Kaddioui Houda, Duong Luc, Joncas Julie, Bellefleur Christian, Nahle Imad, Chémaly Olivier, Nault Marie-Lyne, Parent Stefan, Grimard Guy, Labelle Hubert
Department of Software and IT Engineering, Ecole de Technologie Supérieure, 1100 rue Notre-Dame Ouest, Montréal, QC, Canada H3C 1K3 (H.K., L.D.); Division of Orthopedics, Sainte-Justine Hospital, Montréal, Canada (J.J., C.B., I.N., O.C., S.P., G.G., H.L.); and Department of Surgery, Université de Montréal, Montréal, Canada (M.L.N., S.P., G.G., H.L.).
Radiol Artif Intell. 2020 May 27;2(3):e180063. doi: 10.1148/ryai.2020180063. eCollection 2020 May.
To develop an automatic method for the assessment of the Risser stage using deep learning that could be used in the management panel of adolescent idiopathic scoliosis (AIS).
In this institutional review board approved-study, a total of 1830 posteroanterior radiographs of patients with AIS (age range, 10-18 years, 70% female) were collected retrospectively and graded manually by six trained readers using the United States Risser staging system. Each radiograph was preprocessed and cropped to include the entire pelvic region. A convolutional neural network was trained to automatically grade conventional radiographs according to the Risser classification. The network was then validated by comparing its accuracy against the interobserver variability of six trained graders from the authors' institution using the Fleiss κ statistical measure.
Overall agreement between the six observers was fair, with a κ coefficient of 0.65 for the experienced graders and agreement of 74.5%. The automatic grading method obtained a κ coefficient of 0.72, which is a substantial agreement with the ground truth, and an overall accuracy of 78.0%.
The high accuracy of the model presented here compared with human readers suggests that this work may provide a new method for standardization of Risser grading. The model could assist physicians with the task, as well as provide additional insights in the assessment of bone maturity based on radiographs.© RSNA, 2020.
开发一种使用深度学习评估Risser分期的自动方法,该方法可用于青少年特发性脊柱侧凸(AIS)的管理面板。
在这项经机构审查委员会批准的研究中,回顾性收集了1830例AIS患者(年龄范围10 - 18岁,70%为女性)的后前位X线片,并由6名经过培训的阅片者使用美国Risser分期系统进行人工分级。每张X线片都经过预处理并裁剪以包括整个骨盆区域。训练了一个卷积神经网络,以根据Risser分类自动对传统X线片进行分级。然后,通过使用Fleiss κ统计量将其准确性与作者所在机构的6名训练有素的分级者之间的观察者间变异性进行比较,对该网络进行验证。
6名观察者之间的总体一致性一般,经验丰富的分级者的κ系数为0.65,一致性为74.5%。自动分级方法获得的κ系数为0.72,与真实情况高度一致,总体准确率为78.0%。
与人类阅片者相比,本文提出的模型具有较高的准确性,这表明这项工作可能为Risser分级的标准化提供一种新方法。该模型可以协助医生完成这项任务,并在基于X线片评估骨成熟度方面提供额外的见解。© RSNA,2020。