Radiography Classification: A Comparison between Eleven Convolutional Neural Networks

This paper investigates the classification of normal and abnormal radiographic images. Eleven convolutional neural network architectures (GoogleNet, Vgg-19, AlexNet, SqueezeNet, ResNet-18, Inception-v3, ResNet-50, Vgg-16, ResNet-101, DenseNet-201 and Inception-ResNet-v2) were used to classify a series of x-ray images from Stanford Musculoskeletal Radiographs (MURA) dataset corresponding to the wrist images of the data base. For each architecture, the results were compared against the known labels (normal / abnormal) and then the following metrics were calculated: accuracy (labels correctly classified) and Cohen’s kappa (a measure of agreement) following MURA guidelines. Numerous experiments were conducted by changing classifiers (Adam, Sgdm, RmsProp), the number of epochs, with/without data augmentation. The best results were provided by InceptionResnet-v2 (Mean accuracy = 0.723, Mean Kappa = 0.506). Interestingly, these results lower than those reported in the Leaderboard of MURA. We speculate that to improve the results from basic CNN architectures several options could be tested, for instance: pre-processing, post-processing or domain knowledge, and ensembles.

[1]  C. Seiler,et al.  Open reduction and internal fixation versus casting for highly comminuted and intra-articular fractures of the distal radius (ORCHID): protocol for a randomized clinical multi-center trial , 2011, Trials.

[2]  Laurence Berman,et al.  Accident and emergency radiology : a survival guide , 1995 .

[3]  G C Bannister,et al.  Is manipulation of moderately displaced Colles' fracture worthwhile? A prospective randomized trial. , 1997, Injury.

[4]  Xuelei Wei,et al.  Is volar locking plate superior to external fixation for distal radius fractures? A comprehensive meta-analysis , 2018, Acta orthopaedica et traumatologica turcica.

[5]  Chao Yang,et al.  A Survey on Deep Transfer Learning , 2018, ICANN.

[6]  Parashkev Nachev,et al.  Computer Methods and Programs in Biomedicine NiftyNet: a deep-learning platform for medical imaging , 2022 .

[7]  Peter J. Hunter,et al.  Big Data, Big Knowledge: Big Data for Personalized Healthcare , 2015, IEEE Journal of Biomedical and Health Informatics.

[8]  Jake Luo,et al.  Big Data Application in Biomedical Research and Health Care: A Literature Review , 2016, Biomedical informatics insights.

[9]  Dumitru Erhan,et al.  Going deeper with convolutions , 2014, 2015 IEEE Conference on Computer Vision and Pattern Recognition (CVPR).

[10]  N. González,et al.  Wrist fractures and their impact in daily living functionality on elderly people: a prospective cohort study , 2016, BMC Geriatrics.

[11]  Forrest N. Iandola,et al.  SqueezeNet: AlexNet-level accuracy with 50x fewer parameters and <1MB model size , 2016, ArXiv.

[12]  Scott A. Mitchell,et al.  Radiographic Outcomes of Dorsal Spanning Plate for Treatment of Comminuted Distal Radius Fractures in Non-Elderly Patients , 2019, Journal of hand surgery global online.

[13]  R Madhok,et al.  Different methods of external fixation for treating distal radial fractures in adults. , 2008, The Cochrane database of systematic reviews.

[14]  M. Gschwentner,et al.  A Comparative Study of Clinical and Radiologic Outcomes of Unstable Colles Type Distal Radius Fractures in Patients Older Than 70 Years: Nonoperative Treatment Versus Volar Locking Plating , 2009, Journal of orthopaedic trauma.

[15]  Kevin C Chung,et al.  The evolution of distal radius fracture management: a historical treatise. , 2012, Hand clinics.

[16]  A. Ng,et al.  MURA: Large Dataset for Abnormality Detection in Musculoskeletal Radiographs. , 2017 .

[17]  C. Reyes-Aldasoro,et al.  Geometric Semi-automatic Analysis of Colles’ Fractures , 2020 .

[18]  R Madhok,et al.  Closed reduction methods for treating distal radial fractures in adults. , 2003, The Cochrane database of systematic reviews.

[19]  Robert B. Fisher,et al.  3D Shape Analysis: Fundamentals, Theory, and Applications , 2019 .

