COMPARATIVE ANALYSIS OF DEEP LEARNING ARCHITECTURES FOR OSTEOPOROSIS DETECTION IN KNEE RADIOGRAPHS: FROM CUSTOM CNN TO TRANSFER LEARNING

Abstract

Osteoporosis is a systemic skeletal disease associated with reduced bone mineral density and increased fracture risk. Although dual-energy X-ray absorptiometry remains the diagnostic gold standard, conventional knee radiographs are more widely available and may support preliminary screening in resource-limited clinical settings. The aim of this study was to compare deep learning-based approaches for classifying knee radiographs into Normal and Osteoporosis categories. A publicly available dataset of 372 knee X-ray images was used; image preprocessing included Contrast Limited Adaptive Histogram Equalization (CLAHE), and the models were trained and evaluated under the same experimental conditions. The best screening-oriented performance was achieved by EfficientNet-B3, which reached 80.00% accuracy, 89.74% recall, and an F1-score of 82.35%. The custom convolutional neural network (CNN) demonstrated the highest receiver operating characteristic area under the curve (ROC-AUC), reaching 87.75%. The results suggest that both transfer learning and compact task-specific models may be useful for preliminary osteoporosis detection from knee radiographs. Additional analyses included five-fold cross-validation, confusion matrix-based error analysis, ablation experiments, and Grad-CAM visualization. However, the study is exploratory and limited by the small dataset size and the absence of external validation. Further evaluation on larger independent clinical cohorts is required before clinical application.

More by Assiya Boltaboyeva

• Predicting Adverse ICU Outcomes from Admission-Time Frailty and Nocturnal Sleep Fragmentation Using Explainable AIJournal of Clinical Medicine · 2026
• Frailty-Driven Prediction of Inpatient Obstructive Sleep Apnea and Related Sleep Disorder Diagnoses Using Explainable AIBiomedicines · 2026
• Hybrid Quantum-Classical Neural Network Framework for Sleep Efficiency ClassificationIEEE International Conference on Smart Information Systems and Technologies · 2026
• Benchmarking Tabular Foundation Models and AutoML Systems in Cardiovascular Disease PredictionIEEE International Conference on Smart Information Systems and Technologies · 2026