A single sequence MRI-based deep learning radiomics model in the diagnosis of early osteonecrosis of femoral head

PurposeThe objective of this study was to create and assess a Deep Learning-Based Radiomics model using a single sequence MRI that could accurately predict early Femoral Head Osteonecrosis (ONFH). This is the first time such a model was used for the diagnosis of early ONFH. Its simpler than the previously published multi-sequence MRI radiomics based method, and it implements Deep learning to improve on radiomics. It has the potential to be highly beneficial in the early stages of diagnosis and treatment planning.MethodsMRI scans from 150 patients in total (80 healthy, 70 necrotic) were used, and split into training and testing sets in a 7:3 ratio. Handcrafted as well as deep learning features were retrieved from Tesla 2 weighted (T2W1) MRI slices. After a rigorous selection process, these features were used to construct three models: a Radiomics-based (Rad-model), a Deep Learning-based (DL-model), and a Deep Learning-based Radiomics (DLR-model). The performance of these models in predicting early ONFH was evaluated by comparing them using the receiver operating characteristic (ROC) and decision curve analysis (DCA).Results1,197 handcrafted radiomics and 512 DL features were extracted then processed; after the final selection: 15 features were used for the Rad-model, 12 features for the DL-model, and only 9 features were selected for the DLR-model. The most effective algorithm that was used in all of the models was Logistic regression (LR). The Rad-model depicted good results outperforming the DL-model; AUC = 0.944 (95%CI, 0.862–1.000) and AUC = 0.930 (95%CI, 0.838–1.000) respectively. The DLR-model showed superior results to both Rad-model and the DL-model; AUC = 0.968 (95%CI, 0.909–1.000); and a sensitivity of 0.95 and specificity of 0.920. The DCA showed that DLR had a greater net clinical benefit in detecting early ONFH.ConclusionUsing a single sequence MRI scan, our work constructed and verified a Deep Learning-Based Radiomics Model for early ONFH diagnosis. This strategy outperformed a Deep learning technique based on Resnet18 and a model based on Radiomics. This straightforward method can offer essential diagnostic data promptly and enhance early therapy strategizing for individuals with ONFH, all while utilizing just one MRI sequence and a more standardized and objective interpretation of MRI images.