Automatic multi-class intertrochanteric femur fracture detection from CT images based on AO/OTA classification using faster R-CNN-BO method.

Intertrochanteric (IT) femur fractures are the most common fractures in elderly people, and they lead to significant morbidity, mortality, and reduced quality of life. The different types of fractures require a careful definition to ensure accurate surgical planning and reduce the operation time, healing time, and number of surgical failures. In this study, a deep learning-based automatic multi-class IT fracture detection model was developed using computed tomography (CT) images and based on the AO/OTA classification method. The original CT image was resized and rearranged according to the fracture location and an unsharp masking filter was applied. A multi-class classification of nine different types of IT fractures and no fracture was performed using the faster regional-convolutional neural network (R-CNN). Bayesian optimization was also implemented to determine the optimal hyperparameter values for the faster R-CNN algorithm. In our proposed model, IT fractures classified into two classes showed an average accuracy of 0.97 ± 0.02, which was 0.90 ± 0.02 when classified into ten classes. Additionally, the detected region of interest from our proposed model showed minimum root mean square error and intersection over union values of 16.34 ± 47.01 pixels and 0.87 ± 0.12, respectively. In the future, our proposed automatic multi-class IT femur fracture detection model could allow clinicians to identify the fracture region and diagnose different types of femur fractures faster and more accurately. This will increase the probability of correct surgical treatment and minimize postoperative complications.