Identity-Consistent Diffusion Network for Grading Knee Osteoarthritis Progression in Radiographic Imaging

Knee osteoarthritis (KOA), a common form of arthritis that causes physical disability, has become increasingly prevalent in society. Employing computer-aided techniques to automatically assess the severity and progression of KOA can greatly benefit KOA treatment and disease management. Particularly, the advancement of X-ray technology in KOA demonstrates its potential for this purpose. Yet, existing X-ray prognosis research generally yields a singular progression severity grade, overlooking the potential visual changes for understanding and explaining the progression outcome. Therefore, in this study, a novel generative model is proposed, namely Identity-Consistent Radiographic Diffusion Network (IC-RDN), for multifaceted KOA prognosis encompassing a predicted future knee X-ray scan conditioned on the baseline scan. Specifically, an identity prior module for the diffusion and a downstream generation-guided progression prediction module are introduced. Compared to conventional image-to-image generative models, identity priors regularize and guide the diffusion to focus more on the clinical nuances of the prognosis based on a contrastive learning strategy. The progression prediction module utilizes both forecasted and baseline knee scans, and a more comprehensive formulation of KOA severity progression grading is expected. Extensive experiments on a widely used public dataset, OAI, demonstrate the effectiveness of the proposed method.