Automated Identification of Orthopedic Implants on Radiographs Using Deep Learning
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Issue Date
2021-03-07
Authors
Batta, Vineet
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Abstract
Accurate identification of metallic orthopedic implant design is important for preoperative planning of revision arthroplasty. Surgical
records of implant models are frequently unavailable. The aim of this study was to develop and evaluate a convolutional neural network
for identifying orthopedic implant models using radiographs. In this retrospective study, 427 knee and 922 hip unilateral anteroposterior
radiographs, including 12 implant models from 650 patients, were collated from an orthopedic center between March 2015 and
November 2019 to develop classification networks. A total of 198 images paired with autogenerated image masks were used to develop
a U-Net segmentation network to automatically zero-mask around the implants on the radiographs. Classification networks processing
original radiographs, and two-channel conjoined original and zero-masked radiographs, were ensembled to provide a consensus prediction.
Accuracies of five senior orthopedic specialists assisted by a reference radiographic gallery were compared with network accuracy
using McNemar exact test. When evaluated on a balanced unseen dataset of 180 radiographs, the final network achieved a 98.9% accuracy
(178 of 180) and 100% top-three accuracy (180 of 180). The network performed superiorly to all five specialists (76.1% [137
of 180] median accuracy and 85.6% [154 of 180] best accuracy; both P , .001), with robustness to scan quality variation and difficult
to distinguish implants. A neural network model was developed that outperformed senior orthopedic specialists at identifying implant
models on radiographs; real-world application can now be readily realized
Description
Keywords
Neural Networks , Skeletal-Appendicular , knee , hip , Computer Applications-General , Informatics , Prostheses , Technology Assessment , Observer Performance