[20]  J. Macdermid,et al.  Open reduction internal fixation versus percutaneous pinning with external fixation of distal radius fractures: a prospective, randomized clinical trial. , 2011, The Journal of hand surgery.

[21]  H. Kapoor,et al.  Displaced intra-articular fractures of distal radius: a comparative evaluation of results following closed reduction, external fixation and open reduction with internal fixation. , 2000, Injury.

[22]  Timothy F. Cootes,et al.  Automatic Detection of Wrist Fractures From Posteroanterior and Lateral Radiographs: A Deep Learning-Based Approach , 2018, MSKI@MICCAI.

[23]  Andrew Zisserman,et al.  Very Deep Convolutional Networks for Large-Scale Image Recognition , 2014, ICLR.

[24]  Mert R. Sabuncu,et al.  Multi-atlas segmentation of biomedical images: A survey , 2014, Medical Image Anal..

[25]  Rohit Arora,et al.  Complications Following Internal Fixation of Unstable Distal Radius Fracture With a Palmar Locking-Plate , 2007, Journal of orthopaedic trauma.

[26]  Alex Lallement,et al.  Survey on deep learning for radiotherapy , 2018, Comput. Biol. Medicine.

[27]  Jian Sun,et al.  Deep Residual Learning for Image Recognition , 2015, 2016 IEEE Conference on Computer Vision and Pattern Recognition (CVPR).

[28]  R Madhok,et al.  Conservative interventions for treating distal radial fractures in adults. , 2003, The Cochrane database of systematic reviews.

[29]  A. Barai,et al.  Management of distal radius fractures in the emergency department: A long‐term functional outcome measure study with the Disabilities of Arm, Shoulder and Hand (DASH) scores , 2018, Emergency medicine Australasia : EMA.

[30]  Geoffrey E. Hinton,et al.  ImageNet classification with deep convolutional neural networks , 2012, Commun. ACM.

[31]  S. H. Rhee,et al.  Distal radius fracture metaphyseal comminution: a new radiographic parameter for quantifying, the metaphyseal collapse ratio (MCR). , 2013, Orthopaedics & traumatology, surgery & research : OTSR.

[32]  Yanchun Zhang,et al.  Medical Big Data: Neurological Diseases Diagnosis Through Medical Data Analysis , 2016, Data Science and Engineering.

[33]  Sergey Ioffe,et al.  Rethinking the Inception Architecture for Computer Vision , 2015, 2016 IEEE Conference on Computer Vision and Pattern Recognition (CVPR).

[34]  Ki-Chul Park,et al.  The Effect of Osteoporosis on the Outcomes After Volar Locking Plate Fixation in Female Patients Older than 50 Years With Unstable Distal Radius Fractures. , 2018, The Journal of hand surgery.

[35]  Piet Geusens,et al.  Epidemiology of fractures in the United Kingdom 1988-2012: Variation with age, sex, geography, ethnicity and socioeconomic status. , 2016, Bone.

[36]  J. Kurtzke,et al.  Colles' fracture; a study of two thousand cases from the New York State Workmen's Compensation Board. , 1953, The Journal of bone and joint surgery. American volume.

[37]  L. D. Baker,et al.  Complications of Colles' fractures. , 1946, North Carolina medical journal.

[38]  Tinne Tuytelaars,et al.  Visual Explanation by Interpretation: Improving Visual Feedback Capabilities of Deep Neural Networks , 2017, ICLR.

[39]  Sanjay Meena,et al.  Fractures of Distal Radius: An Overview , 2014, Journal of family medicine and primary care.

[40]  Michael P. Gaspar,et al.  Complications Following Partial and Total Wrist Arthroplasty: A Single-Center Retrospective Review. , 2016, The Journal of hand surgery.

[41]  M. McHugh Interrater reliability: the kappa statistic , 2012, Biochemia medica.

[42]  Artur S. d'Avila Garcez,et al.  Making densenet interpretable a case study in clinical radiology , 2019 .

[43]  Kilian Q. Weinberger,et al.  Densely Connected Convolutional Networks , 2016, 2017 IEEE Conference on Computer Vision and Pattern Recognition (CVPR).

[44]  Sergey Ioffe,et al.  Inception-v4, Inception-ResNet and the Impact of Residual Connections on Learning , 2016, AAAI.