Accurate interpretation of multi-view radiographs is crucial for diagnosing fractures, muscular injuries, and other anomalies. While significant advances have been made in AI-based analysis of single images, current methods often struggle to establish robust correspondences between different X-ray views, an essential capability for precise clinical evaluations. In this work, we present a novel self-supervised pipeline that eliminates the need for manual annotation by automatically generating a many-to-many correspondence matrix between synthetic X-ray views. This is achieved using digitally reconstructed radiographs (DRR), which are automatically derived from unannotated CT volumes. Our approach incorporates a transformer-based training phase to accurately predict correspondences across two or more X-ray views. Furthermore, we demonstrate that learning correspondences among synthetic X-ray views can be leveraged as a pretraining strategy to enhance automatic multi-view fracture detection on real data. Extensive evaluations on both synthetic and real X-ray datasets show that incorporating correspondences improves performance in multi-view fracture classification.
Computer-aided diagnosis (CAD) systems have greatly improved the interpretation of medical images by radiologists and surgeons. However, current CAD systems for fracture detection in X-ray images primarily rely on large, resource-intensive detectors, which limits their practicality in clinical settings. To address this limitation, we propose a novel lightweight CAD system based on the YOLO detector for fracture detection. This system, named ghost convolution-based YOLOv11 (G-YOLOv11), builds on the latest version of the YOLO detector family and incorporates the ghost convolution operation for feature extraction. The ghost convolution operation generates the same number of feature maps as traditional convolution but requires fewer linear operations, thereby reducing the detector's computational resource requirements. We evaluated the performance of the proposed G-YOLOv11 detector on the GRAZPEDWRI-DX dataset, achieving an [email omitted] of 0.535 with an inference time of 2.4 ms on an NVIDIA A10 GPU. Compared to the standard YOLOv11l, G-YOLOv11l achieved reductions of 13.6% in [email omitted] and 68.7% in size. These results establish a new state-of-the-art benchmark in terms of efficiency, outperforming existing detectors. Code and models are available at https://github.com/AbdesselamFerdi/G-YOLOv11.
This paper addresses the medical imaging problem of joint detection in the upper limbs, viz. elbow, shoulder, wrist and finger joints. Localization of joints from X-Ray and Computerized Tomography (CT) scans is an essential step for the assessment of various bone-related medical conditions like Osteoarthritis, Rheumatoid Arthritis, and can even be used for automated bone fracture detection. Automated joint localization also detects the corresponding bones and can serve as input to deep learning-based models used for the computerized diagnosis of the aforementioned medical disorders. This in-creases the accuracy of prediction and aids the radiologists with analyzing the scans, which is quite a complex and exhausting task. This paper provides a detailed comparative study between diverse Deep Learning (DL) models - YOLOv3, YOLOv7, EfficientDet and CenterNet in multiple bone joint detections in the upper limbs of the human body. The research analyses the performance of different DL models, mathematically, graphically and visually. These models are trained and tested on a portion of the openly available MURA (musculoskeletal radiographs) dataset. The study found that the best Mean Average Precision (mAP at 0.5:0.95) values of YOLOv3, YOLOv7, EfficientDet and CenterNet are 35.3, 48.3, 46.5 and 45.9 respectively. Besides, it has been found YOLOv7 performed the best for accurately predicting the bounding boxes while YOLOv3 performed the worst in the Visual Analysis test. Code available at https://github.com/Sohambasu07/BoneJointsLocalization
Children often suffer wrist trauma in daily life, while they usually need radiologists to analyze and interpret X-ray images before surgical treatment by surgeons. The development of deep learning has enabled neural networks to serve as computer-assisted diagnosis (CAD) tools to help doctors and experts in medical image diagnostics. Since YOLOv8 model has obtained the satisfactory success in object detection tasks, it has been applied to various fracture detection. This work introduces four variants of Feature Contexts Excitation-YOLOv8 (FCE-YOLOv8) model, each incorporating a different FCE module (i.e., modules of Squeeze-and-Excitation (SE), Global Context (GC), Gather-Excite (GE), and Gaussian Context Transformer (GCT)) to enhance the model performance. Experimental results on GRAZPEDWRI-DX dataset demonstrate that our proposed YOLOv8+GC-M3 model improves the mAP@50 value from 65.78% to 66.32%, outperforming the state-of-the-art (SOTA) model while reducing inference time. Furthermore, our proposed YOLOv8+SE-M3 model achieves the highest mAP@50 value of 67.07%, exceeding the SOTA performance. The implementation of this work is available at https://github.com/RuiyangJu/FCE-YOLOv8.
