MRI deep learning models for assisted diagnosis of knee pathologies: a systematic review

Objectives: Despite showing encouraging outcomes, the precision of deep learning (DL) models using different convolutional neural networks (CNNs) for diagnosis remains under investigation. This systematic review aims to summarise the status of DL MRI models developed for assisting the diagnosis of a variety of knee abnormalities.

Materials and methods: Five databases were systematically searched, employing predefined terms such as 'Knee AND 3D AND MRI AND DL'. Selected inclusion criteria were used to screen publications by title, abstract, and full text. The synthesis of results was performed by two independent reviewers.

Results: Fifty-four articles were included. The studies focused on anterior cruciate ligament injuries (n = 19, 36%), osteoarthritis (n = 9, 17%), meniscal injuries (n = 13, 24%), abnormal knee appearance (n = 11, 20%), and other (n = 2, 4%). The DL models in this review primarily used the following CNNs: ResNet (n = 11, 21%), VGG (n = 6, 11%), DenseNet (n = 4, 8%), and DarkNet (n = 3, 6%). DL models showed high-performance metrics compared to ground truth. DL models for the detection of a specific injury outperformed those by up to 4.5% for general abnormality detection.

Conclusion: Despite the varied study designs used among the reviewed articles, DL models showed promising outcomes in the assisted detection of selected knee pathologies by MRI. This review underscores the importance of validating these models with larger MRI datasets to close the existing gap between current DL model performance and clinical requirements.

Key points: Question What is the status of DL model availability for knee pathology detection in MRI and their clinical potential? Findings Pathology-specific DL models reported higher accuracy compared to DL models for the detection of general abnormalities of the knee. DL model performance was mainly influenced by the quantity and diversity of data available for model training. Clinical relevance These findings should encourage future developments to improve patient care, support personalised diagnosis and treatment, optimise costs, and advance artificial intelligence-based medical imaging practices.