HipXNet: Deep Learning Approaches to Detect Aseptic Loos-Ening of Hip Implants Using X-Ray Images

Radiographic images are commonly used to detect aseptic loosening of the hip implant in patients with total hip replacement (THR) surgeries. These techniques of manual assessment by medical professionals can suffer from the drawback of low accuracy, poor inter-observer reliability, and delays due to the unavailability of experienced clinicians. Thus, the paper provides a reliable Deep Convolutional Neural Networks (DCNNs) based novel stacking approach (HipXNet) for detecting loosening of the hip implant using X-ray images. Two major investigations were done in this study. Firstly, the performance of four different state-of-the-art object detection YOLOv5 models was evaluated to detect the implant region from the hip X-ray images. Secondly, the study developed a stacking classifier using three different Convolutional neural networks (CNN) models to classify aseptic hip loosening and compared the performance with eight different state-of-the-art CNN networks. Moreover, one publicly accessible dataset with two sub-sets was created for these two experiments, where 200 hip implant X-ray images were collected and annotated by two expert radiologists for implant detection and 206 hip implant X-ray images were collected for loosening detection. YOLOv5m model outperformed the other variants of YOLOv5 to detect the implant region with the precision, recall, mean average precision (mAP)(0.5), mAP(0.5-0.95) of 100%, 100%, 100%, and 87.8%, respectively. Densenet201 CNN model outperformed other CNN models with the accuracy, precision, sensitivity, F1 score, and specificity of 94.66%, 94.66%, 94.66%, 94.66%, and 94.5%, respectively while the stacking technique with Random Forest meta learner classifier produced the best performance with the accuracy, precision, sensitivity, F1 score and specificity of 96.11%, 96.42%, 96.42%, 96.42%, and 96.74% respectively for loosening detection. The reliability of the performance was confirmed by the popular Score-CAM visualization. This study can help in the early and fast identification of hip implant loosening with the help of simple X-ray images and computed aided diagnosis.