Evaluation of a deep learning software for automated measurements on full-leg standing radiographs

Abstract Background Precise lower limb measurements are crucial for assessing musculoskeletal health; fully automated solutions have the potential to enhance standardization and reproducibility of these measurements. This study compared the measurements performed by BoneMetrics (Gleamer, Paris, Fran...

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Main Authors: Louis Lassalle, Nor-Eddine Regnard, Marion Durteste, Jeanne Ventre, Vincent Marty, Lauryane Clovis, Zekun Zhang, Nicolas Nitche, Alexis Ducarouge, Jean-Denis Laredo, Ali Guermazi
Format: Article
Language:English
Published: BMC 2024-11-01
Series:Knee Surgery & Related Research
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Online Access:https://doi.org/10.1186/s43019-024-00246-1
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author Louis Lassalle
Nor-Eddine Regnard
Marion Durteste
Jeanne Ventre
Vincent Marty
Lauryane Clovis
Zekun Zhang
Nicolas Nitche
Alexis Ducarouge
Jean-Denis Laredo
Ali Guermazi
author_facet Louis Lassalle
Nor-Eddine Regnard
Marion Durteste
Jeanne Ventre
Vincent Marty
Lauryane Clovis
Zekun Zhang
Nicolas Nitche
Alexis Ducarouge
Jean-Denis Laredo
Ali Guermazi
author_sort Louis Lassalle
collection DOAJ
description Abstract Background Precise lower limb measurements are crucial for assessing musculoskeletal health; fully automated solutions have the potential to enhance standardization and reproducibility of these measurements. This study compared the measurements performed by BoneMetrics (Gleamer, Paris, France), a commercial artificial intelligence (AI)-based software, to expert manual measurements on anteroposterior full-leg standing radiographs. Methods A retrospective analysis was conducted on a dataset comprising consecutive anteroposterior full-leg standing radiographs obtained from four imaging institutions. Key anatomical landmarks to define the hip–knee–ankle angle, pelvic obliquity, leg length, femoral length, and tibial length were annotated independently by two expert musculoskeletal radiologists and served as the ground truth. The performance of the AI was compared against these reference measurements using the mean absolute error, Bland–Altman analyses, and intraclass correlation coefficients. Results A total of 175 anteroposterior full–leg standing radiographs from 167 patients were included in the final dataset (mean age = 49.9 ± 23.6 years old; 103 women and 64 men). Mean absolute error values were 0.30° (95% confidence interval [CI] [0.28, 0.32]) for the hip–knee–ankle angle, 0.75 mm (95% CI [0.60, 0.88]) for pelvic obliquity, 1.03 mm (95% CI [0.91,1.14]) for leg length from the top of the femoral head, 1.45 mm (95% CI [1.33, 1.60]) for leg length from the center of the femoral head, 0.95 mm (95% CI [0.85, 1.04]) for femoral length from the top of the femoral head, 1.23 mm (95% CI [1.12, 1.32]) for femoral length from the center of the femoral head, and 1.38 mm (95% CI [1.21, 1.52]) for tibial length. The Bland–Altman analyses revealed no systematic bias across all measurements. Additionally, the software exhibited excellent agreement with the gold-standard measurements with intraclass correlation coefficient (ICC) values above 0.97 for all parameters. Conclusions Automated measurements on anteroposterior full-leg standing radiographs offer a reliable alternative to manual assessments. The use of AI in musculoskeletal radiology has the potential to support physicians in their daily practice without compromising patient care standards.
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spelling doaj-art-0bd76bfba8e24f4b871c48825b5b4d3a2024-12-01T12:32:03ZengBMCKnee Surgery & Related Research2234-24512024-11-0136111310.1186/s43019-024-00246-1Evaluation of a deep learning software for automated measurements on full-leg standing radiographsLouis Lassalle0Nor-Eddine Regnard1Marion Durteste2Jeanne Ventre3Vincent Marty4Lauryane Clovis5Zekun Zhang6Nicolas Nitche7Alexis Ducarouge8Jean-Denis Laredo9Ali Guermazi10Réseau Imagerie Sud FrancilienRéseau Imagerie Sud FrancilienGleamerGleamerGleamerGleamerGleamerGleamerGleamerGleamerDepartment of Radiology, Boston University School of MedicineAbstract Background Precise lower limb measurements are crucial for assessing musculoskeletal health; fully automated solutions have the potential to enhance standardization and reproducibility of these measurements. This study compared the measurements performed by BoneMetrics (Gleamer, Paris, France), a commercial artificial intelligence (AI)-based software, to expert manual measurements on anteroposterior full-leg standing radiographs. Methods A retrospective analysis was conducted on a dataset comprising consecutive anteroposterior full-leg standing radiographs obtained from four imaging institutions. Key anatomical landmarks to define the hip–knee–ankle angle, pelvic obliquity, leg length, femoral length, and tibial length were annotated independently by two expert musculoskeletal radiologists and served as the ground truth. The performance of the AI was compared against these reference measurements using the mean absolute error, Bland–Altman analyses, and intraclass correlation coefficients. Results A total of 175 anteroposterior full–leg standing radiographs from 167 patients were included in the final dataset (mean age = 49.9 ± 23.6 years old; 103 women and 64 men). Mean absolute error values were 0.30° (95% confidence interval [CI] [0.28, 0.32]) for the hip–knee–ankle angle, 0.75 mm (95% CI [0.60, 0.88]) for pelvic obliquity, 1.03 mm (95% CI [0.91,1.14]) for leg length from the top of the femoral head, 1.45 mm (95% CI [1.33, 1.60]) for leg length from the center of the femoral head, 0.95 mm (95% CI [0.85, 1.04]) for femoral length from the top of the femoral head, 1.23 mm (95% CI [1.12, 1.32]) for femoral length from the center of the femoral head, and 1.38 mm (95% CI [1.21, 1.52]) for tibial length. The Bland–Altman analyses revealed no systematic bias across all measurements. Additionally, the software exhibited excellent agreement with the gold-standard measurements with intraclass correlation coefficient (ICC) values above 0.97 for all parameters. Conclusions Automated measurements on anteroposterior full-leg standing radiographs offer a reliable alternative to manual assessments. The use of AI in musculoskeletal radiology has the potential to support physicians in their daily practice without compromising patient care standards.https://doi.org/10.1186/s43019-024-00246-1Leg measurementsArtificial intelligenceRadiography
spellingShingle Louis Lassalle
Nor-Eddine Regnard
Marion Durteste
Jeanne Ventre
Vincent Marty
Lauryane Clovis
Zekun Zhang
Nicolas Nitche
Alexis Ducarouge
Jean-Denis Laredo
Ali Guermazi
Evaluation of a deep learning software for automated measurements on full-leg standing radiographs
Knee Surgery & Related Research
Leg measurements
Artificial intelligence
Radiography
title Evaluation of a deep learning software for automated measurements on full-leg standing radiographs
title_full Evaluation of a deep learning software for automated measurements on full-leg standing radiographs
title_fullStr Evaluation of a deep learning software for automated measurements on full-leg standing radiographs
title_full_unstemmed Evaluation of a deep learning software for automated measurements on full-leg standing radiographs
title_short Evaluation of a deep learning software for automated measurements on full-leg standing radiographs
title_sort evaluation of a deep learning software for automated measurements on full leg standing radiographs
topic Leg measurements
Artificial intelligence
Radiography
url https://doi.org/10.1186/s43019-024-00246-1
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