Automated detection and classification of the rotator cuff tear on plain shoulder radiograph using deep learning

Eiko Hashimoto; Satoshi Maki; Nobuyasu Ochiai; Shohei Ise; Kenta Inagaki; Yu Hiraoka; Fumiya Hattori; Seiji Ohtori

doi:10.1016/j.jse.2023.12.009

Automated detection and classification of the rotator cuff tear on plain shoulder radiograph using deep learning

J Shoulder Elbow Surg. 2024 Feb 3:S1058-2746(24)00076-4. doi: 10.1016/j.jse.2023.12.009. Online ahead of print.

Authors

Eiko Hashimoto¹, Satoshi Maki², Nobuyasu Ochiai², Shohei Ise², Kenta Inagaki², Yu Hiraoka², Fumiya Hattori², Seiji Ohtori²

Affiliations

¹ Department of Orthopedics Surgery, Chiba University, Chiba, Japan. Electronic address: eiko1014@hotmail.com.
² Department of Orthopedics Surgery, Chiba University, Chiba, Japan.

PMID: 38311106
DOI: 10.1016/j.jse.2023.12.009

Abstract

Background: The diagnosis of rotator cuff tears (RCTs) using radiographs alone is clinically challenging; thus, the utility of deep learning algorithms based on convolutional neural networks has been remarkable in the field of medical imaging recognition. We aimed to evaluate the diagnostic performance of artificial intelligence (a deep learning algorithm; a convolutional neural network) to detect and classify RCTs using shoulder radiographs, and compare its diagnostic performance with that of orthopedic surgeons.

Methods: A total of 1169 plain shoulder anteroposterior radiographs (1 image per shoulder) were included in the total dataset and divided into four groups: intact, small, medium, and large to massive tear groups. The sensitivity, specificity, positive predictive value, negative predictive value, accuracy, and area under the receiver operating curve were measured for the detection of RCTs through binary classification. The average accuracy, recall, precision, and F1-score were divided into four groups by cuff tear size for multiclass classification.

Results: The convolutional neural network demonstrated a high performance, with 92% sensitivity, 69% specificity, 86% accuracy, and an area under the receiver operating curve of 0.88 for the detection of RCTs. The average accuracy, recall, precision, and F1-score of the convolutional neural network for classification were 60%, 0.42, 0.49, and 0.45, respectively. The accuracy of the convolutional neural network for the detection and classification of RCTs was significantly better than that of orthopedic surgeons.

Conclusion: The convolutional neural network demonstrated the diagnostic ability to detect and classify RCTs using plain shoulder radiographs, and the diagnostic performance exhibited equal to superior accuracy when compared with those of shoulder experts.

Keywords: Rotator cuff tear; artificial intelligence; convolutional neural network; deep learning; diagnostic performance; plain shoulder radiographs.