Accurate Instance Segmentation in Pediatric Elbow Radiographs

Radiography is an essential basis for the diagnosis of fractures. For the pediatric elbow joint diagnosis, the doctor needs to diagnose abnormalities based on the location and shape of each bone, which is a great challenge for AI algorithms when interpreting radiographs. Bone instance segmentation is an effective upstream task for automatic radiograph interpretation. Pediatric elbow bone instance segmentation is a process by which each bone is extracted separately from radiography. However, the arbitrary directions and the overlapping of bones pose issues for bone instance segmentation. In this paper, we design a detection-segmentation pipeline to tackle these problems by using rotational bounding boxes to detect bones and proposing a robust segmentation method. The proposed pipeline mainly contains three parts: (i) We use Faster R-CNN-style architecture to detect and locate bones. (ii) We adopt the Oriented Bounding Box (OBB) to improve the localizing accuracy. (iii) We design the Global-Local Fusion Segmentation Network to combine the global and local contexts of the overlapped bones. To verify the effectiveness of our proposal, we conduct experiments on our self-constructed dataset that contains 1274 well-annotated pediatric elbow radiographs. The qualitative and quantitative results indicate that the network significantly improves the performance of bone extraction. Our methodology has good potential for applying deep learning in the radiography’s bone instance segmentation.