Superiority of multiple-joint space width over minimum-joint space width approach in the machine learning for radiographic severity and knee osteoarthritis progression

James Chung Wai Cheung, Andy Yiu Chau Tam, Lok Chun Chan, Ping Keung Chan, Chunyi Wen

Research output: Journal article publicationJournal articleAcademic researchpeer-review

1 Citation (Scopus)


We compared the prediction efficiency of the multiple-joint space width (JSW) and the minimum-JSW on knee osteoarthritis (KOA) severity and progression by using a deep learning approach. A convolutional neural network (CNN) with ResU-Net architecture was developed for knee X-ray imaging segmentation and has attained a segmentation efficiency of 98.9% intersection over union (IoU) on the distal femur and proximal tibia. Later, by leveraging the image segmentation, the minimum and multiple-JSWs in the tibiofemoral joint were estimated and then validated by radiologist measurements in the Osteoarthritis Initiative (OAI) dataset using Pearson correlation and Bland–Altman plots. The agreement between the CNN-based estimation and radiologist’s measurement of minimum-JSWs reached 0.7801 (p < 0.0001). The estimated JSWs were deployed to predict the radiographic severity and progression of KOA defined by Kellgren-Lawrence (KL) grades using the XGBoost model. The 64-point multiple-JSWs achieved the best performance in predicting KOA progression within 48 months, with the area-under-receiver operating characteristic curve (AUC) of 0.621, outperforming the commonly used minimum-JSW with 0.554 AUC. We provided a fully automated radiographic assessment tool for KOA with comparable performance to the radiologists and showed that the fine-grained measurement of multiple-JSWs yields superior prediction performance for KOA over the minimum-JSW.

Original languageEnglish
Article number1107
Issue number11
Publication statusPublished - 27 Oct 2021


  • Automatic measurement
  • Deep learning
  • Joint space width
  • Kellgren-Lawrence grade
  • Knee osteoarthritis
  • Muscu-loskeletal disorders

ASJC Scopus subject areas

  • Biochemistry, Genetics and Molecular Biology(all)
  • Immunology and Microbiology(all)
  • Agricultural and Biological Sciences(all)

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