Deep learning classification of shoulder fractures on plain radiographs of the humerus, scapula and clavicle

In this study, we present a deep learning model for fracture classification on shoulder radiographs using a convolutional neural network (CNN). The primary aim was to evaluate the classification performance of the CNN for proximal humeral fractures (PHF) based on the AO/OTA classification system. Se...

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Main Authors: Martin Magnéli, Petter Ling, Jacob Gislén, Johan Fagrell, Yilmaz Demir, Erica Domeij Arverud, Kristofer Hallberg, Björn Salomonsson, Max Gordon
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2023-01-01
Series:PLoS ONE
Online Access:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10468075/?tool=EBI
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author Martin Magnéli
Petter Ling
Jacob Gislén
Johan Fagrell
Yilmaz Demir
Erica Domeij Arverud
Kristofer Hallberg
Björn Salomonsson
Max Gordon
author_facet Martin Magnéli
Petter Ling
Jacob Gislén
Johan Fagrell
Yilmaz Demir
Erica Domeij Arverud
Kristofer Hallberg
Björn Salomonsson
Max Gordon
author_sort Martin Magnéli
collection DOAJ
description In this study, we present a deep learning model for fracture classification on shoulder radiographs using a convolutional neural network (CNN). The primary aim was to evaluate the classification performance of the CNN for proximal humeral fractures (PHF) based on the AO/OTA classification system. Secondary objectives included evaluating the model’s performance for diaphyseal humerus, clavicle, and scapula fractures. The training dataset consisted of 6,172 examinations, including 2–7 radiographs per examination. The overall area under the curve (AUC) for fracture classification was 0.89, indicating good performance. For PHF classification, 12 out of 16 classes achieved an AUC of 0.90 or greater. Additionally, the CNN model had excellent overall AUC for diaphyseal humerus fractures (0.97), clavicle fractures (0.96), and good AUC for scapula fractures (0.87). Despite the limitations of the study, such as the reliance on ground truth labels provided by students with limited radiographic assessment experience, our findings are in concordance with previous studies, further consolidating CNN as potent fracture classifiers in plain radiographs. The inclusion of multiple radiographs with different views from each examination, as well as the generally unselected nature of the sample, contributed to the overall generalizability of the study. This is the fifth study published by our group on AI in orthopaedic radiographs, which has consistently shown promising results. The next challenge for the orthopaedic research community will be to transfer these results from the research setting into clinical practice. External validation of the CNN model should be conducted in the future before it is considered for use in a clinical setting.
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spelling doaj.art-8a1122a6fa5f401284c65e914daa399e2023-09-05T05:31:43ZengPublic Library of Science (PLoS)PLoS ONE1932-62032023-01-01188Deep learning classification of shoulder fractures on plain radiographs of the humerus, scapula and clavicleMartin MagnéliPetter LingJacob GislénJohan FagrellYilmaz DemirErica Domeij ArverudKristofer HallbergBjörn SalomonssonMax GordonIn this study, we present a deep learning model for fracture classification on shoulder radiographs using a convolutional neural network (CNN). The primary aim was to evaluate the classification performance of the CNN for proximal humeral fractures (PHF) based on the AO/OTA classification system. Secondary objectives included evaluating the model’s performance for diaphyseal humerus, clavicle, and scapula fractures. The training dataset consisted of 6,172 examinations, including 2–7 radiographs per examination. The overall area under the curve (AUC) for fracture classification was 0.89, indicating good performance. For PHF classification, 12 out of 16 classes achieved an AUC of 0.90 or greater. Additionally, the CNN model had excellent overall AUC for diaphyseal humerus fractures (0.97), clavicle fractures (0.96), and good AUC for scapula fractures (0.87). Despite the limitations of the study, such as the reliance on ground truth labels provided by students with limited radiographic assessment experience, our findings are in concordance with previous studies, further consolidating CNN as potent fracture classifiers in plain radiographs. The inclusion of multiple radiographs with different views from each examination, as well as the generally unselected nature of the sample, contributed to the overall generalizability of the study. This is the fifth study published by our group on AI in orthopaedic radiographs, which has consistently shown promising results. The next challenge for the orthopaedic research community will be to transfer these results from the research setting into clinical practice. External validation of the CNN model should be conducted in the future before it is considered for use in a clinical setting.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10468075/?tool=EBI
spellingShingle Martin Magnéli
Petter Ling
Jacob Gislén
Johan Fagrell
Yilmaz Demir
Erica Domeij Arverud
Kristofer Hallberg
Björn Salomonsson
Max Gordon
Deep learning classification of shoulder fractures on plain radiographs of the humerus, scapula and clavicle
PLoS ONE
title Deep learning classification of shoulder fractures on plain radiographs of the humerus, scapula and clavicle
title_full Deep learning classification of shoulder fractures on plain radiographs of the humerus, scapula and clavicle
title_fullStr Deep learning classification of shoulder fractures on plain radiographs of the humerus, scapula and clavicle
title_full_unstemmed Deep learning classification of shoulder fractures on plain radiographs of the humerus, scapula and clavicle
title_short Deep learning classification of shoulder fractures on plain radiographs of the humerus, scapula and clavicle
title_sort deep learning classification of shoulder fractures on plain radiographs of the humerus scapula and clavicle
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10468075/?tool=EBI
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