Deep learning algorithm for fully automated measurement of sagittal balance in adult spinal deformity.

AIM: Deep learning (DL) algorithms can be used for automated analysis of medical imaging. The aim of this study was to assess the accuracy of an innovative, fully automated DL algorithm for analysis of sagittal balance in adult spinal deformity (ASD). MATERIAL AND METHODS: Sagittal balance (sacral slope, pelvic tilt, pelvic incidence, lumbar lordosis and sagittal vertical axis) was evaluated in 141 preoperative and postoperative radiographs of patients with ASD. The DL, landmark-based measurements, were compared with the ground truth values from validated manual measurements. RESULTS: The DL algorithm showed an excellent consistency with the ground truth measurements. The intra-class correlation coefficient between the DL and ground truth measurements was 0.71-0.99 for preoperative and 0.72-0.96 for postoperative measurements. The DL detection rate was 91.5% and 84% for preoperative and postoperative images, respectively. CONCLUSION: This is the first study evaluating a complete automated DL algorithm for analysis of sagittal balance with high accuracy for all evaluated parameters. The excellent accuracy in the challenging pathology of ASD with long construct instrumentation demonstrates the eligibility and possibility for implementation in clinical routine.

End-to-End Deep Diagnosis of X-ray Images.

We present an end-to-end deep learning frame-work for X-ray image diagnosis. As the first step, our system determines whether a submitted image is an X-ray or not. After it classifies the type of the X-ray, it runs the dedicated abnormality classification network. In this work, we only focus on the chest X-rays for abnormality classification. However, the system can be extended to other X-ray types easily. Our deep learning classifiers are based on DenseNet-121 architecture. The test set accuracy obtained for 'X-ray or Not', 'X-ray Type Classification', and 'Chest Abnormality Classification' tasks are 0.987, 0.976, and 0.947, respectively, resulting into an end-to-end accuracy of 0.91. For achieving better results than the state-of-the-art in the 'Chest Abnormality Classification', we utilize the new RAdam optimizer. We also use Gradient-weighted Class Activation Mapping for visual explanation of the results. Our results show the feasibility of a generalized online projectional radiography diagnosis system.