Automated fracture detection in the ulna and radius using deep learning on upper extremity radiographs

OBJECTIVES: This study aimed to detect single or multiple fractures in the ulna or radius using deep learning techniques fed on upper-extremity radiographs. MATERIALS AND METHODS: The data set used in the retrospective study consisted of different types of upper extremity radiographs obtained from an open-source dataset, with 4,480 images with fractures and 4,383 images without fractures. All fractures involved the ulna or radius. The proposed method comprises two distinct stages. The initial phase, referred to as preprocessing, involved the removal of radiographic backgrounds, followed by the elimination of nonbone tissue. In the second phase, images consisting only of bone tissue were processed using deep learning models, such as RegNetX006, EfficientNet B0, and InceptionResNetV2. Thus, whether one or more fractures of the ulna or the radius are present was determined. To measure the performance of the proposed method, raw images, images generated by background deletion, and bone tissue removal were classified separately using RegNetX006, EfficientNet B0, and InceptionResNetV2 models. Performance was assessed by accuracy, F1 score, Matthew’s correlation coefficient, receiver operating characteristic area under the curve, sensitivity, specificity, and precision using 10-fold cross-validation, which is a widely accepted technique in statistical analysis. RESULTS: The best classification performance was obtained with the proposed preprocessing and RegNetX006 architecture. The values obtained for various metrics were as follows: accuracy (0.9921), F1 score (0.9918), Matthew's correlation coefficient (0.9842), area under the curve (0.9918), sensitivity (0.9974), specificity (0.9863), and precision (0.9923). CONCLUSION: The proposed preprocessing method is able to detect fractures of the ulna and radius by artificial intelligence.