Academic Journal

Multi-Version Evaluation of Deep Learning Architectures for Tibial Plateau Fracture Detection and Deployment in a Web-Based Clinical Support System.

Λεπτομέρειες βιβλιογραφικής εγγραφής
Τίτλος: Multi-Version Evaluation of Deep Learning Architectures for Tibial Plateau Fracture Detection and Deployment in a Web-Based Clinical Support System.
Συγγραφείς: Shih HT; Department of Orthopaedics, Taichung Veterans General Hospital, Taichung City 407219, Taiwan.; Department of Industrial Engineering and Enterprise Information, Tunghai University, Taichung City 407224, Taiwan., Sung YH; Department of Computer Science, Tunghai University, Taichung City 407224, Taiwan., Kristiani E; Department of Computer Science, Tunghai University, Taichung City 407224, Taiwan.; Department of Informatics, Krida Wacana Christian University, Jakarta 11470, Indonesia., Wang SP; Department of Orthopaedics, Taichung Veterans General Hospital, Taichung City 407219, Taiwan.; Department of Post-Baccalaureate Medicine, National Chung Hsing University, Taichung City 40227, Taiwan., Yang CT; Department of Computer Science, Tunghai University, Taichung City 407224, Taiwan.; Research Center for Smart Sustainable Circular Economy, Tunghai University, No. 1727, Sec. 4, Taiwan Boulevard, Taichung City 407224, Taiwan.; Department of Medical Research, Kuang Tien General Hospital, Taichung City 43304, Taiwan.
Πηγή: Diagnostics (Basel, Switzerland) [Diagnostics (Basel)] 2026 Sep 27; Vol. 16 (19). Date of Electronic Publication: 2026 Sep 27.
Τύπος έκδοσης: Journal Article
Γλώσσα: English
Στοιχεία περιοδικού: Publisher: MDPI AG Country of Publication: Switzerland NLM ID: 101658402 Publication Model: Electronic Cited Medium: Print ISSN: 2075-4418 (Print) Linking ISSN: 20754418 NLM ISO Abbreviation: Diagnostics (Basel) Subsets: PubMed not MEDLINE
Imprint Name(s): Original Publication: Basel, Switzerland : MDPI AG, [2011]-
Περίληψη: Background: Tibial plateau fractures are complex knee injuries where timely and accurate diagnosis is critical to preventing long-term disability. In high-pressure emergency settings, the risk of missed fractures (false negatives) remains a significant challenge. Objective: This study aims to develop a robust, clinically safe automated detection model using advanced deep learning architectures. Methods: We utilized a dataset of 1489 real-world clinical X-ray images, annotated by orthopedic surgeons, to train and evaluate five versions of the You Only Look Once (YOLO) algorithm (v8, v9, v10, v11, and v12). A rigorous two-stage evaluation process was implemented. First, an initial screening excluded YOLOv8 and YOLOv10 due to critical detection failures ("background errors"), in which the models failed to detect any object in the target region. Second, a comprehensive performance analysis identified YOLOv11 as the optimal architecture. Based on these results, the YOLOv11 model was integrated into a user-friendly, web-based diagnostic system using the Python Flask framework. Results: The YOLOv11 model achieved the highest Mean Average Precision (mAP) of 99.3% and an Accuracy of 98.32%. Crucially for clinical safety, YOLOv11 demonstrated superior sensitivity (96.58%) with the lowest false negative rate, attributed to its enhanced feature aggregation capabilities which effectively distinguish subtle fracture lines from trabecular bone patterns. Independent web interface validation (n = 109 real-world cases) confirmed 98.17% accuracy, 98.00% sensitivity, 98.31% specificity, 98.00% Positive Predictive Value (PPV), and 98.31% Negative Predictive Value (NPV). Conclusions: This system is designed to support clinical workflows by providing real-time, highly accurate second opinions, thereby reducing diagnostic errors and alleviating radiologist workload.
References: Knee. 2025 Jun;54:81-89. (PMID: 40023913)
Nature. 2015 May 28;521(7553):436-44. (PMID: 26017442)
Radiol Adv. 2025 May 09;2(3):umaf020. (PMID: 41059155)
Diagnostics (Basel). 2026 Jan 06;16(2):. (PMID: 41594158)
BMC Musculoskelet Disord. 2018 Jul 21;19(1):244. (PMID: 30031386)
J Clin Orthop Trauma. 2020 Dec 19;16:143-148. (PMID: 33717949)
Cureus. 2025 Nov 24;17(11):e97674. (PMID: 41293609)
J Orthop Traumatol. 2019 Feb 26;20(1):12. (PMID: 30806822)
Curr Med Sci. 2021 Dec;41(6):1158-1164. (PMID: 34971441)
J Big Data. 2021;8(1):101. (PMID: 34306963)
Br J Hosp Med (Lond). 2020 Oct 2;81(10):1-9. (PMID: 33135915)
Neural Netw. 2015 Jan;61:85-117. (PMID: 25462637)
Cureus. 2021 Jun 22;13(6):e15834. (PMID: 34322331)
BMC Emerg Med. 2006 Feb 16;6:4. (PMID: 16483365)
Grant Information: 114-2622-E-029-003, 114-2221-E-029-025-MY3, 113-2221-E-029-MY3, and 115-2811-E-029-003 National Science and Technology Council (NSTC); TCVGH-T1147805 Taichung Veterans General Hospital
Contributed Indexing: Keywords: You Only Look Once; clinical validation; deep learning; object detection; tibial plateau fracture; web-based system
Entry Date(s): Date Created: 20261016 Date Completed: 20261016 Latest Revision: 20261020
Update Code: 20261020
PubMed Central ID: PMC13664391
DOI: 10.3390/diagnostics16193141
PMID: 42882296
Βάση Δεδομένων: MEDLINE
Περιγραφή
ISSN:2075-4418
DOI:10.3390/diagnostics16193141