Abstract
Developmental dysplasia of the hip (DDH) is a condition affecting up to 1 in 30 infants. DDH is easy to treat if diagnosed early, but undiagnosed DDH can result in life-long hip pain, dysfunction and an increased risk of early onset osteoarthritis, and accounts for around 30 % of all hip replacements in patients under 60. The gold standard for diagnosis in infants is an ultrasound scan, followed by an analysis procedure known as Graf’s method. The application of Graf’s method is notoriously operator-dependent, requiring years of training to reach reasonable and reproducible performance. We describe a novel deep-learning based pipeline that applies Graf’s method to ultrasound scans of the hip. We use a convolutional network with an adversarial component to segment the image into relevant landmarks, and define a set of post-processing rules to translate the segmentations into Graf’s metrics. Comparing our pipeline to estimates made by experts in DDH diagnosis shows promising results.
The CUDL (Collaborative for Ultrasound Deep Learning) Group is an international multidisciplinary academic collaboration between expert clinicians and computer scientists to apply deep learning networks to ultrasound imaging. For a full list of contributors please see the acknowledgments section. For more information visit www.cudl.ai.
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References
Furnes, O., Lie, S.A., Espehaug, B., Vollset, S.E., Engesaeter, L.B., Havelin, L.I.: Hip disease and the prognosis of total hip replacements. Bone Joint J. 83(4), 579–579 (2001)
Graf, R.: The diagnosis of congenital hip-joint dislocation by the ultrasonic combound treatment. Arch. Orthop. Trauma. Surg. 97(2), 117–133 (1980)
Dias, J.J., Thomas, I.H., Lamont, A.C., Mody, B.S., et al.: The reliability of ultrasonographic assessment of neonatal hips. Bone Joint J. 75(3), 479–482 (1993)
Roovers, E.A., Boere-Boonekamp, M.M., Geertsma, T.S.A., Zielhuis, G.A., Kerkhoff, A.H.M.: Ultrasonographic screening for developmental dysplasia of the hip in infants. Bone Joint J. 85(5), 726–730 (2003)
Krizhevsky, A., Sutskever, I., Hinton, G.E.: Imagenet classification with deep convolutional neural networks. In: Advances in Neural Information Processing Systems, pp. 1097–1105 (2012)
LeCun, Y., Bengio, Y., Hinton, G.: Deep learning. Nature 521(7553), 436–444 (2015)
Zhang, W., Li, R., Deng, H., Wang, L., Lin, W., Ji, S., Shen, D.: Deep convolutional neural networks for multi-modality isointense infant brain image segmentation. NeuroImage 108, 214–224 (2015)
Havaei, M., Davy, A., Warde-Farley, D., Biard, A., Courville, A., Bengio, Y., Pal, C., Jodoin, P.-M., Larochelle, H.: Brain tumor segmentation with deep neural networks. Med. Image Anal. (2016)
Long, J., Shelhamer, E., Darrell, T.: Fully convolutional networks for semantic segmentation. In: Proceedings of the IEEE Conference on Computer Vision and Pattern Recognition, pp. 3431–3440 (2015)
Hariharan, B., Arbeláez, P., Girshick, R., Malik, J.: Hypercolumns for object segmentation and fine-grained localization. In: Proceedings of the IEEE Conference on Computer Vision and Pattern Recognition, pp. 447–456 (2015)
Newell, A., Yang, K., Deng, J.: Stacked hourglass networks for human pose estimation. arXiv preprint arXiv:1603.06937 (2016)
Ioffe, S., Szegedy, C., Normalization, B.: Accelerating Deep Network Training by Reducing Internal Covariate Shift. arXiv:1502.03167, pp. 1–11 (2015)
Goodfellow, I., Pouget-Abadie, J., Mirza, M.: Generative Adversarial Networks, arXiv preprint, pp. 1–9 (2014)
Radford, A., Metz, L., Chintala, S.: Unsupervised Representation Learning with Deep Convolutional Generative Adversarial Networks. arXiv, pp. 1–15 (2015)
Abadi, M., Agarwal, A., Barham, P., Brevdo, E., Chen, Z., Citro, C., Corrado, G.S., Davis, A., Dean, J., Devin, M., et al.: TensorFlow: large-scale machine learning on heterogeneous distributed systems. arXiv preprint arXiv:1603.04467 (2016)
Kingma, D.P., Ba, J.L.: Adam: a method for stochastic optimization. In: International Conference on Learning Representations, pp. 1–13 (2015)
He, K., Zhang, X., Ren, S., Sun, J.: Delving Deep into Rectifiers: Surpassing Human-Level Performance on ImageNet Classification. arXiv preprint, pp. 1–11 (2015)
Van der Walt, S., Schönberger, J.L., Nunez-Iglesias, J., Boulogne, F., Warner, J.D., Yager, N., Gouillart, E., Yu, T.: Scikit-image: image processing in Python. PeerJ 2, e453 (2014)
Zieger, M.: Ultrasound of the infant hip. Part 2. Validity of the method. Pediatr. Radiol. 16(6), 488–492 (1986)
Cevik, K.K., Kocer, H.E., Andac, S.: Segmentation of the ilium and femur regions from ultrasound images for diagnosis of developmental dysplasia of the hip. J. Med. Imaging Health Inf. 6(2), 449–457 (2016)
Acknowledgments
Members of CUDL who contributed to paper: Jeevesh Kapur, Singapore, Singapore; Jeffrey Young, Stanford, California, US; Meghan Imrie, Stanford, California, US; Claudia Maizen, London, England; Paulien Bjilsma, London, England; Daniel Reed, London, England; Rosy Jalan, London, England; Ibraheim El-Daly, London, England; Lukasz Matuszewski, Lublin, Poland; Salih Marangoz, Istanbul, Turkey; Greg Firth, Johannesburg, South Africa; Leon Izerel, Johannesburg, South Africa; Ole Rahbek, Aarhus, Denmark; Michel Bach Hellfritzsch, Aarhus, Denmark; Christian Wong, Copenhagen, Denmark; Charlotte Strandberg, Gentofte, Denmark; Michael Christodolou, Athens, Greece; Abhilash Hareendranathan, Edmonton, Alberta, Canada; Dornoosh Zonoobi, Edmonton, Alberta, Canada; Nicole Williams, Adelaide, Australia; Andrew Morris, Adelaide, Australia; Peter Cundy, Adelaide, Australia; Rebecca Linke, Adelaide, Australia.
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Golan, D., Donner, Y., Mansi, C., Jaremko, J., Ramachandran, M., on behalf of CUDL. (2016). Fully Automating Graf’s Method for DDH Diagnosis Using Deep Convolutional Neural Networks. In: Carneiro, G., et al. Deep Learning and Data Labeling for Medical Applications. DLMIA LABELS 2016 2016. Lecture Notes in Computer Science(), vol 10008. Springer, Cham. https://doi.org/10.1007/978-3-319-46976-8_14
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DOI: https://doi.org/10.1007/978-3-319-46976-8_14
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