Aniket Tolpadi

Natalia Konovalova, Aniket Tolpadi, Felix Liu et al.

This study investigates the relationship between deep learning (DL) image reconstruction quality and anomaly detection performance, and evaluates the efficacy of an artificial intelligence (AI) assistant in enhancing radiologists' interpretation of meniscal anomalies on reconstructed images. A retrospective study was conducted using an in-house reconstruction and anomaly detection pipeline to assess knee MR images from 896 patients. The original and 14 sets of DL-reconstructed images were evaluated using standard reconstruction and object detection metrics, alongside newly developed box-based reconstruction metrics. Two clinical radiologists reviewed a subset of 50 patients' images, both original and AI-assisted reconstructed, with subsequent assessment of their accuracy and performance characteristics. Results indicated that the structural similarity index (SSIM) showed a weaker correlation with anomaly detection metrics (mAP, r=0.64, p=0.01; F1 score, r=0.38, p=0.18), while box-based SSIM had a stronger association with detection performance (mAP, r=0.81, p<0.01; F1 score, r=0.65, p=0.01). Minor SSIM fluctuations did not affect detection outcomes, but significant changes reduced performance. Radiologists' AI-assisted evaluations demonstrated improved accuracy (86.0% without assistance vs. 88.3% with assistance, p<0.05) and interrater agreement (Cohen's kappa, 0.39 without assistance vs. 0.57 with assistance). An additional review led to the incorporation of 17 more lesions into the dataset. The proposed anomaly detection method shows promise in evaluating reconstruction algorithms for automated tasks and aiding radiologists in interpreting DL-reconstructed MR images.

Aniket A. Tolpadi, Jinhee J. Lee, Valentina Pedoia et al.

Knee Osteoarthritis (OA) is a common musculoskeletal disorder in the United States. When diagnosed at early stages, lifestyle interventions such as exercise and weight loss can slow OA progression, but at later stages, only an invasive option is available: total knee replacement (TKR). Though a generally successful procedure, only 2/3 of patients who undergo the procedure report their knees feeling ''normal'' post-operation, and complications can arise that require revision. This necessitates a model to identify a population at higher risk of TKR, particularly at less advanced stages of OA, such that appropriate treatments can be implemented that slow OA progression and delay TKR. Here, we present a deep learning pipeline that leverages MRI images and clinical and demographic information to predict TKR with AUC $0.834 \pm 0.036$ (p < 0.05). Most notably, the pipeline predicts TKR with AUC $0.943 \pm 0.057$ (p < 0.05) for patients without OA. Furthermore, we develop occlusion maps for case-control pairs in test data and compare regions used by the model in both, thereby identifying TKR imaging biomarkers. As such, this work takes strides towards a pipeline with clinical utility, and the biomarkers identified further our understanding of OA progression and eventual TKR onset.