AI-powered applications are reliable alternative to manual evaluation of pelvic radiographs

Written By : Dr Supreeth D R |Medically Reviewed By : Dr. Kamal Kant Kohli Published On 2023-04-11T20:00:02+05:30 | Updated On 12 April 2023 2:28 PM IST

Despite advances of three-dimensional imaging pelvic radiographs remain the cornerstone in the evaluation of the hip joint. However, large inter- and intra-rater variabilities were reported due to subjective landmark setting. Artificial intelligence (AI)–powered software applications could improve the reproducibility of pelvic radiograph evaluation by providing standardized measurements.

Schwarz et al conducted a study to evaluate the reliability and agreement of a newly developed AI algorithm for the evaluation of pelvic radiographs.

300 pelvic radiographs from 280 patients with different degrees of acetabular coverage and osteoarthritis (Tönnis Grade 0 to 3) were evaluated. Reliability and agreement between manual measurements and the outputs of the AI software HIPPO (Hip Positioning Assistant 1.03, ImageBiopsy Lab, Vienna, Austria) were assessed for the lateral-center-edge (LCE) angle, neck-shaft angle, sharp angle, acetabular index, as well as the femoral head extrusion index. The algorithm was trained on over 10,000 radiographs from the OAI (Osteoarthritis Initiative study; US six-site multi centre), MOST (Multicenter Osteoarthritis Study, US two site multi-center), CHECK (Cohort Hip and Cohort Knee study; Netherland single center) studies, as well as five sites in Austria.

Key findings of the study were:

• The AI software provided reliable results in 94.3% (283/300).

• The ICC values ranged between 0.73 for the Acetabular Index to 0.80 for the LCE Angle.

• Checking the AI output alone (15.8 ± 4.9 s) was ten times faster than manual measurements (171.0 ± 48.5 s, p < 0.001).

• Agreement between readers and AI outputs, given by the standard error of measurement (SEM), was good for hips with normal coverage (LCE-SEM: 3.4°) and no osteoarthritis (LCE-SEM: 3.3°) and worse for hips with undercoverage (LCE-SEM: 5.2°) or severe osteoarthritis (LCE-SEM: 5.1°).

The authors concluded that – “AI-powered applications are a reliable alternative to manual evaluation of pelvic radiographs. While being accurate for patients with normal acetabular coverage and mild signs of osteoarthritis, it needs improvement in the evaluation of patients with hip dysplasia and severe osteoarthritis.”

Level of Evidence: III, diagnostic study

MBBS, Dip. Ortho, DNB ortho, MNAMS

Dr Supreeth D R (MBBS, Dip. Ortho, DNB ortho, MNAMS) is a practicing orthopedician with interest in medical research and publishing articles. He completed MBBS from mysore medical college, dip ortho from Trivandrum medical college and sec. DNB from Manipal Hospital, Bengaluru. He has expirence of 7years in the field of orthopedics. He has presented scientific papers & posters in various state, national and international conferences. His interest in writing articles lead the way to join medical dialogues. He can be contacted at editorial@medicaldialogues.in.

Dr. Kamal Kant Kohli

Dr Kamal Kant Kohli-MBBS, DTCD- a chest specialist with more than 30 years of practice and a flair for writing clinical articles, Dr Kamal Kant Kohli joined Medical Dialogues as a Chief Editor of Medical News. Besides writing articles, as an editor, he proofreads and verifies all the medical content published on Medical Dialogues including those coming from journals, studies,medical conferences,guidelines etc. Email: drkohli@medicaldialogues.in. Contact no. 011-43720751