AI bone imaging enhances fracture detection in elderly

The tool, described in a new Southwest Research Institute (SwRI)-led study published in Bone, uses artificial intelligence (AI) to create super-resolution images showing the inner structures of bones in great detail to better determine risk for fracture.

SwRI found that in almost all cases, the super-resolution (SR)-enhanced images were more accurate than X-rays or CT scans in quantifying bone characteristics that are indicative of strength and fracture risk.

Osteoporotic fracture in the elderly is a widespread problem with half of women over 55 suffering some sort of fracture at some point. The International Osteoporosis Foundation estimates that 37 million fragility fractures occur annually in individuals aged over 55.
“Engineers and orthopaedic clinicians are trying to identify people at risk because there are interventions that can make bones stronger, but it's all about identifying who is at risk,” SwRI’s Dr Lance Frazer, the study’s lead author said in a statement. “Currently, the most common method to diagnose fracture risk is an X-ray or a CT scan, but the resolution of both imaging techniques is too low to really determine the structural strength of the bone.”

For this study, SwRI used super-resolution technology, which is a set of techniques used to make low-quality images sharper and more detailed. SwRI’s deep-learning SR approach trains AI to map complex patterns and textures by teaching it to observe details in several examples. Consequently, it can use low-resolution image data of bones to predict what a much higher resolution image of that bone would look like.

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“Once we have that high-resolution image data, we have many tools at our disposal to predict just how strong the bone actually is,” said Frazer. “We can see if the bones are susceptible to fracture and if it’s necessary to intervene to prevent that. After all, bones are adaptable. Once a fracture risk is identified, a doctor can recommend medication or exercises to strengthen vulnerable bones and keep an injury from occurring.”

Frazer suggested applying SR technology to medical imaging equipment, which would provide a clinician raw medical images, such as X-rays, as well as processed images enhanced by AI. The resulting images are sharper and clearer, potentially accompanied by additional diagnostics to help physicians make better medical decisions.

“Everybody falls. Everyone over the age of 55, and particularly those over 65, will fall at some point, so understanding bone strength for this population is important,” said Frazer. “A lot can be done in terms of fall prevention. However, the imminent question remains: when you fall, are you at risk for a fracture? Knowing this is critical.”