Department of Textile and Fibre Engineering, Indian Institute of Technology Delhi, New Delhi, India.
Department of Orthopaedics, Indraprastha Apollo Hospital, New Delhi, India.
Tissue Eng Part A. 2024 Oct;30(19-20):591-604. doi: 10.1089/ten.TEA.2023.0206. Epub 2023 Dec 15.
Manual grading of cartilage histology images for investigating the extent and severity of osteoarthritis (OA) involves critical examination of the cell characteristics, which makes this task tiresome, tedious, and error prone. This results in wide interobserver variation, causing ambiguities in OA grade prediction. Such drawbacks of manual assessment can be overcome by implementing artificial intelligence-based automated image classification techniques such as deep learning (DL). Hence, we present the feasibility of training a deep neural network with cartilage histology images, which can grade the extent and severity of knee OA based on modified Mankin scoring system. The grading system used here for automating OA grading was simplified and modified based on the microscopic observations from the histology images, where three parameters (Safranin-O staining intensity, chondrocyte distribution and arrangement, and morphology) were considered for evaluating the OA progression. The histology images were tiled, labeled, and grouped together based on the developed grading system (Grade 0-3). Four different DL architectures were tried for image classification and the best performing model was selected by fivefold validation method. With a validation accuracy of ∼84%, 0.632 Cohen's kappa score, and an excellent receiver operating characteristic (ROC)-area under the ROC curve ranging between 0.89 and 0.99, DenseNet121 was selected among the four models as the best performing model, and was used for inferencing on new data. Final grades obtained from the models were in accordance with the grades provided by the medical experts. We hereby demonstrate that a DL architecture can be taught to interpret the degree of cartilage degradation, with excellent discriminatory ability across all four classes of OA severity. Unlike other works where radiographic images have been considered for grading of OA, we have considered histology images, which is a fundamental approach for grading OA extent and severity. This would bring a paradigm shift in histology-based assessment of OA, making this automated approach to be explored as an option for OA grading standardization. Ethical approval number-IAH-BMR-018/10-19.
手动评估软骨组织学图像来评估骨关节炎(OA)的程度和严重程度,需要对细胞特征进行仔细检查,这使得该任务既繁琐又乏味,并且容易出错。这导致了观察者之间的广泛差异,使得 OA 分级预测存在歧义。这种手动评估的缺点可以通过实施基于人工智能的自动图像分类技术(如深度学习(DL))来克服。因此,我们提出了使用软骨组织学图像训练深度神经网络的可行性,该网络可以根据改良的 Mankin 评分系统对膝关节 OA 的程度和严重程度进行分级。这里用于自动化 OA 分级的分级系统是简化和修改的,基于组织学图像中的微观观察,其中考虑了三个参数(番红 O 染色强度、软骨细胞分布和排列以及形态)来评估 OA 进展。组织学图像根据开发的分级系统(0-3 级)进行平铺、标记和分组。尝试了四种不同的 DL 架构进行图像分类,并通过五重验证方法选择表现最佳的模型。通过验证准确性约为 84%、0.632 Cohen 的kappa 评分和出色的接收器工作特性(ROC)-ROC 曲线下面积在 0.89 到 0.99 之间,DenseNet121 被选为四种模型中表现最佳的模型,并用于对新数据进行推断。模型得出的最终等级与医学专家提供的等级相符。我们证明了可以教导 DL 架构来解释软骨降解的程度,并且在所有四个 OA 严重程度类别中都具有出色的区分能力。与其他考虑用于 OA 分级的放射图像的工作不同,我们考虑了组织学图像,这是分级 OA 程度和严重程度的基本方法。这将使基于组织学的 OA 评估发生范式转变,使这种自动化方法成为 OA 分级标准化的一种选择。伦理批准编号-IAB-BMR-018/10-19。
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