用生成模型复原骨折前椎体,提升骨质疏松骨折分级准确性。
HealthiVert-GAN: A Novel Framework of Pseudo-Healthy Vertebral Image Synthesis for Interpretable Compression Fracture Grading
- 通过粗到精生成网络复原骨折前椎体形态,融合邻近健康椎体信息确保解剖一致性。
- 提出相对高度损失指标(RHLV),分三段量化高度变化,在两个数据集上达到最优分类性能。
- 输出椎体高度损失分布图,辅助医生判断骨折严重程度和手术必要性。
骨质疏松性椎体压缩性骨折(OVCF)在老年人群中普遍,通常通过CT扫描评估椎体高度损失来判断脊柱稳定性及是否需要手术。然而,缺乏骨折前CT和标准化参考椎体导致测量误差与观察者差异,不规则压缩模式进一步影响严重程度精准分级。尽管深度学习在筛查中有潜力,但常缺乏可解释性和足够敏感性,限制临床应用。为此,我们提出一种椎体合成-高度损失量化-骨折分级新框架。所提HealthiVert-GAN模型采用粗到精生成网络,生成模拟骨折前状态的伪健康椎体图像,并集成三个辅助模块,利用邻近健康椎体的形态与高度信息保证解剖一致性。此外,引入相对椎体高度损失(RHLV)作为量化指标,将每椎体分为三段测量前后高度差,再通过支持向量机(SVM)进行骨折严重程度分类。该方法在Verse2019数据集和院内数据集上均达到当前最优分类表现,并提供椎体高度损失的横断面分布图。此实用工具提升了临床诊断准确率,辅助手术决策。
原文摘要 · Abstract (English)
Osteoporotic vertebral compression fractures (OVCFs) are prevalent in the elderly population, typically assessed on computed tomography (CT) scans by evaluating vertebral height loss. This assessment helps determine the fracture's impact on spinal stability and the need for surgical intervention. However, the absence of pre-fracture CT scans and standardized vertebral references leads to measurement errors and inter-observer variability, while irregular compression patterns further challenge the precise grading of fracture severity. While deep learning methods have shown promise in aiding OVCFs screening, they often lack interpretability and sufficient sensitivity, limiting their clinical applicability. To address these challenges, we introduce a novel vertebra synthesis-height loss quantification-OVCFs grading framework. Our proposed model, HealthiVert-GAN, utilizes a coarse-to-fine synthesis network designed to generate pseudo-healthy vertebral images that simulate the pre-fracture state of fractured vertebrae. This model integrates three auxiliary modules that leverage the morphology and height information of adjacent healthy vertebrae to ensure anatomical consistency. Additionally, we introduce the Relative Height Loss of Vertebrae (RHLV) as a quantification metric, which divides each vertebra into three sections to measure height loss between pre-fracture and post-fracture states, followed by fracture severity classification using a Support Vector Machine (SVM). Our approach achieves state-of-the-art classification performance on both the Verse2019 dataset and in-house dataset, and it provides cross-sectional distribution maps of vertebral height loss. This practical tool enhances diagnostic accuracy in clinical settings and assisting in surgical decision-making.
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