BLS-GAN: A Deep Layer Separation Framework for Eliminating Bone Overlap in Conventional Radiographs

Conventional radiography is the widely used imaging technology in diagnosing, monitoring, and prognosticating musculoskeletal (MSK) diseases because of its easy availability, versatility, and cost-effectiveness. In conventional radiographs, bone overlaps are prevalent, and can impede the accurate assessment of bone characteristics by radiologists or algorithms, posing significant challenges to conventional and computer-aided diagnoses. This work initiated the study of a challenging scenario - bone layer separation in conventional radiographs, in which separate overlapped bone regions enable the independent assessment of the bone characteristics of each bone layer and lay the groundwork for MSK disease diagnosis and its automation. This work proposed a Bone Layer Separation GAN (BLS-GAN) framework that can produce high-quality bone layer images with reasonable bone characteristics and texture. This framework introduced a reconstructor based on conventional radiography imaging principles, which achieved efficient reconstruction and mitigates the recurrent calculations and training instability issues caused by soft tissue in the overlapped regions. Additionally, pre-training with synthetic images was implemented to enhance the stability of both the training process and the results. The generated images passed the visual Turing test, and improved performance in downstream tasks. This work affirms the feasibility of extracting bone layer images from conventional radiographs, which holds promise for leveraging bone layer separation technology to facilitate more comprehensive analytical research in MSK diagnosis, monitoring, and prognosis. Code and dataset will be made available.

A Deep Registration Method for Accurate Quantification of Joint Space Narrowing Progression in Rheumatoid Arthritis

Rheumatoid arthritis (RA) is a chronic autoimmune inflammatory disease that results in progressive articular destruction and severe disability. Joint space narrowing (JSN) progression has been regarded as an important indicator for RA progression and has received sustained attention. In the diagnosis and monitoring of RA, radiology plays a crucial role to monitor joint space. A new framework for monitoring joint space by quantifying JSN progression through image registration in radiographic images has been developed. This framework offers the advantage of high accuracy, however, challenges do exist in reducing mismatches and improving reliability. In this work, a deep intra-subject rigid registration network is proposed to automatically quantify JSN progression in the early stage of RA. In our experiments, the mean-square error of Euclidean distance between moving and fixed image is 0.0031, standard deviation is 0.0661 mm, and the mismatching rate is 0.48\%. The proposed method has sub-pixel level accuracy, exceeding manual measurements by far, and is equipped with immune to noise, rotation, and scaling of joints. Moreover, this work provides loss visualization, which can aid radiologists and rheumatologists in assessing quantification reliability, with important implications for possible future clinical applications. As a result, we are optimistic that this proposed work will make a significant contribution to the automatic quantification of JSN progression in RA.