Infrared Thermal Imaging and Artificial Neural Networks to Screen for Wrist Fractures in Pediatrics
Abstract
:1. Introduction
- A new method of IRTI feature extraction to suitably represent the fracture site.
- Demonstration of a statistically significant temperature difference between wrist fracture and wrist sprain (no fracture).
- Development of a multilayer perceptron (MLP) neural network model to discriminate between wrist fracture and wrist sprain.
- Effective utilization of available patient data through random selection of participants for inclusion in the training and test files for MLP processing and averaging the results over 100 trials to obtain sensitivity and specificity.
2. IR Thermal Imaging for Bone Fracture Detection and Monitoring
3. Materials and Methods
3.1. Evaluation Statistics
- True positives, TP, (a): number of participants with wrist fracture (confirmed by x-ray) correctly identified as fracture by IRTI.
- False positives, FP, (b): number of participants with wrist sprain (not-fracture, confirmed by x-ray) misidentified as fracture by IRTI.
- False negatives, FN, (c): number of participants with wrist fracture misidentified as sprain by IRTI.
- True negatives, TN, (d): number of participants with wrist sprain correctly identified as sprain by IRTI.
- Sensitivity: the percentage of true positives (fractures) correctly identified by IRTI, i.e.,
- Positive predictive value: IRTI-identified percentage of participants with positive result (identified as fracture) who have fracture, i.e.,
- Negative predictive value: IRTI-identified percentage of participants with a negative result (identified as sprain) who do not have fracture, i.e.,
- Accuracy: IRTI-identified proportion of true results, either true positive or true negative, in a population. It measures the degree of veracity of IRTI as the fracture screening scheme.
3.2. Recruitment
- Non-native English speakers (the study did not utilize interpreters).
- Patients sustaining multiple injuries (including injury to both wrists).
- Patients triaged above category D due to severe pain or deformity.
- Patients who declined consent.
3.3. Recording
3.4. Image Processing and Feature Extraction
3.4.1. Selection of Region of Interest and Tracking
3.4.2. ROI Feature Extraction
3.5. Discrimination Using Multilayer Perceptron Neural Network
- Error backpropagation learning function to update the weights: gradient descent with momentum. This learning function is commonly used with MLP. The function incorporated two parameters: learning rate and momentum. Learning rate controls its adaptation (learning or training) speed. The momentum term helps the function to move out of local minima to a global minimum when determining error [34]. For both parameters, values between 0.01 and 1 were explored, and 0.05 was selected, as it provided the best differentiation.
- Training termination: Training stopped the duration of each trial when the error became insignificant (0.01) or when the number of iterations reached 20,000. The second criteria ensured training to be terminated when the error could not reach its specified target value.
- Transfer (activation function): the sigmoid transfer function was used for all processing elements. It provides an output between 0 and 1 and is commonly used for MLP [31].
4. Results
4.1 Feature Analysis
- 13 (68.4%) participants with fracture had maximum temperatures greater than sprain participants maximum temperature.
- 10 (52.6%) participants with fracture had minimum temperatures greater than sprain participants minimum temperature.
- 12 (63.2%) participants with fracture had mean temperatures greater than sprain participants mean temperature.
- 14 (73.7%) participants with fracture had standard deviations (from the mean) greater than sprain participants standard deviation.
- 12 (63.2%) participants with fracture had median temperatures greater than sprain participants median temperature.
- 8 (42.1%) participants with fracture had mode temperatures greater than the sprain participants mode temperature.
- 13 (68.4%) participants with fracture had skewness values lower than sprain participants skewness.
- 16 (82.2%) participants with fracture had kurtosis values lower than sprain participants kurtosis.
- 14 (73.7%) participants with fracture had IQR values greater than sprain participants IQR.
- Kurtosis;
- Standard deviation from the mean and IQR;
- Skewness and maximum temperature;
- Mean and median;
- Minimum;
- Mode.
4.2 Multilayer Perceptron Discrimination Results for Investigation A
- Number of true positives = 16;
- Number of true negatives = 15;
- Number of false negatives = 3;
- Number of false positives = 6.
4.3 Multilayer Perceptron Discrimination Results for Investigation B
- Number of true positives = 16;
- Number of true negatives = 15;
- Number of false negatives = 3;
- Number of false positives = 6.
5. Discussion
6. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
Appendix A. Error Backpropagation Algorithm
- The subscripts i, j and k represent the input, hidden and output layers of the MLP, respectively.
- The weights from the hidden layer to the output layer: wkj;
- The weights from the input layer to the hidden layer: wji;
- The input to a processing element: net;
- The output of a processing element (i.e., the transfer function output): y;
- The target (desired) value provided during training: t;
- Number of input examples used during training: k;
- The convergence control parameter (learning rate): ;
- Proportionality: .
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Maximum (°C) | Minimum (°C) | Mean (°C) | Std Dev. (°C) | Median (°C) | Mode (°C) | Skewness | Kurtosis | IQR (°C) | |
---|---|---|---|---|---|---|---|---|---|
Fracture | 1.396 | 0.696 | 0.962 | 0.187 | 0.938 | 0.696 | 0.408 | 2.478 | 0.272 |
Sprain | 1.048 | 0.530 | 0.711 | 0.136 | 0.690 | 0.530 | 0.595 | 2.804 | 0.202 |
%Difference | 24.942 | 23.873 | 26.076 | 27.322 | 26.439 | 23.873 | −45.931 | 13.157 | 25.752 |
Number of participants differentiated | 13 (f > s) | 10 (f > s) | 12 (f > s) | 14 (f > s) | 12 (f > s) | 8 (f > s) | 13 (f < s) | 16 (f < s) | 14 (f > s) |
Injury Types | Average | Standard Deviation |
---|---|---|
Fracture | 0.589 | 0.264 |
Sprain | 0.349 | 0.247 |
Injury Types | Average | Standard Deviation |
---|---|---|
Fracture | 0.617 | 0.280 |
Sprain | 0.345 | 0.252 |
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Shobayo, O.; Saatchi, R.; Ramlakhan, S. Infrared Thermal Imaging and Artificial Neural Networks to Screen for Wrist Fractures in Pediatrics. Technologies 2022, 10, 119. https://doi.org/10.3390/technologies10060119
Shobayo O, Saatchi R, Ramlakhan S. Infrared Thermal Imaging and Artificial Neural Networks to Screen for Wrist Fractures in Pediatrics. Technologies. 2022; 10(6):119. https://doi.org/10.3390/technologies10060119
Chicago/Turabian StyleShobayo, Olamilekan, Reza Saatchi, and Shammi Ramlakhan. 2022. "Infrared Thermal Imaging and Artificial Neural Networks to Screen for Wrist Fractures in Pediatrics" Technologies 10, no. 6: 119. https://doi.org/10.3390/technologies10060119