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Auxiliary diagnosis of developmental dysplasia of the hip by automated detection of Sharp's angle on standardized anteroposterior pelvic radiographs

Developmental dysplasia of the hip (DDH) is common, and features a widened Sharp's angle as observed on pelvic x-ray images. Determination of Sharp's angle, essential for clinical decisions, can overwhelm the workload of orthopedic surgeons. To aid diagnosis of DDH and reduce false negativ...

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Autores principales: Li, Qiang, Zhong, Lei, Huang, Hongnian, Liu, He, Qin, Yanguo, Wang, Yiming, Zhou, Zhe, Liu, Heng, Yang, Wenzhuo, Qin, Meiting, Wang, Jing, Wang, Yanbo, Zhou, Teng, Wang, Dawei, Wang, Jincheng, Xu, Meng, Huang, Ye
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Wolters Kluwer Health 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6946459/
https://www.ncbi.nlm.nih.gov/pubmed/31876738
http://dx.doi.org/10.1097/MD.0000000000018500
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author Li, Qiang
Zhong, Lei
Huang, Hongnian
Liu, He
Qin, Yanguo
Wang, Yiming
Zhou, Zhe
Liu, Heng
Yang, Wenzhuo
Qin, Meiting
Wang, Jing
Wang, Yanbo
Zhou, Teng
Wang, Dawei
Wang, Jincheng
Xu, Meng
Huang, Ye
author_facet Li, Qiang
Zhong, Lei
Huang, Hongnian
Liu, He
Qin, Yanguo
Wang, Yiming
Zhou, Zhe
Liu, Heng
Yang, Wenzhuo
Qin, Meiting
Wang, Jing
Wang, Yanbo
Zhou, Teng
Wang, Dawei
Wang, Jincheng
Xu, Meng
Huang, Ye
author_sort Li, Qiang
collection PubMed
description Developmental dysplasia of the hip (DDH) is common, and features a widened Sharp's angle as observed on pelvic x-ray images. Determination of Sharp's angle, essential for clinical decisions, can overwhelm the workload of orthopedic surgeons. To aid diagnosis of DDH and reduce false negative diagnoses, a simple and cost-effective tool is proposed. The model was designed using artificial intelligence (AI), and evaluated for its ability to screen anteroposterior pelvic radiographs automatically, accurately, and efficiently. Orthotopic anterior pelvic x-ray images were retrospectively collected (n = 11574) from the PACS (Picture Archiving and Communication System) database at Second Hospital of Jilin University. The Mask regional convolutional neural network (R-CNN) model was utilized and finely modified to detect 4 key points that delineate Sharp's angle. Of these images, 11,473 were randomly selected, labeled, and used to train and validate the modified Mask R-CNN model. A test dataset comprised the remaining 101 images. Python-based utility software was applied to draw and calculate Sharp's angle automatically. The diagnoses of DDH obtained via the model or the traditional manual drawings of 3 orthopedic surgeons were compared, each based on the degree of Sharp's angle, and these were then evaluated relative to the final clinical diagnoses (based on medical history, symptoms, signs, x-ray films, and computed tomography images). Sharp's angles on the left and right measured via the AI model (40.07° ± 4.09° and 40.65° ± 4.21°), were statistically similar to that of the surgeons’ (39.35° ± 6.74° and 39.82° ± 6.99°). The measurement time required by the AI model (1.11 ± 0.00 s) was significantly less than that of the doctors (86.72 ± 1.10, 93.26 ± 1.12, and 87.34 ± 0.80 s). The diagnostic sensitivity, specificity, and accuracy of the AI method for diagnosis of DDH were similar to that of the orthopedic surgeons; the diagnoses of both were moderately consistent with the final clinical diagnosis. The proposed AI model can automatically measure Sharp's angle with a performance similar to that of orthopedic surgeons, but requires far less time. The AI model may be a viable auxiliary to clinical diagnosis of DDH.
