Applying deep learning to quantify empty lacunae in histologic sections of osteonecrosis of the femoral head

Lui, Elaine; Maruyama, Masahiro; Guzman, R.; Moeinzadeh, Seyedsina; Chen, Pan; Pius, Alexa K.; Quig, Madison S. V.; Wong, Laurel E.; Goodman, Stuart B.; Yang, Yunzhi Peter

doi:10.1002/jor.25201

Cited by 4 publications

(3 citation statements)

References 18 publications

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“…Considering the potential effects of DBR in vitro , its effects in a SIONFH rat model were further explored. Previous study has indicated that glucocorticoid treatment can lead to an increase in bone cell death and result in an elevated number of empty osteocyte lacunae ( Lui et al, 2022 ). In this study, the rat model was effective in representing the steroid-induced alterations of ROS and osteoclasts before the femoral head collapse in the early-stage SIONFH.…”

Section: Discussionmentioning

confidence: 99%

Dragon blood resin ameliorates steroid-induced osteonecrosis of femoral head through osteoclastic pathways

Liu,

Mo,

et al. 2023

Front. Cell Dev. Biol.

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Objective: Dragon’s Blood resin (DBR) is a traditional medicinal substance renowned for its diverse pharmacological effects, which consists of potent anti-inflammatory, antioxidant and angiogenic properties. This study aimed to elucidate its therapeutic mechanism in alleviating steroid-induced osteonecrosis of the femoral head (SIONFH).Methods: Techniques such as SPR and LC-MS were employed to identify and analyze the target proteins of DBR in bone marrow macrophages (BMMs). In vitro, BMMs were treated with RANKL and DBR, and TRAcP staining and actin belt staining were utilized to assess osteoclast activity. The inhibitory effects and underlying mechanisms of DBR on osteoclastogenesis and reactive oxygen species (ROS) generation were determined using real-time PCR, western blotting and immunofluorescence staining. An in vivo SIONFH rat model was set up to assess the curative impacts of DBR using micro-CT scanning and pathological staining.Results: Bioinformatic tools revealed a pivotal role of osteoclast differentiation in SIONFH. Proteomic analysis identified 164 proteins binding in BMMs. In vitro assessments demonstrated that DBR hindered osteoclastogenesis by modulating the expression of specific genes and proteins, along with antioxidant proteins including TRX1 and Glutathione Reductase. Notably, the resin effectively inhibited the expression of crucial proteins, such as the phosphorylation of JNK and the nuclear localization of p65 within the TRAF6/JNK and NFκB signaling pathways. In vivo experiments further confirmed that DBR mitigated the onset of SIONFH in rats by curbing osteoclast and ROS activities.Conclusion: These findings underscore the potential of Dragon’s Blood as an effective administration for early-stage SIONFH, shedding light on its therapeutic influence on ROS-mediated osteoclastic signaling pathways.

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Section: Discussionmentioning

confidence: 99%

Dragon blood resin ameliorates steroid-induced osteonecrosis of femoral head through osteoclastic pathways

Liu,

Mo,

et al. 2023

Front. Cell Dev. Biol.

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“…The seven fields were four fields of the subchondral area and three fields around the tunnel (Figure S2 A–C). The tissue meeting the following two requirements was determined to contain an osteonecrotic lesion; the presence of empty lacunae and pyknotic nuclei of osteocytes, 25,26,36 We have established a platform for automated cell counting that automatically categorizes and counts healthy osteocytes, pyknotic osteocytes, and empty lacunae using artificial intelligence and convolutional neural networks 37 …”

Section: Methodsmentioning

confidence: 99%

The efficiency of genetically modified mesenchymal stromal cells combined with a functionally graded scaffold for bone regeneration in corticosteroid‐induced osteonecrosis of the femoral head in rabbits

