Improving Image Classification of Knee Radiographs: An Automated Image Labeling Approach

TL;DR

This study introduces an automated labeling method that enhances knee radiograph classification accuracy by leveraging pseudo-labeling, enabling better diagnosis of abnormalities and arthroplasty from large unlabeled datasets.

Contribution

The paper presents a novel automated labeling approach that significantly improves deep learning-based knee radiograph classification performance using pseudo-labeling techniques.

Findings

Higher weighted average AUC (0.903) with the approach

Significant improvement in normal and abnormal image classification

Enhanced dataset curation for knee radiology diagnosis

Abstract

Large numbers of radiographic images are available in knee radiology practices which could be used for training of deep learning models for diagnosis of knee abnormalities. However, those images do not typically contain readily available labels due to limitations of human annotations. The purpose of our study was to develop an automated labeling approach that improves the image classification model to distinguish normal knee images from those with abnormalities or prior arthroplasty. The automated labeler was trained on a small set of labeled data to automatically label a much larger set of unlabeled data, further improving the image classification performance for knee radiographic diagnosis. We developed our approach using 7,382 patients and validated it on a separate set of 637 patients. The final image classification model, trained using both manually labeled and pseudo-labeled data, had the higher weighted average AUC (WAUC: 0.903) value and higher AUC-ROC values among all classes (normal AUC-ROC: 0.894; abnormal AUC-ROC: 0.896, arthroplasty AUC-ROC: 0.990) compared to the baseline model (WAUC=0.857; normal AUC-ROC: 0.842; abnormal AUC-ROC: 0.848, arthroplasty AUC-ROC: 0.987), trained using only manually labeled data. DeLong tests show that the improvement is significant on normal (p-value<0.002) and abnormal (p-value<0.001) images. Our findings demonstrated that the proposed automated labeling approach significantly improves the performance of image classification for radiographic knee diagnosis, allowing for facilitating patient care and curation of large knee datasets.