Research on automated rapid diagnosis of distal radius fractures using X-ray images

Abstract

The primary diagnostic method for distal radius fractures remains conventional X-ray imaging. In emergency situations, rapid assessment and decision-making are often required from non-orthopedic physicians or junior radiologists in the emergency room. Therefore, an accurate and efficient auxiliary diagnostic technology for distal radius fractures is of great significance. This paper combines deep learning with image analysis techniques to propose an effective classification method for types of distal radius fractures. Firstly, an extended U-Net three-level cascade segmentation network is used for precise segmentation of the most critical joint surface and non-joint surface areas for fracture identification. The edge is further optimized using the central pixel image block classification method. Then, fracture identification is performed separately on the joint surface and non-joint surface areas. Finally, based on the classification results of the two types of images, a comprehensive judgment is made to determine normal or ABC fracture types. The experimental X-ray data comes from three tertiary hospitals, with a total of 12,000 images in the training set, 3,000 of each type, and 1,200 images in the test set, 300 of each type. To further demonstrate the generalization performance of the classification experiment, an additional 500 images were added for fracture classification testing, coming from collaborative medical institutions in the United States and Germany. All images were annotated by orthopedic medical experts with more than ten years of experience. The accuracy rates for normal, type A, type B, and type C fractures in the test set were 0.99, 0.92, 0.91, and 0.82, respectively. For orthopedic medical experts, the average recognition accuracy rates were 0.98, 0.90, 0.87, and 0.81. The proposed automatic recognition method overall performs better than experts and can be used for preliminary auxiliary diagnosis of distal radius fractures without expert participation.