Predicting knee osteoarthritis severity: comparative modeling based on patient's data and plain X-ray images
Insight Centre for Data Analytics（洞察数据分析中心）；National University of Ireland Galway（爱尔兰国立高威大学）；Dublin City University（都柏林城市大学）；School of Health and Human Performance（健康与人类表现学院）；ZB MED – Information Centre for Life Sciences（ZB MED——生命科学信息中心）；University of Cologne（科隆大学）；School of Mathematics, Statistics and Applied Mathematics（数学、统计与应用数学学院）
Jaynal Abedin, Joseph Antony, Kevin McGuinness, Kieran Moran, Noel E O'Connor, Dietrich Rebholz-Schuhmann, John Newell
Knee osteoarthritis (KOA) is a disease that impairs knee function and causes pain. A radiologist reviews knee X-ray images and grades the severity level of the impairments according to the Kellgren and Lawrence grading scheme; a five-point ordinal scale (0--4). In this study, we used Elastic Net (EN) and Random Forests (RF) to build predictive models using patient assessment data (i.e. signs and symptoms of both knees and medication use) and a convolution neural network (CNN) trained using X-ray images only. Linear mixed effect models (LMM) were used to model the within subject correlation between the two knees. The root mean squared error for the CNN, EN, and RF models was 0.77, 0.97, and 0.94 respectively. The LMM shows similar overall prediction accuracy as the EN regression but correctly accounted for the hierarchical structure of the data resulting in more reliable inference. Useful explanatory variables were identified that could be used for patient monitoring before X-ray imaging. Our analyses suggest that the models trained for predicting the KOA severity levels achieve comparable results when modeling X-ray images and patient data. The subjectivity in the KL grade is still a primary concern.
University of Oulu（奥卢大学）；Oulu University Hospital（奥卢大学医院）
Knee osteoarthritis (OA) is the most common musculoskeletal disease in the world. In primary healthcare, knee OA is diagnosed using clinical examination and radiographic assessment. Osteoarthritis Research Society International (OARSI) atlas of OA radiographic features allows to perform independent assessment of knee osteophytes, joint space narrowing and other knee features. This provides a fine-grained OA severity assessment of the knee, compared to the gold standard and most commonly used Kellgren-Lawrence (KL) composite score. However, both OARSI and KL grading systems suffer from moderate…
University of Oulu（奥卢大学）；Oulu University Hospital（奥卢大学医院）；Medical Research Center, University of Oulu and Oulu University Hospital（奥卢大学与奥卢大学医院医学研究中心）
Knee osteoarthritis (OA) is very common progressive and degenerative musculoskeletal disease worldwide creates a heavy burden on patients with reduced quality of life and also on society due to financial impact. Therefore, any attempt to reduce the burden of the disease could help both patients and society. In this study, we propose a fully automated novel method, based on combination of joint shape and convolutional neural network (CNN) based bone texture features, to distinguish between the knee radiographs with and without radiographic osteoarthritis. Moreover, we report the first attempt a…
The severity of knee osteoarthritis is graded using the 5-point Kellgren-Lawrence (KL) scale where healthy knees are assigned grade 0, and the subsequent grades 1-4 represent increasing severity of the affliction. Although several methods have been proposed in recent years to develop models that can automatically predict the KL grade from a given radiograph, most models have been developed and evaluated on datasets not sourced from India. These models fail to perform well on the radiographs of Indian patients. In this paper, we propose a novel method using convolutional neural networks to auto…
CT-based Subchondral Bone Microstructural Analysis in Knee Osteoarthritis via MR-Guided Distillation Learning
School of Biomedical Engineering, Shanghai Jiao Tong University（上海交通大学生物医学工程学院）；Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine（上海交通大学医学院附属第九人民医院）
University of Oulu（奥卢大学）；Oulu University Hospital（奥卢大学医院）；Medical Research Center, University of Oulu and Oulu University Hospital（奥卢大学与奥卢大学医院医学研究中心）
