Ludger Tüshaus

Ron Keuth, Christoph Großbröhmer, Franziska Halm et al.

Measuring the angle between bone structures is a routine task in medical image analysis and provides a key quantitative parameter for diagnosis and treatment planning. Automated methods can reduce time and cost while improving reproducibility. In this work, we address automatic bone pose estimation using a learning-based point candidate proposal followed by a line model to extract axis parameters. Since conventional line models such as least squares are sensitive to outliers, we incorporate false-positive reduction strategies and robust fitting techniques, such as RANSAC and Hough transforms, to improve robustness. We evaluate our method on three clinically relevant paediatric angle estimation tasks: fracture fragment assessment in radiographs and ultrasound and developmental dysplasia of the hip evaluation in ultrasound using the Graf method. Our approach achieves mean errors of $4.1^\circ$, $5.4^\circ$, and $5.51^\circ$, respectively, not only remaining within the expected clinical observer variability, but also significantly outperforming landmark-based methods. Our code and annotations for fracture angle assessment in radiographs are publicly available on GitHub.

Ron Keuth, Lasse Hansen, Maren Balks et al.

Semantic segmentation is a crucial task in medical imaging. Although supervised learning techniques have proven to be effective in performing this task, they heavily depend on large amounts of annotated training data. The recently introduced Segment Anything Model (SAM) enables prompt-based segmentation and offers zero-shot generalization to unfamiliar objects. In our work, we leverage SAM's abstract object understanding for medical image segmentation to provide pseudo labels for semi-supervised learning, thereby mitigating the need for extensive annotated training data. Our approach refines initial segmentations that are derived from a limited amount of annotated data (comprising up to 43 cases) by extracting bounding boxes and seed points as prompts forwarded to SAM. Thus, it enables the generation of dense segmentation masks as pseudo labels for unlabelled data. The results show that training with our pseudo labels yields an improvement in Dice score from $74.29\,\%$ to $84.17\,\%$ and from $66.63\,\%$ to $74.87\,\%$ for the segmentation of bones of the paediatric wrist and teeth in dental radiographs, respectively. As a result, our method outperforms intensity-based post-processing methods, state-of-the-art supervised learning for segmentation (nnU-Net), and the semi-supervised mean teacher approach. Our Code is available on GitHub.

Ron Keuth, Maren Balks, Sebastian Tschauner et al.

Fractures, particularly in the distal forearm, are among the most common injuries in children and adolescents, with approximately 800 000 cases treated annually in Germany. The AO/OTA system provides a structured fracture type classification, which serves as the foundation for treatment decisions. Although accurately classifying fractures can be challenging, current deep learning models have demonstrated performance comparable to that of experienced radiologists. While most existing approaches rely solely on radiographs, the potential impact of incorporating other additional modalities, such as automatic bone segmentation, fracture location, and radiology reports, remains underexplored. In this work, we systematically analyse the contribution of these three additional information types, finding that combining them with radiographs increases the AUROC from 91.71 to 93.25. Our code is available on GitHub.