School of Information Science and Engineering, East China University of Science and Technology, Shanghai, 200237, China.
Int J Comput Assist Radiol Surg. 2020 Mar;15(3):457-466. doi: 10.1007/s11548-019-02096-9. Epub 2020 Jan 14.
Knee osteoarthritis (OA) is a common disease that impairs knee function and causes pain. Radiologists usually review knee X-ray images and grade the severity of the impairments according to the Kellgren-Lawrence grading scheme. However, this approach becomes inefficient in hospitals with high throughput as it is time-consuming, tedious and also subjective. This paper introduces a model for automatic diagnosis of knee OA based on an end-to-end deep learning method.
In order to process the input images with location and classification simultaneously, we use Faster R-CNN as baseline, which consists of region proposal network (RPN) and Fast R-CNN. The RPN is trained to generate region proposals, which contain knee joint and then be used by Fast R-CNN for classification. Due to the localized classification via CNNs, the useless information in X-ray images can be filtered and we can extract clinically relevant features. For the further improvement in the model's performance, we use a novel loss function whose weighting scheme allows us to address the class imbalance. Besides, larger anchors are used to overcome the problem that anchors don't match the object when increasing the input size of X-ray images.
The performance of the proposed model is thoroughly assessed using various measures. The results show that our adjusted model outperforms the Faster R-CNN, achieving a mean average precision nearly 0.82 with a sensitivity above 78% and a specificity above 94%. It takes 0.33 s to test each image, which achieves a better trade-off between accuracy and speed.
The proposed end-to-end fully automatic model which is computationally efficient has the potential to achieve the real automatic diagnosis of knee OA and be used as computer-aided diagnosis tools in clinical applications.
膝骨关节炎(OA)是一种常见的疾病,会损害膝关节功能并引起疼痛。放射科医生通常会查看膝关节 X 光图像,并根据 Kellgren-Lawrence 分级方案对损伤的严重程度进行分级。然而,在高吞吐量的医院中,这种方法效率低下,因为它既耗时、乏味,又具有主观性。本文介绍了一种基于端到端深度学习方法的自动诊断膝骨关节炎的模型。
为了同时处理输入图像的位置和分类,我们使用 Faster R-CNN 作为基线,它由区域提议网络(RPN)和 Fast R-CNN 组成。RPN 用于生成包含膝关节的区域提议,然后由 Fast R-CNN 进行分类。由于通过 CNN 进行局部分类,X 光图像中的无用信息可以被过滤掉,我们可以提取临床相关的特征。为了进一步提高模型的性能,我们使用了一种新的损失函数,其加权方案允许我们解决类别不平衡的问题。此外,更大的锚点用于解决增加 X 光图像输入尺寸时锚点与物体不匹配的问题。
使用各种指标对所提出的模型的性能进行了全面评估。结果表明,我们调整后的模型优于 Faster R-CNN,其平均精度接近 0.82,灵敏度高于 78%,特异性高于 94%。测试每张图像需要 0.33 秒,在准确性和速度之间实现了更好的权衡。
提出的端到端全自动模型计算效率高,具有实现膝骨关节炎的真正自动诊断的潜力,并可作为临床应用中的计算机辅助诊断工具。