Objective: To assess the ability of imaging-based deep learning to predict radiographic patellofemoral osteoarthritis (PFOA) from knee lateral view radiographs. Design: Knee lateral view radiographs were extracted from The Multicenter Osteoarthritis Study (MOST) (n = 18,436 knees). Patellar region-of-interest (ROI) was first automatically detected, and subsequently, end-to-end deep convolutional neural networks (CNNs) were trained and validated to detect the status of patellofemoral OA. Patellar ROI was detected using deep-learning-based object detection method. Manual PFOA status assessment p…
PAII Inc.（PAII 公司）；Chang Gung Memorial Hospital（长庚纪念医院）；Ping An Technology（平安科技）
Knee osteoarthritis (OA) is a common degenerate joint disorder that affects a large population of elderly people worldwide. Accurate radiographic assessment of knee OA severity plays a critical role in chronic patient management. Current clinically-adopted knee OA grading systems are observer subjective and suffer from inter-rater disagreements. In this work, we propose a computer-aided diagnosis approach to provide more accurate and consistent assessments of both composite and fine-grained OA grades simultaneously. A novel semi-supervised learning method is presented to exploit the underlying…
Adaptive Variance Thresholding: A Novel Approach to Improve Existing Deep Transfer Vision Models and Advance Automatic Knee-Joint Osteoarthritis Classification
University of Jyväskylä（于韦斯屈莱大学）；University of Helsinki（赫尔辛基大学）
Universitat Politècnica de Catalunya (UPC)（加泰罗尼亚理工大学）；Insight Centre for Data Analytics（Insight数据分析中心）；Dublin City University (DCU)（都柏林城市大学）
This work proposes a novel end-to-end convolutional neural network (CNN) architecture to automatically quantify the severity of knee osteoarthritis (OA) using X-Ray images, which incorporates trainable attention modules acting as unsupervised fine-grained detectors of the region of interest (ROI). The proposed attention modules can be applied at different levels and scales across any CNN pipeline helping the network to learn relevant attention patterns over the most informative parts of the image at different resolutions. We test the proposed attention mechanism on existing state-of-the-art CN…
University of Oulu（奥卢大学）；Oulu University Hospital（奥卢大学医院）；KU Leuven（鲁汶大学）；Ailean Technologies Oy
Knee osteoarthritis (OA) is one of the highest disability factors in the world. This musculoskeletal disorder is assessed from clinical symptoms, and typically confirmed via radiographic assessment. This visual assessment done by a radiologist requires experience, and suffers from moderate to high inter-observer variability. The recent literature has shown that deep learning methods can reliably perform the OA severity assessment according to the gold standard Kellgren-Lawrence (KL) grading system. However, these methods require large amounts of labeled data, which are costly to obtain. In thi…
The University of Queensland（昆士兰大学）；Australian e-Health Research Centre（澳大利亚电子健康研究中心）；Commonwealth Scientific and Industrial Research Organisation（联邦科学与工业研究组织）
In medical image analysis, automated segmentation of multi-component anatomical structures, which often have a spectrum of potential anomalies and pathologies, is a challenging task. In this work, we develop a multi-step approach using U-Net-based neural networks to initially detect anomalies (bone marrow lesions, bone cysts) in the distal femur, proximal tibia and patella from 3D magnetic resonance (MR) images of the knee in individuals with varying grades of osteoarthritis. Subsequently, the extracted data are used for downstream tasks involving semantic segmentation of individual bone and c…
We present a transductive learning approach for morphometric osteophyte grading based on geometric deep learning. We formulate the grading task as semi-supervised node classification problem on a graph embedded in shape space. To account for the high-dimensionality and non-Euclidean structure of shape space we employ a combination of an intrinsic dimension reduction together with a graph convolutional neural network. We demonstrate the performance of our derived classifier in comparisons to an alternative extrinsic approach.
A Progressive Risk Formulation for Enhanced Deep Learning based Total Knee Replacement Prediction in Knee Osteoarthritis
Center for Data Science, New York University（纽约大学数据科学中心）；Department of Radiology, New York University Langone Health（纽约大学朗格尼健康放射科）；Bernard and Irene Schwartz Center for Biomedical Imaging, New York University Langone Health（纽约大学朗格尼健康伯纳德与艾琳·施瓦茨生物医学影像中心）
Temporal Evolution of Knee Osteoarthritis: A Diffusion-based Morphing Model for X-ray Medical Image Synthesis
