Author:
Flannery Sean W.,Beveridge Jillian E.,Proffen Benedikt L.,Walsh Edward G.,Ecklund Kirsten,Micheli Lyle J.,Owens Brett D.,Fadale Paul D.,Hulstyn Michael J.,Costa Meggin Q.,Chrostek Cynthia,Sanborn Ryan M.,Sant Nicholas J.,Yen Yi-Meng,Proffen Benedikt L.,Kramer Dennis E.,Murray Martha M.,Kiapour Ata M.,Fleming Braden C.,Kramer Dennis E.,Murray Martha M.,Kiapour Ata M.,Fleming Braden C.,
Abstract
AbstractNon-invasive methods to document healing anterior cruciate ligament (ACL) structural properties could potentially identify patients at risk for revision surgery. The objective was to evaluate machine learning models to predict ACL failure load from magnetic resonance images (MRI) and to determine if those predictions were related to revision surgery incidence. It was hypothesized that the optimal model would demonstrate a lower mean absolute error (MAE) than the benchmark linear regression model, and that patients with a lower estimated failure load would have higher revision incidence 2 years post-surgery. Support vector machine, random forest, AdaBoost, XGBoost, and linear regression models were trained using MRI T2* relaxometry and ACL tensile testing data from minipigs (n = 65). The lowest MAE model was used to estimate ACL failure load for surgical patients at 9 months post-surgery (n = 46) and dichotomized into low and high score groups via Youden’s J statistic to compare revision incidence. Significance was set at alpha = 0.05. The random forest model decreased the failure load MAE by 55% (Wilcoxon signed-rank test: p = 0.01) versus the benchmark. The low score group had a higher revision incidence (21% vs. 5%; Chi-square test: p = 0.09). ACL structural property estimates via MRI may provide a biomarker for clinical decision making.
Funder
RIH Orthopedic Foundation
Lucy Lippitt Endowment of Brown University
National Institute of General Medical Sciences
National Institutes of Health, United States
Translational Research Program at Boston Children's Hospital
Children's Hospital Orthopaedic Surgery Foundation
Children’s Hospital Sports Medicine Foundation
Football Players Health Study at Harvard University
National Institutes of Health
Publisher
Springer Science and Business Media LLC
Cited by
3 articles.
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