Wrist trauma and even fractures occur frequently in daily life, particularly among children who account for a significant proportion of fracture cases. Before performing surgery, surgeons often request patients to undergo X-ray imaging first, and prepare for the surgery based on the analysis of the X-ray images. With the development of neural networks, You Only Look Once (YOLO) series models have been widely used in fracture detection for Computer-Assisted Diagnosis, where the YOLOv8 model has obtained the satisfactory results. Applying the attention modules to neural networks is one of the effective methods to improve the model performance. This paper proposes YOLOv8-ResCBAM, which incorporates Convolutional Block Attention Module integrated with resblock (ResCBAM) into the original YOLOv8 network architecture. The experimental results on the GRAZPEDWRI-DX dataset demonstrate that the mean Average Precision calculated at Intersection over Union threshold of 0.5 (mAP 50) of the proposed model increased from 63.6% of the original YOLOv8 model to 65.8%, which achieves the state-of-the-art performance. The implementation code is available at https://github.com/RuiyangJu/Fracture_Detection_Improved_YOLOv8.
Wrist fractures are highly prevalent among children and can significantly impact their daily activities, such as attending school, participating in sports, and performing basic self-care tasks. If not treated properly, these fractures can result in chronic pain, reduced wrist functionality, and other long-term complications. Recently, advancements in object detection have shown promise in enhancing fracture detection, with systems achieving accuracy comparable to, or even surpassing, that of human radiologists. The YOLO series, in particular, has demonstrated notable success in this domain. This study is the first to provide a thorough evaluation of various YOLOv10 variants to assess their performance in detecting pediatric wrist fractures using the GRAZPEDWRI-DX dataset. It investigates how changes in model complexity, scaling the architecture, and implementing a dual-label assignment strategy can enhance detection performance. Experimental results indicate that our trained model achieved mean average precision (mAP@50-95) of 51.9\% surpassing the current YOLOv9 benchmark of 43.3\% on this dataset. This represents an improvement of 8.6\%. The implementation code is publicly available at https://github.com/ammarlodhi255/YOLOv10-Fracture-Detection
Diagnosing and treating abnormalities in the wrist, specifically distal radius, and ulna fractures, is a crucial concern among children, adolescents, and young adults, with a higher incidence rate during puberty. However, the scarcity of radiologists and the lack of specialized training among medical professionals pose a significant risk to patient care. This problem is further exacerbated by the rising number of imaging studies and limited access to specialist reporting in certain regions. This highlights the need for innovative solutions to improve the diagnosis and treatment of wrist abnormalities. Automated wrist fracture detection using object detection has shown potential, but current studies mainly use two-stage detection methods with limited evidence for single-stage effectiveness. This study employs state-of-the-art single-stage deep neural network-based detection models YOLOv5, YOLOv6, YOLOv7, and YOLOv8 to detect wrist abnormalities. Through extensive experimentation, we found that these YOLO models outperform the commonly used two-stage detection algorithm, Faster R-CNN, in fracture detection. Additionally, compound-scaled variants of each YOLO model were compared, with YOLOv8m demonstrating a highest fracture detection sensitivity of 0.92 and mean average precision (mAP) of 0.95. On the other hand, YOLOv6m achieved the highest sensitivity across all classes at 0.83. Meanwhile, YOLOv8x recorded the highest mAP of 0.77 for all classes on the GRAZPEDWRI-DX pediatric wrist dataset, highlighting the potential of single-stage models for enhancing pediatric wrist imaging.
Children often suffer wrist injuries in daily life, while fracture injuring radiologists usually need to analyze and interpret X-ray images before surgical treatment by surgeons. The development of deep learning has enabled neural network models to work as computer-assisted diagnosis (CAD) tools to help doctors and experts in diagnosis. Since the YOLOv8 models have obtained the satisfactory success in object detection tasks, it has been applied to fracture detection. The Global Context (GC) block effectively models the global context in a lightweight way, and incorporating it into YOLOv8 can greatly improve the model performance. This paper proposes the YOLOv8+GC model for fracture detection, which is an improved version of the YOLOv8 model with the GC block. Experimental results demonstrate that compared to the original YOLOv8 model, the proposed YOLOv8-GC model increases the mean average precision calculated at intersection over union threshold of 0.5 (mAP 50) from 63.58% to 66.32% on the GRAZPEDWRI-DX dataset, achieving the state-of-the-art (SOTA) level. The implementation code for this work is available on GitHub at https://github.com/RuiyangJu/YOLOv8_Global_Context_Fracture_Detection.
