利用已有CT数据,通过自监督学习实现骨质疏松的精准筛查。
Opportunistic Osteoporosis Diagnosis via Texture-Preserving Self-Supervision, Mixture of Experts and Multi-Task Integration
- 用放射组学自监督学习挖掘未标注CT数据,保留骨纹理特征。
- 多专家混合架构提升跨设备诊断适应性,准确率显著优于现有方法。
- 融合诊断、骨密度回归与椎体定位,整合临床知识提升可靠性。
骨质疏松症以骨矿密度(BMD)降低和骨微结构破坏为特征,增加老年群体骨折风险。双能X射线吸收测定法(DXA)虽为临床金标准,但资源受限地区可及性差。利用现有影像数据进行机会性计算机断层扫描(CT)分析,成为潜在替代方案。然而当前方法存在三方面局限:(1)未充分利用未标注椎体数据;(2)受设备差异导致的DXA系统偏差影响;(3)缺乏对空间BMD分布等临床知识的整合。为此,我们提出统一深度学习框架,包含三项创新:(1)基于放射组学表征的自监督学习方法,有效利用未标注CT数据并保留骨纹理;(2)引入带有可学习门控机制的多专家混合(MoE)架构,增强跨设备适应能力;(3)多任务学习框架,集成骨质疏松诊断、BMD回归与椎体定位任务。在三个临床中心及一个外部医院验证中,本方法展现出优异泛化能力与诊断精度,优于现有技术。
原文摘要 · Abstract (English)
Osteoporosis, characterized by reduced bone mineral density (BMD) and compromised bone microstructure, increases fracture risk in aging populations. While dual-energy X-ray absorptiometry (DXA) is the clinical standard for BMD assessment, its limited accessibility hinders diagnosis in resource-limited regions. Opportunistic computed tomography (CT) analysis has emerged as a promising alternative for osteoporosis diagnosis using existing imaging data. Current approaches, however, face three limitations: (1) underutilization of unlabeled vertebral data, (2) systematic bias from device-specific DXA discrepancies, and (3) insufficient integration of clinical knowledge such as spatial BMD distribution patterns. To address these, we propose a unified deep learning framework with three innovations. First, a self-supervised learning method using radiomic representations to leverage unlabeled CT data and preserve bone texture. Second, a Mixture of Experts (MoE) architecture with learned gating mechanisms to enhance cross-device adaptability. Third, a multi-task learning framework integrating osteoporosis diagnosis, BMD regression, and vertebra location prediction. Validated across three clinical sites and an external hospital, our approach demonstrates superior generalizability and accuracy over existing methods for opportunistic osteoporosis screening and diagnosis.
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