Diagnostic of Injury Risk in the Anterior Cruciate Ligament Based on Shape Context Description of the Intercondylar Notch Curvature

Abstract

An estimated number of 300,000 new anterior cruciate ligament (ACL) injuries occur each year in the United States. Recent studies have pointed out a correlation between the curvature of the femur intercondylar notch and the risk of noncontact ACL injury. Although several magnetic resonance (MR) imaging-based ACL diagnostics methods have already been proposed in the literature, most of them are based on machine learning or deep learning strategies, which are computationally expensive. In this paper, we propose a diagnostics framework for the risk of injury in the ACL based on the application of the inner-distance shape context (IDSC) to describe the curvature of the intercondylar notch from MR images. First, the contours of the intercondylar notch curvature from 91 MR images of the distal end of the femur (70 healthy and 21 with confirmed ACL injury) were extracted manually using standard image processing tools. Next, the IDSC was applied to calculate the similarity factor between the extracted contours and reference standard curvatures. Finally, probability density functions of the similarity factor data were obtained through parametric statistical inference, and the accuracy of the ACL injury risk diagnostics framework was assessed using receiver operating characteristic analysis (ROC). The overall results for the area under the curve (AUC) showed that the method reached a maximum accuracy of about 66%. Furthermore, the sensitivity and specificity results showed that an optimum discrimination threshold value for the similarity factor can be pursued that minimizes the incidence of false positives and false negatives simultaneously.