Transfer Learning for an Automated Detection System of Fractures in Patients with Maxillofacial Trauma

An original maxillofacial fracture detection system (MFDS), based on convolutional neural networks and transfer learning, is proposed to detect traumatic fractures in patients. A convolutional neural network pre-trained on non-medical images was re-trained and fine-tuned using computed tomography (CT) scans to produce a model for the classification of future CTs as either "fracture" or "noFracture". The model was trained on a total of 148 CTs (120 patients labeled with "fracture" and 28 patients labeled with "noFracture"). The validation dataset, used for statistical analysis, was characterized by 30 patients (5 with "noFracture" and 25 with "fracture"). An additional 30 CT scans, comprising 25 "fracture" and 5 "noFracture" images, were used as the test dataset for final testing. Tests were carried out both by considering the single slices and by grouping the slices for patients. A patient was categorized as fractured if two consecutive slices were classified with a fracture probability higher than 0.99. The patients' results show that the model accuracy in classifying the maxillofacial fractures is 80%. Even if the MFDS model cannot replace the radiologist's work, it can provide valuable assistive support, reducing the risk of human error, preventing patient harm by minimizing diagnostic delays, and reducing the incongruous burden of hospitalization.