen Y, Fan Z, Lin J, Yang Q, Li Y, Yan Y. Clinical thought-based software for diagnosing developmental dysplasia of the hip on pediatric pelvic radiographs. Front Pediatr 2023; 11:1080194. [PMID: 37063681 PMCID: PMC10098126 DOI: 10.3389/fped.2023.1080194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Accepted: 03/06/2023] [Indexed: 04/18/2023] Open
Abstract
Background The common methods of radiographic diagnosis of developmental dysplasia of the hip (DDH) include measuring hip parameters and quantifying the degree of hip dislocation. However, clinical thought-based analysis of hip parameters may be a more effective way to achieve expert-like diagnoses of DDH. This study aims to develop a diagnostic strategy-based software for pediatric DDH and validate its clinical feasibility. Methods In total, 543 anteroposterior pelvic radiographs were retrospectively collected from January 2017 to December 2021. Two independent clinicians measured four diagnostic indices to compare the diagnoses made by the software and conventional manual method. The diagnostic accuracy was evaluated using the receiver operator characteristic (ROC) curves and confusion matrix, and the consistency of parametric measurements was assessed using Bland-Altman plots. Results In 543 cases (1,086 hips), the area under the curve, accuracy, sensitivity, and specificity of the software for diagnosing DDH were 0.988-0.994, 99.08%-99.72%, 98.07%-100.00%, and 99.59%, respectively. Compared with the expert panel, the Bland-Altman 95% limits of agreement for the acetabular index, as determined by the software, were -2.09°-2.91° (junior orthopedist) and -1.98°-2.72° (intermediate orthopedist). As for the lateral center-edge angle, the 95% limits were -3.68°-5.28° (junior orthopedist) and -2.94°-4.59° (intermediate orthopedist). Conclusions The software can provide expert-like analysis of pelvic radiographs and obtain the radiographic diagnosis of pediatric DDH with great consistency and efficiency. Its initial success lays the groundwork for developing a full-intelligent comprehensive diagnostic system of DDH.
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Affiliation(s)
- Jia Sha
- Department of Orthopedics, Xijing Hospital, Air Force Military Medical University, Xi’an, China
| | - Luyu Huang
- Department of Orthopedics, Xijing Hospital, Air Force Military Medical University, Xi’an, China
| | - Yaopeng Chen
- School of Telecommunications Engineering, Xidian University, Xi’an, China
- Guangzhou Institute, Xidian University, Xi’an, China
| | - Zongzhi Fan
- Department of Orthopedics, Xijing Hospital, Air Force Military Medical University, Xi’an, China
| | - Jincong Lin
- Department of Orthopedics, Xijing Hospital, Air Force Military Medical University, Xi’an, China
| | - Qinghai Yang
- School of Telecommunications Engineering, Xidian University, Xi’an, China
| | - Yi Li
- School of Telecommunications Engineering, Xidian University, Xi’an, China
- Correspondence: Yabo Yan Yi Li
| | - Yabo Yan
- Department of Orthopedics, Xijing Hospital, Air Force Military Medical University, Xi’an, China
- Correspondence: Yabo Yan Yi Li
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11
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Nam Y, Choi Y, Kang J, Seo M, Heo SJ, Lee MK. Diagnosis of nasal bone fractures on plain radiographs via convolutional neural networks. Sci Rep 2022; 12:21510. [PMID: 36513751 PMCID: PMC9747951 DOI: 10.1038/s41598-022-26161-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Accepted: 12/12/2022] [Indexed: 12/14/2022] Open
Abstract
This study aimed to assess the performance of deep learning (DL) algorithms in the diagnosis of nasal bone fractures on radiographs and compare it with that of experienced radiologists. In this retrospective study, 6713 patients whose nasal radiographs were examined for suspected nasal bone fractures between January 2009 and October 2020 were assessed. Our dataset was randomly split into training (n = 4325), validation (n = 481), and internal test (n = 1250) sets; a separate external dataset (n = 102) was used. The area under the receiver operating characteristic curve (AUC), sensitivity, and specificity of the DL algorithm and the two radiologists were compared. The AUCs of the DL algorithm for the internal and external test sets were 0.85 (95% CI, 0.83-0.86) and 0.86 (95% CI, 0.78-0.93), respectively, and those of the two radiologists for the external test set were 0.80 (95% CI, 0.73-0.87) and 0.75 (95% CI, 0.68-0.82). The DL algorithm therefore significantly exceeded radiologist 2 (P = 0.021) but did not significantly differ from radiologist 1 (P = 0.142). The sensitivity and specificity of the DL algorithm were 83.1% (95% CI, 71.2-93.2%) and 83.7% (95% CI, 69.8-93.0%), respectively. Our DL algorithm performs comparably to experienced radiologists in diagnosing nasal bone fractures on radiographs.