The introduction of YOLOv9, the latest version of the You Only Look Once (YOLO) series, has led to its widespread adoption across various scenarios. This paper is the first to apply the YOLOv9 algorithm model to the fracture detection task as computer-assisted diagnosis (CAD) to help radiologists and surgeons to interpret X-ray images. Specifically, this paper trained the model on the GRAZPEDWRI-DX dataset and extended the training set using data augmentation techniques to improve the model performance. Experimental results demonstrate that compared to the mAP 50-95 of the current state-of-the-art (SOTA) model, the YOLOv9 model increased the value from 42.16% to 43.73%, with an improvement of 3.7%. The implementation code is publicly available at https://github.com/RuiyangJu/YOLOv9-Fracture-Detection.
Conventional deep learning models deal with images one-by-one, requiring costly and time-consuming expert labeling in the field of medical imaging, and domain-specific restriction limits model generalizability. Visual in-context learning (ICL) is a new and exciting area of research in computer vision. Unlike conventional deep learning, ICL emphasizes the model's ability to adapt to new tasks based on given examples quickly. Inspired by MAE-VQGAN, we proposed a new simple visual ICL method called SimICL, combining visual ICL pairing images with masked image modeling (MIM) designed for self-supervised learning. We validated our method on bony structures segmentation in a wrist ultrasound (US) dataset with limited annotations, where the clinical objective was to segment bony structures to help with further fracture detection. We used a test set containing 3822 images from 18 patients for bony region segmentation. SimICL achieved an remarkably high Dice coeffient (DC) of 0.96 and Jaccard Index (IoU) of 0.92, surpassing state-of-the-art segmentation and visual ICL models (a maximum DC 0.86 and IoU 0.76), with SimICL DC and IoU increasing up to 0.10 and 0.16. This remarkably high agreement with limited manual annotations indicates SimICL could be used for training AI models even on small US datasets. This could dramatically decrease the human expert time required for image labeling compared to conventional approaches, and enhance the real-world use of AI assistance in US image analysis.
Wrist trauma and even fractures occur frequently in daily life, particularly among children who account for a significant proportion of fracture cases. Before performing surgery, surgeons often request patients to undergo X-ray imaging first and prepare for it based on the analysis of the radiologist. With the development of neural networks, You Only Look Once (YOLO) series models have been widely used in fracture detection as computer-assisted diagnosis (CAD). In 2023, Ultralytics presented the latest version of the YOLO models, which has been employed for detecting fractures across various parts of the body. Attention mechanism is one of the hottest methods to improve the model performance. This research work proposes YOLOv8-AM, which incorporates the attention mechanism into the original YOLOv8 architecture. Specifically, we respectively employ four attention modules, Convolutional Block Attention Module (CBAM), Global Attention Mechanism (GAM), Efficient Channel Attention (ECA), and Shuffle Attention (SA), to design the improved models and train them on GRAZPEDWRI-DX dataset. Experimental results demonstrate that the mean Average Precision at IoU 50 (mAP 50) of the YOLOv8-AM model based on ResBlock + CBAM (ResCBAM) increased from 63.6% to 65.8%, which achieves the state-of-the-art (SOTA) performance. Conversely, YOLOv8-AM model incorporating GAM obtains the mAP 50 value of 64.2%, which is not a satisfactory enhancement. Therefore, we combine ResBlock and GAM, introducing ResGAM to design another new YOLOv8-AM model, whose mAP 50 value is increased to 65.0%. The implementation code for this study is available on GitHub at https://github.com/RuiyangJu/Fracture_Detection_Improved_YOLOv8.
Part-prototype models are explainable-by-design image classifiers, and a promising alternative to black box AI. This paper explores the applicability and potential of interpretable machine learning, in particular PIP-Net, for automated diagnosis support on real-world medical imaging data. PIP-Net learns human-understandable prototypical image parts and we evaluate its accuracy and interpretability for fracture detection and skin cancer diagnosis. We find that PIP-Net's decision making process is in line with medical classification standards, while only provided with image-level class labels. Because of PIP-Net's unsupervised pretraining of prototypes, data quality problems such as undesired text in an X-ray or labelling errors can be easily identified. Additionally, we are the first to show that humans can manually correct the reasoning of PIP-Net by directly disabling undesired prototypes. We conclude that part-prototype models are promising for medical applications due to their interpretability and potential for advanced model debugging.
