Title
Weakly Supervised Universal Fracture Detection in Pelvic X-Rays
Abstract
Hip and pelvic fractures are serious injuries with life-threatening complications. However, diagnostic errors of fractures in pelvic X-rays (PXRs) are very common, driving the demand for computer-aided diagnosis (CAD) solutions. A major challenge lies in the fact that fractures are localized patterns that require localized analyses. Unfortunately, the PXRs residing in hospital picture archiving and communication system do not typically specify region of interests. In this paper, we propose a two-stage hip and pelvic fracture detection method that executes localized fracture classification using weakly supervised ROI mining. The first stage uses a large capacity fully-convolutional network, i.e., deep with high levels of abstraction, in a multiple instance learning setting to automatically mine probable true positive and definite hard negative ROIs from the whole PXR in the training data. The second stage trains a smaller capacity model, i.e., shallower and more generalizable, with the mined ROIs to perform localized analyses to classify fractures. During inference, our method detects hip and pelvic fractures in one pass by chaining the probability outputs of the two stages together. We evaluate our method on 4 410 PXRs, reporting an under the ROC curve value of 0.975, the highest among state-of-the-art fracture detection methods. Moreover, we show that our two-stage approach can perform comparably to human physicians (even outperforming emergency physicians and surgeons), in a preliminary reader study of 23 readers.
Year
DOI
Venue
2019
10.1007/978-3-030-32226-7_51
Lecture Notes in Computer Science
Keywords
DocType
Volume
Fracture classification and localization,Pelvic X-ray,Weakly supervised detection,Cascade two-stage training,Image level labels
Conference
11769
ISSN
Citations 
PageRank 
0302-9743
1
0.35
References 
Authors
0
8
Name
Order
Citations
PageRank
Yirui Wang141.06
Le Lu2129786.78
Chi-Tung Cheng311.37
Dakai Jin45311.67
Adam P. Harrison510117.06
jing xiao68042.68
Chien-Hung Liao711.71
Shun Miao814317.54