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spelling pubmed-69464592020-01-31 Auxiliary diagnosis of developmental dysplasia of the hip by automated detection of Sharp's angle on standardized anteroposterior pelvic radiographs Li, Qiang Zhong, Lei Huang, Hongnian Liu, He Qin, Yanguo Wang, Yiming Zhou, Zhe Liu, Heng Yang, Wenzhuo Qin, Meiting Wang, Jing Wang, Yanbo Zhou, Teng Wang, Dawei Wang, Jincheng Xu, Meng Huang, Ye Medicine (Baltimore) 4100 Developmental dysplasia of the hip (DDH) is common, and features a widened Sharp's angle as observed on pelvic x-ray images. Determination of Sharp's angle, essential for clinical decisions, can overwhelm the workload of orthopedic surgeons. To aid diagnosis of DDH and reduce false negative diagnoses, a simple and cost-effective tool is proposed. The model was designed using artificial intelligence (AI), and evaluated for its ability to screen anteroposterior pelvic radiographs automatically, accurately, and efficiently. Orthotopic anterior pelvic x-ray images were retrospectively collected (n = 11574) from the PACS (Picture Archiving and Communication System) database at Second Hospital of Jilin University. The Mask regional convolutional neural network (R-CNN) model was utilized and finely modified to detect 4 key points that delineate Sharp's angle. Of these images, 11,473 were randomly selected, labeled, and used to train and validate the modified Mask R-CNN model. A test dataset comprised the remaining 101 images. Python-based utility software was applied to draw and calculate Sharp's angle automatically. The diagnoses of DDH obtained via the model or the traditional manual drawings of 3 orthopedic surgeons were compared, each based on the degree of Sharp's angle, and these were then evaluated relative to the final clinical diagnoses (based on medical history, symptoms, signs, x-ray films, and computed tomography images). Sharp's angles on the left and right measured via the AI model (40.07° ± 4.09° and 40.65° ± 4.21°), were statistically similar to that of the surgeons’ (39.35° ± 6.74° and 39.82° ± 6.99°). The measurement time required by the AI model (1.11 ± 0.00 s) was significantly less than that of the doctors (86.72 ± 1.10, 93.26 ± 1.12, and 87.34 ± 0.80 s). The diagnostic sensitivity, specificity, and accuracy of the AI method for diagnosis of DDH were similar to that of the orthopedic surgeons; the diagnoses of both were moderately consistent with the final clinical diagnosis. The proposed AI model can automatically measure Sharp's angle with a performance similar to that of orthopedic surgeons, but requires far less time. The AI model may be a viable auxiliary to clinical diagnosis of DDH. Wolters Kluwer Health 2019-12-27 /pmc/articles/PMC6946459/ /pubmed/31876738 http://dx.doi.org/10.1097/MD.0000000000018500 Text en Copyright © 2019 the Author(s). Published by Wolters Kluwer Health, Inc. http://creativecommons.org/licenses/by-nc-sa/4.0 This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms. http://creativecommons.org/licenses/by-nc-sa/4.0
spellingShingle 4100
Li, Qiang
Zhong, Lei
Huang, Hongnian
Liu, He
Qin, Yanguo
Wang, Yiming
Zhou, Zhe
Liu, Heng
Yang, Wenzhuo
Qin, Meiting
Wang, Jing
Wang, Yanbo
Zhou, Teng
Wang, Dawei
Wang, Jincheng
Xu, Meng
Huang, Ye
Auxiliary diagnosis of developmental dysplasia of the hip by automated detection of Sharp's angle on standardized anteroposterior pelvic radiographs
title Auxiliary diagnosis of developmental dysplasia of the hip by automated detection of Sharp's angle on standardized anteroposterior pelvic radiographs
title_full Auxiliary diagnosis of developmental dysplasia of the hip by automated detection of Sharp's angle on standardized anteroposterior pelvic radiographs
title_fullStr Auxiliary diagnosis of developmental dysplasia of the hip by automated detection of Sharp's angle on standardized anteroposterior pelvic radiographs
title_full_unstemmed Auxiliary diagnosis of developmental dysplasia of the hip by automated detection of Sharp's angle on standardized anteroposterior pelvic radiographs
title_short Auxiliary diagnosis of developmental dysplasia of the hip by automated detection of Sharp's angle on standardized anteroposterior pelvic radiographs
title_sort auxiliary diagnosis of developmental dysplasia of the hip by automated detection of sharp's angle on standardized anteroposterior pelvic radiographs
topic 4100
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6946459/
https://www.ncbi.nlm.nih.gov/pubmed/31876738
http://dx.doi.org/10.1097/MD.0000000000018500
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