Massachusetts General Hospital（麻省总医院）；Harvard Medical School（哈佛医学院）；University of Orleans（奥尔良大学）；IDP Institute（IDP研究所）；Jiangsu Institute of Hematology（江苏省血液研究所）；First Affiliated Hospital of Soochow University（苏州大学附属第一医院）；Cancer Hospital of Pernambuco（伯南布哥癌症医院）
Unsupervised Domain Adaptation for Automated Knee Osteoarthritis Phenotype Classification
The Chinese University of Hong Kong（香港中文大学）；Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine（上海交通大学医学院附属第六人民医院）
Rethinking Knee Osteoarthritis Severity Grading: A Few Shot Self-Supervised Contrastive Learning Approach
Science Foundation Ireland Centre for Research Training in Machine Learning（爱尔兰科学基金会机器学习研究培训中心）；School of Medicine（医学院）；School of Computer Science, University College Dublin（都柏林大学学院计算机科学学院）；Insight Centre for Data Analytics, University College Dublin（都柏林大学学院洞察数据分析中心）
Deep Learning for Predicting Progression of Patellofemoral Osteoarthritis Based on Lateral Knee Radiographs, Demographic Data and Symptomatic Assessments
University of Oulu（奥卢大学）；Lund University（隆德大学）；Diakonhjemmet Hospital（迪亚科涅米特医院）；Juntendo University（顺天堂大学）；Oulu University Hospital（奥卢大学医院）
The aim of this study was to investigate the influence of MRI and patient data on the prediction of knee osteoarthritis (OA) incidence using different deep learning architectures. Knee OA incidence within 24 months was predicted using the intermediate-weighted turbo spin-echo (IW-TSE) sequence of 593 patients from the Osteoarthritis Initiative. To extract a region of interest containing the knee joint from the IW-TSE sequence, a U-Net model was trained and used to segment bone on a dual echo steady state (DESS) sequence. Subsequently, IW-TSE and DESS sequences were registered and the DESS segm…
Duke University（杜克大学）；Duke Clinical Research Institute（杜克临床研究所）；Duke-Margolis Center for Health Policy（杜克-马戈利斯卫生政策中心）；Duke Cancer Institute（杜克癌症研究所）
The assessment of knee osteoarthritis (KOA) severity on knee X-rays is a central criteria for the use of total knee arthroplasty. However, this assessment suffers from imprecise standards and a remarkably high inter-reader variability. An algorithmic, automated assessment of KOA severity could improve overall outcomes of knee replacement procedures by increasing the appropriateness of its use. We propose a novel deep learning-based five-step algorithm to automatically grade KOA from posterior-anterior (PA) views of radiographs: (1) image preprocessing (2) localization of knees joints in the im…
Knee Osteoarthritis Severity Prediction using an Attentive Multi-Scale Deep Convolutional Neural Network
Indian Institute of Technology Guwahati（印度古瓦哈蒂印度理工学院）；Cleveland Clinic（克利夫兰诊所）；Duke-NUS Medical School（杜克-新加坡国立大学医学院）；National University of Singapore（新加坡国立大学）
University of Oulu（奥卢大学）；Oulu University Hospital（奥卢大学医院）；Medical Research Center（医学研究中心）
Objective is to assess the ability of texture features for detecting radiographic patellofemoral osteoarthritis (PFOA) from knee lateral view radiographs. We used lateral view knee radiographs from MOST public use datasets (n = 5507 knees). Patellar region-of-interest (ROI) was automatically detected using landmark detection tool (BoneFinder). Hand-crafted features, based on LocalBinary Patterns (LBP), were then extracted to describe the patellar texture. First, a machine learning model (Gradient Boosting Machine) was trained to detect radiographic PFOA from the LBP features. Furthermore, we u…
Diffusion-based Counterfactual Augmentation: Towards Robust and Interpretable Knee Osteoarthritis Grading
Department of Radiology, Harvard Medical School（哈佛医学院放射科）；Jiangsu Institute of Hematology, The First Affiliated Hospital of Soochow University（苏州大学第一附属医院江苏血液研究所）；L2TI Laboratory, University Sorbonne Paris Nord（巴黎-萨克雷大学L2TI实验室）；department of Medical School, Henan University of Chinese Medicine（河南中医药大学医学院）；Institute for Diagnostic and Interventional Radiology, Faculty of Medicine and University Hospital Cologne, University of Cologne（科隆大学医学院和科隆大学医院诊断与介入放射学研究所）；Department of Electrical and Electronic Engineering, University of Hong Kong（香港大学电子与电气工程系）；Nuclear Medicine Division, Geneva University Hospital（日内瓦大学医院核医学科）；IDP Institute, UMR CNRS 7013, University of Orleans（奥尔良大学IDP研究所，CNRS UMR 7013）
Key-Exchange Convolutional Auto-Encoder for Data Augmentation in Early Knee Osteoarthritis Detection