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Affiliation(s)
- Yoonho Nam
- grid.440932.80000 0001 2375 5180Division of Biomedical Engineering, Hankuk University of Foreign Studies, Yongin-si, Gyeonggi‐do Republic of Korea
| | - Yangsean Choi
- grid.411947.e0000 0004 0470 4224Department of Radiology, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Junghwa Kang
- grid.440932.80000 0001 2375 5180Division of Biomedical Engineering, Hankuk University of Foreign Studies, Yongin-si, Gyeonggi‐do Republic of Korea
| | - Minkook Seo
- grid.411947.e0000 0004 0470 4224Department of Radiology, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Soo Jin Heo
- grid.411947.e0000 0004 0470 4224Department of Radiology, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Min Kyoung Lee
- grid.411947.e0000 0004 0470 4224Department of Radiology, Yeouido St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
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12
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Kim DH, Chai JW, Kang JH, Lee JH, Kim HJ, Seo J, Choi JW. Ensemble deep learning model for predicting anterior cruciate ligament tear from lateral knee radiograph. Skeletal Radiol 2022; 51:2269-2279. [PMID: 35792956 DOI: 10.1007/s00256-022-04081-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Revised: 05/24/2022] [Accepted: 05/24/2022] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To develop an ensemble deep learning model (DLM) predicting anterior cruciate ligament (ACL) tears from lateral knee radiographs and to evaluate its diagnostic performance. MATERIALS AND METHODS In this study, 1433 lateral knee radiographs (661 with ACL tear confirmed on MRI, 772 normal) from two medical centers were split into training (n = 1146) and test sets (n = 287). Three single DLMs respectively classifying radiographs with ACL tears, abnormal lateral femoral notches, and joint effusion were developed. An ensemble DLM predicting ACL tears was developed by combining the three DLMs via stacking method. The sensitivities, specificities, and area under the receiver operating characteristic curves (AUCs) of the DLMs and three radiologists were compared using McNemar test and Delong test. Subgroup analysis was performed to identify the radiologic features associated with the sensitivity. RESULTS The sensitivity, specificity, and AUC of the ensemble DLM were 86.8% (95% confidence interval [CI], 79.9-92.0%), 89.4% (95% CI, 83.4-93.8%), and 0.927 (95% CI, 0.891-0.954), achieving diagnostic performance comparable with that of a musculoskeletal radiologist (P = 0.193, McNemar test; P = 0.131, Delong test). The AUC of the ensemble DLM was significantly higher than those of non-musculoskeletal radiologists (P = 0.043, P < 0.001). The sensitivity of the DLM was higher than that of the radiologists in the absence of an abnormal lateral femoral notch or joint effusion. CONCLUSION The diagnostic performance of the ensemble DLM in predicting lateral knee radiographs with ACL tears was comparable to that of a musculoskeletal radiologist.
