Opportunistic Bone-Loss Screening from Routine Knee Radiographs Using a Multi-Task Deep Learning Framework with Sensitivity-Constrained Threshold Optimization

Background: Osteoporosis and osteopenia are often undiagnosed until fragility fractures occur. Dual-energy X-ray absorptiometry (DXA) is the reference standard for bone mineral density (BMD) assessment, but access remains limited. Knee radiographs are obtained at high volume for osteoarthritis evaluation and may offer an opportunity for opportunistic bone-loss screening. Objective: To develop and evaluate a multi-task deep learning system for opportunistic bone-loss screening from routine knee radiographs without additional imaging or patient visits. Methods: We developed STR-Net, a multi-task framework for single-channel grayscale knee radiographs. The model includes a shared backbone, global average pooling feature aggregation, a shared neck, and a task-aware representation routing module connected to three task-specific heads: binary screening (Normal vs. Bone Loss), severity sub-classification (Osteopenia vs. Osteoporosis), and weakly coupled T-score regression with optional clinical variables. A sensitivity-constrained threshold optimization strategy (minimum sensitivity >= 0.86) was applied. The dataset included 1,570 knee radiographs, split at the patient level into training (n=1,120), validation (n=226), and test (n=224) sets. Results: On the held-out test set, STR-Net achieved an AUROC of 0.933, sensitivity of 0.904, specificity of 0.773, and AUPRC of 0.956 for binary screening. Severity sub-classification achieved an AUROC of 0.898. The T-score regression branch showed a Pearson correlation of 0.801 with DXA-measured T-scores in a pilot subset (n=31), with MAE of 0.279 and RMSE of 0.347. Conclusions: STR-Net enables single-pass bone-loss screening, severity stratification, and quantitative T-score estimation from routine knee radiographs. Prospective clinical validation is needed before deployment.

Text Image Inpainting via Global Structure-Guided Diffusion Models

Real-world text can be damaged by corrosion issues caused by environmental or human factors, which hinder the preservation of the complete styles of texts, e.g., texture and structure. These corrosion issues, such as graffiti signs and incomplete signatures, bring difficulties in understanding the texts, thereby posing significant challenges to downstream applications, e.g., scene text recognition and signature identification. Notably, current inpainting techniques often fail to adequately address this problem and have difficulties restoring accurate text images along with reasonable and consistent styles. Formulating this as an open problem of text image inpainting, this paper aims to build a benchmark to facilitate its study. In doing so, we establish two specific text inpainting datasets which contain scene text images and handwritten text images, respectively. Each of them includes images revamped by real-life and synthetic datasets, featuring pairs of original images, corrupted images, and other assistant information. On top of the datasets, we further develop a novel neural framework, Global Structure-guided Diffusion Model (GSDM), as a potential solution. Leveraging the global structure of the text as a prior, the proposed GSDM develops an efficient diffusion model to recover clean texts. The efficacy of our approach is demonstrated by thorough empirical study, including a substantial boost in both recognition accuracy and image quality. These findings not only highlight the effectiveness of our method but also underscore its potential to enhance the broader field of text image understanding and processing. Code and datasets are available at: https://github.com/blackprotoss/GSDM.