Massachusetts General Hospital（麻省总医院）；Harvard Medical School（哈佛医学院）；University Sorbonne Paris Nord（巴黎北部索邦大学）；Jiangsu Institute of Hematology（江苏血液学研究所）；The First Affiliated Hospital of Soochow University（苏州大学附属第一医院）；Henan University of Chinese Medicine（河南中医药大学）；German Cancer Research Center（德国癌症研究中心）；Athinoula A. Martinos Centre for Biomedical Imaging（阿西努拉·A.马蒂诺斯生物医学成像中心）；Geneva University Hospital（日内瓦大学医院）；IDP Institute（IDP研究所）；University of Orleans（奥尔良大学）
Transformer with Selective Shuffled Position Embedding and Key-Patch Exchange Strategy for Early Detection of Knee Osteoarthritis
IDP Institute（IDP研究所）；UMR CNRS 7013（法国国家科学研究中心UMR 7013）；University of Orleans（奥尔良大学）；PRISME Laboratory（PRISME实验室）；Massachusetts General Hospital（麻省总医院）；Harvard Medical School（哈佛医学院）；Geneva University Hospital（日内瓦大学医院）
Confidence-Driven Deep Learning Framework for Early Detection of Knee Osteoarthritis
Massachusetts General Hospital（麻省总医院）；Harvard Medical School（哈佛医学院）；University Sorbonne Paris Nord（巴黎北索邦大学）；Jiangsu Institute of Hematology（江苏血液学研究所）；The First Affiliated Hospital of Soochow University（苏州大学附属第一医院）；Henan University of Chinese Medicine（河南中医药大学）；German Cancer Research Center（德国癌症研究中心）；Athinoula A. Martinos Centre for Biomedical Imaging（阿西诺拉·A.马蒂诺斯生物医学影像中心）；Geneva University Hospital（日内瓦大学医院）；IDP Institute（IDP研究所）；University of Orleans（奥尔良大学）
Stanford University（斯坦福大学）；University of Central Florida（中佛罗里达大学）；Columbia University（哥伦比亚大学）；University of Pennsylvania（宾夕法尼亚大学）；University of Minnesota（明尼苏达大学）；University of Copenhagen（哥本哈根大学）；Cleveland Clinic（克利夫兰诊所）；New York University（纽约大学）；Langone Health（朗格尼健康中心）
Purpose: To organize a knee MRI segmentation challenge for characterizing the semantic and clinical efficacy of automatic segmentation methods relevant for monitoring osteoarthritis progression. Methods: A dataset partition consisting of 3D knee MRI from 88 subjects at two timepoints with ground-truth articular (femoral, tibial, patellar) cartilage and meniscus segmentations was standardized. Challenge submissions and a majority-vote ensemble were evaluated using Dice score, average symmetric surface distance, volumetric overlap error, and coefficient of variation on a hold-out test set. Simil…
School of Biomedical Engineering, Shanghai Jiao Tong University（上海交通大学生物医学工程学院）；Shanghai United Imaging Intelligence Co., Ltd.（上海联影智能医疗科技有限公司）；Department of Imaging, Tongren Hospital, Shanghai Jiao Tong University School of Medicine（上海交通大学医学院附属同仁医院影像科）；School of Biomedical Engineering, ShanghaiTech University（上海科技大学生物医学工程学院）
Knee osteoarthritis (OA) is the most common osteoarthritis and a leading cause of disability. Cartilage defects are regarded as major manifestations of knee OA, which are visible by magnetic resonance imaging (MRI). Thus early detection and assessment for knee cartilage defects are important for protecting patients from knee OA. In this way, many attempts have been made on knee cartilage defect assessment by applying convolutional neural networks (CNNs) to knee MRI. However, the physiologic characteristics of the cartilage may hinder such efforts: the cartilage is a thin curved layer, implying…
Harbin Institute of Technology（哈尔滨工业大学）；University of Western Ontario（西安大略大学）
The morphological changes in knee cartilage (especially femoral and tibial cartilages) are closely related to the progression of knee osteoarthritis, which is expressed by magnetic resonance (MR) images and assessed on the cartilage segmentation results. Thus, it is necessary to propose an effective automatic cartilage segmentation model for longitudinal research on osteoarthritis. In this research, to relieve the problem of inaccurate discontinuous segmentation caused by the limited receptive field in convolutional neural networks, we proposed a novel position-prior clustering-based self-atte…
Schulich School of Engineering, University of Calgary（卡尔加里大学舒立克工程学院）；Department of Radiology & Diagnostic Imaging, University of Alberta（阿尔伯塔大学放射与诊断成像系）；Alberta Machine Intelligence Institute (AMII), University of Alberta（阿尔伯塔大学阿尔伯塔机器智能研究所（AMII））；Mechanical and Manufacturing Engineering, University of Calgary（卡尔加里大学机械与制造工程系）
Objective assessment of Magnetic Resonance Imaging (MRI) scans of osteoarthritis (OA) can address the limitation of the current OA assessment. Segmentation of bone, cartilage, and joint fluid is necessary for the OA objective assessment. Most of the proposed segmentation methods are not performing instance segmentation and suffer from class imbalance problems. This study deployed Mask R-CNN instance segmentation and improved it (improved-Mask R-CNN (iMaskRCNN)) to obtain a more accurate generalized segmentation for OA-associated tissues. Training and validation of the method were performed usi…
