Organizations: Center for Computational & Data Sciences, Independent University, Bangladesh · Department of Computer Science and Engineering, Independent University, Bangladesh · Advanced Medical Engineering Research Institute, University of Hyogo, Japan · Graduate School of Engineering, University of Hyogo, Japan
Abstract
Pelvic fractures pose significant diagnostic challenges, particularly in cases where fracture signs are subtle or invisible on standard radiographs. To address this, we introduce PelFANet, a dual-stream attention network that fuses raw pelvic X-rays with segmented bone images to improve fracture classification. The network employs Fused Attention Blocks (FABlocks) to iteratively exchange and refine features from both inputs, capturing global context and localized anatomical detail. Trained in a two-stage pipeline with a segmentation-guided approach, PelFANet demonstrates superior performance over conventional methods. On the AMERI dataset, it achieves 88.68% accuracy and 0.9334 AUC on visible fractures, while generalizing effectively to invisible fracture cases with 82.29% accuracy and 0.8688 AUC, despite not being trained on them. These results highlight the clinical potential of anatomy-aware dual-input architectures for robust fracture detection, especially in scenarios with subtle radiographic presentations.
Pelvic segmentation is one of the most important and fundamental research problems in precise and intelligent diagnosis and treatment, as well as surgical planning and navigation for pelvic fractures. By combining an improved geodesic active contour model with deep neural networks, we propose GUMP-Net, an interpretable model-data-driven intelligent algorithm for multi-class pelvic segmentation, in which three network modules are designed to constitute the overall segmentation framework together: the object detection module for automatic level set initialization, the edge detector module for learning an anatomy-aware edge detector function and the iteration module for deep level set evolution. Leveraging the advantages of level set representation and deep learning, GUMP-Net shows more accurate, robust and consistent segmentation performance, especially in small training data situation, compared to the state-of-the-art methods. Extensive experiments on pelvic datasets demonstrate the rationality and effectiveness of the proposed algorithm. Further experiments extended to ankle dataset indicate broader applications to other anatomies. The proposed algorithm not only provides an efficient segmentation method for complex fracture reduction, but also gives an interpretable geometric perspective for understanding deep learning segmentation.
Female pelvic diseases remain an under researched area characterized by often delayed diagnosis. While pelvic MRI offers superior soft-tissue contrast for diagnosis and image-guided procedures, real-time anomaly detection remains challenging due to physiological motion, tissue deformation, and instrument artifacts. Existing supervised approaches are impractical, as adverse events are rare, heterogeneous, and difficult to annotate. We present a Dinomaly-based unsupervised anomaly detection framework adapted for pelvic MRI that learns normative representations from healthy cases and flags deviations without requiring labels. Our approach leverages a frozen DINOv3 Vision Transformer encoder combined with a noisy MLP bottleneck and Linear Attention decoder to prevent identity mapping while maintaining computational efficiency. Anomalies are localized via per-token cosine distance between encoder and decoder representations, yielding spatial anomaly maps that provide immediate feedback at the scanner to support radiologist decision-making and adaptive protocol adjustment. Evaluated on a curated subset of the Uterine Myoma Dataset, the framework achieves a pixel-level AUROC of 88.06% and high specificity (95.45%) at frame level at 40.5 slices/s, meeting real-time clinical deployment requirements. The spatial anomaly maps and frame-level scores provide immediate, localized feedback at the scanner to support radiologist decision-making and adaptive protocol adjustment during active procedures.
Anika Knupfer, Maximilian Lindholz, Johanna Paula Müller +4
Deep learning models for medical image analysis typically apply a fixed amount of computation to every input, regardless of case difficulty. Anatomy-guided dual-stream architectures have been shown to improve diagnostic performance, but they evaluate both streams unconditionally, even on cases a single stream could already resolve confidently. We propose SecondOpinion, a framework in which a fast primary stream processes every case, while a second, anatomy-guided stream is invoked only when GateKeeper, a gating mechanism trained explicitly as a binary correctness classifier, judges that the primary stream's prediction needs additional scrutiny, much as a clinician might seek a second opinion on a difficult case. When activated, the two streams are combined through a lightweight cross-attention fusion module. We evaluate SecondOpinion on a unified five-class chest X-ray dataset and a pelvic fracture dataset, the latter including a held-out, harder subset of fractures that are invisible on X-ray but confirmed via CT. SecondOpinion matches or exceeds prior state-of-the-art performance on both tasks, while activating its anatomy-guided stream on only 9.23% of chest X-ray cases, rising to 24.12% on visible fractures and 45.71% on invisible fractures, an activation rate that tracks task difficulty directly. These results suggest that supervising a gating signal toward correctness, rather than relying on unsupervised confidence, allows a model to allocate anatomical reasoning where it is actually needed.