Deep learning (DL)-based rib fracture detection has shown promise of playing an important role in preventing mortality and improving patient outcome. Normally, developing DL-based object detection models requires a huge amount of bounding box annotation. However, annotating medical data is time-consuming and expertise-demanding, making obtaining a large amount of fine-grained annotations extremely infeasible. This poses a pressing need {for} developing label-efficient detection models to alleviate radiologists' labeling burden. To tackle this challenge, the literature on object detection has witnessed an increase of weakly-supervised and semi-supervised approaches, yet still lacks a unified framework that leverages various forms of fully-labeled, weakly-labeled, and unlabeled data. In this paper, we present a novel omni-supervised object detection network, ORF-Netv2, to leverage as much available supervision as possible. Specifically, a multi-branch omni-supervised detection head is introduced with each branch trained with a specific type of supervision. A co-training-based dynamic label assignment strategy is then proposed to enable flexible and robust learning from the weakly-labeled and unlabeled data. Extensive evaluation was conducted for the proposed framework with three rib fracture datasets on both chest CT and X-ray. By leveraging all forms of supervision, ORF-Netv2 achieves mAPs of 34.7, 44.7, and 19.4 on the three datasets, respectively, surpassing the baseline detector which uses only box annotations by mAP gains of 3.8, 4.8, and 5.0, respectively. Furthermore, ORF-Netv2 consistently outperforms other competitive label-efficient methods over various scenarios, showing a promising framework for label-efficient fracture detection. The code is available at: https://github.com/zhizhongchai/ORF-Net.
Hospital emergency departments frequently receive lots of bone fracture cases, with pediatric wrist trauma fracture accounting for the majority of them. Before pediatric surgeons perform surgery, they need to ask patients how the fracture occurred and analyze the fracture situation by interpreting X-ray images. The interpretation of X-ray images often requires a combination of techniques from radiologists and surgeons, which requires time-consuming specialized training. With the rise of deep learning in the field of computer vision, network models applying for fracture detection has become an important research topic. In this paper, we use data augmentation to improve the model performance of YOLOv8 algorithm (the latest version of You Only Look Once) on a pediatric wrist trauma X-ray dataset (GRAZPEDWRI-DX), which is a public dataset. The experimental results show that our model has reached the state-of-the-art (SOTA) mean average precision (mAP 50). Specifically, mAP 50 of our model is 0.638, which is significantly higher than the 0.634 and 0.636 of the improved YOLOv7 and original YOLOv8 models. To enable surgeons to use our model for fracture detection on pediatric wrist trauma X-ray images, we have designed the application "Fracture Detection Using YOLOv8 App" to assist surgeons in diagnosing fractures, reducing the probability of error analysis, and providing more useful information for surgery.
Wrist Fracture is the most common type of fracture with a high incidence rate. Conventional radiography (i.e. X-ray imaging) is used for wrist fracture detection routinely, but occasionally fracture delineation poses issues and an additional confirmation by computed tomography (CT) is needed for diagnosis. Recent advances in the field of Deep Learning (DL), a subfield of Artificial Intelligence (AI), have shown that wrist fracture detection can be automated using Convolutional Neural Networks. However, previous studies did not pay close attention to the difficult cases which can only be confirmed via CT imaging. In this study, we have developed and analyzed a state-of-the-art DL-based pipeline for wrist (distal radius) fracture detection -- DeepWrist, and evaluated it against one general population test set, and one challenging test set comprising only cases requiring confirmation by CT. Our results reveal that a typical state-of-the-art approach, such as DeepWrist, while having a near-perfect performance on the general independent test set, has a substantially lower performance on the challenging test set -- average precision of 0.99 (0.99-0.99) vs 0.64 (0.46-0.83), respectively. Similarly, the area under the ROC curve was of 0.99 (0.98-0.99) vs 0.84 (0.72-0.93), respectively. Our findings highlight the importance of a meticulous analysis of DL-based models before clinical use, and unearth the need for more challenging settings for testing medical AI systems.
Convolutional Neural Networks (ConvNets) are commonly developed at a fixed resource budget, and then scaled up for better accuracy if more resources are available. In this paper, we systematically study model scaling and identify that carefully balancing network depth, width, and resolution can lead to better performance. Based on this observation, we propose a new scaling method that uniformly scales all dimensions of depth/width/resolution using a simple yet highly effective compound coefficient. We demonstrate the effectiveness of this method on scaling up MobileNets and ResNet. To go even further, we use neural architecture search to design a new baseline network and scale it up to obtain a family of models, called EfficientNets, which achieve much better accuracy and efficiency than previous ConvNets. In particular, our EfficientNet-B7 achieves state-of-the-art 84.3% top-1 accuracy on ImageNet, while being 8.4x smaller and 6.1x faster on inference than the best existing ConvNet. Our EfficientNets also transfer well and achieve state-of-the-art accuracy on CIFAR-100 (91.7%), Flowers (98.8%), and 3 other transfer learning datasets, with an order of magnitude fewer parameters. Source code is at https://github.com/tensorflow/tpu/tree/master/models/official/efficientnet.