CNN-based Automatic Detection of Bone Conditions via Diagnostic CT Images for Osteoporosis Screening

Purpose: The purpose is to design a novelty automatic diagnostic method for osteoporosis screening by using the potential capability of convolutional neural network (CNN) in feature representation and extraction, which can be incorporated into the procedure of routine CT diagnostic in physical examination thereby improving the osteoporosis diagnosis and reducing the patient burden. Methods: The proposed convolutional neural network-based method mainly comprises two functional modules to perform automatic detection of bone condition by analyzing the diagnostic CT image. The first functional module aims to locate and segment the ROI of diagnostic CT image, called Mark-Segmentation-Network (MS-Net). The second functional module is used to determine the category of bone condition by the features of ROI, called Bone-Conditions-Classification-Network (BCC-Net). The trained MS-Net can get the mark image of inputted original CT image, thereby obtain the segmentation image. The trained BCC-Net can obtain the probability value of normal bone mass, low bone mass, and osteoporosis by inputting the segmentation image. On the basis of network results, the radiologists can provide preliminary qualitative diagnosis results of bone condition. Results: The proposed MS-Net has an excellent segmentation precision on the shape preservation of different lumbar vertebra. The numerical indicators of segmentation results are greater than 0.998. The proposed BCC-Net was evaluated with 3,024 clinical images and achieved an accuracy of 76.65% and an area under the receiver operating characteristic curve of 0.9167. Conclusions: This study proposed a novel two-step method for automatic detection of bone conditions via diagnostic CT images and it has great potential in clinical applications for osteoporosis screening. The method can potentially reduce the manual burden to radiologists and diagnostic cost to patients.