Abstract
Common pediatric distal forearm fractures necessitate precise detection. To support prompt treatment planning by clinicians, our study aimed to create a multi-class convolutional neural network (CNN) model for pediatric distal forearm fractures, guided by the AO Foundation/Orthopaedic Trauma Association (AO/ATO) classification system for pediatric fractures. The GRAZPEDWRI-DX dataset (2008–2018) of wrist X-ray images was used. We labeled images into four fracture classes (FRM, FUM, FRE, and FUE with F, fracture; R, radius; U, ulna; M, metaphysis; and E, epiphysis) based on the pediatric AO/ATO classification. We performed multi-class classification by training a YOLOv4-based CNN object detection model with 7006 images from 1809 patients (80% for training and 20% for validation). An 88-image test set from 34 patients was used to evaluate the model performance, which was then compared to the diagnosis performances of two readers—an orthopedist and a radiologist. The overall mean average precision levels on the validation set in four classes of the model were 0.97, 0.92, 0.95, and 0.94, respectively. On the test set, the model’s performance included sensitivities of 0.86, 0.71, 0.88, and 0.89; specificities of 0.88, 0.94, 0.97, and 0.98; and area under the curve (AUC) values of 0.87, 0.83, 0.93, and 0.94, respectively. The best performance among the three readers belonged to the radiologist, with a mean AUC of 0.922, followed by our model (0.892) and the orthopedist (0.830). Therefore, using the AO/OTA concept, our multi-class fracture detection model excelled in identifying pediatric distal forearm fractures.
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Data Availability
The dataset analyzed during the current study is available on Figshare at: https://doi.org/10.6084/m9.figshare.14825193.v2.
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The authors would like to acknowledge the Research Promotion Center at TMU for English editing services.
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This work was supported by the National Science and Technology Council, Taiwan [grant number MOST111-2628-E-038–002-MY3].
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LNB and NQKL: conceptualization, methodology, validation, formal analysis, investigation, writing—original draft preparation, visualization. VPTV, TNKH, DLHS, NB, HQH, and LVT: methodology, data curation, validation, formal analysis. NTN: methodology, revising, and editing the manuscript. JHK: conceptualization, methodology, and revising the manuscript. All authors have read and agreed to the published version of the manuscript.
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Binh, L.N., Nhu, N.T., Vy, V.P.T. et al. Multi-Class Deep Learning Model for Detecting Pediatric Distal Forearm Fractures Based on the AO/OTA Classification. J Digit Imaging. Inform. med. 37, 725–733 (2024). https://doi.org/10.1007/s10278-024-00968-4
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DOI: https://doi.org/10.1007/s10278-024-00968-4