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Affiliation(s)
- Dong Hyun Kim
- Department of Radiology, SMG-SNU Boramae Medical Center, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Jee Won Chai
- Department of Radiology, SMG-SNU Boramae Medical Center, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Ji Hee Kang
- Department of Radiology, Konkuk University Medical Center, 120-1 Neungdong-ro, Gwangjin-gu, Seoul, 05030, Republic of Korea.
| | - Ji Hyun Lee
- Department of Radiology, SMG-SNU Boramae Medical Center, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Hyo Jin Kim
- Department of Radiology, SMG-SNU Boramae Medical Center, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Jiwoon Seo
- Department of Radiology, SMG-SNU Boramae Medical Center, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Jae Won Choi
- Armed Forces Yangju Hospital, Yangju, Republic of Korea.,Department of Radiology, Seoul National University Hospital, Seoul, Republic of Korea
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13
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Jensen J, Graumann O, Overgaard S, Gerke O, Lundemann M, Haubro MH, Varnum C, Bak L, Rasmussen J, Olsen LB, Rasmussen BSB. A Deep Learning Algorithm for Radiographic Measurements of the Hip in Adults-A Reliability and Agreement Study. Diagnostics (Basel) 2022; 12:2597. [PMID: 36359441 PMCID: PMC9689405 DOI: 10.3390/diagnostics12112597] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Revised: 10/22/2022] [Accepted: 10/24/2022] [Indexed: 08/04/2023] Open
Abstract
Hip dysplasia (HD) is a frequent cause of hip pain in skeletally mature patients and may lead to osteoarthritis (OA). An accurate and early diagnosis may postpone, reduce or even prevent the onset of OA and ultimately hip arthroplasty at a young age. The overall aim of this study was to assess the reliability of an algorithm, designed to read pelvic anterior-posterior (AP) radiographs and to estimate the agreement between the algorithm and human readers for measuring (i) lateral center edge angle of Wiberg (LCEA) and (ii) Acetabular index angle (AIA). The algorithm was based on deep-learning models developed using a modified U-net architecture and ResNet 34. The newly developed algorithm was found to be highly reliable when identifying the anatomical landmarks used for measuring LCEA and AIA in pelvic radiographs, thus offering highly consistent measurement outputs. The study showed that manual identification of the same landmarks made by five specialist readers were subject to variance and the level of agreement between the algorithm and human readers was consequently poor with mean measured differences from 0.37 to 9.56° for right LCEA measurements. The algorithm displayed the highest agreement with the senior orthopedic surgeon. With further development, the algorithm may be a good alternative to humans when screening for HD.
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Affiliation(s)
- Janni Jensen
- Department of Radiology, Odense University Hospital, 5000 Odense, Denmark
- Research and Innovation Unit of Radiology, University of Southern Denmark, 5230 Odense, Denmark
- Open Patient Data Explorative Network, OPEN, Odense University Hospital, 5000 Odense, Denmark
| | - Ole Graumann
- Department of Radiology, Odense University Hospital, 5000 Odense, Denmark
- Research and Innovation Unit of Radiology, University of Southern Denmark, 5230 Odense, Denmark
| | - Søren Overgaard
- Department of Orthopaedic Surgery and Traumatology, Copenhagen University Hospital, Bispebjerg, 2100 Copenhagen, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, 1165 Copenhagen, Denmark
| | - Oke Gerke
- Department of Clinical Research, University of Southern Denmark, 5230 Odense, Denmark
- Department of Nuclear Medicine, Odense University Hospital, 5000 Odense, Denmark
| | | | - Martin Haagen Haubro
- Department of Orthopedic Surgery and Traumatology, Odense University Hospital, 5000 Odense, Denmark
| | - Claus Varnum
- Department of Orthopedic Surgery and Traumatology, Odense University Hospital, 5000 Odense, Denmark
- Department of Orthopedic Surgery, Lillebaelt Hospital—Vejle, University Hospital of Southern Denmark, 7100 Vejle, Denmark
