Artificial intelligence assistance in radiographic detection and classification of knee osteoarthritis and its severity: a cross-sectional diagnostic study

N. Pongsakonpruttikul, C. Angthong, V. Kittichai, S. Chuwongin, P. Puengpipattrakul, P. Thongpat, S. Boonsang, T. Tongloy

Faculty of Medicine, King Mongkut’s Institute of Technology Ladkrabang, Bangkok, Thailand. chayanin.an@kmitl.ac.th

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• Orthopedics
• Radiology

OBJECTIVE: Radiographic interpretation suffers from an ever-increasing workload in orthopedic and radiology departments. The present study applied and assessed the performance of a convolutional neural network designed to assist orthopedists and radiologists in the detection and classification of knee osteoarthritis from early to severe degrees in accordance with the Kellgren-Lawrence (KL) classification system.

MATERIALS AND METHODS: In total, 1650 knee joint radiographs (anteroposterior view) were collected from the Osteoarthritis Initiative public resource. Two models were developed: one distinguished normal (KL 0-I) from osteoarthritic knees (KL II-IV), and the other classified the severity as normal (KL 0-I), non-severe (KL II), or severe (KL III-IV). The regions of interest were labeled under the supervision of experts. Our artificial intelligence (AI) models were trained using the You Only Look Once version 3 (YOLOv3) detection algorithm.

RESULTS: Our first AI model using YOLOv3 tiny could detect and classify normal and osteoarthritic knees on plain knee joint radiographs with 85% accuracy and 81% mean average precision. The second AI model for classifying severity achieved a total accuracy of 86.7% and mean average precision of 70.6%.

CONCLUSIONS: Our proposed deep learning models provided high accuracy and satisfactory precision for the detection and classification of early to severe knee osteoarthritis on anteroposterior radiographs. These models may be used as diagnostic aids by interpreting knee radiographs and guiding the treatment options via each osteoarthritic stage for related physicians and specialists.

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