Computer-Aided Detection (CADx) for Plastic Deformation Fractures in Pediatric Forearm.
Bowing fractures are incomplete fractures of tubular long bones, often observed in pediatric patients, where plain radiographic film is the non-invasive imaging modality of choice in routine radiological workflow. Due to weak association between bent bone and distinct cortex disruption, bowing fractures may not be diagnosed properly while reading plain radiography. Missed fractures and dislocations are common in accidents and emergency practice, particularly in children. These missed injuries can result in more complicated treatment or even long-term disability. The most common reason for missed fractures is that junior radiologists or physicians lack expertise in pediatric skeletal injury diagnosis. Not only is additional radiation exposure inevitable in the case of misdiagnosis, but other consequences include the patient's prolonged uncomfortableness and possible unnecessary surgical procedures. Therefore, a computerized image analysis system, which would be secondary to the radiologists' interpretations, may reduce adverse effects and improve the diagnostic rates of bowing fracture (detection and quantification). This system would be highly desirable and particularly useful in emergency rooms. To address this need, we investigated and developed a new Computer Aided Detection (CADx) system for pediatric bowing fractures. The proposed system has been tested on 226 cases of pediatric forearms with bowing fractures with respect to normal controls. Receiver operation characteristic (ROC) curves show that the sensitivity and selectivity of the developed CADx system are satisfactory and promising. A clinically feasible graphical user interface (GUI) was developed to serve the practical needs in the emergency room as a diagnostic reference. The developed CADx system also has strong potential to train radiology residents for diagnosing pediatric forearm bowing fractures.
Department of Biomedical Engineering, University of Miami, Coral Gables, FL 33146, USA.
Yuwei
Y
Zhou
Department of Radiology, University of Miami Miller School of Medicine, Miami, FL 33136, USA.
Uygar
U
Teomete
Department of General Surgery, Bursa Military Hospital, Bursa 16800, Turkey.
Ozgur
O
Dandin
Department of Electrical and Electronics Engineering, Istanbul Arel University, Istanbul 34500, Turkey.
Onur
O
Osman
Department of Physical Medicine and Rehabilitation, Bursa Military Hospital, Bursa 16800, Turkey.
Taner
T
Dandinoglu
Center for Research in Computer Vision, University of Central Florida, Orlando, FL 32816, USA.
Ulas
U
Bagci
Department of Biomedical Engineering, University of Miami, Coral Gables, FL 33146, USA; Department of Radiology, University of Miami Miller School of Medicine, Miami, FL 33136, USA. Electronic address: w.zhao1@miami.edu.
Weizhao
W
Zhao
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D016208:Databases, Factual; D006801:Humans; D007090:Image Interpretation, Computer-Assisted / Q000379:methods*; D007223:Infant; D012372:ROC Curve; D011885:Radius Fractures / Q000000981:diagnostic imaging*; D012189:Retrospective Studies; D014458:Ulna Fractures / Q000000981:diagnostic imaging*
Bowing fracture; CADx; Plastic deformation; Radius; Ulna