- Department of Regional Health Research, University of Southern Denmark, 5230 Odense, Denmark
| | - Lene Bak
- Department of Radiology, Odense University Hospital, 5000 Odense, Denmark
| | - Janne Rasmussen
- Department of Radiology, Odense University Hospital, 5700 Svendborg, Denmark
| | - Lone B. Olsen
- Department of Radiology, Odense University Hospital, 5000 Odense, Denmark
| | - Benjamin S. B. Rasmussen
- Department of Radiology, Odense University Hospital, 5000 Odense, Denmark
- Research and Innovation Unit of Radiology, University of Southern Denmark, 5230 Odense, Denmark
- Department of Radiology, Odense University Hospital, 5700 Svendborg, Denmark
- CAI-X (Centre for Clinical Artificial Intelligence), Odense University Hospital, University of Southern Denmark, 5230 Odense, Denmark
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14
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Meshaka R, Pinto Dos Santos D, Arthurs OJ, Sebire NJ, Shelmerdine SC. Artificial intelligence reporting guidelines: what the pediatric radiologist needs to know. Pediatr Radiol 2022; 52:2101-2110. [PMID: 34196729 DOI: 10.1007/s00247-021-05129-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Revised: 05/06/2021] [Accepted: 06/10/2021] [Indexed: 11/28/2022]
Abstract
There has been an exponential rise in artificial intelligence (AI) research in imaging in recent years. While the dissemination of study data that has the potential to improve clinical practice is welcomed, the level of detail included in early AI research reporting has been highly variable and inconsistent, particularly when compared to more traditional clinical research. However, inclusion checklists are now commonly available and accessible to those writing or reviewing clinical research papers. AI-specific reporting guidelines also exist and include distinct requirements, but these can be daunting for radiologists new to the field. Given that pediatric radiology is a specialty faced with workforce shortages and an ever-increasing workload, AI could help by offering solutions to time-consuming tasks, thereby improving workflow efficiency and democratizing access to specialist opinion. As a result, pediatric radiologists are expected to be increasingly leading and contributing to AI imaging research, and researchers and clinicians alike should feel confident that the findings reported are presented in a transparent way, with sufficient detail to understand how they apply to wider clinical practice. In this review, we describe two of the most clinically relevant and available reporting guidelines to help increase awareness and engage the pediatric radiologist in conducting AI imaging research. This guide should also be useful for those reading and reviewing AI imaging research and as a checklist with examples of what to expect.
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Affiliation(s)
- Riwa Meshaka
- Department of Clinical Radiology, Great Ormond Street Hospital for Children, London, WC1N 3JH, UK.,UCL Great Ormond Street Institute of Child Health, Great Ormond Street Hospital for Children, London, UK.,Great Ormond Street Hospital NIHR Biomedical Research Centre, London, UK
| | | | - Owen J Arthurs
- Department of Clinical Radiology, Great Ormond Street Hospital for Children, London, WC1N 3JH, UK.,UCL Great Ormond Street Institute of Child Health, Great Ormond Street Hospital for Children, London, UK.,Great Ormond Street Hospital NIHR Biomedical Research Centre, London, UK
| | - Neil J Sebire
- UCL Great Ormond Street Institute of Child Health, Great Ormond Street Hospital for Children, London, UK.,Great Ormond Street Hospital NIHR Biomedical Research Centre, London, UK.,Department of Pathology, Great Ormond Street Hospital for Children, London, UK
| | - Susan C Shelmerdine
- Department of Clinical Radiology, Great Ormond Street Hospital for Children, London, WC1N 3JH, UK. .,UCL Great Ormond Street Institute of Child Health, Great Ormond Street Hospital for Children, London, UK. .,Great Ormond Street Hospital NIHR Biomedical Research Centre, London, UK. .,Department of Clinical Radiology, St. George's Hospital, London, UK.
