Learning From Highly Confident Samples for Automatic Knee Osteoarthritis Severity Assessment: Data From the Osteoarthritis Initiative.

Knee osteoarthritis (OA) is a chronic disease that considerably reduces patients' quality of life. Preventive therapies require early detection and lifetime monitoring of OA progression. In the clinical environment, the severity of OA is classified by the Kellgren and Lawrence (KL) grading system, ranging from KL-0 to KL-4. Recently, deep learning methods were applied to OA severity assessment to improve accuracy and efficiency. However, this task is still challenging due to the ambiguity between adjacent grades, especially in early-stage OA. Low confident samples, which are less representative than the typical ones, undermine the training process. Targeting the uncertainty in the OA dataset, we propose a novel learning scheme that dynamically separates the data into two sets according to their reliability. Besides, we design a hybrid loss function to help CNN learn from the two sets accordingly. With the proposed approach, we emphasize the typical samples and control the impacts of low confident cases. Experiments are conducted in a five-fold manner on five-class task and early-stage OA task. Our method achieves a mean accuracy of 70.13% on the five-class OA assessment task, which outperforms all other state-of-art methods. Despite early-stage OA detection still benefiting from the human intervention of lesion region selection, our approach achieves superior performance on the KL-0 vs. KL-2 task. Moreover, we design an experiment to validate large-scale automatic data refining during training. The result verifies the ability to characterize low confidence samples. The dataset used in this paper was obtained from the Osteoarthritis Initiative.