Image analysis for extracapsular hip fracture surgery

PhD ThesisDuring the implant insertion phase of extracapsular hip fracture surgery, a surgeon visually inspects digital radiographs to infer the best position for the implant. The inference is made by “eye-balling”. This clearly leaves room for trial and error which is not ideal for the patient. This thesis presents an image analysis approach to estimating the ideal positioning for the implant using a variant of the deformable templates model known as the Constrained Local Model (CLM). The Model is a synthesis of shape and local appearance models learned from a set of annotated landmarks and their corresponding local patches extracted from digital femur x-rays. The CLM in this work highlights both Principal Component Analysis (PCA) and Probabilistic PCA as regularisation components; the PPCA variant being a novel adaptation of the CLM framework that accounts for landmark annotation error which the PCA version does not account for. Our CLM implementation is used to articulate 2 clinical metrics namely: the Tip-Apex Distance and Parker’s Ratio (routinely used by clinicians to assess the positioning of the surgical implant during hip fracture surgery) within the image analysis framework. With our model, we were able to automatically localise signi cant landmarks on the femur, which were subsequently used to measure Parker’s Ratio directly from digital radiographs and determine an optimal placement for the surgical implant in 87% of the instances; thereby, achieving fully automatic measurement of Parker’s Ratio as opposed to manual measurements currently performed in the surgical theatre during hip fracture surgery

A Survey on Deep Learning in Medical Image Analysis

Deep learning algorithms, in particular convolutional networks, have rapidly become a methodology of choice for analyzing medical images. This paper reviews the major deep learning concepts pertinent to medical image analysis and summarizes over 300 contributions to the field, most of which appeared in the last year. We survey the use of deep learning for image classification, object detection, segmentation, registration, and other tasks and provide concise overviews of studies per application area. Open challenges and directions for future research are discussed.Comment: Revised survey includes expanded discussion section and reworked introductory section on common deep architectures. Added missed papers from before Feb 1st 201

3D shape reconstruction of the femur from planar X-ray images using statistical shape and appearance models

Major trauma is a condition that can result in severe bone damage. Customised orthopaedic reconstruction allows for limb salvage surgery and helps to restore joint alignment. For the best possible outcome three dimensional (3D) medical imaging is necessary, but its availability and access, especially in developing countries, can be challenging. In this study, 3D bone shapes of the femur reconstructed from planar radiographs representing bone defects were evaluated for use in orthopaedic surgery. Statistical shape and appearance models generated from 40 cadaveric X-ray computed tomography (CT) images were used to reconstruct 3D bone shapes. The reconstruction simulated bone defects of between 0% and 50% of the whole bone, and the prediction accuracy using anterior–posterior (AP) and anterior–posterior/medial–lateral (AP/ML) X-rays were compared. As error metrics for the comparison, measures evaluating the distance between contour lines of the projections as well as a measure comparing similarities in image intensities were used. The results were evaluated using the root-mean-square distance for surface error as well as differences in commonly used anatomical measures, including bow, femoral neck, diaphyseal–condylar and version angles between reconstructed surfaces from the shape model and the intact shape reconstructed from the CT image. The reconstructions had average surface errors between 1.59 and 3.59 mm with reconstructions using the contour error metric from the AP/ML directions being the most accurate. Predictions of bow and femoral neck angles were well below the clinical threshold accuracy of 3°, diaphyseal–condylar angles were around the threshold of 3° and only version angle predictions of between 5.3° and 9.3° were above the clinical threshold, but below the range reported in clinical practice using computer navigation (i.e., 17° internal to 15° external rotation). This study shows that the reconstructions from partly available planar images using statistical shape and appearance models had an accuracy which would support their potential use in orthopaedic reconstruction

A review of arthritis diagnosis techniques in artificial intelligence era: Current trends and research challenges

Deep learning, a branch of artificial intelligence, has achieved unprecedented performance in several domains including medicine to assist with efficient diagnosis of diseases, prediction of disease progression and pre-screening step for physicians. Due to its significant breakthroughs, deep learning is now being used for the diagnosis of arthritis, which is a chronic disease affecting young to aged population. This paper provides a survey of recent and the most representative deep learning techniques (published between 2018 to 2020) for the diagnosis of osteoarthritis and rheumatoid arthritis. The paper also reviews traditional machine learning methods (published 2015 onward) and their application for the diagnosis of these diseases. The paper identifies open problems and research gaps. We believe that deep learning can assist general practitioners and consultants to predict the course of the disease, make treatment propositions and appraise their potential benefits

A Survey on Artificial Intelligence Techniques for Biomedical Image Analysis in Skeleton-Based Forensic Human Identification

This paper represents the first survey on the application of AI techniques for the analysis of biomedical images with forensic human identification purposes. Human identification is of great relevance in today’s society and, in particular, in medico-legal contexts. As consequence, all technological advances that are introduced in this field can contribute to the increasing necessity for accurate and robust tools that allow for establishing and verifying human identity. We first describe the importance and applicability of forensic anthropology in many identification scenarios. Later, we present the main trends related to the application of computer vision, machine learning and soft computing techniques to the estimation of the biological profile, the identification through comparative radiography and craniofacial superimposition, traumatism and pathology analysis, as well as facial reconstruction. The potentialities and limitations of the employed approaches are described, and we conclude with a discussion about methodological issues and future research.Spanish Ministry of Science, Innovation and UniversitiesEuropean Union (EU) PGC2018-101216-B-I00Regional Government of Andalusia under grant EXAISFI P18-FR-4262Instituto de Salud Carlos IIIEuropean Union (EU) DTS18/00136European Commission H2020-MSCA-IF-2016 through the Skeleton-ID Marie Curie Individual Fellowship 746592Spanish Ministry of Science, Innovation and Universities-CDTI, Neotec program 2019 EXP-00122609/SNEO-20191236European Union (EU)Xunta de Galicia ED431G 2019/01European Union (EU) RTI2018-095894-B-I0