University of California, Berkeley（加州大学伯克利分校）；University of California, San Francisco（加州大学旧金山分校）
Knee Osteoarthritis (OA) is a common musculoskeletal disorder in the United States. When diagnosed at early stages, lifestyle interventions such as exercise and weight loss can slow OA progression, but at later stages, only an invasive option is available: total knee replacement (TKR). Though a generally successful procedure, only 2/3 of patients who undergo the procedure report their knees feeling ''normal'' post-operation, and complications can arise that require revision. This necessitates a model to identify a population at higher risk of TKR, particularly at less advanced stages of OA, su…
Institute for Medical Imaging Technology, School of Biomedical Engineering, Shanghai Jiao Tong University（上海交通大学医学院生物医学工程学院医学影像技术研究所）；Shanghai United Imaging Intelligence Co., Ltd.（上海联影智能科技有限公司）；Department of Imaging, Tongren Hospital, Shanghai Jiao Tong University School of Medicine（上海交通大学医学院附属同仁医院影像科）
Knee osteoarthritis (OA) is one of the most common musculoskeletal disorders and requires early-stage diagnosis. Nowadays, the deep convolutional neural networks have achieved greatly in the computer-aided diagnosis field. However, the construction of the deep learning models usually requires great amounts of annotated data, which is generally high-cost. In this paper, we propose a novel approach for knee cartilage defects assessment, including severity classification and lesion localization. This can be treated as a subtask of knee OA diagnosis. Particularly, we design a self-ensembling frame…
Feasibility Study of a Diffusion-Based Model for Cross-Modal Generation of Knee MRI from X-ray: Integrating Radiographic Feature Information
Massachusetts General Hospital（麻省总医院）；Harvard Medical School（哈佛医学院）；University Sorbonne Paris Nord（巴黎北大索邦大学）；German Cancer Research Center（德国癌症研究中心）；Jiangsu Institute of Hematology（江苏血液学研究所）；The First Affiliated Hospital of Soochow University（苏州大学附属第一医院）；Henan University of Chinese Medicine（河南中医药大学）；Athinoula A. Martinos Centre for Biomedical Imaging（阿西努拉·A.马蒂诺斯生物医学成像中心）；IDP Institute（IDP研究所）；University of Orleans（奥尔良大学）
Mayo Clinic（梅奥诊所）；Case Western Reserve University（凯斯西储大学）；University of Southern Maine（南缅因大学）；Dubyak Center for Digital Science and Innovation, University of Southern Maine（南缅因大学Dubyak数字科学与创新中心）；Department of Artificial Intelligence and Informatics, Mayo Clinic（梅奥诊所人工智能与信息学系）；Department of Health Sciences Research, Mayo Clinic（梅奥诊所健康科学研究系）；Department of Computer and Data Sciences, Case Western Reserve University（凯斯西储大学计算机与数据科学系）；Department of Orthopedics, Mayo Clinic（梅奥诊所骨科系）；Department of Computer Science, University of Southern Maine（南缅因大学计算机科学系）
Knee pain is undoubtedly the most common musculoskeletal symptom that impairs quality of life, confines mobility and functionality across all ages. Knee pain is clinically evaluated by routine radiographs, where the widespread adoption of radiographic images and their availability at low cost, make them the principle component in the assessment of knee pain and knee pathologies, such as arthritis, trauma, and sport injuries. However, interpretation of the knee radiographs is still highly subjective, and overlapping structures within the radiographs and the large volume of images needing to be …
Utilizing 3D Fast Spin Echo Anatomical Imaging to Reduce the Number of Contrast Preparations in $T_{1ρ}$ Quantification of Knee Cartilage Using Learning-Based Methods
Nara Institute of Science and Technology（奈良先端科学技术大学院大学）；Osaka University Graduate School of Medicine（大阪大学大学院医学系研究科）；Ehime University Graduate School of Medicine（爱媛大学大学院医学系研究科）
We propose a method for estimating the bone mineral density (BMD) from a plain x-ray image. Dual-energy X-ray absorptiometry (DXA) and quantitative computed tomography (QCT) provide high accuracy in diagnosing osteoporosis; however, these modalities require special equipment and scan protocols. Measuring BMD from an x-ray image provides an opportunistic screening, which is potentially useful for early diagnosis. The previous methods that directly learn the relationship between x-ray images and BMD require a large training dataset to achieve high accuracy because of large intensity variations i…
