Intelligent extraction of CT image landmarks for improving cam-type femoroacetabular impingement assessment.
Authors
Affiliations (5)
Affiliations (5)
- Department of Medical Physics and Biomedical Engineering, Tehran University of Medical Science, Tehran, Iran.
- Sohrevardi Imaging Center, Tehran, Iran.
- Research Center for Biomedical Technologies and Robotics (RCBTR), Tehran University of Medical Sciences, Tehran, Iran.
- Department of Medical Physics and Biomedical Engineering, Tehran University of Medical Science, Tehran, Iran. [email protected].
- Research Center for Molecular and Cellular Imaging (RCMCI), Advanced Medical Technologies and Equipment Institute (AMTEI), Tehran University of Medical Sciences (TUMS), Tehran, Iran. [email protected].
Abstract
Femoroacetabular impingement (FAI) with cam-type morphology is a common hip disorder that can result in groin pain and eventually osteoarthritis. The pre-operative assessment is based on parameters obtained from x-ray or computed tomography (CT) scans, namely alpha angle (AA) and femoral head-neck offset (FHNO). The goal of our study was to develop a computer-aided detection (CAD) system to automatically select the hip region and measure diagnostic parameters from CT scans to overcome the limitations of the tedious and time-consuming process of subjectively selecting CT image slices to obtain parameters. 271 cases of ordinary abdominopelvic CT examination were collected retrospectively from two hospitals between 2018 and 2022, each equipped with a distinct CT scanner. First, a convolution neural network (CNN) was designed to select hip region slices among abdominopelvic CT scan image series. This CNN was trained using 80 CT scans divided into 50%, 20%, and 30% for training, validation and testing groups, respectively. Second, the most appropriate oblique slice passing through the femoral head-neck complex was selected, and AA and FHNO landmarks were calculated using image-processing algorithms. The best oblique slices were selected/measured manually for each hip as ground truth and its related parameters. CT hip-region selection using CNN yielded 99.34% accuracy. Pearson correlation coefficient between manual and automatic parameters measurement were 0.964 and 0.856 for AA and FHNO, respectively. The results of this study are promising for future development of a CAD software application for screening CT scans that may aid physicians to assess FAI. Question Femoroacetabular impingement is a common, underdiagnosed hip disorder requiring time-consuming image-based measurements. Can AI improve the efficiency and consistency of its radiologic assessment? Findings Automated slice selection and landmark detection using a hybrid AI method improved measurement efficiency and accuracy, with minimal bias confirmed through Bland-Altman analysis. Clinical relevance An AI-based method enables faster, more consistent evaluation of cam-type femoroacetabular impingement in routine CT images, supporting earlier identification and reducing dependency on operator experience in clinical workflows.