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15
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Bekkouch IEI, Maksudov B, Kiselev S, Mustafaev T, Vrtovec T, Ibragimov B. Multi-landmark environment analysis with reinforcement learning for pelvic abnormality detection and quantification. Med Image Anal 2022; 78:102417. [PMID: 35325712 DOI: 10.1016/j.media.2022.102417] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Revised: 01/14/2022] [Accepted: 03/03/2022] [Indexed: 12/22/2022]
Abstract
Morphological abnormalities of the femoroacetabular (hip) joint are among the most common human musculoskeletal disorders and often develop asymptomatically at early easily treatable stages. In this paper, we propose an automated framework for landmark-based detection and quantification of hip abnormalities from magnetic resonance (MR) images. The framework relies on a novel idea of multi-landmark environment analysis with reinforcement learning. In particular, we merge the concepts of the graphical lasso and Morris sensitivity analysis with deep neural networks to quantitatively estimate the contribution of individual landmark and landmark subgroup locations to the other landmark locations. Convolutional neural networks for image segmentation are utilized to propose the initial landmark locations, and landmark detection is then formulated as a reinforcement learning (RL) problem, where each landmark-agent can adjust its position by observing the local MR image neighborhood and the locations of the most-contributive landmarks. The framework was validated on T1-, T2- and proton density-weighted MR images of 260 patients with the aim to measure the lateral center-edge angle (LCEA), femoral neck-shaft angle (NSA), and the anterior and posterior acetabular sector angles (AASA and PASA) of the hip, and derive the quantitative abnormality metrics from these angles. The framework was successfully tested using the UNet and feature pyramid network (FPN) segmentation architectures for landmark proposal generation, and the deep Q-network (DeepQN), deep deterministic policy gradient (DDPG), twin delayed deep deterministic policy gradient (TD3), and actor-critic policy gradient (A2C) RL networks for landmark position optimization. The resulting overall landmark detection error of 1.5 mm and angle measurement error of 1.4° indicates a superior performance in comparison to existing methods. Moreover, the automatically estimated abnormality labels were in 95% agreement with those generated by an expert radiologist.
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Affiliation(s)
- Imad Eddine Ibrahim Bekkouch
- Sorbonne Center for Artificial Intelligence, Sorbonne University, Paris, France; Institute of Data Science and Artificial Intelligence, Innopolis University, Innopolis, Russia
| | - Bulat Maksudov
- Institute of Data Science and Artificial Intelligence, Innopolis University, Innopolis, Russia; Department of Computer Science, University College Dublin, Dublin, Ireland
| | - Semen Kiselev
- Institute of Data Science and Artificial Intelligence, Innopolis University, Innopolis, Russia
| | - Tamerlan Mustafaev
- Institute of Data Science and Artificial Intelligence, Innopolis University, Innopolis, Russia; Public Hospital #2, Department of Radiology, Kazan, Russia
| | - Tomaž Vrtovec
- Faculty of Electrical Engineering, University of Ljubljana, Ljubljana, Slovenia
| | - Bulat Ibragimov
- Faculty of Electrical Engineering, University of Ljubljana, Ljubljana, Slovenia; Department of Computer Science, University of Copenhagen, Copenhagen, Denmark.
