Fracture Recognition in Paediatric Wrist Radiographs: An Object Detection Approach

Abstract

Wrist fractures are commonly diagnosed using X-ray imaging, supplemented by magnetic resonance imaging and computed tomography when required. Radiologists can sometimes overlook the fractures because they are difficult to spot. In contrast, some fractures can be easily spotted and only slow down the radiologists because of the reporting systems. We propose a machine learning model based on the YOLOv4 method that can help solve these issues. The rigorous testing on three levels showed that the YOLOv4-based model obtained significantly better results in comparison to the state-of-the-art method based on the U-Net model. In the comparison against five radiologists, YOLO 512 Anchor model-AI (the best performing YOLOv4-based model) was significantly better than the four radiologists (AI AUC-ROC =0.965, Radiologist average AUC-ROC =0.831±0.075). Furthermore, we have shown that three out of five radiologists significantly improved their performance when aided by the AI model. Finally, we compared our work with other related work and discussed what to consider when building an ML-based predictive model for wrist fracture detection. All our findings are based on a complex dataset of 19,700 pediatric X-ray images.