Evaluation of a Newly Designed Deep Learning-Based Algorithm for Automated Assessment of Scapholunate Distance in Wrist Radiography As a Surrogate Parameter for Scapholunate Ligament Rupture and the Correlation with Arthroscopy.

Purpose Not diagnosed or mistreated scapholunate ligament (SL) tears represent a frequent cause of degenerative wrist arthritis. A newly developed deep learning (DL)-based automated assessment of the SL distance on radiographs may support clinicians in initial image interpretation. Materials and Methods A pre-trained DL algorithm was specifically fine-tuned on static and dynamic dorsopalmar wrist radiography (training data set n = 201) for the automated assessment of the SL distance. Afterwards the DL algorithm was evaluated (evaluation data set n = 364 patients with n = 1604 radiographs) and correlated with results of an experienced human reader and with arthroscopic findings. Results The evaluation data set comprised arthroscopically diagnosed SL insufficiency according to Geissler’s stages 0–4 (56.5%, 2.5%, 5.5%, 7.5%, 28.0%). Diagnostic accuracy of the DL algorithm on dorsopalmar radiography regarding SL integrity was close to that of the human reader (e.g. differentiation of Geissler’s stages ≤ 2 versus > 2 with a sensitivity of 74% and a specificity of 78% compared to 77% and 80%) with a correlation coefficient of 0.81 ( P < 0.01). Conclusion A DL algorithm like this might become a valuable tool supporting clinicians’ initial decision making on radiography regarding SL integrity and consequential triage for further patient management.