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.

Active Teacher for Semi-Supervised Object Detection

In this paper, we study teacher-student learning from the perspective of data initialization and propose a novel algorithm called Active Teacher(Source code are available at: \url{https://github.com/HunterJ-Lin/ActiveTeacher}) for semi-supervised object detection (SSOD). Active Teacher extends the teacher-student framework to an iterative version, where the label set is partially initialized and gradually augmented by evaluating three key factors of unlabeled examples, including difficulty, information and diversity. With this design, Active Teacher can maximize the effect of limited label information while improving the quality of pseudo-labels. To validate our approach, we conduct extensive experiments on the MS-COCO benchmark and compare Active Teacher with a set of recently proposed SSOD methods. The experimental results not only validate the superior performance gain of Active Teacher over the compared methods, but also show that it enables the baseline network, ie, Faster-RCNN, to achieve 100% supervised performance with much less label expenditure, ie 40% labeled examples on MS-COCO. More importantly, we believe that the experimental analyses in this paper can provide useful empirical knowledge for data annotation in practical applications.