In The journal of trauma and acute care surgery
OBJECTIVE : Characterizing and enumerating rib fractures is critical to informing clinical decisions, yet in-depth characterization is rarely performed due to the manual burden of annotating these injuries on computed tomography (CT) scans. We hypothesized that our deep learning model, FasterRib, could predict the location and percentage displacement of rib fractures using chest CT scans.
METHODS : The development and internal validation cohort comprised over 4,700 annotated rib fractures from 500 chest CT scans within the public RibFrac. We trained a convolutional neural network to predict bounding boxes around each fracture per CT slice. Adapting an existing rib segmentation model, FasterRib outputs the three-dimensional locations of each fracture (rib number and laterality). A deterministic formula analyzed cortical contact between bone segments to compute percentage displacements. We externally validated our model on our institution's dataset.
RESULTS : FasterRib predicted precise rib fracture locations with 0.95 sensitivity, 0.90 precision, 0.92 f1-score, with an average of 1.3 false positive fractures per scan. On external validation, FasterRib achieved 0.97 sensitivity, 0.96 precision, and 0.97 f1-score, and 2.24 false positive fractures per scan. Our publicly-available algorithm automatically outputs the location and percent displacement of each predicted rib fracture for multiple input CT scans.
CONCLUSION : We built a deep learning algorithm that automates rib fracture detection and characterization using chest CT scans. FasterRib achieved the highest recall and the second highest precision among known algorithms in literature. Our open source code could facilitate FasterRib's adaptation for similar computer vision tasks and further improvements via large-scale external validation.
LEVEL OF EVIDENCE : Level III. Diagnostic tests/criteria.
Edamadaka Sathya, Brown David J, Swaroop Roshan, Kolodner Matthew, Spain David A, Forrester Joseph D, Choi Jeff
2023-Mar-06