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16
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Xu W, Shu L, Gong P, Huang C, Xu J, Zhao J, Shu Q, Zhu M, Qi G, Zhao G, Yu G. A Deep-Learning Aided Diagnostic System in Assessing Developmental Dysplasia of the Hip on Pediatric Pelvic Radiographs. Front Pediatr 2022; 9:785480. [PMID: 35356707 PMCID: PMC8959123 DOI: 10.3389/fped.2021.785480] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Accepted: 12/31/2021] [Indexed: 11/13/2022] Open
Abstract
Background Developmental dysplasia of the hip (DDH) is a common orthopedic disease in children. In clinical surgery, it is essential to quickly and accurately locate the exact position of the lesion, and there are still some controversies relating to DDH status. We adopt artificial intelligence (AI) to solve the above problems. Methods In this paper, automatic DDH measurements and classifications were achieved using a three-stage pipeline. In the first stage, we used Mask-RCNN to detect the local features of the image and segment the bony pelvis, including the ilium, pubis, ischium, and femoral heads. For the second stage, local image patches focused on semantically related areas for DDH landmarks were extracted by high-resolution network (HRNet). In the third stage, some radiographic results are obtained. In the above process, we used 1,265 patient x-ray samples as the training set and 133 samples from two other medical institutions as the verification set. The results of AI were compared with three orthopedic surgeons for reliability and time consumption. Results AI-aided diagnostic system's Tönnis and International Hip Dysplasia Institute (IHDI) classification accuracies for both hips ranged from 0.86 to 0.95. The measurements of numerical indices showed that there was no statistically significant difference between surgeons and AI. Tönnis and IHDI indicators were similar across the AI system, intermediate surgeon, and junior surgeon. Among some objective interpretation indicators, such as acetabular index and CE angle, there were good stability and consistency among the four observers. Intraclass consistency of acetabular index and CE angle among surgeons was 0.79-0.98, while AI was 1.00. The measurement time required by AI was significantly less than that of the doctors. Conclusion The AI-aided diagnosis system can quickly and automatically measure important parameters and improve the quality of clinical diagnosis and screening referral process with a convenient and efficient way.
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Affiliation(s)
- Weize Xu
- The Children's Hospital, Zhejiang University School of Medicine, Hangzhou, China
- National Clinical Research Center for Child Health, Hangzhou, China
- Department of Orthopedics, The Children's Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Liqi Shu
- Department of Neurology, The Warren Alpert Medical School of Brown University, Providence, RI, United States
| | - Ping Gong
- Deepwise AI Lab, Beijing Deepwise & League of PHD Technology Co., Ltd., Beijing, China
| | - Chencui Huang
- Deepwise AI Lab, Beijing Deepwise & League of PHD Technology Co., Ltd., Beijing, China
| | - Jingxu Xu
- Deepwise AI Lab, Beijing Deepwise & League of PHD Technology Co., Ltd., Beijing, China
| | - Jingjiao Zhao
- Deepwise AI Lab, Beijing Deepwise & League of PHD Technology Co., Ltd., Beijing, China
| | - Qiang Shu
- The Children's Hospital, Zhejiang University School of Medicine, Hangzhou, China
- National Clinical Research Center for Child Health, Hangzhou, China
- Sino-Finland Joint AI Laboratory for Child Health of Zhejiang Province, Beijing, China
| | - Ming Zhu
- The Children's Hospital, Zhejiang University School of Medicine, Hangzhou, China
- National Clinical Research Center for Child Health, Hangzhou, China
- Department of Orthopedics, The Children's Hospital, Zhejiang University School of Medicine, Hangzhou, China
- Sino-Finland Joint AI Laboratory for Child Health of Zhejiang Province, Beijing, China
| | - Guoqiang Qi
- The Children's Hospital, Zhejiang University School of Medicine, Hangzhou, China
- National Clinical Research Center for Child Health, Hangzhou, China
- Sino-Finland Joint AI Laboratory for Child Health of Zhejiang Province, Beijing, China
| | - Guoqiang Zhao
- The Children's Hospital, Zhejiang University School of Medicine, Hangzhou, China
- National Clinical Research Center for Child Health, Hangzhou, China
- Department of Orthopedics, The Children's Hospital, Zhejiang University School of Medicine, Hangzhou, China
- Sino-Finland Joint AI Laboratory for Child Health of Zhejiang Province, Beijing, China
| | - Gang Yu
- The Children's Hospital, Zhejiang University School of Medicine, Hangzhou, China
- National Clinical Research Center for Child Health, Hangzhou, China
- Sino-Finland Joint AI Laboratory for Child Health of Zhejiang Province, Beijing, China
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