Tsubosaka

Maruyama

Lui

et al. 2023

J Biomedical Materials Res

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Core decompression (CD) with mesenchymal stromal cells (MSCs) is an effective therapy for early-stage osteonecrosis of the femoral head (ONFH). Preconditioning of MSCs, using inflammatory mediators, is widely used in immunology and various cell therapies. We developed a three-dimensional printed functionally graded scaffold (FGS), made of β-TCP and PCL, for cell delivery at a specific location. The present study examined the efficacy of CD treatments with genetically modified (GM) MSCs over-expressing PDGF-BB (PDGF-MSCs) or GM MSCs co-over-expressing IL-4 and PDGF-BB and preconditioned for three days of exposure to lipopolysaccharide and tumor necrosis factor-alpha (IL-4-PDGF-pMSCs) using the FGS for treating steroidinduced ONFH in rabbits. We compared CD without cell-therapy, with IL-4-PDGF-pMSCs alone, and with FGS loaded with PDGF-MSCs or IL-4-PDGF-pMSCs. For the area inside the CD, the bone volume in the CD alone was higher than in both FGS groups. The IL-4-PDGF-pMSCs alone and FGS + PDGF-MSCs reduced the occurrence of empty lacunae and improved osteoclastogenesis. There was no significant difference in angiogenesis among the four groups. The combined effect of GM MSCs or pMSCs and the FGS was not superior to the effect of each alone. To establish an important adjunctive therapy for CD for early ONFH in the future, it is necessary and essential to develop an FGS that delivers biologics appropriately and provides structural and mechanical support.

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“…Artificial intelligence has been received with enthusiasm and optimism because of its potential to automate medical processes generally handled by humans, particularly processes in image classification. 4,5 In the future, every medical discipline is expected to be affected by artificial intelligence, including orthopedic surgery, despite thus far only having a theoretical basis in certain fields, such as radiology and pathology.…”

Section: Introductionmentioning

confidence: 99%

Successful real‐world application of an osteoarthritis classification deep‐learning model using 9210 knees—An orthopedic surgeon's view

Wang

Huang

Thogiti

et al. 2022

Journal Orthopaedic Research

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This study aimed to evaluate the performance of a deep‐learning model to evaluate knee osteoarthritis using Kellgren–Lawrence grading in real‐life knee radiographs. A deep convolutional neural network model was trained using 8964 knee radiographs from the osteoarthritis initiative (OAI), including 962 testing set images. Another 246 knee radiographs from the Far Eastern Memorial Hospital were used for external validation. The OAI testing set and external validation images were evaluated by experienced specialists, two orthopedic surgeons, and a musculoskeletal radiologist. The accuracy, interobserver agreement, F1 score, precision, recall, specificity, and ability to identify surgical candidates were used to compare the performances of the model and specialists. Attention maps illustrated the interpretability of the model classification. The model had a 78% accuracy and consistent interobserver agreement for the OAI (model‐surgeon 1 К = 0.80, model‐surgeon 2 К = 0.84, model‐radiologist К = 0.86) and external validation (model‐surgeon 1 К = 0.81, model‐surgeon 2 К = 0.82, model‐radiologist К = 0.83) images. A lower interobserver agreement was found in the images misclassified by the model (model‐surgeon 1 К = 0.57, model‐surgeon 2 К = 0.47, model‐radiologist К = 0.65). The model performed better than specialists in identifying surgical candidates (Kellgren–Lawrence Stages 3 and 4) with an F1 score of 0.923. Our model not only had comparable results with specialists with respect to the ability to identify surgical candidates but also performed consistently with open database and real‐life radiographs. We believe the controversy of the misclassified knee osteoarthritis images was based on a significantly lower interobserver agreement.

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Applying deep learning to quantify empty lacunae in histologic sections of osteonecrosis of the femoral head

Cited by 4 publications

References 18 publications

Dragon blood resin ameliorates steroid-induced osteonecrosis of femoral head through osteoclastic pathways

Dragon blood resin ameliorates steroid-induced osteonecrosis of femoral head through osteoclastic pathways

The efficiency of genetically modified mesenchymal stromal cells combined with a functionally graded scaffold for bone regeneration in corticosteroid‐induced osteonecrosis of the femoral head in rabbits

Successful real‐world application of an osteoarthritis classification deep‐learning model using 9210 knees—An orthopedic surgeon's view

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