Improving Generalization in MRI-Based Deep Learning Models for Total Knee Replacement Prediction

Knee osteoarthritis (KOA) is a common joint disease that causes pain and mobility issues. While MRI-based deep learning models have demonstrated superior performance in predicting total knee replacement (TKR) and disease progression, their generalizability remains challenging, particularly when applied to imaging data from different sources. In this study, we have shown that replacing batch normalization with instance normalization, using data augmentation, and applying contrastive loss improves model generalization in a baseline deep learning model for knee osteoarthritis (KOA) prediction. We trained and evaluated our model using MRI data from the Osteoarthritis Initiative (OAI) database, considering sagittal fat-suppressed intermediate-weighted turbo spin-echo (FS-IW-TSE) images as the source domain and sagittal fat-suppressed three-dimensional (3D) dual-echo in steady state (DESS) images as the target domain. The results demonstrate a statistically significant improvement in classification accuracy across both domains, with our approach outperforming the baseline model.