Detecting Avascular Necrosis of the Lunate from Radiographs Using a Deep-Learning Model

Krista Wernér, Turkka Anttila, Sina Hulkkonen, Timo Viljakka, Ville Haapamäki, Jorma Ryhänen

Research output: Contribution to journalArticleScientificpeer-review


Deep-learning (DL) algorithms have the potential to change medical image classification and diagnostics in the coming decade. Delayed diagnosis and treatment of avascular necrosis (AVN) of the lunate may have a detrimental effect on patient hand function. The aim of this study was to use a segmentation-based DL model to diagnose AVN of the lunate from wrist postero-anterior radiographs. A total of 319 radiographs of the diseased lunate and 1228 control radiographs were gathered from Helsinki University Central Hospital database. Of these, 10% were separated to form a test set for model validation. MRI confirmed the absence of disease. In cases of AVN of the lunate, a hand surgeon at Helsinki University Hospital validated the accurate diagnosis using either MRI or radiography. For detection of AVN, the model had a sensitivity of 93.33% (95% confidence interval (CI) 77.93–99.18%), specificity of 93.28% (95% CI 87.18–97.05%), and accuracy of 93.28% (95% CI 87.99–96.73%). The area under the receiver operating characteristic curve was 0.94 (95% CI 0.88–0.99). Compared to three clinical experts, the DL model had better AUC than one clinical expert and only one expert had higher accuracy than the DL model. The results were otherwise similar between the model and clinical experts. Our DL model performed well and may be a future beneficial tool for screening of AVN of the lunate.
Original languageEnglish
JournalJournal of Imaging Informatics in Medicine
Issue number2
Pages (from-to)706-714
Number of pages9
Publication statusPublished - 2024
MoE publication typeA1 Journal article-refereed

Fields of Science

  • 3126 Surgery, anesthesiology, intensive care, radiology

Cite this